Original article by Michael Thorpy, MD

What are some examples of good sleep hygiene?

The most important sleep hygiene measure is to maintain a regular wake and sleep pattern seven days a week. It is also important to spend an appropriate amount of time in bed, not too little, or too excessive. This may vary by individual; for example, if someone has a problem with daytime sleepiness, they should spend a minimum of eight hours in bed, if they have difficulty sleeping at night, they should limit themselves to 7 hours in bed in order to keep the sleep pattern consolidated. In addition, good sleep hygiene practices include:

•  Avoid napping during the day. It can disturb the normal pattern of sleep and wakefulness.
• Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime. While alcohol is well known to speed the onset of sleep, it disrupts sleep in the second half as the body begins to metabolize the alcohol, causing arousal.
• Exercise can promote good sleep. Vigorous exercise should be taken in the morning or late afternoon. A relaxing exercise, like yoga, can be done before bed to help initiate a restful night's sleep.
• Food can be disruptive right before sleep.  Stay away from large meals close to bedtime. Also dietary changes can cause sleep problems, if someone is struggling with a sleep problem, it's not a good time to start experimenting with spicy dishes. And, remember, chocolate has caffeine.
• Ensure adequate exposure to natural light. This is particularly important for older people who may not venture outside as frequently as children and adults. Light exposure helps maintain a healthy sleep-wake cycle. This can also be augmented by the use of a blue light during the morning or afternoon.
• Establish a regular relaxing bedtime routine. Try to avoid emotionally upsetting conversations and activities before trying to go to sleep. Don't dwell on, or bring your problems to bed.
• Associate your bed with sleep. It's not a good idea to use your bed to watch TV, listen to the radio, or read.
• Make sure that the sleep environment is pleasant and relaxing. The bed should be comfortable, the room should not be too hot or cold, or too bright.

Why is it important to practice good sleep hygiene?

Sleep hygiene is important for everyone, from childhood through adulthood. A good sleep hygiene routine promotes healthy sleep and daytime alertness. Good sleep hygiene practices can prevent the development of sleep problems and disorders.

How does someone know if his or her sleep hygiene is poor?

Sleep disturbances and daytime sleepiness are the most telling signs of poor sleep hygiene. If one is experiencing a sleep problem, he or she should evaluate their sleep routine. It may take some time for the changes to have a positive effect.

How do I know the best sleep hygiene routine for me?

If you're taking too long to fall asleep, or awakening during the night, you should consider revising your bedtime habits. Most important for everyone is to maintain a regular sleep-wake schedule throughout the week and consider how much time you spend in bed, which could be too much or too little.

--Michael Thorpy, MD, is the director of the Sleep-Wake Disorders Center Montefiore Medical Center in Bronx, New York and an associate professor of neurology at the Albert Einstein College of Medicine. He and Jan Yager, PhD, are the co-authors of Sleeping Well and the Encyclopedia of Sleep and Sleep Disorders .

This article originally appeared in the Spring 2003 issue of sleepmatters.