Sleep Hygiene rules for Insomnia

PLEASE NOTE:

This site does not provide medical advice. The information presented here is informational only and should be used in conjunction with the comprehensive care by your physician. Review the Terms of Use of this website before proceeding. Be extra cautious when modifying your sleep habits and patterns, as reductions in sleep time can lead to increased sleepiness during the day. You should not perform potentially dangerous activities (such as driving) when you are sleepy.

Sleep hygiene refers to “cleaning up” sleep habits that interfere with good sleep. These habits often develop in response to insomnia, but are counterproductive. Practicing good sleep hygiene is recommended for all patients with insomnia.

1. Sleep as much as needed to feel refreshed and healthy during the following day, but not more. Curtailing time in bed a bit seems to solidify sleep; excessively long times in bed seem related to fragmented and shallow sleep.

2. Maintain a consistent, regular routine. Start by setting a routine time to wake up and get out of bed. Once your sleep improves, keep to a standard time to go to bed. This routine needs to be maintained every day of the week.

3. Never try to sleep. Only go to bed when you feel sleepy and do not try to force yourself to fall asleep. This will only tend to make you more awake and is counterproductive. If you wake up in the middle of the night, let yourself fall asleep within 15-20 minutes. If you cannot fall asleep, get out of bed and do something relaxing. When you are sleepy, return to bed and go to sleep.

4. Use the bedroom only for sleep and intimacy. Do not watch TV, eat, drink, read, have arguments or discussions while in bed. These tend to keep you awake.

5. Avoid napping unless absolutely required. Particularly avoid routine, daily naps. Napping interferes with the ability to fall asleep at night. If you need to nap for safety reasons (driving, etc) then a short 30-60 minute nap is okay.

6. Avoid coffee, alcohol, and nicotine. Caffeine will tend to keep you awake. The effects of caffeine on sleep usually takes several hours to go away, however in some people the effects are prolonged. Alcohol may make some people fall asleep more quickly (but not everyone), however alcohol leads to fragmented sleep and does not provide good restful sleep. Nicotine is a stimulant and tends to reduce the quality of sleep, and nicotine withdrawal at night tends to do the same. Quitting smoking is recommended for all smokers for many reasons.

7. Exercise in the late afternoon or early evening can improve sleep. Do not exercise within several hours of attempting to go to sleep – this will keep you awake. Gentle stretching for relaxation can help you fall asleep.

8. Ensure you are sleeping in a quiet, dark, comfortable environment.

9. A light bedtime snack (especially warm milk or similar drink) seems to help many individuals sleep. Hunger may disturb sleep.

10. Move the bedroom clock to where you cannot see it. Some recommend removing the clock from the bedroom entirely. Looking at the clock will keep you awake; it does not help you fall asleep.

Modified from:

· Kryger et al, Principles and Practice of Sleep Medicine, 2^nd Edition 2005, Chapter 61

· Morin et al. Nonpharmacologic Treatment of Chronic Insomnia. An American Academy of Sleep Medicine Review. Sleep 1999;22:1134.