If you’ve ever experienced difficulty getting to sleep at night, you may have heard about the importance of ‘sleep hygiene.’
Just like ‘dental hygiene’ is about recommendations that help you to look after the health of your teeth, sleep hygiene is about doing the right things to ensure a good night’s sleep.
The problem with sleep hygiene recommendations, though, is that everyone seems to have their unique list of the essential things you need to do to sleep well at night.
A 2003 review study attempted to define sleep hygiene recommendations and found 19 different rules across seven studies.
I don’t know about you, but if I am already worried about my sleep, following 19 different rules each night probably won’t be relaxing. The more stressed and tense I am, the lower my sleep quality could be, even if I practice good sleep hygiene.
For this reason, little evidence supports sleep hygiene as an effective strategy for significantly improving your sleep.
For example, someone may have bought an expensive bed and pillows, worn earplugs and eye masks, stayed away from caffeine, and slept poorly. However, another person might not do any of these things but feel confident about their ability to sleep, go to bed when they feel sleepy at night and sleep excellently.
How our brains work, particularly our fear circuit, can keep us up at night. All it takes is a few horrible nights of sleep where someone sees the negative consequences that not sleeping can have. They then begin to lose confidence in their natural ability to switch off and let sleep come once they are in bed. They then try to force themselves to sleep, sometimes well before their natural body clock is ready for sleep.
Once sleeping difficulties begin, a person’s brain is likely to perceive not sleeping well or enough as a threat. Our brain’s fear centre activates and triggers the fight-or-flight mechanism in response to the perceived threat. Changes occur in the brain and body to prepare the person to attack or run away from the danger. But if the threat is not sleeping, how helpful is the fight-or-flight response in helping that person drift off to sleep?
Unfortunately, the fear of not sleeping well can become the very thing that prevents people from sleeping well. By feeling like you need to worry about 19 things every night in order to sleep well, this fear probably isn’t going to improve.
Chronic insomnia is a big problem in our society, and sleep difficulties impact at least 30 percent of us. However, unless you are not prioritising sleep enough, making you worry more about the sleep you’re not getting enough of each night will not help you sleep any better.
Instead of focusing on all the sleep hygiene tips, see if there is one or two things that you could try that you think could make a big difference for you. Let’s say that you are drinking five cups of coffee a day. Maybe it would be worth cutting it down a bit or having your last coffee before 2pm. If you are already not drinking much caffeine and only having it in the mornings, being more strict about it probably won’t be worth it. Instead, see if there is something else that could be more helpful, such as having a regular wake time each day, waiting until you feel sleepy before going to bed, or getting some morning sunlight exposure.
By trying one or two things at a time, you are likely to be less overwhelmed. You are also going to be more likely to stick to any changes that you try, and then see if it makes any positive difference for you. If it doesn’t, switch your focus to something else that you think might help, try it for at least a week, and then review. If you keep doing it this, eventually you will learn what does and doesn’t work for you, and be able to turn to the most helpful strategies for you when you really need it.
If you aren’t sleeping well and haven’t been for some time, it might be worth getting some expert help. Cognitive Behavioural Therapy for Insomnia (CBT-I) is the gold standard treatment for people with difficulties falling asleep, remaining asleep, and not feeling refreshed during the day. A lot of research has shown that it can help people improve in as little as two sessions of treatment, and improvements are often maintained one year later. Sleeping pills can sometimes help in the short term, but your insomnia is likely to come back as soon as you stop taking them, and they’re not recommended on a long-term basis.
If you can’t find a sleep physician or psychologist trained in CBT-I, there are also some good online CBT-I courses that can teach you all the skills you need. If that doesn’t help, please check out my latest book, Deliberately Better Sleep. It will help you set up your own sleep experiment tailored to you as an individual and assess how much difference it makes for you. Most importantly, it will help you regain confidence in your sleep so that if you ever have a poor night’s sleep, you will understand why and what you can do about it.
Dr Damon Ashworth, Clinical Psychologist and Author of Deliberately Better Sleep.
2 thoughts on “If You’re Not Sleeping Well, Your Sleep Hygiene Is Probably Not the Answer”
I like the point you highlighted about 19 different things to help you sleep better based on 7 different studies. I have concluded that there is so much information out there, and much of it experiential, that is difficult to sort through the chaos. Thank you for clarity.
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Thank you. You’re welcome!