Summary
The ineffectiveness of sleep hygiene as a treatment in clinical sleep medicine has raised some interesting questions. If it is known that, individually, each specific component of sleep hygiene is related to sleep, why wouldn't addressing multiple individual components (i.e., sleep hygiene education) result in improved sleep? Is there still a use for sleep hygiene? Global public health concern over poor sleep has increased the demand for effective sleep promotion strategies that are easily accessible to the general population. However, the extent to which sleep hygiene principles and strategies apply outside of clinical settings is not well known. The present review sought to evaluate the empirical evidence for several common sleep hygiene recommendations, including regular exercise, stress management, noise reduction, sleep timing regularity, and avoidance of caffeine, nicotine, alcohol, and daytime napping, with a particular emphasis on their public health utility. Thus, our review is not intended to be exhaustive regarding the clinical application of these techniques, but rather to focus on broader applications. Overall, though epidemiologic and experimental research generally supported an association between individual sleep hygiene recommendations and nocturnal sleep, the direct effects of individual recommendations on sleep remains largely untested in the general population. Suggestions for further clarification of sleep hygiene recommendations and considerations for the use of sleep hygiene in nonclinical populations are discussed.