Use of sleep hygiene in the treatment of insomnia
Abstract
Sleep hygiene (SH) refers to a list of behaviors, environmental conditions, and other sleep-related factors that can be adjusted as a stand-alone treatment or component of multimodal treatment for patients with insomnia. This paper presents a review of SH, how this concept has been applied and often modified over the past 24 years, and how it relates to the modern sleep disorder nosology, particularly Inadequate Sleep Hygiene. Although a recognized and commonly utilized treatment option, there is no absolute consensus about which steps must be included to constitute SH treatment, and there is much overlap between SH and other cognitive-behavioral treatments for insomnia such as Stimulus Control Procedures and Sleep Restriction Therapy. The literature on the effects of manipulations of individual components of SH under experimental conditions (e.g. effects of presleep alcohol or caffeine intake) in normal sleepers show mixed results. Empirical data demonstrating the role of poor SH as a contributor to insomnia, or showing that good SH improves sleep in patients with insomnia, is not available. Instead of evaluating the impact of a comprehensive list of SH recommendations, a focus on guidelines for use of individual rules is needed.
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A strength in using such methods as comparators is the low efficacy compared to other interventions.
“A strength in using such methods as comparators is the low efficacy compared to other interventions (50, 51).”
From Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial (2021) · cites this paper as [51]
There is insufficient evidence for sleep hygiene to be an option for single therapy.
“Although there is insufficient evidence for sleep hygiene to be an option for single therapy, it is usually provided in conjunction with other modalities [18,28].”
From Non-Pharmacological Treatment of Insomnia (2012) · cites this paper as [28]
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- Authors
- Stepanski, E. J., & Wyatt, J. K.
- Affiliations
- Rush University Medical Center (US)
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2003-06
- Volume
- 7
- Issue
- 3
- Pages
- 215-225
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W2129344959
- Cited by
- 733
- References
- 50
- Citations by year
- 2026: 18 · 2025: 34 · 2024: 26 · 2023: 56 · 2022: 46 · 2021: 46 · 2020: 58 · 2019: 46 · 2018: 36 · 2017: 42 · 2016: 38 · 2015: 40 · 2014: 47 · 2013: 28 · 2012: 24
- FWCI
- 2.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- 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, insomnia treatment, cognitive behavioral therapy for insomnia, stimulus control, sleep restriction therapy, caffeine consumption
- MeSH terms
- Ethanol, Central Nervous System Stimulants, Body Temperature, Caffeine, Environment, Humans, Sleep Initiation and Maintenance Disorders, Noise, Television, Wakefulness, Exercise, Cognitive Behavioral Therapy
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