Sleep and Midlife: Part 2: Sleep Hygiene 101

doctorerika
Sep 29
3 min read

Are you dreading your alarm every morning?

When I talk with patients about sleep, I always start with the basics: sleep hygiene. These are the lifestyle habits and environmental tweaks that set the stage for better rest. Think of them as clearing the path so your body and mind can do what they’re naturally designed to do—sleep deeply and restore.

Sleep Hygiene Do’s

Wake up at the same time every day – yes, even on weekends.
Get morning light exposure – bright light helps regulate your circadian rhythm.
Move your body daily – regular activity supports sleep, but avoid vigorous exercise within 2 hours of bedtime.
Schedule “worry time” earlier in the day – if racing thoughts keep you up, give them space earlier, then close the loop before bed.
Limit caffeine to before 11 a.m. – some people metabolize it slowly, and even an afternoon cup can disrupt sleep.
Create a cool, dark, comfortable bedroom – think breathable bedding, blackout curtains, and a fan if needed.
Avoid heavy duvets or thick blankets – overheating can trigger night sweats. A light cotton blanket is best.
Take a warm bath or shower before bed – it helps lower core body temperature, signaling your body it’s time to sleep.
Limit alcohol close to bedtime – it may make you drowsy, but it fragments sleep and reduces quality.
Cut back on screens before bed – blue light suppresses melatonin. Swap scrolling for reading, journaling, or gentle self‑care.
Go to bed when you’re sleepy – not just because the clock says so.

Sleep Hygiene Don’ts

Avoid naps – they can throw off your sleep drive.
Skip heavy meals before bed – digestion can interfere with rest.
Don’t use your bed for anything but sleep or sex – this strengthens the brain’s association between bed and rest.
Stop clock‑watching – it only fuels anxiety.
Don’t go to bed too early – lying awake trains your brain to link bed with wakefulness.
Limit bright light exposure before bedtime – dim the lights to cue your body for sleep.

Beyond Basics: CBT‑I Strategies

Sometimes, even with perfect sleep hygiene, insomnia persists. That’s where structured approaches from Cognitive Behavioral Therapy for Insomnia (CBT‑I) come in. Two of the most effective are Stimulus Control and Sleep Restriction.

Stimulus Control

Go to bed only when sleepy.
Use the bed only for sleep or sex.
If you’re not asleep within ~30 minutes, get up and do something quiet in dim light. Return only when sleepy.
Repeat as needed.
Wake up at the same time every morning, no matter how much you slept.
Avoid daytime naps.

Sleep Restriction

Track your sleep for 1–2 weeks to see how much you’re actually getting.
Set your “time in bed” equal to your average sleep time (but not less than 5 hours).
Calculate sleep efficiency: total sleep ÷ total time in bed.
- ≥ 90% → increase time in bed by 20 minutes
- < 85% → decrease time in bed by 20 minutes
- 85–90% → no change
Keep a consistent wake time.
No naps.

This method gradually retrains your body to consolidate sleep, improving both quality and efficiency.

The Takeaway

Good sleep hygiene is the foundation, but sometimes you need more structured strategies to break the cycle of insomnia. Combining lifestyle habits with CBT‑I techniques like stimulus control and sleep restriction can be transformative. The key is consistency—small, steady changes add up to big improvements over time.