Effects of sleep hygiene education for insomnia: A systematic review and meta-analysis
Open accessAbstract
Sleep hygiene education (SHE) as a single therapy for insomnia still lacks sufficient evidence. This study aimed to quantify the effects of SHE on insomnia treatment. A literature search was conducted on seven databases from inception up to 30 September 2024 to retrieve randomized controlled trials. Meta-analyses were performed to estimate the mean difference (MD) of Insomnia Severity Index (ISI) (primary outcome) using a random-effects model. Risk of Bias 2 tool was applied to measure methodological quality. Forty-two RCTs encompassing 4245 adults (65.5 % female) were included. The pooled results showed significant pretreatment-to-posttreatment improvement in ISI score (MD = 3.4, 95 % confidence interval (CI) [2.08, 4.64]). However, SHE was inferior as a cognitive behavioral therapy for insomnia (CBT-I) (MD = 3.8, 95 % CI [2.92, 4.76]), partial CBT-I (MD = 4.5, 95 % CI [3.33, 5.60]), exercises (MD = 2.9, 95 % CI [0.81, 5.04]), and acupressure (MD = 1.9, 95 % CI [0.82, 3.00]) regarding the ISI score. The majority of included trials (85.71 %) had a high overall risk of bias, and the remaining had "some concerns." Future work is encouraged to generate robust evidence through the development of well-designed SHE as an examined intervention for insomnia that involves process evaluation and treatment fidelity.
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“Dimming lights at least one hour before bedtime can promote relaxation and facilitate faster sleep onset [50].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [50]
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- Authors
- Ruan, J. Y., Liu, Q., Chung, K. F., Ho, K. Y., & Yeung, W. F.
- Affiliations
- Hong Kong Polytechnic University (HK)
- University of Hong Kong (HK)
- Corresponding author
- Yeung, Wing Fai
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2025-08
- Volume
- 82
- Pages
- 102109
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W4410709025
- Cited by
- 31
- References
- 86
- Citations by year
- 2026: 25 · 2025: 6
- FWCI
- 5.07
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- PolyU Institutional Research Archive (Hong Kong Polytechnic University) (submittedVersion, cc-by-nc-nd)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- sleep hygiene education, insomnia, Insomnia Severity Index, cognitive behavioral therapy for insomnia, acupressure, exercise therapy, insomnia treatment, risk of bias
- MeSH terms
- Sleep Hygiene, Humans, Sleep Initiation and Maintenance Disorders, Patient Education as Topic, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic
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