Cited by 733Sleep and related disordersObstructive Sleep Apnea ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Use of sleep hygiene in the treatment of insomnia

Stepanski, Edward J, Wyatt, James K·2003·Sleep Medicine Reviews

DOI 10.1053/smrv.2001.0246

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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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“Time of day results, however, are inconsistent with past research and sleep-hygiene recommendations indicating that exercising within a few hours of bedtime may be detrimental to sleep (Stepanski & Wyatt, 2003).”
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“... the psychometric implications of the use of causal variables in the assessment of sleep hygiene (Bollen and Lennox, 1991), (b) create more complete models of sleep hygiene in an effort to understand and explain the precipitation and maintenance of sleep hygiene related behaviors, and (c) examine sleep hygiene beha…”
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Authors: Stepanski, E. J., & Wyatt, J. K.
Affiliations: Rush University Medical Center (US)
ORCID: Stepanski, Edward J
Wyatt, James K
Venue: Sleep Medicine Reviews
Publisher: Elsevier BV
Published: 2003-06
Volume: 7
Issue: 3
Pages: 215-225
ISSN: 1087-0792 (ISSN-L)
DOI: 10.1053/smrv.2001.0246
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
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Sleep Medicine Reviews (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Health Sciences › Medicine › Physiology (medical) › 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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Use of sleep hygiene in the treatment of insomnia

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