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Sleep hygiene: What it is and how to establish a better nighttime routine

Sleep is considered the third pillar of health, but poor bedtime habits can wreak havoc on your ability to get your z's.

A woman wearing a sleep mask lies in bed.
Sleeping in a dark, cool environment can help improve your overall sleep. (Getty Creative)

Sleep is commonly referred to as the third pillar of health, yet research repeatedly shows that as many as one-third of Americans aren't getting enough of it. According to the American Academy of Sleep Medicine, adults should be logging seven or more hours of shut-eye per night, but whether they're lying awake at night thinking about politics, skyrocketing inflation or the next round of layoffs, those seven-plus hours remain elusive for many.

In the real world, a restless night here and there shouldn't be cause for concern — we're only human after all, right? Consistent trouble falling asleep and staying asleep, however, might be something to discuss with your doctor. While you wait for your appointment, you could try some sleep hygiene interventions to get your sleep back on track.

Jennifer L. Martin, PhD, former president and spokesperson for the American Academy of Sleep Medicine, tells Yahoo Life, "Sleep hygiene is a set of general guidelines that all people should follow for healthy sleep." More specifically, sleep hygiene refers to the healthy habits, behaviors and environmental factors that promote healthy, restful and restorative sleep. When done right, sleep hygiene can not only help us fall asleep faster, but when we stick to these practices night after night, it can boost our sleep quality and duration.

Joseph Dzierzewski, PhD, senior vice president of research and scientific affairs with the National Sleep Foundation, says sleep hygiene is important because "sleep health is a crucial contributor to our health and well-being, impacting virtually everything, from our immune system to our decision making."

Now, short-lived bouts of sleeplessness are just a part of the human condition. However, prolonged stints of sleepless nights tend to be accompanied by bothersome side effects that can lead to more serious health consequences over the long run.

Common short-term side effects of sleep deprivation may include:

  • Daytime sleepiness

  • Lack of alertness

  • Moodiness and irritability

  • Fatigue

  • Impaired memory

Common long-term side effects of sleep deprivation may include:

  • High blood pressure

  • Diabetes

  • Heart attack

  • Heart disease

  • Stroke

Ultimately, Dzierzewski says, "when we practice more healthy sleep behaviors, we are more likely to get enough quality sleep and be satisfied with our sleep."

And while sleep hygiene is one way to protect our sleep health, keeping all of the above at bay, Martin says, "it's not an all-or-nothing game." Just because you scrolled a little longer on your cellphone last night, that doesn't mean all of your prior efforts toward good sleep hygiene are for naught. Martin typically advises that people should be mindful of their sleep hygiene at least 80% of the time. And the other 20% of the time? Just live your life.

As we mentioned earlier, sleep hygiene isn't a singular action. It's a series of behaviors and practices (like maintaining a consistent sleep schedule, managing screen time before bed and fine-tuning your sleep environment) that help us optimize our sleep. Here are a few key components.

Research shows that erratic sleep schedules can meddle with your ability to fall asleep. Moreover, inconsistent sleep-wake patterns may also interfere with overall sleep quality and duration. If you don't see where this is going, it means that going to bed and waking up at the same time every day — even on the weekend, even on holidays — tops the list of sleep hygiene best practices.

Without getting too deep into the scientific weeds here, sleep experts have found that maintaining a consistent sleep-wake schedule trains your internal clock (or circadian rhythm) to prepare to sleep and wake up on a regular schedule.

Martin cautions that while consistency is key, this component of sleep hygiene has to be viewed in the context of being in bed long enough to get the sleep you need. She explains that maintaining a consistent sleep schedule works, but it won't work if you're going to bed at midnight and waking up at 4 a.m. every day — that may check the box for consistency, but it certainly doesn't check the box for duration.

"Most people need a little time to wind down at the end of the day and put the day to rest," says Martin, and that's where relaxing bedtime routines come in.

In terms of hard-and-fast rules for creating a bedtime routine, Martin says there are none simply because people are so different. Ultimately, she says, creating a bedtime routine is really about taking stock of activities you enjoy and what relaxes you, and leaning into those before bed. For some people, a solid bedtime routine may involve practicing yoga. For others, it could be reading a book or taking a warm bath.

The only requirements here are that the activity helps you wind down and that it's appropriate to do before bed. At the end of the day (no pun intended), a relaxing bedtime routine is designed to cue your body that it's time to go to sleep.

"The overarching theme about your sleep environment is that when you walk in there, it should be calm and peaceful," says Martin. It should feel like a place where you think you'll get a good night's sleep. She adds that this may differ from one person to the next, but your sleep environment should generally be quiet, cool and dark.

Beyond sleep masks or blackout curtains to help manage light and white noise machines to manage ambient noise, Martin notes that sleep surfaces and pillows are often overlooked but play an important role in your sleep experience.

The typical lifespan of a mattress is seven to 10 years, and Martin says if your mattress is within that window, there's no need to go out and bust your budget to replace it. Instead, she encourages more manageable changes to your sleep surface, like swapping out old pillows and sheets for ones that are more in line with your sleep preferences (i.e., firm pillows for side sleepers and cooling sheets for hot sleepers).

Spicy foods, heavy meals and caffeine or alcohol consumption right before bed can all deliver a significant blow to your sleep both in terms of quality and duration. Spicy foods and heavy meals can cause gastric reflux and general discomfort, leading to poor sleep, and caffeine's stimulating effect can wreak havoc all its own.

Alcohol can be a little trickier as its depressant effects can shorten the time it takes to fall asleep, so much so that many people use it as a sleep aid. However, leaning into a drink (or three) can have a deleterious effect on your sleep quality, as your favorite nightcap can end up promoting fragmented and shallow sleep and wakefulness as it metabolizes in your body overnight.

In terms of diet and sleep, Martin says, "what you do in the second half of the day is more important than what you do in the first half of the day." And that certainly stands to reason, so go ahead and have your cup of joe in the morning or a glass of wine with dinner — just be sure to watch the clock and avoid imbibing more as the night wears on.

For optimal health, the American Heart Association prescribes 150 minutes per week of moderate-intensity aerobic activity and muscle-strengthening activity at least twice a week. And while following these guidelines can help lower your risk of heart disease, stroke, type 2 diabetes, obesity and high blood pressure, research shows that exercise can improve your sleep in terms of efficiency (the amount of time you spend in bed asleep compared to your total time in bed) and duration.

The one caveat for adding exercise to your sleep hygiene plan is to be mindful of the timing. Typically, it's best not to exercise right before bedtime — 30 minutes of moderate exercise in the morning or afternoon is ideal.

Our internal clock or circadian rhythm is driven by the rising and setting of the sun. Martin says spending time outdoors every day has a myriad of health benefits, including supporting quality sleep. She adds that morning light has the strongest influence on keeping our circadian rhythms steady, so where and when possible, she suggests going for a 10-minute walk in the morning.

While watching TV and scrolling through Instagram are standard operating procedures for most bedtime routines, screen time before bed doesn't make for the best sleep. Using electronic devices before bed can not only stimulate our minds, but the blue light these devices emit can profoundly suppress our production of melatonin (the sleep hormone). So instead of feeling sleepy, engaging with our devices causes us to feel more alert — more often than not, delaying sleep.

While sleep experts often sound the alarm regarding screen time before bed, Martin says she tends to take the middle ground on the topic. Ultimately, she says, "if it's keeping you awake, put it away; if it's not, don't stress out about it." Martin adds, "It's useful to reflect on whether your device use forces you to procrastinate going to bed in the first place or causes you to feel stressed (thinking about the news or what's going down on social media) when you get into bed." If that's the case, she suggests creating some distance between those activities and your hard bedtime.

If you're not ready to go screen-free, think about curbing your usage and putting devices away at least 30 minutes to one hour before lights out. Instead, opt for analog activities like listening to music or audiobooks, engaging in puzzles or journaling. This digital downtime gives your mind (and body) some breathing room to transition from active and alert to relaxed and ready for sleep.

According to Martin, sleep hygiene can promote healthy sleep, but it's likely not the singular answer for those with sleep disorders like chronic insomnia and obstructive sleep apnea. Instead, she says, sleep hygiene should be paired with approved treatment strategies for the respective conditions.

For example, Martin tells us that cognitive behavioral therapy for insomnia (CBT-I) is the recommended treatment for those struggling with the condition, and sleep hygiene is a foundational part of it. Insomnia is more effectively treated when you pair education around sleep habits (sleep hygiene) and cognitive behavioral techniques (CBT-I).

Likewise, in the case of other sleep disorders like obstructive sleep apnea (OSA) and restless legs syndrome (RLS), Martin says sleep hygiene alone won't solve the problem. However, it can help set those dealing with the conditions up for success.

Regarding OSA, Martin says it often takes time to get used to a CPAP (continuous positive airway pressure) mask but good sleep hygiene can help with that. "When you get into bed and fall asleep quickly, it's much easier to adjust to the treatment than if you get in bed with a CPAP mask and lie awake for an extended period of time," she says, adding that good sleep hygiene can also boost the benefits of medications used in the treatment of RLS.

If you're a part of the one-third of Americans who aren't getting enough sleep each night and sleep hygiene is now on your radar, here are a few tips for creating a successful routine.

Start with a self-assessment to identify your specific sleep challenges and establish a sleep hygiene plan accordingly. For instance, if hanging out on X well past your bedtime and eating late dinners are your regular habits, start your sleep hygiene plan by addressing these issues.

When establishing a sleep hygiene plan, you don't have to tick every box on the first night. (FYI, making too many changes at once is a good way to set yourself up for failure.)

Dzierzewski says, "When making behavioral or environmental changes, it is important to be consistent and target changes that are realistic and sustainable." He adds that people are unique. So while some people can handle multiple changes at once, others can't. There's no right or wrong way to approach change, so people should do what feels comfortable to them.

Change doesn't happen overnight, so when implementing a sleep hygiene plan, Martin says it's important to give things some time to work. She suggests keeping track of the changes you make and whether they're making a difference to your sleep. Martin says, "If you're not sleeping or feeling better after a week or two, it might be time to speak with your doctor."

The most common signs of poor sleep hygiene include difficulty falling asleep or staying asleep and a consistent failure to wake feeling refreshed and restored.

Twenty to 30 minutes is an acceptable time frame for sleep onset. If you can't fall asleep within that window, it's best to get out of bed and do something relaxing or boring (using only dim light). When you begin to feel sleepy, return to bed and try again.

Everyone is different, so the use of sleep aids is best discussed with your doctor, who knows you and your medical history. Before tangling with sleep aids, consider implementing a solid sleep hygiene routine to see if that helps.

Your sleep environment should be conducive to restful and restorative sleep — that means cool, dark and quiet. You can use sleep masks or blackout curtains to keep your sleep space dark, and colored noise machines to mask ambient noise.

If you have difficulty falling asleep and staying asleep for an extended period of time, and your efforts with sleep hygiene don't seem to make a difference, it's probably time to speak with your doctor. If possible, keep a sleep diary (a log of your sleep practices, timing and how you feel upon waking). This will give your doctor a clear picture of your sleep health and allow you to discuss your sleep issues in more detail.

Our health content is for informational purposes only and is not intended as professional medical advice. Consult a medical professional on questions about your health.