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{{stub}} '''Sleep hygiene''' is a group of "behaviors, environmental conditions, and other sleep-related factors" that used to try to reduce [[insomnia]], improve sleep quality, or reduce [[hypersomnia]] (excessive sleeping).<ref name="Stepanskif2003">{{Cite journal | last = Stepanski | first = Edward J | last2 = Wyatt | first2 = James K| date = 2003-06-01 | title = Use of sleep hygiene in the treatment of insomnia|url=http://www.sciencedirect.com/science/article/pii/S1087079201902461|journal=Sleep Medicine Reviews|language=en|volume=7|issue=3|pages=215β225|doi=10.1053/smrv.2001.0246|issn=1087-0792}}</ref> Sleep hygiene can be used alone, or to support other treatments, for example [[:Category:Sleep aids and hypnotics|sleep medication]].<ref name="Stepanskif2003" /> Sleep hygiene is commonly used in a variety of chronic illnesses, or in otherwise healthy people with insomnia. Sleep hygiene is a self-help approach, and is unlikely to be adequate as a standalone treatment for severe insomnia or sleep disorders such as [[sleep apnea]].<ref name="Stepanskif2003" /><ref name="Irish2015" /> ==Strategies for improving sleep== There is no overall consensus about what should be included in sleep hygiene, and there is often some overlap with cognitive behavioral therapy for insomnia.<ref name="Stepanskif2003" /> Crawley and Chambers (2005) recommend: *Make sure you only sleep in your bedroom *Have a sleep routine *Try not to stimulate yourself just before bed *Avoid day/night reversal *Do not sleep too much and correct day/night reversal *Limit daytime naps<ref name="Crawley2005">{{Cite journal | last = Crawley | first = Esther | authorlink = Esther Crawley | last2 = Chambers | first2 = Tim | author-link2 = | date = 2005-12-01 | title = Itβs not all in ME mind, doc|url=https://ep.bmj.com/content/90/4/ep92|journal=Archives of Disease in Childhood - Education and Practice|language=en|volume=90|issue=4| pages = ep92βep97|doi=10.1136/adc.2004.062893|issn=1743-0585|pmc=|pmid=|access-date=|quote=|via=}}</ref> Other possible changes include: * including regular [[exercise]] (usually not part of sleep hygiene for ME/CFS patients) * stress management, e.g. doing relaxing activities just before bedtime * noise reduction * sleep timing regularity, and avoiding [[caffeine]], nicotine, and [[alcohol]]<ref name="Irish2015" /> ==Theory== Each specific component in sleep hygiene is known to be related to improved sleep, so by grouping many components together, and educating the patient, the expectation is that overall sleep will improve.<ref name="Irish2015">{{Cite journal | last = Irish | first = Leah A. | author-link = | last2 = Kline | first2 = Christopher E. | authorlink2 = | last3 = Gunn | first3=Heather E. | authorlink3 = | last4 = Buysse | first4 = Daniel J. | authorlink4 = | last5 = Hall | first5 = Martica H. | authorlink5 = | date = Aug 2015 | title = The Role of Sleep Hygiene in Promoting Public Health: A Review of Empirical Evidence|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4400203/|journal=Sleep medicine reviews|volume=22|issue=|pages=23β36|doi=10.1016/j.smrv.2014.10.001|issn=1087-0792|pmc=4400203|pmid=25454674|access-date=|quote=|via=}}</ref> ==Evidence in ME/CFS== Sleep hygiene is recommended by the [[International Consensus Criteria|International Consensus primer]] for [[Myalgic encephalomyelitis|ME]] and the [[Canadian Consensus Criteria]] for ME/CFS.<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 = N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | authorlink14 = John Chia | last15 = Darragh | first15 = A | authorlink15 = Austin Darragh | last16 = Gerken | first16 = A | authorlink16 = Anne Gerken | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18 = DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012 | isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref><ref name="canadianconsensus-CCC">{{Citation | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | authorlink9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | authorlink10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 | pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref> These recommendations are based on the experience of expert clinicians, rather than clinical trials of patients with ME/CFS. A review by Irish et al. (2015) found significant gaps in the evidence for different sleep hygiene recommendations, with many studies focusing on the effects of different sleep hygiene components on healthy people rather than those with sleep problems, or limited to only small studies or specific age groups.<ref name="Irish2015" /> Irish et al. also commented that poor sleep may lead to some of the behaviors that sleep hygiene typically advises against, for example using alcohol to induce sleep, or using caffeine. They comment that changing behaviors that began as a result of sleep problems is unlikely to resolve the sleep problems.<ref name="Irish2015" /> ==Risks and safety== ==Costs and availability== Sleep hygiene is a free self-help approach and does not require any medical equipment.<ref name="Crawley2005" /> ==Notable studies== *2015, The Role of Sleep Hygiene in Promoting Public Health: A Review of Empirical Evidence<ref name="Irish2015" /> - [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4400203/ (Full text)] ==See also== *[[Sleep dysfunction]] *[[Insomnia]] *[[Hypersomnia]] *[[Melatonin]] *[[:Category:Sleep aids and hypnotics|Hypnotics]] (category) - sleep drugs ==Learn more== *[https://www.cci.health.wa.gov.au/~/media/cci/mental%20health%20professionals/sleep/sleep%20-%20information%20sheets/sleep%20information%20sheet%20-%2004%20-%20sleep%20hygiene.pdf Sleep Hygiene handout] - Center for Clinical Interventions, Western Australia ==References== {{Reflist}} [[Category:Potential treatments]] [[Category:Management strategies]] [[Category:Sleep management strategies]]
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