Sleep problems can be frustrating and inconvenient, but it doesn’t always have to be this way. Proper sleep hygiene is vital to facilitate all daily functions, including physical activities, good memory recollection, balanced emotional health, efficient problem-solving skills, and even immunity [1]. A decline in sleep can result in increased irritability and fatigue.
Sleep hygiene encompasses a variety of practices to ensure one gets better sleep [2]. Patients suffering from autoimmune disorders are vulnerable to poor sleep hygiene due to factors such as chronic pain, discomfort, and stress.
Developing proper sleep hygiene can also be tricky, as addressing this problem is not the same for everyone. Different people react differently to various strategies; however, understanding and applying the key principles of good sleep hygiene can improve both sleep at night and one’s overall well-being the next day.
Sleep and autoimmune disorders
Chronic insomnia simply means having trouble falling asleep and/or staying asleep at least 3 nights a week for a duration of 3 months or longer [3]. A study of over 30,000 persons with chronic insomnia noted that there may be a 70% chance of the risk of an autoimmune disorder, specifically primary Sjogren’s Disease (SjD) [4].
Studies have shown that sleep loss can activate inflammatory cytokines such as TNF-α (Tumor Necrosis Factor-alpha) and IL-6 (Interleukin-6), which can be used as markers of inflammation. These markers were elevated in both men and women who experienced sleep loss [5]. A large-scale cohort study observed the effect of insomnia on specific autoimmune diseases in over 300,000 persons. Impaired sleep resulted in an increased occurrence of rheumatoid arthritis (RA), cutaneous lupus erythematosus (CLE), Sjogren’s Disease (SjD), and autoimmune thyroiditis [6].
However, it would be remiss to ignore the bidirectional relationship between sleep and autoimmune disorders. Whilst evidence suggests a lack of sleep may increase the risk of autoimmune disorders, having autoimmune disorders, mainly due to chronic or acute pain, can cause a lack of sleep.
Signs of poor sleep hygiene
Poor sleep hygiene goes beyond sleep at night and even affects a person’s well-being the next day. Over time, poor sleep hygiene may lead to the onset of negative physical, mental, and emotional symptoms. It is therefore important to recognize the signs of poor sleep hygiene early to proactively develop healthier sleep habits. Some signs of poor sleep hygiene can include:
- Difficulty falling asleep and staying asleep during the night.
- Increased need for junk and sugary food, coffee, and other stimulants throughout the day
- Feeling fatigued, irritable and stressed [7]
- Neurological effects such as brain fog, trouble focusing and headaches
More severe symptoms can include involuntary eye twitching, hand tremors and impulsive behavior [8]
Practising good sleep hygiene
Good sleep hygiene is needed for proper physical and mental functioning. Psychiatric disorders were three times more prevalent in persons with sleeping disorders than in those without sleeping complaints [9]. It is therefore imperative for people to develop good sleep hygiene. However, this requires consistency with evidence-based sleep hygiene techniques such as:
- Setting your circadian rhythm: You can think about your circadian rhythm as your body’s internal clock. It controls various systems and functions, like hormones, and it tells your body when to wake up and when to go to sleep. This system is dynamic, so maintaining a good circadian rhythm is key [10]. You can achieve this by having a set time to go to sleep every night and wake up in the mornings. In doing so, a habit begins to form, and your circadian rhythms will start to adjust and condition over time.
- Integrating healthy daily habits: Other habits which support your circadian rhythm and overall sleep hygiene include: getting daily sunlight exposure, avoiding stimulants like caffeine and nicotine especially before bedtime, regular exercise, avoiding heavy meals before bed and limiting naps throughout the day.
- Optimizing your sleep environment: Whilst internal factors like your circadian rhythm are important, external factors also play a major role in proper sleep hygiene. Some adjustments that can be made to your bedroom include limiting disturbances at night. These disturbances can include light and noise, which can be controlled by blackout curtains and earplugs. Additionally, an optimal temperature of approximately 18°C should be maintained. Some people have reported benefits from using scents such as lavender and eucalyptus before bed. Other aspects that can be refined are your mattress, pillows, and bedding.
- Supplements: While not a magic solution to sleep, some supplements can be used to aid in achieving good sleep hygiene. Research is still limited; however, some studies suggest an improvement in sleep in patients who utilized melatonin, vitamin D, and L-theanine (an amino acid that can be found in foods such as green tea). Various individuals in different groups showed improvement in sleep with these supplements. However, other supplements such as magnesium, zinc, and nitrates did not have consistent, significant findings with sleep improvement [11].
Conclusion
A key takeaway is that sleep hygiene is flexible. Thus, it does not look the same for everyone. Some people may prefer to sleep in silence, whilst others may enjoy white noise. It’s all about finding what works best for you to ensure good sleep quantity and quality. Recognizing the signs and symptoms of poor sleep hygiene is an integral step to the development of good sleep hygiene.
Jadon Soodoo
Incoming Year 1 DDS Student, U.W.I., St. Augustine
References
[1] “Why Do We Need Sleep?,” Sleep Foundation. [Online]. Available: https://www.sleepfoundation.org/how-sleep-works/why-do-we-need-sleep
[2] J. Solodar, “Sleep hygiene: Simple practices for better rest,” Harvard Health. [Online]. Available: https://www.health.harvard.edu/healthy-aging-and-longevity/sleep-hygiene-simple-practices-for-better-rest
[3] S. McNamara, B. C. Spurling, and P. C. Bollu, “Chronic Insomnia,” StatPearls, Mar. 2025. https://www.ncbi.nlm.nih.gov/books/NBK526136/
[4] V. C. Kok et al., “Risk of Autoimmune Disease in Adults with Chronic Insomnia Requiring Sleep-Inducing Pills: A Population-Based Longitudinal Study,” Journal of general internal medicine, vol. 31, no. 9, pp. 1019–26, Sep. 2016, doi: 10.1007/s11606-016-3717-z. https://pubmed.ncbi.nlm.nih.gov/27130621/
[5] “Sleep loss activates cellular markers of inflammation: Sex differences,” Brain, Behavior, and Immunity, vol. 24, no. 1, pp. 54–57, doi: 10.1016/j.bbi.2009.06.001. https://www.sciencedirect.com/science/article/abs/pii/S0889159109002001
[6] S. Stenger, A. Vorobyev, K. Bieber, T. Lange, R. J. Ludwig, and J. E. Hundt, “Insomnia increases the risk for specific autoimmune diseases: a large-scale retrospective cohort study,” Frontiers in network physiology, vol. 5, p. 1499297, Apr. 2025, doi: 10.3389/fnetp.2025.1499297. https://pubmed.ncbi.nlm.nih.gov/40276126/
[7] “Sleep Quality: How to Determine if You’re Getting Poor Sleep,” Sleep Foundation. [Online]. Available: https://www.sleepfoundation.org/sleep-hygiene/how-to-determine-poor-quality-sleep
[8] “Sleep Deprivation,” Cleveland Clinic. [Online]. Available: https://my.clevelandclinic.org/health/diseases/23970-sleep-deprivation#symptoms-and-causes
[9] D. E. Ford and D. B. Kamerow, “Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention?,” JAMA, vol. 262, no. 11, pp. 1479–84, Sept. 1989, doi: 10.1001/jama.262.11.1479.
https://pubmed.ncbi.nlm.nih.gov/2769898
[10] C. C. medical professional, “Circadian Rhythm,” Cleveland Clinic. [Online]. Available: https://my.clevelandclinic.org/health/articles/circadian-rhythm
[11] M. K. Esquivel and B. Ghosn, “Current Evidence on Common Dietary Supplements for Sleep Quality,” American journal of lifestyle medicine, vol. 18, no. 3, pp. 323–327, Jan. 2024, doi: 10.1177/15598276241227915.