Sleep Hygiene: What the NHS Advises, and What It Does Not

The honest framing

Habits are where the NHS starts and not where it stops. Its insomnia advice is a short list of things to do and not do, followed by a plain instruction: see a GP if changing your sleeping habits has not helped, or if you have had trouble sleeping for months.

So read this page as the list rather than as the treatment. The NHS says a GP will sometimes offer cognitive behavioural therapy, and that GPs now rarely prescribe sleeping pills.

That matters because sleep hygiene is what people are usually given first, and when it does not work they conclude nothing will. What follows separates the items the NHS actually publishes from the ones the sleep market has added to them, which is a more honest split than ranking them by evidence I cannot show you.

What the NHS actually advises

Five dos and six do nots, in the NHS wording. The dos: only go to bed when you are sleepy, wake up and get out of bed at the same time every day, relax at least 1 hour before bed, make sure your bedroom is dark and quiet, and exercise regularly during the day.

The gaps are the ones the NHS publishes in its insomnia advice, counted back from the moment you go to bed: no smoking, alcohol, tea or coffee for at least 6 hours, no exercise within 4 hours, relax for at least 1 hour, and go to bed only when you are sleepy. The morning is marked because the NHS pairs getting out of bed at the same time every day with that last item, which makes the wake time the anchor and the bedtime the thing that moves. Two items on the same list, the late meal and the daytime nap, carry no published timing, so they are named without one rather than given a position here.

The do nots: do not smoke or drink alcohol, tea or coffee at least 6 hours before going to bed, do not eat a big meal late at night, do not exercise at least 4 hours before bed, do not watch television or use devices right before going to bed, do not nap during the day, and do not sleep in after a bad night's sleep.

Two of those are worth drawing out, because people get them the wrong way round. The fixed point is getting out of bed at the same time every day, not the bedtime, since the NHS pairs it with only going to bed when you are sleepy. And the bedroom instruction is dark and quiet, which in practice means blackout lining, or an eye mask, which the NHS also suggests where light is still a problem.

NHS Every Mind Matters adds that a room which is quiet, dark and cool is easier to sleep in, that clocks are best kept out of view with the phone face down, and that phones, tablets and computers are best left alone for an hour before bed.

The four people argue about

Caffeine. The NHS line is no tea or coffee for at least 6 hours before bed, which for an eleven o clock bedtime means nothing after five. People routinely read it as no coffee after dinner and then wonder why it made no difference.

Alcohol. Covered by the same 6 hour rule, and Every Mind Matters adds that alcohol and nicotine have disruptive effects on sleep. It is a sedative, not a sleep aid, and nothing on this site treats it as one.

Evening exercise. Exercising regularly during the day is on the NHS do list, and not exercising within 4 hours of bed is on the NHS do not list. An earlier version of this page said that evening restriction had softened. That was my reading of the research rather than published UK guidance, so it has gone and the NHS wording stands.

Naps. Same story. The NHS says do not nap during the day. This page used to call a short early afternoon nap harmless, which is not what the guidance says, so that has gone too.

The things the sleep market added

Blue light filters. The NHS advice is about the device rather than the tint: do not watch television or use devices right before going to bed, and leave phones, tablets and computers for an hour beforehand. A filter on a screen you are still scrolling at midnight is not following that advice, and I have no UK guidance to offer you on whether the filters themselves do anything.

Lavender and pillow sprays. Not in the NHS advice at all. They can work as a wind-down cue, which is the relax for an hour item wearing a nicer label, and that is the most I would claim for them.

Elaborate bedtime routines. The NHS instruction is simply to relax at least 1 hour before bed, and Every Mind Matters suggests gentle yoga, a book or quiet music. Doing the same undemanding thing each night is the whole of it. The candle is optional.

Sleep tracking. Reasonable for spotting trends over weeks, and weaker on sleep stages, which consumer devices infer rather than measure. If you find yourself checking a score before deciding how you feel, the tracker has stopped helping.

The part that is not on the list

This one is not on the insomnia self-help list, but it is still NHS advice, and for anyone who lies awake it is the most useful thing on the page.

Get up if you cannot sleep. Every Mind Matters puts it like this: try not to force it, and if you are still awake after around 20 minutes, get up and sit somewhere comfortable, do something relaxing such as gentle yoga, reading a book or listening to quiet music, and go back to bed when you feel sleepy.

The logic: your brain learns associations. If bed reliably means sleep, lying down triggers the wind-down. If bed also means scrolling, working and lying awake worrying, lying down triggers alertness instead.

The related rule, from the same page: keep clocks out of view and the phone face down. Knowing the time turns a brief waking into arithmetic about how much sleep is left, and the arithmetic is the problem.

The physical bedroom, briefly

Worth getting right because it is cheap and permanent, and worth putting last because it is not where most sleep problems live.

Temperature is the most misdiagnosed cause of waking. Check the duvet tog before suspecting the mattress: 7 to 10.5 suits most modern UK bedrooms. Then check the mattress protector, because a cheap plastic-backed one blocks air as well as liquid.

Pillow height is free to check and is the most commonly wrong thing in a bedroom. Lie in your sleeping position for ten minutes and have someone look from behind: your neck should be a straight continuation of your spine.

The mattress matters if you wake uncomfortable rather than simply waking. Waking with pain that eases within half an hour of getting up is a bedding pattern; struggling to fall asleep usually is not.

When to stop optimising and ask for help

If you have been doing the NHS items consistently and sleep is still poor, more sleep hygiene is not the answer. The NHS says to see a GP when changing your sleeping habits has not helped, when you have had trouble sleeping for months, or when insomnia is affecting your daily life in a way that makes it hard for you to cope.

At that appointment, the NHS says, you will sometimes be offered cognitive behavioural therapy, and GPs now rarely prescribe sleeping pills. Pharmacy sleep aids, it says, cannot cure insomnia and should not be taken for longer than 1 to 2 weeks.

And some symptoms point away from insomnia entirely. The NHS lists breathing that stops and starts, gasping, snorting or choking noises, and always feeling very tired during the day as reasons to see a GP about sleep apnoea rather than to adjust a bedtime.

One thing to be straight about, since this is a mattress site writing about a medical condition: every clinical line above is quoted from the NHS pages linked on this page, and my own ten years is in beds. The bedroom section is mine. The rest is theirs, and neither of them is a diagnosis.

How sleep works

When it goes wrong

The bedroom

How this site works

Nothing here is paid for by a brand. No manufacturer has copy approval, a preview, or the ability to change a score, and where a link earns a commission that never changes a ranking.

Where a brand does not publish a specification, that is stated rather than estimated, because an absent number is itself information. The corrections log and the products I will not recommend page are both public.

Questions people ask

Does sleep hygiene actually work?

The habits on this page are the NHS self-help list for insomnia, so they are worth doing. The NHS also says to see a GP if changing your sleeping habits has not helped, or if you have had trouble sleeping for months.

What is the most effective sleep hygiene change?

The NHS pairs two instructions: get out of bed at the same time every day, and only go to bed when you are sleepy. That makes the morning the fixed point rather than the bedtime, and it costs nothing.

Do blue light glasses help you sleep?

I have no UK guidance to cite on the glasses themselves. The NHS advice is about the device rather than the tint: no television or devices right before bed, and phones, tablets and computers left alone for an hour beforehand.

What should I do if I cannot get back to sleep?

NHS Every Mind Matters says not to force it: if you are still awake after around 20 minutes, get up and sit somewhere comfortable, do something relaxing, and go back to bed once you feel sleepy.

Should I track my sleep?

It is reasonable for trends over weeks and weaker on sleep stages, which consumer devices infer rather than measure. If you check a score before deciding how you feel, that is a signal to stop.