Sleep Hygiene Assessment

When to Use

Use in the assessment phase of CBT-I to identify modifiable sleep hygiene factors. While sleep hygiene alone is insufficient to treat chronic insomnia, poor sleep hygiene can undermine other CBT-I interventions.

How to Introduce

Present as a check of environmental and behavioural factors that can help or hinder sleep. Emphasise that sleep hygiene is a foundation but not a complete treatment — it works best combined with other CBT-I strategies. Avoid implying that poor sleep hygiene is the client's fault.

Adaptations

For shift workers, focus on the factors that are modifiable within their constraints rather than prescribing an ideal routine. For clients with financial constraints affecting their sleep environment (e.g., noise, temperature), problem-solve within realistic limits.

Do not use as a standalone intervention for chronic insomnia — evidence is clear that sleep hygiene education alone is insufficient. If a client has already optimised sleep hygiene without improvement, validate this and move to active CBT-I components.

Clinical Tips

The most impactful sleep hygiene factors are typically caffeine timing (none after early afternoon), alcohol reduction (disrupts sleep architecture even if it aids sleep onset), and consistent wake time. Screen use before bed is commonly cited but evidence is mixed — focus on what the screen content does to arousal rather than blue light per se.