1. Maintain a regular sleep schedule. It is helpful to maintain a regular bedtime and arise time on weekdays and weekends. Failure to do so, for example, by frequently staying up late, can reset the internal biologic clock to a later bedtime, leading to a biologic clock disorder called DSPS. Also, it is especially important to avoid sleeping in the morning after a night of poor sleep. Instead, arise at the same time every morning on weekdays and weekends, regardless of how poor the prior nights sleep has been. Although this can be difficult to initiate at first, it can, after a few weeks, help normalize the sleep-wake rhythm and increase sleep efficiency.

2. Get enough daylight. Lack of sufficient daily exposure to sunlight often is partially responsible for difficulty sleeping at night (daylight is a powerful regulator of the circadian cycle). It is beneficial to spend at least 30 minutes per day outside, in natural sunlight, preferably during the first hour or two in the morning. If unable to do so, try for a minimum of 30 minutes per day in strong artificial light.

3. Avoid post-lunch caffeine. Most people know that the intake of caffeine and similar stimulants in the evening can interfere with falling asleep and remaining asleep at night. Most doctors, therefore, advise avoiding caffeinated coffee, tea, and carbonated beverages beginning right after lunch and caffeine-like substances found in chocolate, cocoa, and some weight-control aids, pain relievers, diuretics, and cold and allergy remedies. Some individuals are highly sensitive to caffeine and should stop its use entirely.

4. Avoid daytime napping. With some exceptions (for example, in some cases of insomnia in the elderly), daytime napping solves only a short-term problem of fatigue, and it can contribute to the long-term development of insomnia at night by disrupting normal sleep-wake rhythms (discussed previously). In most cases, napping should be eliminated.

5. Make the bedroom quiet and comfortable. Insomniacs often overlook the fact that their bed and bedroom may not be as quiet or comfortable as they could be to promote restful sleep. It is wise to assess for any disruptive lights, sounds, temperatures, or tough sensations and adopt whatever measures are necessary to reduce or eliminate these discomforts (for example, use eyeshades, earplugs, a low-volume background sound, or a new mattress or pillow). A bedroom temperature of 65 to 68 F is recommended for good sleep.

6. Avoid alcohol within 3 hours of bedtime. Aside from the risk of developing alcoholism, it is not productive to use alcohol as a sleeping aid, despite the popular notion that an evening nightcap promotes sleep. Research shows that although one to two drinks within 2 to 3 hours of bedtime may assist with falling asleep, they tend to disrupt subsequent sleep by increasing later wakefulness. Also, alcohol intake prior to bedtime tends to relax the muscles of the throat and to suppress awakening mechanisms, making snoring and sleep apnea episodes more likely.

7. Avoid smoking nicotine products within 2 hours of bedtime. Aside from the health risk associated with smoking, it is not productive to smoke up until bedtime. Like caffeine, nicotine is a central nervous system stimulant, and evening smoking tends to increase heart rate and blood pressure and stimulate brain activity in ways that are incompatible with sleep. Also, nicotine withdrawal symptoms during the night can contribute to wakefulness. People who stop smoking are likely to sleep better after 10 days of abstinence.

8. Avoid large meals within 2 hours of bedtime. Although a light snack before bed can be beneficial, consuming large meals in the late evening is not recommended. It can be sleep incompatible to assign the gastrointestinal tract the task of digesting a large meal at night, and it can increase the risk of heartburn during the night.

9. Avoid exercise within 2 hours of bedtime. As part of the circadian cycle, core body temperature begins to decrease in the late evening, and this assists with falling asleep and remaining asleep later. Engaging in vigorous exercise within 2 hours of bedtime can be counterproductive because it tends to raise core body temperature and activate the nervous system. In the interest of improving sleep, the best time to exercise is in the late afternoon.

10. Wind down before bedtime. Insomniacs commonly complain of physical tension and mental alertness when they should be sleeping. In the interest of physical relaxation and mental calm, it is wise to wind down for 1 to 2 hours before bed by engaging in an enjoyable, relaxing activity. During this wind-down period, avoid working, studying, talking on the telephone, arguing, watching exciting television shows, reading exciting books, and so forth.

Three Mental Strategies

1. Avoid worrying, clockwatching, trying. Clinicians routinely prescribe only 2 activities for the bedroom: sleep and romance. Virtually all other activities belong outside the bedroom, by night and by day. It is not useful to associate sleep-incompatible activities with the bedroom. This holds true particularly for insomniacs, who are prone to associate the bedroom with sleep-preventing activities, such as worrying, watching the clock, and trying to force the onset of sleep–all of which generally serve only to increase body tension and mental alertness. It is better to conceal clocks from view and simply wake up when they ring.

2. Leave the bedroom when unable to sleep. One method to stop associating the bedroom with non-sleep-inducing activities is to
Leave the bedroom, after approximately 10 minutes (20 minutes for people ages 60 and over) of sleeplessness, in order to worry or, for example, watch television or read in another room for as long as it takes to feel sleepy, and then
Return to the bedroom with positive expectations of sleeping.
This sequence should be repeated in a given night as many times as necessary to achieve sleep. Although this so-called "stimulus control" technique can be difficult to initiate, to can be helpful after at least 4 weeks of practice.

3. Associate the bedroom with relaxing. Good sleepers cultivate strong mental associations of physical relaxation, mental calm, and good sleep with their bedtime, bed, bedroom, and bedtime rituals (such as tooth brushing and setting the alarm clock). Insomniacs can learn to become better sleepers by establishing and strengthening these associations. Practicing muscle relaxation and deep breathing and focusing on relaxing mental imagery while in bed can help–particularly in conjunction with listening to relaxing, recorded guided imagery programs.