Sleep Hygiene: The Primary Care Foundation
Sleep hygiene is the first-line, no-cost set of behaviours a family doctor recommends before anything else: a fixed wake time, a cool dark quiet room, caffeine stopped about eight hours before bed, screens off for the last hour, and getting out of bed if you are still awake after about twenty minutes. It is a foundation, not a treatment for a diagnosed sleep disorder.
Fix your wake time before anything else Same wake time every day, including weekends, even after a bad night
A fixed wake time is the anchor the rest of the routine hangs off; the National Sleep Foundation and CDC both put consistent timing first.
Set the room cool Roughly 60 to 68F (15.6 to 20C); about 65F (18.3C) is the commonly cited optimum
Core body temperature has to drop for sleep onset, and a cool room is the easiest way to let that happen.
Make the room properly dark Blackout curtains or a sleep mask; cover or remove standby LEDs
Light is the strongest signal to the circadian clock, so residual light delays and fragments sleep.
Make the room quiet, or consistently noisy Earplugs, or steady white noise if you cannot remove the noise source
Intermittent noise causes arousals you often will not remember but that still cost you sleep quality.
Stop caffeine early No caffeine within eight hours of bedtime; for a 10pm bedtime that means nothing after 2pm
The Sleep Foundation advises a minimum of eight hours, because caffeine's half-life leaves a meaningful dose in your system well into the evening.
Get off screens for the final hour Screen free for the hour before bed; if that is impossible, dim everything and put the device down at lights out
Evening screen light and the engagement itself both delay sleep onset; the Sleep Foundation's concrete recommendation is the hour before bed.
Skip the nightcap and the late heavy meal No alcohol as a sleep aid; finish large meals well before bed
Alcohol shortens sleep onset but fragments the second half of the night, and a large late meal adds reflux and discomfort.
Move during the day, and finish hard training with time to spare Any daily activity counts, even a ten minute walk; CDC guidance is to finish exercise at least three hours before sleep
Daytime activity improves sleep quality, while vigorous exercise too close to bedtime keeps core temperature and arousal elevated.
Choose bedding that lets you stay cool, not a specific fabric Pick breathable, moisture-wicking bedding and sleepwear that keep you in that 60 to 68F comfort range; fabric choice itself is preference
A 2024 systematic review in the Journal of Sleep Research found no fabric consistently superior, with wool and linen outperforming cotton in several trials, so the supported principle is thermal comfort and breathability rather than any one material. The source video was a paid Cotton Incorporated partnership and its cotton-specific claim is not independently supported.
Get out of bed rather than lying there After about twenty minutes awake, get up, do something quiet and dim, and return only when sleepy
This is stimulus control, a core component of CBT-I, the first-line treatment for chronic insomnia; it stops the bed becoming a cue for being awake and frustrated.
Sleep hygiene is the first-line, lowest-risk intervention in primary care because the individual behaviours have consistent supporting evidence and essentially no downside.
View sources
Proven Sleep Tips | How to Fall Asleep Faster (Doctor Mike, paid Cotton Incorporated partnership)
Sleep Tips (National Sleep Foundation)
Best Temperature for Sleep (Sleep Foundation)
Caffeine and Sleep (Sleep Foundation)
How Electronics Affect Sleep (Sleep Foundation)
Bedding fibres and sleep quality: a 2024 systematic review (Journal of Sleep Research)
Not medical advice. This page is for education only and is not a substitute for professional medical care. Consult a qualified clinician before changing your health routine.
Independent curation. YourProtocol is an independent platform. This protocol is based on the publicly available work of Mikhail Varshavski, DO and is not created, reviewed, endorsed by, or affiliated with Mikhail Varshavski, DO or Family Medicine Physician.
Is this for you
- Anyone who takes a long time to fall asleep and has not yet done the basics
- A first-line foundation, not a treatment for diagnosed insomnia, sleep apnoea or a circadian disorder
- Not a substitute for seeing a doctor if you snore heavily, stop breathing in your sleep, or are exhausted despite sleeping enough
Cautions
- The source video was a paid Cotton Incorporated brand partnership; we grade every step against independent guidance instead, and no independent evidence supports cotton bedding specifically
- Sleep hygiene alone does not treat chronic insomnia; CBT-I is the first-line treatment and is worth asking a clinician about
- Loud snoring, witnessed pauses in breathing, or daytime exhaustion despite adequate sleep are reasons to see a doctor, not reasons to try harder at sleep hygiene
- Do not use alcohol as a sleep aid
- No diagnosis is made or implied by this page
- Educational only, not medical advice
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