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  • Updated 03.05.2023
  • Released 03.05.2001
  • Expires For CME 03.05.2026

Inadequate sleep hygiene



Inadequate sleep hygiene entails the behaviors, practices, rituals, and habits that result in sleep onset or maintenance difficulties and unrefreshing sleep. It is prevalent across all age groups from young children to the elderly. Consensus statements have been published by the American Academy of Sleep Medicine and Centers for Disease Control regarding recommended duration of sleep for both the pediatric and adult populations (11; 42). Our society promotes sacrificing sleep to enhance academic performance, productivity, or fulfill social obligations, resulting in habits that make it difficult to sleep through the night, leading to chronic sleep complaints, daytime fatigue, and sleepiness. Poor sleep hygiene exacerbates psychiatric and neurologic disorders. Increased electronic device use before bedtime, particularly in young adults, is associated with poor sleep quality and academic performance. Recognizing, counseling, and using therapeutic strategies can increase sleep quantity and improve sleep quality and daytime functioning. The authors explore the symptoms, consequences, and treatment of inadequate sleep hygiene in this article.

Key points

• Staying in bed for longer than 20 minutes or trying to force sleep may increase latency to sleep.

• Exposure to light (such as from screens associated with televisions, computers, mobile phones, handheld video games, or tablet devices) prolongs latency to sleep.

• Frequent daytime napping or napping late in the evening often results in sleep-onset difficulties.

• As the components of sleep hygiene, including bedtime routine, bed time, and wake up times, are individual-specific, it is important to keep in mind that the treatment for inadequate sleep hygiene must also be individually tailored.

Historical note and terminology

The concept of sleep hygiene has been referenced as far back as 1864 by Italian neurologist Paolo Mantegazza (21). Inadequate sleep hygiene was formerly recognized as a subtype of chronic insomnia; however, this classification was abandoned in the 2014 revision of the International Classification of Sleep Disorders (ICSD-3) due to the ubiquity of poor sleep practices across various forms of insomnia and other sleep disorders. Inadequate sleep hygiene refers to behaviors that disrupt the maintenance of good quality sleep and normal daytime alertness, such as daytime napping, inconsistent sleep/wake schedules, using sleep-disruptive products (eg, caffeine, tobacco, alcohol, illicit substances) before bedtime, engaging in mentally or physically stimulating activities before bedtime, using the bed and bedroom for activities other than sleep, or creating an uncomfortable sleeping environment. Patients with poor sleep hygiene often experience ongoing sleep/wake difficulties.

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