Which bedtime habits can you change?

There are many different things you can do to change your bedtime habits. You can try them out at home or learn about them in a course. Research hasn't clearly shown which approaches are likely to work best.

Sleep hygiene

Good “sleep hygiene” mainly involves making sure you have a pleasant space to sleep in and a regular sleeping pattern, and also adopting habits that help you sleep better. Things you can do include:

• Not drinking alcohol, coffee or tea and avoiding other stimulants four to six hours before going to bed.
• Not smoking before bedtime or during the night.
• Avoiding heavy meals and spicy foods before going to bed.
• Getting physical exercise during the day, but avoiding exercise right before going to bed.
• Making sure your bedroom is quiet, dark and not too hot or cold.
• Going to bed and getting up at around the same time every day.

It is also a good idea not to listen to loud music, or work or play on a computer or smartphone in the time before you go to bed. If background noise is disturbing your sleep, earplugs might be worth a try.

Sleep hygiene: Tips for sleeping better

Can napping during the day help?

There are conflicting theories and research results about whether it's a good or bad idea to nap during the day. Some studies have looked at whether napping during the day can make up for not getting enough sleep at night, helping you to do things like drive more safely. Other researchers have studied whether napping helps you sleep better at night or perhaps even has the opposite effect, making you sleep worse at night instead. There are no clear results yet.

How do relaxation techniques work?

The aim of relaxation techniques is to relax your body and mind. They are meant to reduce physical tension and interrupt the thoughts that are affecting sleep.

There are different types of relaxation techniques, including:

• Progressive muscle relaxation, also called Jacobson's or deep muscle relaxation: This technique involves tensing groups of muscles all over the body one by one, and then consciously relaxing them again.
• Autogenic training: This approach involves focusing awareness on different parts of the body and consciously relaxing them. At an advanced level, even involuntary body functions like your pulse and breathing can be influenced in order to reach a very deep state of physical relaxation.
• Imagery (visualizations): Another common type of relaxation training is imagery, where you visualize peaceful, pleasant scenes or imagine yourself breathing quietly, gently falling asleep and having a good night's sleep.
• Breathing exercises and meditation.
• Gentle physical exercise like going for a walk, doing simple yoga exercises or tai chi.
• Biofeedback: This method helps you to see how your body reacts to tension and relaxation. It involves placing electrodes on your body to measure muscle tension, your pulse and brain activity. You can monitor these different measurements on a screen and see how muscle relaxation or thinking particular thoughts affects them. Biofeedback can be done at the doctor's or by using a portable biofeedback device at home once you've been shown how to use it.

A lot of relaxation techniques can be learned in courses, an audio or online tutorial, or with the help of an app.

Can physical activity improve your sleep?

Exercise can help you relax. Exercise involving regular movements, such as jogging and brisk walking, is particularly good. But the research so far hasn't clearly shown that physical activity leads to a noticeable improvement in people with sleep disorders.

What about acupuncture and similar remedies?

Some people who have trouble sleeping try acupuncture or acupressure. Various studies have been carried out on the effect of these treatments on sleep problems, but no clear conclusions can be drawn yet.

Can home remedies help?

Sometimes, people use home remedies to try to get a better night's sleep. These include:

• Warm drinks: Drink a cup of warm milk, or chamomile or valerian tea
• Heat: Take a warm shower or bath, or soak your feet in warm water
• Essential oils like chamomile or lavender

People often find home remedies comforting. These remedies are unlikely to have any negative effects, but it's not clear whether they do actually help improve sleep. So, as with many issues surrounding sleep, the best thing to do is try things out and see what works best for you.

Sources

• Banno M, Harada Y, Taniguchi M et al. Exercise can improve sleep quality: a systematic review and meta-analysis. PeerJ 2018; 6: e5172.
• Brasure M, MacDonald R, Fuchs E et al. Management of Insomnia Disorder (AHRQ Comparative Effectiveness Reviews; Volume 159). 2015.
• Cao HJ, Yu ML, Wang LQ et al. Acupuncture for Primary Insomnia: An Updated Systematic Review of Randomized Controlled Trials. J Altern Complement Med 2019; 25(5): 451-474.
• Chen MC, Yang LY, Chen KM et al. Systematic Review and Meta-Analysis on Using Acupressure to Promote the Health of Older Adults. J Appl Gerontol 2020; 39(10): 1144-1152.
• Haghayegh S, Khoshnevis S, Smolensky MH et al. Before-bedtime passive body heating by warm shower or bath to improve sleep: A systematic review and meta-analysis. Sleep Med Rev 2019; 46: 124-135.
• He W, Li M, Zuo L et al. Acupuncture for treatment of insomnia: An overview of systematic reviews. Complement Ther Med 2019; 42: 407-416.
• Hieu TH, Dibas M, Surya Dila KA et al. Therapeutic efficacy and safety of chamomile for state anxiety, generalized anxiety disorder, insomnia, and sleep quality: A systematic review and meta-analysis of randomized trials and quasi-randomized trials. Phytother Res 2019; 33(6): 1604-1615.
• Lin PC, Lee PH, Tseng SJ et al. Effects of aromatherapy on sleep quality: A systematic review and meta-analysis. Complement Ther Med 2019; 45: 156-166.
• Lowe H, Haddock G, Mulligan LD et al. Does exercise improve sleep for adults with insomnia? A systematic review with quality appraisal. Clin Psychol Rev 2019; 68: 1-12.
• Rash JA, Kavanagh VA, Garland SN. A Meta-Analysis of Mindfulness-Based Therapies for Insomnia and Sleep Disturbance: Moving Towards Processes of Change. Sleep Med Clin 2019; 14(2): 209-233.
• Ruggiero JS, Redeker NS. Effects of napping on sleepiness and sleep-related performance deficits in night-shift workers: a systematic review. Biol Res Nurs 2014; 16(2): 134-142.

• IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.