Chapter 3 – Sleep Hygiene

Publisher Summary Sleep hygiene is indicated for patients who engage in habits, consume substances, and/or set up sleep environments that are not conducive to initiating or maintaining sleep. There is no evidence to suggest that this form of therapy is differentially effective for one or another type of insomnia or for any of the phenotypes/subtypes of insomnia. The role, and perhaps the relevance, of sleep hygiene have varied with time. Decades ago, prior to the widespread dissemination of sleep hygiene instructions, it is entirely plausible that some insomnias were precipitated and perpetuated by poor sleep hygiene. That is, it is entirely plausible that patients seeking clinical help might have reported that they were, for example, drinking three cups of coffee, eating heavy meals, and/or engaging in strenuous exercise before bed. In such cases, altering these behaviors might have resolved the sleep complaint. In the present era, this seems less likely. More often than not patients, long before they seek professional help, are already aware of sleep hygiene and have addressed their most egregious infractions. In fact, it is far more likely that patients have always practiced moderately good sleep hygiene and, following the development of chronic insomnia, simply fail to see the relevance of minor sleep hygiene infractions as disease/disorder moderators (as opposed to causal factors).