Summary
Sleep hygiene is a behavioral and environmental practice developed in the late 1970s as a method to help people with mild to moderate insomnia. Clinicians assess the sleep hygiene of people with insomnia and other conditions, such as depression, and offer recommendations based on the assessment. Sleep hygiene recommendations include: establishing a regular sleep schedule; using naps with care; not exercising physically or mentally too close to bedtime; limiting worry; limiting exposure to light in the hours before sleep; getting out of bed if sleep does not come; not using bed for anything but sleep and sex; avoiding alcohol as well as nicotine, caffeine, and other stimulants in the hours before bedtime; and having a peaceful, comfortable and dark sleep environment. However, , the empirical evidence for the effectiveness of sleep hygiene is "limited and inconclusive" for the general population and for the treatment of insomnia, despite being the oldest treatment for insomnia. A systematic review by the AASM concluded that clinicians should not prescribe sleep hygiene for insomnia due to the evidence of absence of its efficacy and potential delaying of adequate treatment, recommending instead that effective therapies such as CBT-i should be preferred. Assessing sleep hygiene is important to determine whether an individual has inadequate sleep hygiene disorder. The diagnostic assessment is usually conducted using clinical interview and supplemented by self-report questionnaires and sleep diaries, which are typically kept from one to two weeks, to record a representative sample data. There are also computerized assessments such as the Sleep-EVAL system, which can be employed in the diagnostic process. It features 1,543 possible questions automatically selected according to the individual's previous answers. Practice of sleep hygiene and knowledge of sleep hygiene practices can be assessed with measures such as the Sleep Hygiene Index, Sleep Hygiene Awareness and Practice Scale, or the Sleep Hygiene Self-Test.
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