GUIDE · SLEEP

Sleep hygiene: which habits help, and why they rarely fix insomnia on their own

It's 11:40 p.m., and you've followed every tip on the list: no coffee after lunch, phone charging in the kitchen, blackout curtains, and you're still wide awake. Some sleep hygiene habits hold up well in studies, while others have surprisingly little behind them. For chronic insomnia, the American Academy of Sleep Medicine (AASM) advises clinicians not to rely on sleep hygiene alone.

What sleep hygiene is

Sleep hygiene is a set of everyday habits and bedroom conditions meant to make good sleep more likely. The AASM's 2021 guideline on behavioral treatments for insomnia describes it as general advice about lifestyle (diet, exercise, substance use) and surroundings (light, noise, temperature). It can also include some education about normal sleep and how sleep changes with age.

The individual tips do have a basis. A 2015 review in Sleep Medicine Reviews by Irish and colleagues checked the evidence behind eight common recommendations, from caffeine to naps. Epidemiologic and experimental studies generally linked each one with nighttime sleep. Still, the review found that the direct effect of following each tip remains largely untested in the general population. Knowing that late coffee goes with worse sleep doesn't prove that cutting it will fix yours.

Sleep hygiene tips and what the evidence says

Caffeine: In a 2013 study by Drake and colleagues, 12 healthy sleepers who regularly had caffeine took a 400 mg caffeine pill at bedtime, 3 hours before bed or 6 hours before, and a placebo on another night. By the study's estimate of 100 mg per 8-ounce cup of home-brewed coffee, that's about four cups. Every timing disrupted sleep. Even at 6 hours, a home sleep monitor recorded more than an hour less sleep, though the sleep diaries didn't show a clear difference. The authors took this as support for avoiding substantial caffeine for at least 6 hours before bed. It's one small study of one large dose, so it can't tell you your own cutoff.

Alcohol: A 2013 review by Ebrahim and colleagues pulled together studies of alcohol and sleep in healthy volunteers. At every dose, alcohol helped people fall asleep faster and made the first half of the night steadier, and then sleep became more disrupted in the second half. It also delayed the first stretch of REM sleep, and at moderate and high doses most studies found less REM over the whole night. A nightcap can seem to work because the trouble shows up hours later.

A regular wake time: The Irish review found that irregular schedules generally go with more daytime sleepiness and worse self-reported sleep, and people with insomnia tend to vary more from night to night. Experiments are thinner. Putting college students without sleep complaints on a fixed schedule didn't measurably improve their sleep in two small studies, while a 4-week trial in 39 students with irregular schedules and heavy daytime sleepiness did cut their sleepiness. The review notes that clinical insomnia treatments ask for a regular wake time but let bedtime vary, since you go to bed only when sleepy. For that reason, it advises against a fixed bedtime as general advice.

Screens and evening light: In a 2015 study in PNAS by Chang and colleagues, 12 healthy young adults read for about 4 hours before bed on five evenings in a row, once on a light-emitting e-reader and once from a printed book, in otherwise very dim light. With the e-reader, they took nearly 10 minutes longer on average to fall asleep and made less melatonin. Their body clocks shifted later, and they were less alert the next morning. Four hours of reading is a heavy dose, so the study says less about a few minutes on your phone.

The bedroom: The Irish review looked at one part of the bedroom, noise, and called the advice to reduce it sound. Noise at night causes more arousals and lighter sleep, even when you don't notice it. In lab studies, sleep recordings showed people getting used to noise within a few days, but their bodies' arousal responses and their complaints about sleep hadn't faded in the few weeks the studies lasted. Earplugs and white noise helped patients sleep in intensive care units, and cutting traffic noise at home brought modest gains.

Exercise timing: The usual tip is to avoid working out near bedtime. According to the Irish review, a single bout of exercise tends to bring a modest improvement in that night's sleep, and the evidence doesn't support the claim that late exercise disturbs sleep in the general population. A 2019 meta-analysis of 23 studies in healthy adults, by Stutz and colleagues, agreed: evening exercise didn't harm sleep and, if anything, helped slightly. The exception was vigorous exercise ending an hour or less before bed, which might make it harder to fall asleep.

Naps: Lists often say to avoid naps longer than 30 minutes. In the Irish review, most studies, largely in older adults, found no clear link between napping and night sleep, and the direct evidence for avoiding naps was limited. Experiments that added naps point in different directions. Two weeks of daily 90-minute afternoon naps shortened older adults' measured night sleep, though the authors judged the effect very small, while one evening nap made young adults' sleep worse that night. No study had tested whether habitual nappers sleep better once they stop.

Does sleep hygiene work for insomnia?

For chronic insomnia, the AASM's 2021 guideline, written by Edinger and colleagues, suggests that clinicians not use sleep hygiene as a single-component therapy, meaning the only treatment. It's a conditional recommendation, the weaker of the guideline's two grades. The task force found three randomized trials in adults with chronic insomnia that compared sleep hygiene with a wait list, a minimal intervention or a placebo. In the one trial with usable data, sleep hygiene beat the control, but cognitive behavioral therapy for insomnia (CBT-I) beat sleep hygiene in the same study. The people who improved with sleep hygiene had also made other changes, like keeping a regular sleep schedule, without being told to. When studies of other treatments used sleep hygiene as the comparison, it did less than the active treatments.

The guideline still leaves room for the habits. Common-sense principles, such as avoiding too much caffeine or alcohol, may help as part of a fuller treatment, and CBT-I often includes sleep hygiene education. In place of sleep hygiene alone, it strongly recommends multicomponent CBT for insomnia. As single-component options, it suggests stimulus control, sleep restriction therapy or relaxation therapy. If worry is what keeps you up, our page on anxiety and sleep may fit better.

How to test sleep hygiene tips for two weeks

These steps turn the better-supported tips into a two-week experiment, so you can see what changes for you instead of following a list on faith. If you've had insomnia for months, use them alongside CBT-I rather than in place of it.

1. Keep a sleep diary for a few days first. Each morning, note when you went to bed, about when you fell asleep and when you woke. Add what you had in the evening, such as caffeine, alcohol or a nap. A baseline makes a change easier to spot.
2. Pick a wake time and keep it every day. Use the same alarm on weekends too. Go to bed when you feel sleepy instead of at a set hour, which is how the clinical insomnia treatments in the Irish review handle bedtime.
3. Move caffeine earlier. Aim to have your last substantial caffeine at least 6 hours before bed, the cutoff the 2013 caffeine study supports. Energy drinks and large coffees count, not only the cup after dinner.
4. Watch what alcohol does to the second half of the night. If you drink in the evening, compare your diary on nights with and without it. In the review above, alcohol helped people fall asleep but disrupted sleep later in the night.
5. Swap the backlit screen for paper. For the last hour or so before bed, read a printed book in dim light. The e-reader study used about 4 hours of reading, so it's less clear how much a shorter session matters for you.
6. Deal with noise. If traffic or a noisy building wakes you, try earplugs, a fan or a white-noise machine. If the snoring that wakes the house is yours, see a doctor.
7. Read your diary after two weeks. If you're falling asleep faster and waking less, keep going. If you still lie awake most nights, move on to stimulus control or sleep restriction, which the AASM guideline supports for chronic insomnia, unlike sleep hygiene alone.

If someone notices you snore loudly or gasp in your sleep, or you struggle to stay awake during the day, see a doctor before you spend more weeks adjusting habits.

A made-up example

Dana is made up, and her story shows how the pieces might fit, not a real result. She's had trouble sleeping for most of a year. She drinks a large coffee around 3 p.m., has two glasses of wine to wind down, and reads on her tablet in bed until she feels drowsy.

She moves her last coffee to noon and swaps the tablet for a paperback. The wine becomes a weekend thing. After two weeks, her diary shows she falls asleep a little faster. She still wakes around 3 a.m. most nights and lies there for an hour, going over the next day. Months of that is the kind of chronic insomnia the AASM guideline sends toward CBT-I, so she starts a CBT-I program and keeps the new habits as part of it.

When to see a doctor about sleep

Better habits won't fix a sleep disorder with a physical cause. The AASM's 2009 guideline on obstructive sleep apnea, by Epstein and colleagues, describes apnea by signs such as daytime sleepiness, loud snoring, breathing pauses someone else notices, and waking up gasping or choking. Its fuller list of symptoms to ask about includes trouble staying asleep and morning headaches. The guideline also names motor vehicle accidents among the consequences doctors should check for.

See a doctor if those signs fit, if an uncomfortable urge to move your legs keeps you from falling asleep, or if poor sleep has gone on for months despite steady habits. If you've nodded off while driving, or come close, stop driving drowsy and get checked soon. Our sleep test can help you describe your sleep before the appointment.

Talk through your evenings

The chat below runs with Helpy, the site's AI assistant. Describe a usual evening, from your last coffee to lights out, and it can help you choose which habit to test first and plan how to track it. It can't diagnose a sleep disorder, so take snoring, gasping or months of insomnia to a doctor.

Evidence and sources

• Edinger et al. (2021), Journal of Clinical Sleep Medicine: AASM guideline on behavioral and psychological treatments for chronic insomnia in adults. It suggests clinicians not use sleep hygiene as the only treatment and strongly recommends multicomponent CBT-I. Full text, sleep hygiene section read. The recommendation against sleep hygiene alone is conditional and rests partly on indirect evidence.
• Irish et al. (2015), Sleep Medicine Reviews: Review of the evidence behind common sleep hygiene tips, from caffeine and alcohol to exercise, noise, sleep timing and naps. Full text, relevant sections read. Most studies involved people without sleep complaints, and many findings are associations, not tests of changing a habit.
• Drake et al. (2013), Journal of Clinical Sleep Medicine: 400 mg of caffeine at bedtime, 3 hours before or 6 hours before bed disrupted sleep compared with placebo; at 6 hours, measured sleep fell by more than an hour. Full text read. Only 12 people, one large dose in pill form, and a portable home monitor.
• Ebrahim et al. (2013), Alcoholism: Clinical and Experimental Research: Review of studies on alcohol and sleep in healthy volunteers: faster sleep onset and a steadier first half of the night, then more disruption in the second half, with REM sleep delayed. Abstract only. A qualitative review of healthy volunteers, not people with insomnia.
• Chang et al. (2015), PNAS: Reading on a light-emitting e-reader for about 4 hours before bed, compared with a printed book, delayed sleep by nearly 10 minutes on average, suppressed melatonin and shifted the body clock later. Full text, main results read. Only 12 healthy young adults, with long reading sessions in very dim room light.
• Stutz et al. (2019), Sports Medicine: Meta-analysis of 23 studies comparing one evening exercise session with no exercise in healthy adults. Evening exercise didn't harm sleep overall, though vigorous exercise ending an hour or less before bed might. Abstract only. Single sessions in healthy adults, not people with insomnia.
• Epstein et al. (2009), Journal of Clinical Sleep Medicine: AASM guideline on evaluating and managing obstructive sleep apnea, the source of the warning signs above. Relevant sections read. Written for clinicians, and it's now 17 years old.

Read next

How to Beat Insomnia Without Pills: CBT-I, Step by StepWhen sleep hygiene isn't enoughStimulus Control for Insomnia: The CBT-I Rules ExplainedTeach your bed to mean sleepAnxiety at Night: How to Stop a Racing Mind & SleepWhen worry keeps you up

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