From the Guidelines
A consistent bedtime routine for adults should begin 30-60 minutes before target sleep time, incorporating relaxing activities and sleep hygiene practices, as supported by moderate-quality evidence from the American College of Physicians guideline on management of chronic insomnia disorder in adults 1.
Key Components of Bedtime Routine
- Setting a regular sleep schedule, going to bed and waking up at the same time daily
- Dimming lights and avoiding blue light from screens about an hour before bed
- Engaging in relaxing activities like reading, warm baths, gentle stretching, meditation, or deep breathing exercises
- Avoiding caffeine after mid-afternoon and limiting alcohol before bed
- Keeping the bedroom cool (around 65-68°F), dark, and quiet
Importance of Cognitive Behavioral Therapy for Insomnia (CBT-I)
- CBT-I is recommended as the initial treatment for chronic insomnia disorder in adults, with moderate-quality evidence showing improved global outcomes, remission, and treatment response 1
- CBT-I can be delivered through various methods, including in-person individual or group therapy, telephone-based modules, Web-based modules, or self-help books
Additional Considerations
- Journaling can help clear the mind and reduce racing thoughts before bed
- Over-the-counter options like melatonin (0.5-5mg taken 30 minutes before bed) may help reset the sleep cycle for occasional sleep difficulties, but should not be used long-term
- These practices work by signaling to the body that it's time to wind down, triggering the release of sleep hormones like melatonin while reducing stress hormones like cortisol, making the transition to sleep smoother and more natural 1
From the Research
Effective Bedtime Routine Components
- A consistent sleep schedule is essential for maintaining good sleep habits, as evidenced by the study 2, which found that adults with regular sleep schedules had better physical and emotional well-being.
- Engaging in a regular bedtime routine can help improve sleep quality, according to the study 3, which recommends achieving 7 to 9 hours of sleep, maintaining a consistent sleep/wake schedule, and adopting a contemplative practice.
- Avoiding substances that can disrupt sleep, such as caffeine, alcohol, and heavy meals, can also help improve sleep quality, as suggested by the study 3.
- Creating a comfortable sleep environment is crucial for better sleep, as found in the study 4, which reported that participants self-reported better sleep quality on days when they slept in a comfortable environment.
Sleep Schedule and Timing
- Adhering to a structured sleep schedule can result in more regular sleep timing and improved alignment between sleep and circadian timing, as shown in the study 5.
- Maintaining a consistent wake time is associated with better sleep quality and efficiency, according to the study 4.
- A late circadian phase and a slow build-up of sleep need can contribute to a delayed sleep schedule, as suggested by the study 6.
Lifestyle Interventions
- Engaging in regular exercise and adopting a contemplative practice can help improve sleep quality, as recommended by the study 3.
- Limiting naps to 30 minutes can also help improve sleep quality, as reported in the study 4.
- Avoiding blue light exposure before bedtime can help regulate circadian rhythms, as found in the study 6.