What are the recommended practices for good sleep hygiene?

Good Sleep Hygiene Practices

Good sleep hygiene consists of behavioral and environmental modifications that promote consistent, restorative sleep, with the most critical elements being a regular sleep-wake schedule, optimized bedroom environment, and strategic avoidance of sleep-disrupting substances.

Core Sleep Schedule Recommendations

• Maintain a consistent sleep-wake schedule every day, including weekends, as this stabilizes circadian rhythms and is the single most important sleep hygiene practice 1
• Wake up at the same time every morning regardless of how much sleep was obtained the previous night, which strengthens the homeostatic sleep drive 1, 2
• If a consistent schedule is impossible due to situational demands, establish a regular bedtime routine that can be practiced nightly to signal the body that sleep is approaching 1

Bedroom Environment Optimization

• Keep the bedroom cool, dark, and comfortable, as temperature and light are powerful circadian regulators 1
• Ensure the bedroom is quiet and temperature-regulated, using white noise machines, earplugs, or fans to mask disruptive sounds 1, 2
• Seek bright light exposure during the day, especially in the morning, and avoid bright light at night, particularly in the hours before bedtime when light exposure further delays sleep onset 1

Substance Avoidance Guidelines

• Avoid caffeine for at least 6 hours before bedtime, as caffeine is a stimulant that interferes with sleep onset and maintenance 1
• Avoid nicotine entirely or at minimum before bedtime, as it is a stimulant that disrupts sleep architecture 1
• Avoid alcohol close to bedtime (at least 4 hours before sleep), because although it may reduce time to fall asleep, it severely fragments sleep quality and prevents restorative sleep cycles 1, 2
• Avoid consuming excessive food and liquids at night, as these may disrupt sleep through gastroesophageal reflux and increased nocturnal urination 1

Activity and Exercise Timing

• Exercise regularly but not within 2–4 hours of bedtime, as late exercise raises core body temperature and increases alertness 1
• Carry out relaxing activities before bed, such as reading, gentle stretching, or taking a hot bath 90 minutes before bedtime 1
• Develop a 30-minute pre-sleep relaxation period or bedtime ritual to transition from wakefulness to sleep 1

Bedroom Use and Stimulus Control

• Use the bedroom only for sleep and sex—do not watch television, work, read, or engage in vigorous discussions or arguments in bed 1
• Avoid obsessive clock-watching at night, as looking at the clock increases mental activity and makes resuming sleep more difficult 1
• Go to bed only when sleepy, not simply because it is bedtime 1
• If unable to fall asleep within approximately 15–20 minutes, leave the bedroom and return only when sleepy 1, 3

Daytime Napping Restrictions

• Avoid daytime napping entirely if possible; if napping is necessary, limit it to 30 minutes and do not nap after 2 PM 1, 3

Electronic Device Management

• Avoid evening use of electronic devices, as screen exposure suppresses melatonin levels and increases alertness, both of which delay sleep onset and contribute to sleep deprivation 1, 3

Important Caveats

Sleep hygiene education alone is insufficient as a standalone treatment for chronic insomnia and must be combined with other cognitive-behavioral interventions such as stimulus control therapy, sleep restriction therapy, and cognitive restructuring to achieve meaningful clinical improvement 1, 3. While individual sleep hygiene components are associated with better sleep in epidemiologic studies, the direct causal effects of comprehensive sleep hygiene recommendations on sleep outcomes in the general population remain largely untested 4, 5.

The effectiveness of sleep hygiene as monotherapy in clinical populations is limited 4, 5, but these practices form an essential foundation for sleep health in the general population and serve as a critical component of multimodal insomnia treatment 1, 3.