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Sleep Hygiene: The Primary Care Foundation

The ten first-line sleep behaviours a family doctor runs through before reaching for anything stronger, each one graded against independent sleep guidance rather than anyone's say-so.

Evidence: B, the individual sleep-hygiene behaviours are consistently recommended by the National Sleep Foundation and CDC and are low risk, but sleep hygiene alone is a foundation rather than a treatment for diagnosed insomnia; the bedding step is weaker still and its source was a paid partnership
Not endorsed · based on the published work of Mikhail Varshavski, DO
Paid partnership disclosure. The Doctor Mike video this page is built from, "Proven Sleep Tips | How to Fall Asleep Faster", was a paid brand partnership with Cotton Incorporated and was tagged #ad. We do not treat it as evidence. Every step below is graded against independent sleep guidance, and we found no independent evidence that cotton bedding specifically improves sleep.
At a glance
Time
Nightly routine
Steps
10
Difficulty
Beginner
Moderate Sleep hygiene is the first-line, lowest-risk intervention in primary care because the individual behaviours have consistent supporting evidence and essentially no downside.
The protocol

Fix your wake time before anything else

Same wake time every day, including weekends, even after a bad night
Why

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.

National Sleep Foundation

Set the room cool

Roughly 60 to 68F (15.6 to 20C); about 65F (18.3C) is the commonly cited optimum
Why

Core body temperature has to drop for sleep onset, and a cool room is the easiest way to let that happen.

Sleep Foundation, best temperature for sleep

Make the room properly dark

Blackout curtains or a sleep mask; cover or remove standby LEDs
Why

Light is the strongest signal to the circadian clock, so residual light delays and fragments sleep.

National Sleep Foundation

Make the room quiet, or consistently noisy

Earplugs, or steady white noise if you cannot remove the noise source
Why

Intermittent noise causes arousals you often will not remember but that still cost you sleep quality.

National Sleep Foundation

Stop caffeine early

No caffeine within eight hours of bedtime; for a 10pm bedtime that means nothing after 2pm
Why

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.

Sleep Foundation, caffeine and sleep

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
Why

Evening screen light and the engagement itself both delay sleep onset; the Sleep Foundation's concrete recommendation is the hour before bed.

Sleep Foundation, how electronics affect sleep

Skip the nightcap and the late heavy meal

No alcohol as a sleep aid; finish large meals well before bed
Why

Alcohol shortens sleep onset but fragments the second half of the night, and a large late meal adds reflux and discomfort.

National Sleep Foundation

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
Why

Daytime activity improves sleep quality, while vigorous exercise too close to bedtime keeps core temperature and arousal elevated.

CDC sleep guidance

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
Why

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.

Journal of Sleep Research systematic review, 2024

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
Why

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.

CBT-I stimulus control
The evidence 6
Moderate

Sleep hygiene is the first-line, lowest-risk intervention in primary care because the individual behaviours have consistent supporting evidence and essentially no downside.

Proven Sleep Tips | How to Fall Asleep Faster (Doctor Mike, paid Cotton Incorporated partnership) Watch youtube.com
Sleep Tips (National Sleep Foundation) Read thensf.org
Best Temperature for Sleep (Sleep Foundation) Read sleepfoundation.org
Caffeine and Sleep (Sleep Foundation) Read sleepfoundation.org
How Electronics Affect Sleep (Sleep Foundation) Read sleepfoundation.org
Bedding fibres and sleep quality: a 2024 systematic review (Journal of Sleep Research) Read pmc.ncbi.nlm.nih.gov

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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