Sleep hygiene, does it really work?
As we hear more and more in the media about how to improve your sleep using sleep hygiene tips, I want to talk about why sleep hygiene might actually be making your sleep worse. But first, for those of you that haven’t heard of it, what is sleep hygiene?
If we Google ‘how to sleep better’, what comes up is a long list of tips on sleep hygiene. These are pointers such as giving up caffeine, making sure you don’t go to bed on an empty stomach, ensuring you have blackout blinds, having a long wind down routine, taking a hot bath and not looking at blue lights etc.
Firstly, I must point out that nothing on that list is particularly bad advice, or anything that I would say would necessarily cause a sleep problem. However, the majority of the people I work with will come to me having already tried all these tips, finding they’re not making a difference at all. So, I want to talk about why this is, and how they these sleep hygiene steps might actually be making things worse.
In order to explain that, first I need to explain how we end up in a pattern of poor sleep and develop a cycle of insomnia. So, imagine you’re a good sleeper and have no problems with sleeping, but one night for whatever reason you go to bed and can’t fall asleep or stay asleep, then resulting in a terrible night.
As humans we’re pretty intolerant of sleeping badly and fairly quickly we want to fix it. So, the first thing we do is start making changes. For example, if I’ve slept badly for a week I might go to bed a bit earlier, maybe drink more caffeine to keep myself awake or drink less because I think that’s caused the problem. Then, if that doesn’t work, I might buy a sleeping spray, or download a couple of apps to track my sleep. What I’m doing here in the short term is trying to find a solution to poor sleep. However, in the long term I’m changing what my body knows about sleep. The more I buy, Google and ask for advice from other people, the more I’m thinking about sleep and going to bed with sleep on my mind.
Fast forward a few weeks and I’ll have gone through the whole sleep hygiene list, quit tea and coffee, quit drinking alcohol, and after a month or two months I’ve cut out evening socialising in favour of my long wind down routine, cut out TV before bed and find myself going through loads of apps to try and relax and clear my mind. So now, my sleep hygiene is arguably perfect BUT I’m trying a million things to try and sleep well and am going to bed with sleep on the brain. Feeling wound up, my adrenaline response has kicked in because I’ve started to fear going to bed, so the more things I do, the more things I try, the worse it gets. And this is how sleep hygiene can actually make things worse.
Regularly I see people with perfect sleep hygiene sleeping terribly, and actually there’s very little evidence that sleep hygiene is a cure for people with insomnia.
I’m not saying that we should all be drinking coffee right before bed, or that it doesn’t matter about blue light, I’m saying that when you develop a sleep problem, the fix and the cure you’re looking for is not sleep hygiene. It’s CBT for insomnia (CBT-i).
CBT-i is not a programme of sleep hygiene. There’s far more to it. It looks at our internal system, our circadian rhythm and getting that back in line, exploring how we create a higher sleep drive to fall asleep faster, and that’s just the tip of the iceberg!
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