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). Sleep hygiene can be used alone, or to support other treatments, for example sleep medication. 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.
Strategies for improving sleep[edit | edit source]
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. 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
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
Theory[edit | edit source]
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.
Evidence in ME/CFS[edit | edit source]
Sleep hygiene is recommended by the International Consensus primer for ME and the Canadian Consensus Criteria for ME/CFS. 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. 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.
Risks and safety[edit | edit source]
Costs and availability[edit | edit source]
Sleep hygiene is a free self-help approach and does not require any medical equipment.
Notable studies[edit | edit source]
- 2015, The Role of Sleep Hygiene in Promoting Public Health: A Review of Empirical Evidence - (Full text)
See also[edit | edit source]
Learn more[edit | edit source]
- Sleep Hygiene handout - Center for Clinical Interventions, Western Australia
References[edit | edit source]
- Stepanski, Edward J; Wyatt, James K (Jun 1, 2003). "Use of sleep hygiene in the treatment of insomnia". Sleep Medicine Reviews. 7 (3): 215–225. doi:10.1053/smrv.2001.0246. ISSN 1087-0792.
- Irish, Leah A.; Kline, Christopher E.; Gunn, Heather E.; Buysse, Daniel J.; Hall, Martica H. (Aug 2015). "The Role of Sleep Hygiene in Promoting Public Health: A Review of Empirical Evidence". Sleep medicine reviews. 22: 23–36. doi:10.1016/j.smrv.2014.10.001. ISSN 1087-0792. PMC . PMID 25454674.
- Crawley, Esther; Chambers, Tim (Dec 1, 2005). "It's not all in ME mind, doc". Archives of Disease in Childhood - Education and Practice. 90 (4): ep92–ep97. doi:10.1136/adc.2004.062893. ISSN 1743-0585.
- Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6
- Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, A C Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I. (2003), "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols" (PDF), Journal of Chronic Fatigue Syndrome, 11 (2): 7-115, doi:10.1300/J092v11n01_02
chronic fatigue syndrome (CFS) - A fatigue-based illness. The term CFS was invented invented by the U.S. Centers for Disease Control as an replacement for myalgic encephalomyelitis (ME). Some view CFS as a neurological disease, others use the term for any unexplained long-term fatigue. Sometimes used as a the term as a synonym of myalgic encephalomyelitis, despite the different diagnostic criteria.