II. Indications
III. 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]
IV. 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
V. 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
VI. Protocol: Make the bedroom comfortable
- Keep Temperature in your bedroom comfortable
- Cooler Temperatures 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
VII. 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
VIII. 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
- Regular Exercise improves sleep
- Take medications only as directed
- Eat a light bedtime snack or warm drink
- Warm milk
- Warm herbal tea (non-caffeinated)
IX. Protocol: Special Therapy Measures
X. 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 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
XI. References
- McCollom (2022) EM:Rap, Why We Sleep, 8/12/2024
- Holder (2022) Am Fam Physician 105(4): 397-405 [PubMed]