Sleep Hygiene Not Working for You? Here’s Why
- Lorraine Irlam, Registered Clinical Counsellor
- Aug 16
- 5 min read
You stopped drinking coffee in the afternoon. You put away your phone before bed. Your bedroom is cool, quiet and dark. You bought new pillows, developed a calming bedtime routine and tried to go to bed at the same time every night.
And yet, you are still awake.
If this sounds familiar, you may have started to wonder whether you are doing sleep hygiene incorrectly—or whether you are simply a hopeless sleeper.
Neither is necessarily true.
Sleep hygiene can help create conditions that support healthy sleep. But despite how often it is recommended, sleep hygiene alone is not considered an effective treatment for chronic insomnia.
This is important because people with insomnia are often given a list of basic sleep tips and sent home to figure it out themselves. When those tips do not work, they may blame themselves, try to follow the rules even more rigidly or conclude that nothing can help.
Sleep hygiene is important, but often not enough. The real problem may be that they were given general sleep advice when they needed treatment.
What Is Sleep Hygiene?
Sleep hygiene refers to habits and environmental conditions that can support sleep. Common recommendations include:
limiting caffeine later in the day
keeping the bedroom dark, quiet and comfortable
avoiding heavy meals close to bedtime
allowing time to wind down
exercising regularly
reducing activities that are especially stimulating late at night
maintaining reasonably consistent sleep and wake times
These recommendations are not meaningless. Drinking several coffees in the evening, sleeping in a noisy room or working on an exciting project until the moment you turn out the light could certainly interfere with sleep.
Sleep hygiene can be especially useful when a person’s habits or environment are clearly disrupting an otherwise healthy sleep system. It may also help prevent occasional sleep difficulties from becoming worse.
But chronic insomnia is usually more complicated than an insufficiently dark bedroom or an imperfect bedtime routine.
Sleep Hygiene Is Not the Same as Insomnia Treatment
Chronic insomnia is not simply a collection of “bad habits.”
Over time, the brain can begin to associate bedtime and the bed itself with wakefulness, frustration, effort and worry. A person may spend increasingly long periods in bed hoping to obtain more sleep, nap or cancel activities to compensate for a bad night, monitor constantly for signs of tiredness, and feel growing pressure to make sleep happen.
These reactions are understandable. Unfortunately, they can also help perpetuate insomnia.
A person can therefore have excellent sleep hygiene and still experience significant difficulty falling asleep, staying asleep or returning to sleep after waking.
This is why repeatedly offering sleep hygiene to someone with chronic insomnia can feel rather like telling a person with a broken leg to wear more supportive shoes. The advice may be sensible in general, but it may not adequately address the problem requiring treatment.
Is Sleep Hygiene Really Used as a Placebo?
You may have heard the surprising claim that sleep hygiene is used as a placebo in insomnia research.
There is some truth behind the statement, but it needs context.
In clinical trials, researchers need to determine whether an insomnia treatment produces benefits beyond those that might result from receiving attention, information, encouragement or the expectation of improvement. Some studies have therefore compared Cognitive Behavioural Therapy for Insomnia—usually called CBT-I—with sleep-hygiene education.
Sleep hygiene can serve as a useful “control" or comparison condition because it sounds credible, is related to sleep and gives participants something to do. However, it does not contain the main therapeutic strategies believed to change the processes maintaining chronic insomnia.
In that sense, sleep-hygiene education has sometimes played a placebo-like role in research. That does not mean every sleep-hygiene recommendation is false or useless. It means that researchers have not generally expected a list of healthy sleep habits to produce the same therapeutic effects as a structured insomnia treatment.
A 2021 American Academy of Sleep Medicine guideline specifically advised against using sleep hygiene as a stand-alone treatment for chronic insomnia. More recent research reviews have continued to find that evidence for sleep-hygiene education by itself is limited.
Why Can Sleep Hygiene Advice Sometimes Make Insomnia Worse?
The advice itself is not always the problem. The way it is understood and applied can be.
When people become desperate for sleep, reasonable suggestions can gradually turn into rigid rules:
“I must follow the perfect routine or I won’t sleep.”
“I looked at a screen, so tonight is ruined.”
“My bedroom was one degree too warm.”
“I didn’t finish winding down early enough.”
“I need to try harder to relax.”
“I have to make up for last night’s sleep somehow.”
“My bedroom’s too hot.”
“My bedroom’s too cool.”
This creates more monitoring, more effort and more anxiety around sleep.
Sleep is a biological process. We can support it, but we cannot directly control it. Trying harder to sleep often increases the alertness and frustration that keep sleep away.
Sleep Hygiene Isn't One-Size-Fits-All
Some popular sleep-hygiene rules can also be oversimplified. For example, screens are not equally disruptive in every situation. The effect may depend on brightness, duration, timing, viewing distance, content and individual sensitivity. A calming television program watched at low brightness may be less activating for one person than lying in darkness worrying about whether they will sleep. Interestingly, how badly one might be impacted by light at night, actually has a lot to do with how much they were exposed to during the day, especially mornings. To learn more, read "Ever Wonder Why Evening Screentime Affects Some People's Sleep and Not Others?" and "Blue Light Blocking Glasses: When to Wear Them - and When Not To."
Effective insomnia treatment looks at what is happening for the individual rather than demanding perfect compliance with a universal checklist.
When Sleep Tips Aren't Enough
If you have good sleep habits but continue to struggle with insomnia, the answer is probably not to work even harder at perfecting your bedtime routine. Chronic insomnia usually requires an approach that addresses the patterns keeping it going—not simply another list of sleep tips.
In my next post, I’ll explain how Cognitive Behavioural Therapy for Insomnia, or CBT-I, differs from sleep hygiene and why it is considered the gold-standard treatment for chronic insomnia.
References
Edinger, J. D., Arnedt, J. T., Bertisch, S. M., Carney, C. E., Harrington, J. J., Lichstein, K. L., Sateia, M. J., & Troxel, W. M. (2021). Behavioral and psychological treatments for chronic insomnia disorder in adults: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 17(2). https://doi.org/10.5664/jcsm.8986
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