From the Guidelines
To improve sleep quality, it is essential to prioritize Cognitive Behavioral Therapy for Insomnia (CBT-I) as the first-line treatment, as it has the strongest evidence supporting its effectiveness in addressing chronic insomnia disorder 1.
Key Components of Sleep Hygiene
When implementing sleep hygiene practices, consider the following:
- Establish a consistent sleep schedule by going to bed and waking up at the same time every day, including weekends
- Create a relaxing bedtime routine that might include reading, taking a warm bath, or practicing relaxation techniques like deep breathing or meditation
- Make your bedroom comfortable, dark, quiet, and cool (around 65°F or 18°C)
- Avoid electronic devices at least 30 minutes before bedtime as the blue light can suppress melatonin production
- Limit caffeine, alcohol, and large meals close to bedtime, as these can disrupt sleep quality
Additional Recommendations
Regular physical activity during the day can help you fall asleep more easily at night, but avoid vigorous exercise close to bedtime 1. If you can't fall asleep within 20 minutes, get up and do something relaxing until you feel sleepy. These practices work by regulating your body's internal clock, reducing stimulation before sleep, and creating an environment conducive to rest, allowing your brain and body to properly transition into sleep mode.
Evidence-Based Guidance
The American Academy of Sleep Medicine recommends CBT-I as the treatment of choice for chronic insomnia disorder, with a strong recommendation based on high-quality evidence 1. While sleep hygiene is not recommended as a single-component therapy due to limited evidence, certain common-sense principles of sleep hygiene may be helpful in a comprehensive treatment approach. Clinicians should prioritize CBT-I and other evidence-based treatments over sleep hygiene alone, as they have been shown to produce durable improvements in insomnia symptoms.
From the Research
Sleep Hygiene Practices
- Achieving 7 to 9 hours of sleep per night is recommended for improved sleep quality 2
- Maintaining a consistent sleep/wake schedule and a regular bedtime routine can help improve sleep quality 2
- Engaging in regular exercise and adopting a contemplative practice can also promote better sleep 2
- Avoiding substances like caffeine, alcohol, and heavy meals late in the day can help improve sleep quality 2
Cognitive Behavioral Therapy for Insomnia
- Cognitive Behavioral Therapy for Insomnia (CBT-i) is a effective treatment for adults with chronic insomnia 3, 4, 5
- CBT-i encompasses sleep hygiene, stimulus control, sleep restriction, cognitive therapy, and relaxation training 3, 4, 5
- CBT-i has been shown to improve sleep onset latency, wakefulness after sleep, sleep efficiency, and sleep quality in adults with insomnia 4
Digital Cognitive Behavioral Therapy
- Digital cognitive behavioral therapy has been shown to have a positive impact on brain function and improve insomnia symptoms 6
- Digital CBT-i can be an effective treatment for insomnia, with improvements in sleep quality and reductions in insomnia symptom severity 6
Key Components of Sleep Hygiene
- Sleep restriction therapy, stimulus control therapy, sleep hygiene, and cognitive therapy are core components of CBT-i 5
- Relapse prevention strategies and multicultural considerations are also important aspects of CBT-i 5
- Adjuvants to traditional interventions, treatment adherence issues, and efficacy are also key factors in CBT-i 5