Understanding CBT-I: What Is Sleep Hygiene?
Sleep hygiene is a term for a set of healthy habits that can help a person sleep better. Sleep hygiene is a type of tool used in cognitive behavioral therapy for insomnia (CBT-I). It won’t help much as a standalone strategy for your insomnia, but it’s still an important part of CBT-I treatment.
Keeping good sleep hygiene means changing habits with diet and exercise. It also may mean changing your sleep environment. Healthy sleep habits can make you feel more rested and alert during the day. If you have insomnia, good sleep hygiene may help you get better sleep.
Healthy sleep habits
Good sleep hygiene includes:
Creating a good sleep setting. The best kind of environment for sleep is cool, dark, and quiet. Your bedding should be comfortable and not too light or heavy. If you are sensitive to noise, try ear plugs or a white noise machine. If your room isn’t dark enough, try an eye mask.
Having a bedtime routine. A calming routine can help you get ready for sleep. Take time to have a bath, listen to soft music, or read a book.
Avoiding naps. Naps are tempting when you’re tired. But naps can upset a person’s sleep-wake cycle. They can make it harder to fall asleep and stay asleep at night.
Exercising earlier. Exercising too close to bedtime can make it harder for you to get to sleep. Instead, plan your workouts for at least 3 to 5 hours before bedtime.
Steering clear of caffeine later in the day. Caffeine is a stimulant and lasts in the body for a long time. It can make it harder to fall asleep if you have it too late in the day. Keep in mind that most black or green teas, coffee, chocolate, energy drinks, and some sodas have caffeine.
Limiting alcohol at night. It may seem that alcohol makes it easier to fall asleep. But it can upset later stages of sleep. This can lead to light sleep, or make you wake up too early.
Eating lighter in the evening. Large meals and foods heavy in fat can disrupt sleep for some people. Try to eat lighter at night. And it may help to finish eating 3 hours before bedtime.
Skipping nicotine before bed. Smoking or chewing tobacco before bed can make it hard for you to fall and stay asleep. Nicotine withdrawal in the middle of the night can also disrupt sleep. Talk with your health care provider about a plan to stop smoking to help your sleep.
Minimizing nighttime light. Bright light in the evening can disrupt a person’s natural sleep cycle. Don’t use a computer or other device just before bed, or watch TV in bed. Turn off excess lights in your home.
Checking your medicines. Some over-the-counter cold and allergy medicines can make it harder to sleep. And some prescription medicines can disrupt sleep. If you have sleep problems, talk with your healthcare provider about the medicines you take.
How a sleep diary can help
If you’re having trouble sleeping, keep a daily diary of your sleep. This includes writing down your intake of caffeine, alcohol, and medicines. Note the things mentioned above. Over time, you can see what factors may be hurting your sleep. And you can see what changes may help you sleep better. Be patient — it may take days or weeks for changes to affect your sleep.
Working with CBT-I
Sleep hygiene is often done along with other CBT-I tools. These can include stimulus control, sleep efficiency training, cognitive therapy, and relaxation. Your healthcare provider can tell you more about these tools and which can work best for you.
For more information
If you are a Veteran and you have insomnia, contact your VA healthcare provider about CBT-I or check out some of the below resources.