Sleep Hygiene: Evidence-Based Strategies for Better Sleep

Sleep difficulties are among the most common complaints in mental health care, and poor sleep has a bidirectional relationship with virtually every psychological condition — it both contributes to and results from depression, anxiety, PTSD, and other mental health difficulties. Sleep hygiene refers to a set of behavioural and environmental practices that promote healthy, restorative sleep. Whilst these strategies may sound simple, they are based on well-established principles of sleep science and are recommended by NICE as a first-line intervention for insomnia.

The foundation of good sleep hygiene is stimulus control — strengthening the association between your bed and sleep. Use your bed only for sleep and intimacy. If you are unable to fall asleep within approximately twenty minutes, get up, go to a different room, and engage in a quiet, non-stimulating activity until you feel sleepy, then return to bed. This prevents your bed from becoming associated with wakefulness and frustration. Maintain a consistent sleep schedule: go to bed and wake up at the same time every day, including weekends, to regulate your circadian rhythm.

Environmental factors play a significant role in sleep quality. Keep your bedroom cool (approximately sixteen to eighteen degrees Celsius), dark (consider blackout curtains or an eye mask), and quiet (use earplugs or white noise if necessary). Remove electronic devices from the bedroom and avoid screens for at least sixty minutes before bed, as the blue light emitted by phones, tablets, and computers suppresses melatonin production and interferes with the circadian signal for sleep.

Behavioural habits that support good sleep include limiting caffeine intake after midday, avoiding alcohol within four hours of bedtime (alcohol fragments sleep architecture and reduces sleep quality despite its sedative effect), taking regular physical exercise (but not within three hours of bedtime), and establishing a relaxing pre-sleep routine that signals to your body that sleep is approaching. If sleep difficulties persist despite implementing sleep hygiene measures, Cognitive Behavioural Therapy for Insomnia (CBT-I) is the most effective treatment and is recommended by NICE ahead of sleeping medication.