What is an effective bedtime routine for adults?

From the Guidelines

Adults with chronic insomnia disorder should receive cognitive behavioral therapy for insomnia (CBT-I) as the initial treatment, which includes a combination of cognitive therapy, behavioral interventions, and education on sleep hygiene, as it has been shown to improve global outcomes and reduce insomnia severity 1. To establish an effective bedtime routine, consider the following key elements:

• Set a regular sleep schedule, going to bed and waking up at the same time daily, even on weekends
• Dim the lights and avoid blue light from screens 30-60 minutes before bed
• Practice relaxation techniques like deep breathing, progressive muscle relaxation, or meditation for 5-10 minutes
• Keep the bedroom cool (65-68°F), dark, and quiet
• Avoid caffeine after noon, limit alcohol, and finish eating at least 2-3 hours before bedtime These habits can help signal the brain to produce melatonin naturally and reduce stress hormones like cortisol that interfere with sleep onset 1. Key components of CBT-I include:
• Sleep restriction and stimulus control
• Cognitive therapy around sleep
• Education on sleep hygiene CBT-I can be delivered in various formats, including individual or group therapy, telephone- or Web-based modules, or self-help books, and has been shown to be effective in improving sleep outcomes 1.

From the Research

Effective Bedtime Routines for Adults

• A consistent bedtime routine can improve sleep quality and reduce insomnia severity in adults, as seen in studies on melatonin use 2 and music therapy 3
• Elements of a bedtime routine may include:
  • Relaxation techniques, such as deep breathing and mindfulness 3
  • Listening to music, such as classical or jazz, for at least 30 minutes before bedtime 3
  • Establishing a consistent sleep schedule with set bed and wake times 4
  • Engaging in quiet activities, such as reading or meditation, before bedtime
• The timing of bedtime routines can also be important, with some studies suggesting that implementing a routine 1-2 hours before bedtime can be beneficial 2
• Individual differences in sleep and circadian timing should be considered when establishing a bedtime routine, as some people may respond better to structured sleep schedules than others 4

Benefits of Bedtime Routines

• Improved sleep quality and reduced insomnia severity 2, 3
• Enhanced mood and reduced symptoms of depression and anxiety 3
• Increased consistency in sleep timing and duration 4
• Improved alignment between sleep onset and circadian phase 4
• Reduced night-to-night variability in sleep timing and sleep duration 4

Considerations for Establishing a Bedtime Routine

• It may take some time to notice improvements in sleep quality, but some studies suggest that changes can occur within a few nights of implementing a consistent bedtime routine 5
• Individual differences in sleep and circadian timing should be considered when establishing a bedtime routine 4
• A bedtime routine can be tailored to an individual's specific needs and preferences, and may include a combination of relaxation techniques, music, and other activities 3, 6