Sleep Hygiene and Insomnia: A Practical Guide to Better Sleep
To recognise World Sleep Day on the 13th of March, I’ve written a how to guide for all things sleep.
Insomnia looks different for different people. Some people find it really difficult to get to sleep, while others have difficulty staying asleep, waking too early or being unable to get back to sleep when they wake during the night. This impacts the quality and quantity of sleep as well as sleep cycles.
Sleep difficulties are extremely common. Short-term insomnia affects a large proportion of adults at some point, and chronic sleep disruption can significantly impact mood, cognition, physical health, and emotional regulation.
The good news: most insomnia is highly responsive to behavioural changes. Sleep hygiene and structured cognitive-behavioural strategies are often more effective long-term than medication.
This guide outlines:
The science of good sleep
Why sleep breaks down
What maintains insomnia
Practical, evidence-based strategies to improve sleep
The Science of Good Sleep
It’s hard to talk about getting better sleep if you don’t know what good sleep looks like. Here’s a brief explainer of sleep.
Why do we need sleep?
Sleep science is still catching up to understanding other areas of body functions so there is still a lot that we don’t know. Scientists are unsure of exactly how sleep helps, but they are aware that it serves many important biological and psychological purposes such as:
Removing toxins that build up in your brain
Improving your ability to cope with changes (such as stressful situations)
Improving brain plasticity (ability to adapt to your environment)
Processing and storing memories
Consolidating learning
Regulating emotions
Improving judgment and decision making
Improving problem solving
Conserving energy
Growth and healing
Supporting immune function
That’s a lot of different body functions! It makes sense then that when we don’t get enough sleep, we can feel it in a number of different ways.
What happens when we don’t get enough sleep?
Lack of sleep is associated with a long list of cognitive, emotional, physical and behavioural consequences such as:
Slower reaction time
Reduced concentration and attention
Memory issues
Poor decision making
Irritability
Emotional reactivity
Anxiety and depression
Fatigue
Headaches
Tinnitus
Increased pain sensitivity
Hormonal disruption (e.g. appetite reduction)
Weaken immune system
Reduced productivity
Increased health issues
Drug, alcohol or other addictions as coping mechanisms
The longest anyone has ever gone without sleep is documented at 11 days by Randy Gardner in 1965. Here’s what happens when we don’t get enough sleep:
24 hours without sleep: cognitive decline similar to a .10% blood alcohol level
36 hours without sleep: fatigue, memory lapses, hormonal fluctuations
48hrs without sleep: microsleeps, severe mood swings, immune system shutdown
72hrs without sleep: paranoia, hallucinations, inability to concentrate or take in information
It’s a commonly held belief that people can die from lack of sleep, however, there are no documented cases of this happening. BUT… sleep loss can contribute in major ways to conditions that make death more likely such as poor decision making, lack of attention and concentration and visual hallucinations. So whilst this is at the extreme end, the impacts of sleep loss are profound.
What does good sleep look like?
There are four different stages of sleep*:
Onset sleep (N1) - the lightest part of sleep involves transitioning from wakefulness to sleep. Your brain waves, heart rate and breathing begin to slow and muscles begin to relax. If you wake during this stage, you may not even be aware that you were asleep. Light sleep should only be about 5% of total sleep as it’s mostly a transitional state.
Light sleep (N2) - this is when you relax more fully with further drops in heart rate and a lowering of body temperature. Brain waves show as rapid, rhythmic waves. Light sleep typically makes up about 50% of total sleep.
Deep / restorative sleep (N3) - this sleep type is most important and when the body repairs tissues, builds muscle and boosts immune function. You get most of your deep sleep during the first half of your sleep period. Ideally deep sleep should be about 10-25% of total sleep.
REM sleep - referred to as Rapid Eye Movement sleep, your brain is highly active, causing vivid dreams. Heart rate and breathing increase, while hormones are release that prevent muscle movement (to prevent sleep-walking and other movements that could occur whilst dreaming. REM sleep is important for maintenance of cognitive functions, emotional regulation and transitioning memories from short to long term. REM sleep is typically 20-25% of total sleep.
Sleep cycles
The average sleep cycle takes between 90 to 120 minutes with sleep cycles becoming progressively shorter throughout the total sleep period. You will generally have between 4-6 cycles across your sleep period. Your sleep cycles from onset > light > deep > light > REM.
How much sleep is optimal?
Your sleep needs are quite individual and they change across the lifespan. Children and teens need on average about 9.5 hours of sleep per night, whereas most adults need between 7-9hrs. Older adults tend to sleep less overnight (averaging about 5-6hrs), but they generally require extra naps or down times during the day to make up for this sleep deficit. Some people can function quite well on less than 5hrs sleep a night. To work out how much sleep you need, it’s best to track your sleep over a period of 2 weeks:
When do you go to bed
When do you fall asleep
When do you wake up
How often are you waking up during the night
Are you restless? Do you toss and turn a lot?
Do you grind your teeth?
Anything else you notice
How do you feel when you wake up: are you groggy, tired, energised or happy? (most important part)
At the end of those 2 weeks, try to find patterns - on the days when you felt like you had a good nights sleep what did that look like? How much sleep did you get? Did you wake up often? Did you go to sleep quickly? You should be able to get a good baseline for how much sleep you need by doing this.
Why Sleep Breaks Down
Insomnia usually develops through a combination of predisposing, precipitating, and perpetuating factors.
Predisposing factors:
Predisposing factors are things that make you more susceptible to sleep difficulties such as:
Personality traits - if you’re prone to anxiety, perfectionism or tendency to worry
Genetics / biology: if you have family history of sleep disturbances, neurodiversity or a hyperactive nervous system
Demographics: if you’re female (due to hyperactive nervous system and hormones) or older (due to age related sleep changes)
Mental health: if you have a history of anxiety, depression, trauma or PTSD
You cannot change your predisposing factors but you can be aware of them.
Precipitating factors:
Precipitating factors are events or situations that make sleep issues more likely such as:
Stressful life events such as job loss, relationship breakdown, grief or loss, significant life event or any other stressors
Medical issues or life stage changes such as acute pain, illness or hormonal changes (such as puberty, menopause or pregnancy)
Environment changes such as shift work, jet lag, noise, temperature or other things associated with where you sleep
Substance use - stimulants such as caffeine, medication or alcohol significantly affect sleep cycles
Perpetuating factors:
Perpetuating factors are things that maintain sleep difficulties in a cyclical fashion. These are the factors that we have the most direct control over such as:
Sleep hygiene - spending extended time in bed awake, scrolling, worrying, or watching TV teaches the brain that bed = wakefulness.
Conditioned arousal - associating the bedroom with anything except sleep such as frustration, activity, exercise, work or screen time. Blue light from phones and laptops also suppresses melatonin (the sleep hormone). More importantly, stimulating content increases cognitive arousal.
Stress and hyperarousal - stress is the most common sleep difficulties trigger. When the nervous system is activated, the brain prioritises vigilance over rest. Even once the stressor resolves, the body may remain conditioned to stay alert at night. Common contributors include work pressure, relationship stress, parenting demands, health concerns and rumination and worry at bedtime
Anxiety and thought cycling - Many people talk about overthinking. From a psychological perspective, thinking isn’t a bad thing, but it can create difficulties if your thoughts are running in a constant cycle that makes it difficult for you to break out of. These cycles can interfere with relationships, work performance, decision making and sleep. I encourage all my clients to think of it not as overthinking (which has a negative connotation that thinking = bad), but rather as thought cycles or fixations.
Irregular sleep patterns - shifted bed times, sleeping in and weekend catch-up sleep disrupt circadian rhythm. Sleep thrives on predictability. And our bodies thrive on routine. Having a consistent sleep and wake time makes a huge difference.
Lifestyle factors - excessive caffeine (especially after midday), alcohol (helps sleep onset but fragments sleep later), late heavy meals, and sedentary lifestyle all impact sleep
Many people also report:
“I’m tired all day but wide awake at night.”
Racing thoughts once the lights go out.
Anxiety about not sleeping.
The bed becomes associated with performance pressure and monitoring.
What Maintains Insomnia
Insomnia often persists because of well-intended coping strategies:
Going to bed earlier to “catch up”
Sleeping in after a bad night
Napping during the day
Lying in bed trying to force sleep
Clock watching
Increasing anxiety about consequences of poor sleep
These behaviours weaken sleep drive and strengthen bed–wakefulness association.
Practical Sleep Hygiene Strategies
1. Keep a Consistent Wake-Up Time
This is the most powerful intervention.
Wake at the same time every day (including weekends), regardless of how you slept. This strengthens circadian rhythm and builds sleep pressure.
2. Strengthen Sleep Drive
Sleep works on a pressure system: the longer you are awake, the stronger the drive to sleep.
Avoid daytime naps (or keep under 20 minutes before 2pm).
Do not go to bed unless genuinely sleepy.
If awake more than ~20 minutes, get up and do something calm in dim light until sleepy.
3. Reserve Bed for Sleep
No scrolling, watching shows, or worrying in bed.
The brain learns through association.
4. Manage Light Exposure
Morning sunlight within 30–60 minutes of waking.
Dim lights 1–2 hours before bed.
Reduce screen use at night (or use night-shift mode).
Leave the curtains or blinds open (this helps align your circadian rhythm with the natural day/night cycles based on light exposure)
5. Create a Wind-Down Routine
The nervous system cannot switch instantly from alert to asleep.
30–60 minutes before bed:
Gentle stretching
Reading (paper book)
Warm shower
Journaling to “download” worries
Play white noise (e.g. static, consistent rain)
Play brown noise (e.g. deep rumbling noises such as waterfalls or running streams) - better for those with ADHD
Play ASMR noise - Autonomous Sensory Meridian Response (e.g. specific, soft and repetitive sounds such as whispering, tapping or crinkling) - these sounds can trigger a pleasant tingling sensations that acts as a ‘brain massage’. Research shows that people who seek out new and novel experiences and have higher emotional sensitivity tend to prefer these sounds. Neurodiverse individuals may also benefit (particularly those with ADHD), although for some these types of noises may result in sensory overload and actually prevent rather than elicit sleep.
I often talk to my clients about ‘book ending’. That is, every night just before sleep do some breathing exercises, mindfulness practices or guided meditations. These prepare your body/brain for sleep and down-shift your nervous system.
6. Manage Racing Thoughts
Worry Scheduling
Set aside 15–20 minutes earlier in the evening to write:
What is worrying me?
What can I control?
What is the next small step?
This reduces bedtime rumination.
Cognitive Shift
If awake in bed:
Instead of “Why am I not asleep?”
Try: “Rest is still restorative. Sleep will come when my body is ready.”
Reducing performance anxiety improves sleep onset.
7. Caffeine and Alcohol
Avoid caffeine after midday (earlier if sensitive).
Limit alcohol; it fragments REM sleep and worsens early waking.
8. Optimise the Environment
Cool, dark room
Comfortable bedding
Minimal noise (white noise if helpful)
9. Reduce external factors
Can you reduce sources of stress (work, relationship or family)?
10. Remove negative associations
Are there other factors contributing to sleep issues?
Do you have any associations with your sleep environment that need to be addressed, removed or changed? (e.g. sleeping with your ex partner’s pillow is not advisable, regardless of how much kleenex might appreciate it)
Hormones and Midlife Sleep
In midlife, fluctuating estrogen and progesterone can:
Increase night waking
Reduce sleep depth
Increase anxiety
In these cases, behavioural strategies remain essential, but medical review may also be appropriate.
When to Seek Further Help
Consider referral or further assessment if:
Insomnia persists >3 months
Loud snoring, gasping, or apnoea suspected
Significant restless legs
Severe mood disturbance
Trauma-related night symptoms
Cognitive Behavioural Therapy for Insomnia (CBT-I) remains first-line treatment for chronic insomnia and shows strong long-term outcomes.
A Realistic Perspective on Sleep
It is normal to:
Wake briefly during the night
Have occasional poor nights
Sleep slightly less with age
The goal is not perfect sleep. The goal is predictable, restorative sleep most nights without fear or struggle.
Improving sleep is rarely about doing more — it is usually about removing the habits that interfere with the body’s natural rhythm.
