Sleep hygiene isn’t enough to treat insomnia because insomnia is not a problem of “wrong conditions” — it is a problem of arousal. Good sleep habits create better conditions for sleep, which helps people without a real sleep problem. But for someone with insomnia, strict adherence to sleep hygiene rarely solves it, and can sometimes make it worse. The effective treatment is CBT-I.
If you suffer from insomnia, there is a good chance you have already heard the usual advice: don’t drink coffee in the evening, switch off screens before bed, keep the room dark and quiet, go to bed at a fixed time. All of these belong to what is called sleep hygiene.
There is no doubt that sleep hygiene matters. The problem begins when it is presented as a complete treatment for insomnia.
What is sleep hygiene?
Sleep hygiene is a collection of general recommendations designed to create better conditions for sleep: a pleasant sleep environment, healthy habits, and a relatively fixed routine. The logic is simple: if the conditions are good, sleep should follow. And that is indeed true for people who do not have a significant sleep problem. But for someone with insomnia, the story is far more complex.
Why doesn’t sleep hygiene solve insomnia?
Insomnia is not a problem of “wrong conditions” — it is a problem of arousal. The brain has learned to be alert precisely at night. The bed has become a place of struggle, racing thoughts, frustration and fear of sleep itself. In that state, strict adherence to sleep hygiene almost never suffices. Sometimes it even makes the problem worse.
The bigger problem: when sleep hygiene becomes a test
People with insomnia tend to take the rules of sleep hygiene very seriously — sometimes too seriously. They check themselves every evening:
- Did I have my coffee early enough?
- Did I switch off screens in time?
- Did I go to bed at the “right” hour?
And when it doesn’t work, the hard thought arrives: “I did everything right — and still didn’t fall asleep. Something is wrong with me.” In this way sleep hygiene, instead of calming, can increase pressure, self-monitoring and anxiety about sleep. Sleep becomes a task to “perform correctly”, rather than a natural process that happens on its own.
Sleep hygiene ≠ treatment for insomnia
It is worth saying clearly: sleep hygiene is a good foundation — but it is not a treatment for insomnia. It does not address:
- The fear of the night
- The intrusive thoughts about sleep
- The link that forms between the bed and wakefulness
- The attempts to “force” ourselves to sleep
Without treatment aimed directly at these patterns, sleep usually does not return in a stable way.
So what does help?
In cases of persistent insomnia, what is needed is treatment that addresses the mechanism itself — not just the external conditions. Cognitive behavioural therapy for insomnia (CBT-I) is the treatment recommended by NICE, the NHS and the American Academy of Sleep Medicine as the first-line approach for chronic insomnia. Sleep hygiene can be a small part of the path, but it should not be the main thing, and certainly not the only thing.
If you feel you are “doing everything right” by the rules of sleep hygiene — and still not sleeping — it does not mean you have failed. It is a sign that the problem runs deeper, and that the solution needs to be more precise. Good sleep does not come from the force of effort. Sometimes, to sleep well, you need to stop fighting sleep and start working with it.
Take a short insomnia self-assessment or book a consultation with Dr Jonathan Kushnir, clinical psychologist (HCPC PYL042430).