Sleep hygiene
Sleep hygiene is a behavioral and environmental practice[2] developed in the late 1970s as a method to help people with mild to moderate insomnia.
[3] A systematic review by the American Academy of Sleep Medicine concluded that clinicians should not prescribe sleep hygiene for insomnia due to the evidence of absence of its efficacy and potential delaying of adequate treatment, recommending instead that effective therapies such as cognitive behavioral therapy for insomnia should be preferred.
[4] The diagnostic assessment is usually conducted using clinical interview and supplemented by self-report questionnaires[4] and sleep diaries, which are typically kept from one to two weeks, to record a representative sample data.
[10] Clinicians choose among recommendations for improving sleep quality for each individual and counselling is presented as a form of patient education.
[2] Conversely, continuing important work activities or planning shortly before bedtime or once in bed has been shown to delay falling asleep.
[15] Similarly, good sleep hygiene involves minimizing time spent thinking about worries or anything emotionally upsetting shortly before bedtime.
[16] A number of foods and substances have been found to disturb sleep, due to stimulant effects or disruptive digestive demands.
Avoiding nicotine, caffeine (including coffee, energy drinks, soft drinks, tea, chocolate, and some pain relievers), and other stimulants in the hours before bedtime is recommended by most sleep hygiene specialists,[17][18] as these substances activate neurobiological systems that maintain wakefulness.
[14][21] Other recommendations that are frequently made, though less studied, include selecting comfortable mattresses, bedding, and pillows,[11] and eliminating a visible bedroom clock, to prevent focusing on time passing when trying to fall asleep.
[11] There is a lack of evidence for the effects of certain sleep hygiene recommendations, including getting a more comfortable mattress, removing bedroom clocks, not worrying, and limiting liquids.
It was also impossible to conduct a network analysis of the efficacy of specific items of sleep hygiene due to the wide heterogeneity and lack of systematic reporting of content and delivery methods.
[28] Harvard University, for example, requires all incoming first-year undergraduates to take a short online course on the subject before the fall semester begins.
[29] Similarly, shift workers have difficulty maintaining a healthy sleep-wake schedule due to night or irregular work hours.
[30] Shift workers need to be strategic about napping and drinking caffeine, as these practices may be necessary for work productivity and safety, but should be timed carefully.
In low SES populations, irregular and long work hours may force an individual to attempt to sleep during the day.
[34] In addition to sleep hygiene education, bright light therapy can be a useful treatment for individuals with depression and circadian rhythm disturbances.
[35] Not only can morning bright light therapy help establish a better sleep-wake schedule, but it also has been shown to be effective for treating depression directly, especially when related to seasonal affective disorder.
[15] As attention to the role of sleep hygiene in promoting public health has grown, there has been an increase in the number of resources available in print and on the internet.
In 1977, a book entitled "No More Sleepless Nights" by psychologist Peter Hauri introduced the concept within the context of modern sleep medicine.
[44] Inadequate sleep hygiene was a subclassification of Chronic Insomnia Disorder in the ICSD-II published in 2005; it was removed from the 2014 ICSD-III along with two other classifications.
