sleep hygiene

Assessment of sleep hygiene includes a clinical interview and self-report questionnaires{{Cite book|title=Insomnia: Diagnosis and Treatment|url=https://archive.org/details/insomniadiagnosi00mich|url-access=limited|last1=Sateia|first1=Michael J.|last2=Buysse|first2=Daniel|publisher=Informa Healthcare|year=2010|isbn=9781420080797|location=Essex, UK|pages=[https://archive.org/details/insomniadiagnosi00mich/page/n131 115]}} and sleep diaries, which are typically kept from one to two weeks, to record a representative sample data.{{Cite book|title=Principles and Practice of Sleep Medicine E-Book|last1=Kryger|first1=Meir H.|last2=Roth|first2=Thomas|last3=Dement|first3=William C.|publisher=Elsevier Health Sciences|year=2015|isbn=9780323242882|location=Philadelphia, PA|pages=791}} There are also computerized assessments such as the Sleep-EVAL system, which can be employed in the diagnostic process.{{Cite book|title=Handbook of Assessment and Treatment Planning for Psychological Disorders, Second Edition|last1=Antony|first1=Martin|last2=Barlow|first2=David|publisher=The Guilford Press|year=2011|isbn=9781606238684|location=New York|pages=641}} It features 1,543 possible questions automatically selected according to the individual's previous answers.

Practice of sleep hygiene and knowledge of sleep hygiene practices can be assessed with measures such as the Sleep Hygiene Index,{{cite journal|last1=Mastin|first1=David F.|last2=Bryson|first2=Jeff|last3=Corwyn|first3=Robert|title=Assessment of Sleep Hygiene Using the Sleep Hygiene Index|journal=Journal of Behavioral Medicine|date=24 March 2006|volume=29|issue=3|pages=223–227|doi=10.1007/s10865-006-9047-6|pmid=16557353|s2cid=12044837}} Sleep Hygiene Awareness and Practice Scale, or the Sleep Hygiene Self-Test.{{cite journal|last1=Cho|first1=Sungkun|last2=Kim|first2=Gye-Seok|last3=Lee|first3=Jang-Han|title=Psychometric evaluation of the sleep hygiene index: a sample of patients with chronic pain|journal=Health and Quality of Life Outcomes|date=2013|volume=11|issue=1|pages=213|doi=10.1186/1477-7525-11-213|pmid=24359272|pmc=3905101 |doi-access=free }} {{open access}} For younger individuals, sleep hygiene can be assessed by the Adolescent Sleep Hygiene Scale, the Children's Sleep Hygiene Scale,{{cite journal |vauthors=Lewandowski AS, Toliver-Sokol M, Palermo TM |title=Evidence-based review of subjective pediatric sleep measures |journal=J Pediatr Psychol |volume=36 |issue=7 |pages=780–93 |date=August 2011 |pmid=21227912 |pmc=3146754 |doi=10.1093/jpepsy/jsq119}} or Tayside children's sleep questionnaire.{{Cite journal |last1=Rajaee Rizi |first1=Farid |last2=Asgarian |first2=Fatemeh Sadat |date=2022-08-24 |title=Reliability, validity, and psychometric properties of the Persian version of the Tayside children's sleep questionnaire |journal=Sleep and Biological Rhythms |volume=21 |issue=1 |pages=97–103 |doi=10.1007/s41105-022-00420-6 |issn=1446-9235 |pmid=38468908|pmc=10899986 }}

Clinicians choose among recommendations for improving sleep quality for each individual.Hauri, P. (2011). Sleep/wake lifestyle modifications: Sleep hygiene. In Barkoukis TR, Matheson JK, Ferber R, Doghramji K, eds. Therapy in Sleep Medicine. Elsevier Saunders, Philadelphia, PA. pp. 151–60.

Awakening around the same time every morning and keeping a regular sleep schedule tends to improve sleep.

Getting 7–8 hours of sleep can prevent various physical and mental health deficits,{{cite journal|last1=Luyster|first1=Faith S.|last2=Strollo|first2=Patrick J.|last3=Zee|first3=Phyllis C.|last4=Walsh|first4=James K.|title=Sleep: A Health Imperative|journal=Sleep|volume=35|issue=6|pages=727–734|date=1 June 2012|doi=10.5665/sleep.1846|pmid=22654183|pmc=3353049}} and therefore a top sleep hygiene recommendation is allowing enough time for sleep. Clinicians will frequently advise that these hours of sleep be obtained at night instead of through napping, because while naps can be helpful after sleep deprivation, in the longterm naps may be detrimental to nighttime sleep. Negative effects of napping on sleep and performance have been found to depend on duration and timing, with shorter midday naps being the least disruptive.

Exercise is an activity that can facilitate or inhibit sleep quality; people who exercise experience better quality of sleep than those who do not,{{cite journal|last1=Driver|first1=Helen S.|last2=Taylor|first2=Sheila R.|title=Exercise and sleep|journal=Sleep Medicine Reviews|date=August 2000|volume=4|issue=4|pages=387–402|doi=10.1053/smrv.2000.0110 |pmid=12531177|s2cid=20809909 }} but exercising too late in the day can be activating and delay falling asleep. Increasing exposure to bright and natural light during the daytime and avoiding bright light in the hours before bedtime may help promote a sleep-wake schedule aligned with nature's daily light-dark cycle.{{cite journal|last1=Czeisler|first1=C. A.|last2=Gooley|first2=J. J.|title=Sleep and Circadian Rhythms in Humans|journal=Cold Spring Harbor Symposia on Quantitative Biology|date=January 2007|volume=72|issue=1|pages=579–97|doi=10.1101/sqb.2007.72.064|pmid=18419318|doi-access=free}}

Activities that reduce physiological arousal and cognitive activity promote falling asleep, so engaging in relaxing activities before bedtime is recommended. Conversely, continuing important work activities or planning shortly before bedtime or once in bed has been shown to delay falling asleep.{{cite journal|last1=Stepanski|first1=Edward J|last2=Wyatt|first2=James K|title=Use of sleep hygiene in the treatment of insomnia|journal=Sleep Medicine Reviews|date=June 2003|volume=7|issue=3|pages=215–25|doi=10.1053/smrv.2001.0246|pmid=12927121}} Similarly, good sleep hygiene involves minimizing time spent thinking about worries or anything emotionally upsetting shortly before bedtime. Trying purposefully to fall asleep may induce frustration that further prevents falling asleep, so in such situations a person may be advised to get out of bed and try something else for a brief amount of time.

Generally, for people experiencing difficulties with sleep, spending less time in bed results in deeper and more continuous sleep, so clinicians will frequently recommend eliminating use of the bed for any activities except sleep or sex.{{cite journal|last1=Morin|first1=CM|last2=Bootzin|first2=RR|last3=Buysse|first3=DJ|last4=Edinger|first4=JD|last5=Espie|first5=CA|last6=Lichstein|first6=KL|title=Psychological and behavioral treatment of insomnia:update of the recent evidence (1998–2004).|journal=Sleep|date=November 2006|volume=29|issue=11|pages=1398–414|pmid=17162986|doi=10.1093/sleep/29.11.1398|doi-access=free}}

A number of foods and substances have been found to disturb sleep, due to stimulant effects or disruptive digestive demands. Avoiding nicotine, caffeine (including coffee, energy drinks, soft drinks, tea, chocolate, and some pain relievers), and other stimulants in the hours before bedtime is recommended by most sleep hygiene specialists,{{cite journal|last1=Sin|first1=Celia WM|last2=Ho|first2=Jacqueline SC|last3=Chung|first3=Joanne WY|title=Systematic review on the effectiveness of caffeine abstinence on the quality of sleep|journal=Journal of Clinical Nursing|date=January 2009|volume=18|issue=1|pages=13–21|doi=10.1111/j.1365-2702.2008.02375.x|pmid=19120728|hdl=10397/18014|hdl-access=free}}{{cite journal|last1=Jaehne|first1=Andreas|last2=Loessl|first2=Barbara|last3=Bárkai|first3=Zsuzsanna|last4=Riemann|first4=Dieter|last5=Hornyak|first5=Magdolna|title=Effects of nicotine on sleep during consumption, withdrawal and replacement therapy|journal=Sleep Medicine Reviews|date=October 2009|volume=13|issue=5|pages=363–77|doi=10.1016/j.smrv.2008.12.003|pmid=19345124}} as these substances activate neurobiological systems that maintain wakefulness.{{cite journal |vauthors=Boutrel B, Koob GF |title=What keeps us awake: the neuropharmacology of stimulants and wakefulness-promoting medications |journal=Sleep |volume=27 |issue=6 |pages=1181–94 |date=September 2004 |pmid=15532213 |doi=10.1093/sleep/27.6.1181|doi-access=free }} Alcohol near bedtime is frequently discouraged by clinicians, because, although alcohol can induce sleepiness initially, the arousal caused by metabolizing alcohol can disrupt and significantly fragment sleep.{{cite journal|last1=Irish|first1=Leah A.|last2=Kline|first2=Christopher E|last3=Gunn|first3=Heather E|last4=Buysse|first4=Daniel J|last5=Hall|first5=Martica H|title=The role of sleep hygiene in promoting public health: A review of empirical evidence|journal=Sleep Medicine Reviews|date=October 2014|doi=10.1016/j.smrv.2014.10.001|pmid= 25454674|pmc=4400203|volume=22|pages=23–36}} Smoking tobacco products before bed is also thought to reduce one's quality of resting by decreasing the time spent in deep sleep, leading to sleep fragmentation and nocturnal restlessness.{{Cite book|title = Abnormal Psychology: An Integrative Approach|url = https://archive.org/details/abnormalpsycholo00davi_297|url-access = limited|last1 = Barlow|first1 = David|publisher = Wadsworth|year = 2012|isbn = 9781111343620|location = Belmont, CA|pages = [https://archive.org/details/abnormalpsycholo00davi_297/page/n330 301]|edition = 6th|last2 = Durand|first2 = Mark}}{{Dead link|date=April 2024}} Both consumption of a large meal just before bedtime, requiring effort to metabolize it all, and hunger have been associated with disrupted sleep; clinicians may recommend eating a light snack before bedtime. Limiting intake of liquids before bedtime can prevent interruptions of sleep due to urination.

Arranging a sleep environment that is quiet, very dark, and cool is recommended. Noises, light, and uncomfortable temperatures have been shown to disrupt continuous sleep.{{cite journal |vauthors=Xie H, Kang J, Mills GH |title=Clinical review: The impact of noise on patients' sleep and the effectiveness of noise reduction strategies in intensive care units |journal=Crit Care |volume=13 |issue=2 |page=208 |year=2009 |pmid=19344486 |pmc=2689451 |doi=10.1186/cc7154 |doi-access=free }} Other recommendations that are frequently made, though less studied, include selecting comfortable mattresses, bedding, and pillows, and eliminating a visible bedroom clock, to prevent focusing on time passing when trying to fall asleep.

Light exposure when sleeping has been shown to cause ocular fatigue.{{cite journal |vauthors=Park CY |title=Night Light Pollution and Ocular Fatigue |journal=J Korean Med Sci |volume=33 |issue=38 |pages=e257 |date=September 2018 |pmid=30220898 |pmc=6137033 |doi=10.3346/jkms.2018.33.e257 }}

In 2015, a systematic review of studies on mattresses concluded that medium-firm, custom-inflated mattresses were best for pain and neutral spinal alignment.{{Cite journal|last1 = Radwan|first1 = Ahmed|last2 = Fess|first2 = Philip|last3 = James|first3 = Darcy|last4 = Murphy|first4 = John|last5 = Myers|first5 = Joseph|last6 = Rooney|first6 = Michelle|last7 = Taylor|first7 = Jason|last8 = Torii|first8 = Alissa|title = Effect of different mattress designs on promoting sleep quality, pain reduction, and spinal alignment in adults with or without back pain; systematic review of controlled trials|journal = Sleep Health|volume = 1|issue = 4|pages = 257–267|doi = 10.1016/j.sleh.2015.08.001|pmid = 29073401|year=2015}}

Sleep hygiene studies use different sets of sleep hygiene recommendations, and the evidence that improving sleep hygiene improves sleep quality is weak and inconclusive {{as of|2014|lc=y}}. Most research on sleep hygiene principles has been conducted in clinical settings, and there is a need for more research on non-clinical populations.

The strength of research support for each recommendation varies; some of the more robustly researched and supported recommendations include the negative effects of noisy sleep environments, alcohol consumption in the hours before sleep, engaging in mentally difficult tasks before sleep, and trying too hard to fall asleep. There is a lack of evidence for the effects of certain sleep hygiene recommendations, including getting a more comfortable mattress, removing bedroom clocks, not worrying, and limiting liquids. Other recommendations, such as the effects of napping or exercise, have a more complicated evidence base. The effects of napping, for example, seem to depend on the length and timing of napping, in conjunction with how much cumulative sleep an individual has had in recent nights.

There is support showing positive sleep outcomes for people who follow more than one sleep hygiene recommendation. There is however no evidence that poor sleep hygiene can contribute to insomnia.{{cite journal |last1=Stepanski |first1=EJ |last2=Wyatt |first2=JK |title=Use of sleep hygiene in the treatment of insomnia. |journal=Sleep Medicine Reviews |date=June 2003 |volume=7 |issue=3 |pages=215–25 |doi=10.1053/smrv.2001.0246 |pmid=12927121 }}

While there is inconclusive evidence that sleep hygiene alone is effective as a treatment for insomnia, some research studies have shown improvement in insomnia for patients who receive sleep hygiene education in combination with cognitive behavioral therapy practices.

The American Academy of Sleep Medicine released in 2021 a meta-analysis on behavioral therapies concluding that they "did not favor the use of sleep hygiene as a stand-alone therapy for chronic insomnia" since "recent evidence shows that it is no longer supported as a single-component therapy". They further recommend educating clinicians and patients to avoid the recommendation of sleep hygiene as this can cause a "delayed implementation of effective therapies with continued or worsening insomnia symptoms" and furthermore may demotivate patients from "undergoing other treatments based on their experience using an ineffective intervention". It was also impossible to conduct a network analysis of the efficacy of specific items of sleep hygiene due to the wide heterogeneity and lack of systematic reporting of content and delivery methods.{{cite journal |last1=Edinger |first1=JD |last2=Arnedt |first2=JT |last3=Bertisch |first3=SM |last4=Carney |first4=CE |last5=Harrington |first5=JJ |last6=Lichstein |first6=KL |last7=Sateia |first7=MJ |last8=Troxel |first8=WM |last9=Zhou |first9=ES |last10=Kazmi |first10=U |last11=Heald |first11=JL |last12=Martin |first12=JL |title=Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. |journal=Journal of Clinical Sleep Medicine |date=1 February 2021 |volume=17 |issue=2 |pages=263–298 |doi=10.5664/jcsm.8988 |pmid=33164741|pmc=7853211 |doi-access=free }}

Sleep hygiene is a central component of cognitive behavioral therapy for insomnia.{{cite journal|last1=Morin|first1=CM|last2=Bootzin|first2=RR|last3=Buysse|first3=DJ|last4=Edinger|first4=JD|last5=Espie|first5=CA|last6=Lichstein|first6=KL|title=Psychological and behavioral treatment of insomnia:update of the recent evidence (1998–2004)|journal=Sleep|date=November 2006|volume=29|issue=11|pages=1398–414|pmid=17162986|doi=10.1093/sleep/29.11.1398|doi-access=free}} Specific sleep disorders may require other or additional treatment approaches, and continuing difficulties with sleep may require additional assistance from healthcare providers.{{cite web |url= http://www.medscape.com/viewarticle/768414_2 |title= Running on Empty: Fatigue and Healthcare Professionals: The Consequences of Inadequate Sleep |publisher= NIOSH: Workplace Safety and Health |date= August 2, 2012 |author= Caruso, Claire C |access-date= December 14, 2014}}

College students are at risk of engaging in poor sleep hygiene and also of being unaware of the resulting effects of sleep deprivation.{{cite journal|last1=Brown|first1=Franklin C.|last2=Buboltz|first2=Walter C.|last3=Soper|first3=Barlow|date=January 2002|title=Relationship of Sleep Hygiene Awareness, Sleep Hygiene Practices, and Sleep Quality in University Students |journal=Behavioral Medicine |volume=28 |issue=1 |pages=33–8 |doi=10.1080/08964280209596396 |pmid=12244643 |s2cid=45735065}}{{Unreliable medical source|date=December 2014}} Because of irregular weekly schedules and the campus environment, college students may be likely to have variable sleep-wake schedules across the week, take naps, drink caffeine or alcohol near bedtime, and sleep in disruptive sleeping environments. Because of this, researchers recommend sleep hygiene education on college campuses. Harvard University, for example, requires all incoming first-year undergraduates to take a short online course on the subject before the fall semester begins.[http://www.wbur.org/commonhealth/2018/08/31/harvard-sleep-101-freshmen Sleep 101: Harvard Freshmen Required To Take Sleep Course Before School Begins]

Similarly, shift workers have difficulty maintaining a healthy sleep-wake schedule due to night or irregular work hours.{{cite journal | author = Åkerstedt T | year = 1998 | title = Shift work and disturbed sleep/wakefulness | journal = Sleep Medicine Reviews | volume = 2 | issue = 2| pages = 117–28 | doi=10.1016/s1087-0792(98)90004-1| pmid = 15310506 }} Shift workers need to be strategic about napping and drinking caffeine, as these practices may be necessary for work productivity and safety, but should be timed carefully. Because shift workers may need to sleep while other individuals are awake, additional sleeping environment changes should include reducing disturbances by turning off phones and posting signs on bedroom doors to inform others when they are sleeping.

Additionally, Socioeconomic status (SES) often determines access to care leading to a downward trajectory in health.{{Cite journal |last1=McMaughan |first1=Darcy Jones |last2=Oloruntoba |first2=Oluyomi |last3=Smith |first3=Matthew Lee |date=2020-06-18 |title=Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging |journal=Frontiers in Public Health |volume=8 |page=231 |doi=10.3389/fpubh.2020.00231 |doi-access=free |issn=2296-2565 |pmc=7314918 |pmid=32626678}} Those with lower SES have limited access to quality living conditions. Economic status can contribute to tremendous stress. Sleep is the primary mechanism in biological and psychosocial stressors that can help one recover from moderate stress. However, the stress level will affect the brain by disrupting the circadian cycle, meaning that more stress will lead to more sleep disturbances.{{Cite journal |last1=Sosso |first1=Faustin Armel Etindele |last2=Holmes |first2=Sari D. |last3=Weinstein |first3=Ali A. |date=2021-08-01 |title=Influence of socioeconomic status on objective sleep measurement: A systematic review and meta-analysis of actigraphy studies |url=https://www.sleephealthjournal.org/article/S2352-7218(21)00112-1/abstract |journal=Sleep Health: Journal of the National Sleep Foundation |language=English |volume=7 |issue=4 |pages=417–428 |doi=10.1016/j.sleh.2021.05.005 |issn=2352-7218 |pmid=34266774|url-access=subscription }} The data points to an inverse relationship: lower SES will result in insufficient sleep and a decline in sleep quality compared to high SES. Light and noise will significantly impact one's sleeping patterns. Exposure to light will disrupt the body's natural circadian rhythm. In low SES populations, irregular and long work hours may force an individual to attempt to sleep during the day. This will significantly disrupt the physiological benefits that come from sleep. Additionally, urban neighborhoods will likely have greater night noise, crime, and violence. In these neighborhoods, the body will be in a constant state of survival, releasing cortisol and adrenaline, which interfere with sleep.{{Cite journal |last=Billings |first=Martha |date=September 29, 2020 |title=Disparities in Sleep Health and Potential Intervention Models |journal=Chest |volume=159 |issue=3 |pages=1232–1240|doi=10.1016/j.chest.2020.09.249 |pmid=33007324 |pmc=7525655 }}

Due to symptoms of low mood and energy, individuals with depression may be likely to have behaviors that are counter to good sleep hygiene, such as taking naps during the day, consuming alcohol near bedtime, and consuming large amounts of caffeine during the day.{{cite journal | author = Doghramji K | year = 2003 | title = Treatment strategies for sleep disturbance in patients with depression | journal = Journal of Clinical Psychiatry | volume = 64 | pages = 24–9 | pmid = 14658932 }} In addition to sleep hygiene education, bright light therapy can be a useful treatment for individuals with depression and circadian rhythm disturbances.{{cite journal |last1=Geoffroy |first1=PA |last2=Schroder |first2=CM |last3=Reynaud |first3=E |last4=Bourgin |first4=P |title=Efficacy of light therapy versus antidepressant drugs, and of the combination versus monotherapy, in major depressive episodes: A systematic review and meta-analysis. |journal=Sleep Medicine Reviews |date=December 2019 |volume=48 |pages=101213 |doi=10.1016/j.smrv.2019.101213 |pmid=31600678|s2cid=204244335 |doi-access=free }} Not only can morning bright light therapy help establish a better sleep-wake schedule, but it also has been shown to be effective for treating depression directly, especially when related to seasonal affective disorder.{{cite journal|last1=Golden|first1=RN|last2=Gaynes|first2=BN|last3=Ekstrom|first3=RD|last4=Hamer|first4=RM|last5=Jacobsen|first5=FM|last6=Suppes|first6=T|author6-link=Trisha Suppes|last7=Wisner|first7=KL|last8=Nemeroff|first8=CB|title=The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence.|journal=The American Journal of Psychiatry|date=April 2005|volume=162|issue=4|pages=656–62|pmid=15800134|doi=10.1176/appi.ajp.162.4.656}}

Individuals with breathing difficulties due to asthma or allergies may experience additional barriers to quality sleep that can be addressed by specific variations of sleep hygiene recommendations. Difficulty with breathing can cause disruptions to sleep, reducing the ability to stay asleep and to achieve restful sleep.{{cite journal|last1=Koinis-Mitchell|first1=Daphne|last2=Craig|first2=Timothy|last3=Esteban|first3=Cynthia A.|last4=Klein|first4=Robert B.|title=Sleep and allergic disease: A summary of the literature and future directions for research|journal=Journal of Allergy and Clinical Immunology|date=December 2012|volume=130|issue=6|pages=1275–81|doi=10.1016/j.jaci.2012.06.026|pmid=22867694|pmc=3576835}} For individuals with allergies or asthma, additional considerations must be given to potential triggers in the bedroom environment. Medications that might improve ability to breathe while sleeping may also impair sleep in other ways, so there must be careful management of decongestants, asthma controllers, and antihistamines.{{cite journal|last1=Muliol|first1=J|last2=Maurer|first2=M|last3=Bousquet|first3=J|title=Sleep and allergic rhinitis|journal=Journal of Investigational Allergology & Clinical Immunology|date=2008|volume=18|issue=6|pages=415–9|pmid=19123431}}

Sleep hygiene strategies include advice about timing of sleep and food intake in relationship to exercise and sleeping environment. Recommendations depend on knowledge of the individual situation; counselling is presented as a form of patient education.

As attention to the role of sleep hygiene in promoting public health has grown, there has been an increase in the number of resources available in print and on the internet. Organizations running public health initiatives include the National Sleep Foundation and the Division of Sleep Medicine at Harvard Medical School, both of which have created public websites with sleep hygiene resources, such as tips for sleep hygiene, instructional videos, sleep hygiene self-assessments, poll statistics on sleep hygiene, and tools to find sleep professionals.{{cite web|last1=National Sleep Foundation|title=National Sleep Foundation|url=http://sleepfoundation.org/|access-date=14 December 2014}}{{cite web|last1=Division of Sleep Medicine at Harvard Medical School and WGBH Educational Foundation|title=Healthy Sleep|url=http://healthysleep.med.harvard.edu/|access-date=14 December 2014|archive-date=15 April 2018|archive-url=https://web.archive.org/web/20180415104524/http://healthysleep.med.harvard.edu/|url-status=dead}} A cooperative agreement between the U.S. Centers for Disease Control and Prevention and the American Academy of Sleep Medicine was established in 2013 to coordinate the National Healthy Sleep Awareness Project, with one of their aims being to promote sleep hygiene awareness.{{cite web|last1=American Academy of Sleep Medicine|title=AASM partners with CDC to address chronic sleep loss epidemic|date=13 November 2013|url=http://www.aasmnet.org/articles.aspx?id=4320|access-date=14 December 2014}}{{cite web|last1=Centers for Disease Control and Prevention|title=National Healthy Sleep Awareness Project|url=https://www.cdc.gov/sleep/projects_partners.htm|access-date=14 December 2014}}

Long and irregular work hours contribute to the sleep health disparity in the US. Local governments could regulate business hours for those that employ high rates of low-income families. Additionally, access to care is often determined by that individual's occupation. Clinicians in the communities should advocate insurance coverage and access to care for sleep-related services. Telemedicine is a promising approach proposed to reduce barriers to sleep health care. This eliminates transportation challenges for underserved populations and is more cost-effective. Actigraphy can provide a cost-effective method to diagnose sleeping disorders.{{Cite web |date=2021-10-01 |title=How Is Actigraphy Used to Evaluate Sleep? |url=https://www.sleepfoundation.org/sleep-studies/actigraphy |access-date=2024-04-09 |website=Sleep Foundation |language=en-US}} Neighborhoods can be improved by updating urban planning. Noise population can be reduced by promoting walkability among communities. Walkability is only possible when neighborhood safety is optimized.

Some of the concepts of sleep hygiene first appeared in a book by Paolo Mantegazza published in 1864.{{cite journal|last1=Gigli|first1=Gian Luigi|last2=Valente|first2=Mariarosaria|title=Should the definition of "sleep hygiene" be antedated of a century? A historical note based on an old book by Paolo Mantegazza, rediscovered|journal=Neurological Sciences|date=30 June 2012|volume=34|issue=5|pages=755–60|doi=10.1007/s10072-012-1140-8|pmid=22752854|s2cid=8607322}}

The term sleep hygiene was first introduced in 1939 by Nathaniel Kleitman. In 1977, a book entitled "No More Sleepless Nights" by psychologist Peter Hauri introduced the concept within the context of modern sleep medicine.de Biase et al. Sleep Hygiene. Chapter 27 in Sleepiness and human impact assessment. Eds. Garborino LN et al. Springer Milan, 2014. {{ISBN|978-88-470-5388-5}}{{rp|289}} In this book Hauri outlined a list of behavioral rules intended to promote improved sleep. The 1990 publication of the International Classification of Sleep Disorders (ICSD) introduced the diagnostic category Inadequate Sleep Hygiene. Inadequate sleep hygiene was a subclassification of Chronic Insomnia Disorder in the ICSD-II published in 2005; it was removed from the 2014 ICSD-III along with two other classifications. The term “chronic insomnia disorder” is used for all subtypes of chronic insomnia and inadequate sleep hygiene is no longer required to diagnose any sleep disorder, including insomnia and insufficient sleep syndrome.{{Cite journal |last1=Mader |first1=Edward C |last2=Mader |first2=Annie Cielo L |last3=Singh |first3=Prachi |title=Insufficient Sleep Syndrome: A Blind Spot in Our Vision of Healthy Sleep |journal=Cureus |date=2022 |volume=14 |issue=10 |pages=e30928 |doi=10.7759/cureus.30928 |doi-access=free |issn=2168-8184 |pmc=9626376 |pmid=36337802}}

Specific sleep hygiene recommendations have changed over time. For example, advice to simply avoid sleeping pills was included in early sets of recommendations, but as more drugs to help with sleep have been introduced, recommendations concerning their use have become more complex.

{{Portal|Psychology|Medicine}}

• Chronotype
• Circadian rhythm
• Dark therapy

{{reflist}}

• [https://sleep.hms.harvard.edu/education-training/public-education/sleep-and-health-education-program/sleep-health-education-50 Steps for improving sleep], Division of Sleep Medicine, Harvard University Medical School

{{Sleep}}

{{DEFAULTSORT:Sleep Hygiene}}

Category:Sleep

Category:Self-care

Category:Hygiene