What is sleep hygiene? You may have heard the term sleep hygiene. What is it and what does sleep hygiene consist of?

sleep hygieneUnlike what some people think, sleep hygiene isn’t about the cleanliness of your bedroom or sleep environment. Rather it refers to your behaviour around bed, and your bedroom environment. How you behave before bed can have a significant impact on sleep. It’s also important that your bedroom is conducive to good sleep with not too much light, the right temperature and isn’t too noisy. I think of sleep hygiene as showing respect for sleep. That is, having body and mind prepared for sleep and an environment that’s appropriate for sleep.

What’s the basis behind sleep hygiene?

Sleep hygiene is a group of recommendations that aim to promote better quality sleep through managing behaviour around sleep and the sleep environment. They have largely arisen through observation and common sense, rather than research, and dictate practices that are felt to optimise the conditions for sleep. Although sleep hygiene measures are one of the 5 core components of cognitive behavioural therapy for insomnia, recent research suggests that by themselves individual sleep hygiene measures may not have much of an impact on sleep. However, when more than 1 sleep hygiene measure is used, or sleep hygiene measures are used in conjunction with other components of cognitive behavioural therapy, they have been shown to have an effect.

The concept of sleep hygiene is not new. Some of the principles of sleep hygiene were noted in writings from 1864, and the term was first used in 1939 by Nathaniel Kleitman. But, sleep hygiene as we know it now, came in to popular use and terminology with the publication of Peter Hauri’s book ‘The Sleep Disorders’ in 1977.

What are you trying to achieve?

By following sleep hygiene rules, you are aiming to have body and mind ready for sleep and the bedroom environment conducive for sleep.

Body and mind – There are 3 main components to sleep hygiene for preparing body and mind for sleep

  1. Sleep schedule – Maintaining a regular sleep routine and allowing enough time or an adequate opportunity for sleep.
  2. Activity – Exercise and physical activity are generally good for health and sleep. Whilst it’s important to exercise, if exercise or physical activity is too close to bed time it can make it harder to switch off at night.
  3. Food – Some foods can impact on sleep such as caffeine and alcohol. Having caffeine or alcohol, or large meals too close to bedtime can make it harder to get to sleep or disturb sleep during the night.

sleep hygieneBedroom environment – There are 4 components to sleep hygiene that relate to the bedroom

  1. Noise – The bedroom should be reasonably quiet.
  2. Light – There should be good window coverings that allow the bedroom to be dark during the night. Window coverings can also help reduce noise and regulate temperature.
  3. Temperature – The bedroom temperature shouldn’t be too hot or too cold. Personal preference and bedding come in to this, but most people find a temperature of between 16-22 degrees celsius comfortable for sleep.
  4. Activity / clutter – The bedroom should be a place for sleep, not an extension of the living room or home office, cluttered with computers, TVs or work tools.

 So what are the sleep hygiene rules?

  1. Products containing caffeine (tea, coffee, chocolate, soft drinks, etc.) should be discontinued at least 4 hours before bedtime. Caffeine is a stimulant, and can keep you awake.
  2. Avoid nicotine (including nicotine patches or chewing gum, etc) an hour before bedtime and when waking at night. Nicotine is also a stimulant.
  3. Avoid alcohol around bedtime; although it can help you to get to sleep, it can disrupt sleep later in the night.
  4. Avoid eating a large meal right before bedtime, although a light snack may be beneficial.
  5. Try to do regular physical exercise if you are able, but avoid doing this in the 2 hours preceding bedtime.
  6. Keep the bedroom calm and tidy. Select a mattress, sheets, and pillows that are comfortable.
  7. Avoid extreme room temperature in the bedroom.
  8. Keep the bedroom quiet and darkened.
  9. Keep your bedroom mainly for sleeping; try to avoid watching television, listening to the radio, or eating in your bedroom
  10. Try to keep regular bedtimes

You can download a copy of the sleep hygiene rules here.

Be careful about being too strict on sleep hygiene

For many people I see, the first thing they do when they’re not sleeping well is work on improving their sleep hygiene. That’s a great place to start and usually they get some improvements. But, as they’re still having trouble, they can then get in to a pattern of being increasingly focussed on being more and more strict about sleep hygiene and begin adding their own rules to the list. This doesn’t lead to any further improvements in sleep and often makes things worse by increasing anxiety around sleep. I discuss this more and outline ways of reducing this in a blog post on sleep rules.

If sleep hygiene hasn’t fixed things, get help

Whilst sleep hygiene can be a helpful measure at first, and is important in developing a healthy respect for sleep, if you’re following the general principles of sleep hygiene and still having trouble with sleep, you need to look at other strategies and get help from your health professional. You may need further evaluation for sleep disorders or additional treatment such as cognitive behavioural therapy for insomnia.

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