Sleep problems are extremely common in people experiencing mental health conditions, substance use, medication changes, or chronic pain. Good sleep hygiene — the habits and practices that support healthy sleep — can make a meaningful difference, often without the need for medication. This sheet outlines the key evidence-based strategies.
Why does sleep matter?
Sleep is not a passive state — it is an active biological process essential for memory consolidation, emotional regulation, immune function, and the brain's overnight "clean-up" of waste products. Consistently poor sleep worsens depression, anxiety, pain sensitivity, and impulse control, and significantly increases the risk of relapse in people recovering from substance use disorders.
The 10 key sleep hygiene strategies
Keep consistent sleep & wake times
Go to bed and wake up at the same time every day — including weekends. This anchors your body clock (circadian rhythm) and is the single most effective sleep hygiene strategy.
Make your bedroom sleep-friendly
Keep the room cool (around 18°C is ideal), dark, and quiet. Use block-out curtains or an eye mask. Use earplugs or white noise if sound is an issue. Reserve the bedroom for sleep and intimacy only.
Avoid screens before bed
Blue light from phones, tablets, and televisions suppresses melatonin production. Switch off screens at least 60 minutes before bed. Use night-mode settings during evening hours if you must use a device.
Limit caffeine & alcohol
Avoid caffeine (coffee, tea, cola, energy drinks) after 2pm. While alcohol may feel sedating initially, it fragments sleep and reduces restorative deep sleep — often causing early waking and vivid dreams.
Exercise regularly — but not too late
Regular daytime exercise improves sleep quality and reduces time to fall asleep. However, vigorous exercise within 2–3 hours of bedtime can be stimulating — aim for morning or early afternoon where possible.
Keep naps short & early
If you nap, limit it to 20–30 minutes and take it before 3pm. Longer or later naps reduce sleep pressure (adenosine build-up) and make it harder to fall asleep at night.
Watch food & fluid timing
Avoid heavy meals within 2–3 hours of bed. A light snack is fine. Limit fluids in the evening to reduce overnight trips to the bathroom. Avoid spicy or acidic foods that may cause reflux lying down.
Wind down before bed
Build a relaxing pre-sleep routine — a warm bath or shower, light reading, gentle stretching, or mindfulness. This signals to your brain that sleep is approaching. Avoid emotionally stimulating content (news, arguments, social media).
Stimulus control — teaching your brain to associate bed with sleep
Stimulus control therapy is one of the most effective behavioural interventions for insomnia. The idea is simple: if you spend a lot of time in bed awake, your brain starts to associate the bed with wakefulness rather than sleep. These rules help reverse that:
Go to bed only when you feel sleepy — not just tired.
Use your bed only for sleep and intimacy. No reading, watching TV, scrolling, or working in bed.
If you cannot sleep within 20 minutes, get up and go to another room. Do something calm in dim light, then return when you feel sleepy.
Repeat as often as needed through the night.
Get up at the same time every morning regardless of how little you slept.
Avoid daytime napping (or keep them very short and early).
Your evening wind-down routine
A consistent routine in the 1–2 hours before bed is a powerful signal to your nervous system. Here is a suggested framework — adapt it to suit your life:
2 hours before bed
Dim the lights, finish eating
Lower light levels help trigger melatonin. Avoid heavy food. Finish any important conversations or tasks — leave work for tomorrow.
90 minutes before bed
Warm shower or bath
A warm bath or shower raises then lowers your core temperature, promoting drowsiness. One of the most evidence-backed sleep-onset aids.
60 minutes before bed
Screens off
Put the phone down — notifications, social media, and news are stimulating. Switch to reading a physical book, journalling, or gentle stretching.
30 minutes before bed
Relaxation practice
Slow breathing, progressive muscle relaxation, a body scan, or mindfulness. Even 10 minutes reduces cortisol and prepares the nervous system for sleep.
Bedtime — same time each night
To bed only when sleepy
Do not go to bed "just to rest." Go when you feel genuinely sleepy. If you are still awake after ~20 minutes, get up and return to a quiet activity until you are.
What about sleeping tablets?
Sleeping tablets (benzodiazepines and "Z-drugs" such as zolpidem, zopiclone, temazepam) are sometimes prescribed for short-term sleep difficulties. However, they have significant limitations for longer-term use:
They suppress deep (slow-wave) and REM sleep, reducing sleep quality even while increasing total sleep time
They carry risks of dependence, tolerance, and withdrawal
They are associated with falls and cognitive impairment, particularly in older adults
Stopping them after prolonged use can itself cause rebound insomnia — which can be mistaken for the original sleep problem returning
Cognitive Behavioural Therapy for Insomnia (CBT-I) is now recommended as the first-line treatment for chronic insomnia by major sleep organisations worldwide — and it produces more durable results than sleeping tablets. It combines stimulus control, sleep restriction, and cognitive techniques. Ask Dr Kenchaiah whether a referral to a CBT-I practitioner would be appropriate for you.
When is poor sleep a symptom of something else?
Sleep hygiene alone will not resolve sleep problems caused by an underlying condition. If any of the following apply, please discuss with your doctor:
Depression or anxiety — frequently disrupts sleep architecture
PTSD — nightmares and hyperarousal are core features
Sleep apnoea — characterised by snoring, witnessed apnoeas, and unrefreshing sleep; requires overnight sleep study
Restless legs syndrome — uncomfortable urge to move legs, worse at night
Medication side effects — many psychiatric and other medications affect sleep
Alcohol and substance use — major disruptors of sleep architecture, often underrecognised
If you are reducing or stopping a benzodiazepine or sleeping tablet, do not attempt this abruptly. Rebound insomnia is expected and temporary. A gradual, medically supervised taper — discussed at your appointment — will make the process far more manageable.
Content informed by sleep hygiene resources from SA Health (Government of South Australia) and the Sleep Health Foundation (Australia). Adapted and expanded with the permission framework of acknowledged sources for use in Dr Kenchaiah's practice. Original SA Health materials are available at sahealth.sa.gov.au.