Prevent
Sleep Hygiene
search
Sleep Hygiene
, Insomnia Nonpharmacologic Management
See Also
Insomnia
Cognitive Behavioral Therapy for Insomnia
(
CBT-I
)
Indications
Insomnia
Efficacy
Allow 2-4 weeks to see results
For transient
Insomnia
, Sleep Hygiene improvements will likely offer benefit
For chronic
Insomnia
, Sleep Hygiene is best practiced in combination with
Cognitive Behavioral Therapy for Insomnia
Sleep Hygiene education alone has poor efficacy for chronic
Insomnia
Chung (2018) Fam Pract 35(4): 365-75 [PubMed]
Protocol
Establish a regular sleep schedule
Go to bed at same time each night
Get up at same time each day
Avoid "sleeping-in" on Sunday morning
Protocol
Cut down time in bed (if not asleep, get up)
See
Sleep Stimulus Control
Avoid trying to force yourself to sleep
Use your bed only for sleep and sex
Do not read or watch Television in bed
Protocol
Make the bedroom comfortable
Keep
Temperature
in your bedroom comfortable
Cooler
Temperature
s are typically better for sleep (65 F is considered ideal)
Keep bedroom quiet when sleeping
Consider ear plugs (silicon) or sleep headphones
Keep bedroom dark enough (create a sleep cave)
Use dark blinds or wear an eye mask if needed
Protocol
Relax at bedtime
See
Relaxation Technique
Relax each
Muscle
group individually
Begin with your feet
Work toward your head
Deal with your worries before bedtime
Set aside a worry time for 30 minutes earlier
Listen to relaxation tapes
Classical Music or Nature sounds
Imagine a tranquil scene (e.g. waterfall or beach)
Consider a hot shower before bed
Back Massage
Gentle 5-minute back rub prior to bedtime
Protocol
Perform measures to make you tired at bedtime
Get regular
Exercise
each day (6 hours before bed is ideal)
Regular
Exercise
improves sleep
Effect may be delayed 2 months
King (1997) JAMA 277:32-7 [PubMed]
Tai Chi improved sleep in older adults
Li F (2004) J Am Geriatr Soc 52:892-900 [PubMed]
Take medications only as directed
Eat a light bedtime snack or warm drink
Warm milk
Warm herbal tea (non-caffeinated)
Protocol
Special Therapy Measures
See
Sleep Restriction Therapy
See
Sleep Stimulus Control
Protocol
Things to avoid
Do not
Exercise
within 90 minutes of bedtime
Avoid bright light exposure before bed or in bed
Electronic device screens emit blue light which is activating
No overstimulating activities just before bed
No competitive games before bedtime
No exciting Television programs before bedtime
Avoid
Nicotine
(
Tobacco
,
Vaping
) after 4 pm
Avoid
Caffeine
after lunchtime or after 4 pm (caffeine
Half-Life
exceeds 4 hours)
Avoid
Chocolate
Avoid coffee, tea, or soda
Do not eat a heavy meal within 2 hours of bedtime
Avoid excessive fluids immediately before bedtime
Avoid
Alcohol
for 4 to 6 hours before bedtime
Do not use
Alcohol
to induce sleep (worsens
Insomnia
)
Do not take someone else's sleeping pills
Do not look at the clock when awakening
Avoid staring at the clock when unable to get back to sleep (see
Sleep Stimulus Control
)
Do not turn on light when getting up to use bathroom
References
McCollom (2022) EM:Rap, Why We
Sleep
, 8/12/2024
Holder (2022) Am Fam Physician 105(4): 397-405 [PubMed]
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