Sleep Hygiene

DR TANEISHA K MCGHIE-PHILLIPS BSC (HONS) M.B.B.S DM, CONSULTANT PHYSICIAN AND RHEUMATOLOGIST

Growing public health concern over poor sleep has placed a demand for effective sleep promotion strategies and sleep hygiene education is often cited as the answer to this need Sleep hygiene (SH), coined by Hauri in 19771 refers to a set of recommendations that are believed to promote improved quantity and quality of sleep

These rules target lifestyle and environmental factors that can influence sleep enabling us to make our environment more sleep-friendly and put our body in the ideal state for sleep before bed The original list provided by Hauri were for patients with insomnia Some of these rules were derived from scientific studies regarding the effects of caffeine or alcohol on sleep and others were the result of Hauri’s clinical observations of patients with poor sleep

Data from “normal sleepers” clearly demonstrates that sleep quality and quantity are adversely affected when certain sleep behaviours are followed. However, for some patients with insomnia, the empiric evidence for the success of SH as a stand-alone treatment approach is very limited2.

Sleep hygiene recommendations have evolved over time with increased understanding of the varied behavioural factors that improve or worsen sleep and each rule is supported by plausible physiological and psychosocial mechanisms.

A review of the role of SH in promoting public health found that although each recommendation is theoretically sound, individual SH recommendations regarding specific factors such as caffeine use, alcohol use, exercise and stress lack empirical support for generalization3 For example the impact of caffeine on sleep quality will vary as the peak plasma levels are influenced by individual differences in sensitivity, metabolism, and accumulation3

In conclusion, SH education has the potential to address the growing concern of sleep complaints in the general population and can be used as general guidance. A good start to a good night’s sleep might be “the big seven” which have been most consistently included in the evolving list of SH rules.

Taneisha K McGhie-Phillips Cornwall Regional Hospital Associate Lecturer, Department of Medicine University of the West Indies, Mona 876 952 5100 (O), 876 822 5372 (C)

References:

1 Hauri P The sleep disorders Kalamazoo Michigan: Upjohn Publishing; 1977

2 Morin CM, Nonpharmacologic treatment of chronic insomnia Sleep 1999;22:1134-56

3 Irish LA, The role of sleep hygiene in promoting public health: A review of empirical evidence Sleep Med Rev 2015 Aug;22:23-36

4 Morin CM Cognitive-behavioral approaches to the treatment of insomnia J Clin Psychiatry 2004;65 Suppl 16:33-40