Sleep Hygiene

This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (17/03/2024)
Original Editor - User Name
Top Contributors - Romy Hageman and Carina Therese Magtibay

Introduction[edit | edit source]

Sleep disturbances, including insomnia, sleep apnea, circadian rhythm disorders, or disruptions caused by lifestyle factors, environmental influences, or underlying medical conditions, can have a considerable impact on health and may worsen both medical and psychiatric conditions[1]. The most effective approach for sustained improvement in sleep quality involves adopting proper sleep hygiene practices, which entail modifying behaviors and habits related to sleep[1]. Sleep hygiene is a range of behaviors and environmental factors designed to promote restful and high-quality sleep[2]. During sleep hygiene education, patients are instructed on how to develop healthy sleep habits and are motivated to adhere to a set of guidelines aimed at enhancing their sleep quality. Sleep hygience strategies offer a simple, and inexpensive way for individuals to improve their sleep.

While current guidelines do not recommend sleep hygiene as a standalone therapy for insomnia, it is frequently used as a control condition in randomized trials of cognitive behavioral treatments[3]. However, sleep hygiene practices might be particularly beneficial for certain people, such as adolescents, young adults, and workers, as they can enhance daily performance[4][5][6][7]. Individuals under the age of 65, who are good sleepers may also derive more benefits from sleep hygiene compared to those with insomnia[8]. However, the effectiveness of sleep hygiene in individuals over 65, regardless of their sleep quality, remains uncertain[9]. Nevertheless, when combined with behavioral sleep interventions, sleep hygiene can help alleviate symptoms of insomnia[2].Sleep hygiene awareness alone does not guarantee improved sleep quality.

Importance of Sleep Hygiene[edit | edit source]

Sleep problems are becoming increasingly concerning for global public health, as inadequate sleep is linked to deficiencies in motivation, emotion, and cognitive function, along with a heightened risk for severe conditions such as diabetes, cardiovascular disease, and cancer, as well as all-cause mortality, even when symptoms fall below the threshold for clinical sleep disorders[10][11][12].

Sleep-related factors, including going to bed later on weekdays, experiencing difficulties maintaining sleep, arousal disorders, negative emotions at bedtime, and inconsistent sleep schedules, are found to be independently linked to heightened mental health issues[13]. Daytime sleepiness increases the risk of harm at work or at home, contributes to car accidents, and reduces overall productivity[14].

Common Sleep Hygiene Practices[edit | edit source]

Recommendations to improve sleep include:

  • Achieving 7 to 9 hours of sleep[1]
  • Maintaining a consistent sleep/wake schedule[1][15]
  • A regular bedtime routine[1]
  • Engaging in regular exercise[1][16][17]
  • Avoiding many substances late in the day: Caffeine, alcohol, and heavy meals are associated with fragmented poor-quality sleep[1][15][16].
  • Avoiding nicotine: smoking disrupts the sleep[15][16].
  • Managing stress: stress is associated with impaired sleep[16].
  • Reducing bedroom noise: noise increases arousal[16].

Sleep Hygiene for different age groups[edit | edit source]

Infants, toddlers, and preschool-age children[edit | edit source]

Establishing healthy sleep patterns and effectively managing sleep issues can be achieved through sleep-promoting parenting practices, commonly known as ''good sleep hygiene''[18]. Quality sleep, especially during the night, promotes full daytime alertness[19][20].

Consistent routines play a crucial role in maintaining good sleep hygiene, particularly through regular sleep schedules and pre-sleep routines. For young children, routines offer a sense of predictability and security, aiding in smoother transitions between activities while also helping to moderate impulsivity and enhance self-regulation[18]. Additionally, routines are thought to contribute to overall family well-being by reducing conflicts between caregivers and children[18]. The presence of a regular bedtime routine has been linked to improve sleep, influencing factors such as sleep latency (time taken to fall asleep) and the frequency of night waking in infants and toddlers[21]. Bedtime routines serve as external cues signaling the approach of sleep and help children mentally prepare for bedtime by offering predictability and a calming environment. It is recommended to initiate a regular bedtime routine by around the age of 6 months[18]. These routines should be relatively brief, lasting no more than 30-45 minutes, and consist of a set of relaxing activities performed before bedtime each day[18]. Examples include a warm bath, reading stories, and singing lullabies[22].

After engaging in calming pre-bedtime activities, children should be provided with a comfortable sleep environment characterized by a calm, quiet, dark, and warm atmosphere, without the presence of a TV[23].

Regular bedtimes, naptimes, and wake times helpt to synchronize sleep and wake cycles with the circadian rhythm. Naptimes should be timed correctly, making sure naps are not too late in the afternoon. This could make children less sleepy when it is bedtime[24].

During the waking times of a child, they should be exposed to bright ligts in the morning and encouraged to have regular exercise during the day.

They should avoid stimulating activities and foods near sleep times. Parents should make sure to avoid sugar and caffeine prior to bedtime[25]. Children should avoid screentime before bed, particularly with violent content[26].

School-age children[edit | edit source]

A lot of school-age children experience parent-reported sleep problems[27][28]. This can affect their academic performances, as well as their behavior and health[27][28][29]. Consistent bedtimes, bedtime routines and use of electronic devices are associated with sleep problems[30].

  • Consistent bedtimes on school and non-school nights[27][31]
  • Limiting media use before bedtime[27][30][31][32]
  • No TV in the bedroom[30][33]
  • Enough after-school leisure-time physical activity[31][32]
  • Healthy nutrition[31]and not eating meals just before bedtime
  • Eliminate exciting activities just before bedtime[34]

Adolescents[edit | edit source]

Many adolescents frequently sleep less than they need over an extended period, leading to chronic sleep deprivation. They prefer to go to bed later and to wake up much later than adults or children[35]. Adolescents with good sleep hygiene tend to go to bed earlier, have a shorter sleep latency, and a longer sleep duration[36]. Studies have shown that the sleep of adolescents can be positively changed by sleep hygiene training[37][38]. Adolescents may choose to keep their phones nearby at night to maintain their perceived connection with social media and to avoid distrss induced by FOMO (Fear Of Missing Out)[39]. This may impact their sleep.

  • Caffeine: caffeine peaks approximately 30 minutes after drinking, and the half-life of a single dose is 3 - 7 hours. The half-life of caffeine increases with age, so that the substance remains active for a longer time in older adults[40]. Adolescent boys drink soda and energy drinks more frequently than girls[41].
  • Reducing evening technology / computer use before bedtime[35][36].
  • No artificial light before bed[36][42].
  • A parent-set bedtime[36].
  • Reducing hot beverage intake (tea and chocolate)[35].

Students[edit | edit source]

Students are often recognized for not getting enough sleep during the week and compensating with longer hours of sleep on the weekends[43][15]. In fact, the sleep schedules of students are so inconsistent that twice as many students as individuals in the general population exhibit symptoms consistent with delayed sleep phase syndrome. This is characterized by increasingly later wake-up times on non-work or non-school days, resulting in suboptimal job and academic performance and excessive sleepines during the week[43]. Students often choose to maintain contact with friends and family on social media, rather than choosing to get enough sleep[44]. 50% percent of college students experience daytime sleepiness, and 70% experience insufficient sleep[45].

Important sleep hygiene for students:

  • Maintaining a consistent sleep-wake schedule[43]
  • Going to bed without being thirsty or hungry[43][46]
  • Reducing worry before falling asleep[43]
  • Reducing environmental noise (can be challenging, especially in university dormitories)[43], by using earplugs.
  • Paying attention to the campus environment: using strategies to enhance relaxation, using the dorms only for sleeping (not for eating or socializing)[47].
  • Avoiding strenuous exercise before bedtime[46].
  • Avoiding caffeinated drinks, nicotine, and alcohol within four hours of bedtime[46].
  • Setting time to relax before sleeping[46].

Adults[edit | edit source]

Poor sleep quality is common in adults. Sleep quality has a positive association with awareness of sleep hygiene practices about sleep medication use, consistent wake-up times, and exercising in the afternoon or early evening[48].

  • Eating regular meals[49]
  • Avoiding nightcaps, nicotine, and caffeine[49][50][51]
  • Maintaining a healthy body weight[49]
  • Getting light exposure in the morning[49]
  • Avoiding blue light in the evening[49], put away all electronics 1-2 hours before bedtime[50], not using media/ social media in the bedroom[52][53][54].
  • Eating enough vegetables[49]
  • Maintaining a regular sleep schedule[50][54]
  • Reduce light and noise in the bedroom[50][54]
  • Go to bed when sleepy, try not to force sleep[50]
  • Establish a bedtime routine[50]
  • Try to reduce stress[50][51][54][55][56]
  • Make sure to exercise each day[50][51]
  • Avoiding daytime naps[51]
  • Maintaining strict work-home life boundaries[57]

Elderly[edit | edit source]

Athletes[edit | edit source]

Elite athletes consistently obtain less total sleep compared to non-athletes[58]. This trend persists across various sport disciplines, including individual versus team sports and strenght versus endurance sports[58]. Olympic athletes often fall short of the traditional 8-hour sleep recommendation and typically sleep for 6.5-6.8 hours[58][59]. There are several reasons for this. Athletes typically adhere to rigorous and strict training schedules, have travel obligations, and may experience time zone changes due to competitions and events. Some athletes are exposed to bright lights during a match, which may impact their sleep[60]. Additionally, athletes may underestimate the significance of sleep, prioritizing other aspects of their mandatory training over rest and recovery[59]. Athletes could benefit from enhancing their sleep hygiene practices[61][62][63]. By implementing regular routines and creating an optimal sleep environment, athletes can train and improve their sleep quality. While it may nog be feasible for atheletes to adopt all sleep hygiene recommendations, they should strive to incorporate as many as possible to optimize this crucial aspect of physical recovery and performance[59]. Sleep hygiene strategies could be used during off days to promote restorative sleep[60].

  • Avoiding blue light from screens before bed[59][64]
  • Following a regular bedtime and wake time routine on off days[60][63]
  • On off days, athletes should get some light exercise (walking, cycling) to promote sleep without inducing extra fatique and/or muscle soreness[60]
  • Get bright, natural light in the morning[59][64]
  • Not using the snooze button[59][64]
  • If a computer must be used in the evenig, install a color-adjusting and blue light reducing software or use blue-light blocking glasses[59][64]
  • Use meditation[59][60][64]
  • Higher carbohydrate intake at night can improve sleep, as well as high protein meals[59][64][60][65]
  • Consuming high-electrolyte fluids[60]
  • Magnesium supplements[59][64]
  • Don't fall asleep to the TV[59][64]
  • Don't drink too much before bedtime[59][64]
  • Cooling your body temperature may improve sleep[59][64]
  • Checking the mattress. It could be old and contain allergens[59][64]
  • Reduce external stressors[59][64].
  • Using recovery strategies aimed at reducing muscle soreness (cold water, compression, massage)[60][66]
  • Create a low-light, cool sleep environment[60]
  • Use brief naps (5-30 min)[60]

Gender differences[edit | edit source]

Poor sleep is significantly more common in girls than in boys[35][32]. Sleep latency is more prevalent in girls. Poor sleep quality among university students is found to have a significant association with being female[67].

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Baranwal N, Yu PK, Siegel NS. Sleep physiology, pathophysiology, and sleep hygiene. Progress in Cardiovascular Diseases. 2023; 77: 59-69
  2. 2.0 2.1 Voinescu BI, Szentagotai-Tatar A. Sleep hygiene awareness: its relation to sleep quality and diurnal preference. Journal of Molecular Psychiatry. 2015; 3: 1
  3. Perlis M, Aloia M, Kuhn B. Behavioral Treatments for Sleep Disorders. A Comprehensive Primer of Behavioral Sleep Medicine Interventions. Londen, UK: Academic Press. 2011
  4. Digdon NL. Circadian Preference and College Students' Beliefs About Sleep Education. Chronobiology International. 2010; 27(2): 297-317
  5. Billows M, Gradisar M, Dohnt H, Johnston A, McCappin S, Hudson J. Family disorganization, sleep hygiene, and adolescent sleep disturbance. Journal of clinical child and adolescent psychology: the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53. 2009;38(5):745–52
  6. Barber L, Grawitch MJ, Munz DC. Are Better Sleepers More Engaged Workers? A Self-regulatory Approach to Sleep Hygiene and Work Engagement. Stress and Health: Journal of the International Society for the Investigation of Stress. 2013; 29(4): 307-16
  7. Chen PH, Kuo HY, Chueh KH. Sleep hygiene education: efficacy on sleep quality in working women. Journal of Nursing Research. 2010; 18(4): 283–9
  8. Yang CM, Lin SC, Hsu SC, Cheng CP. Maladaptive sleep hygiene practices in good sleepers and patients with insomnia. Journal of Health Psycholy. 2010;15(1):147–55.
  9. McCrae CS, Rowe MA, Dautovich ND, Lichstein KL, Durrence HH, Riedel BW, Taylor DJ, Bush A. Sleep hygiene practices in two community dwelling samples of older adults. Sleep. 2007; 29(12): 1551–60.
  10. Banks S, Dinges DF. Behavioral and physiological consequences of sleep restriction. Journal of Clinical Sleep Medicine. 2007; 3: 519-28
  11. Walker MP. The role of sleep in cognition and emotion. Annals of the New York Academy of Sciences. 2009; 1156: 168-97
  12. Zaharna M, Guilleminault C. Sleep, noise and health: review. Noise & Health. 2010; 12(47): 64-9
  13. Zhang J, Xu Z, Zhao K, Chen T, Ye X, Shen Z, Li S. Sleep Habits, Sleep Problems, Sleep Hygiene, and Their Associations With Mental Health Problems Among Adolescents. Journal of the American Psychiatric Nurses Association. 2017; 24(3): 223-234
  14. Mohit B, Chang R, Wickwire EM. Health economics of sleep disorders . Sleep and Neuropsychiatric Disorders. Gupta R, Neubauer DN, Pandi-Perumal SR (ed): Springer, Heidelberg, Germany; 2022. 141-64.
  15. 15.0 15.1 15.2 15.3 Dietrich SK, Francis-Jimenez CM, Knibbs MD, Umali IL, Truglio-Londrigan M. Effectiveness of sleep education programs to improve sleep hygiene and/or sleep quality among college students. JBI Database of Systematic Reviews and Implementation Reports. 2016; 14(9): 108-134
  16. 16.0 16.1 16.2 16.3 16.4 Irish LA, Kline CE, Gunn HE, Buysse DJ, Hall MH. The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Medicine Reviews. 2015; 22: 23-36
  17. Kredlow Ma, Capozzoli MC, Hearon BA, Calkins AW, Otto MW. The effects of physical activity on sleep: a meta-analytic review. Journal of Behavioral Medicine. 2015; 38(3): 427-49
  18. 18.0 18.1 18.2 18.3 18.4 Bathory E, Tomopoulos S. Sleep Regulation, Physiology and Development, Sleep Duration and Patterns, and Sleep Hygiene in Infants, Toddlers, and Preschool-Age Children. Current Problems in Pediatric and Adolescent Health Care. 2017; 47(2): 29–42.
  19. Thompson DA, Christakis DA. The Association Between Television Viewing and Irregular Sleep Schedules among Children Less Than 3 Years of Age. Pediatrics. 2005; 116(4): 851-856
  20. Hale L, Berger LM, LeBourgeois MK, Brooks-Gunn J. Social and demographic predictors of preschoolers' bedtime routines. Journal of Developmental & Behavioral Pediatrics. 2009; 30(5): 394-402
  21. Mindell JA, Telofski LS, Wiegand B, Kurtz ES. A nightly bedtime routine: impact on sleep in young children and maternal mood. Sleep. 2009; 32(5): 599-606
  22. Galland BC, Mitchell EA. Helping children sleep. Archives of Disease in childhood. 2010; 95(10): 850-3
  23. Dworak M, Schierl T, Bruns T, Strüder HK. Impact of singular excessive computer game and television exposure on sleep patterns and memory performance of school-aged children. Pediatrics. 2007; 120(5): 978-85
  24. Galland BC, Taylor BJ, Elder DE, Herbison P. Normal sleep patterns in infants and children: a systematic review of observational studies. Sleep Medicine Reviews. 2012; 16(3): 213-22
  25. Roehrs T, Roth T. Caffeine: sleep and daytime sleepiness. Sleep Medicine Reviews. 2008; 12(2): 153-62
  26. Garrison MM, Liekweg K, Christakis DA. Media use and child sleep: the impact of content, timing, and environment. Pediatrics. 2011; 128(1): 29-35
  27. 27.0 27.1 27.2 27.3 Uebergang LK, Arnup SJ, Hiscock H, Care E, Quach J. Sleep problems in the first year of elementary school: The role of sleep hygiene, gender and socioeconomic status. Sleep Health. 2017; 3(3): 142–147.
  28. 28.0 28.1 Quach J, Hiscock H, Wake M. Sleep problems and mental health in primary school new entrants: Cross-sectional community-based study. Journal of Paediatrics and Child Health. 2012; 48(12): 1076-1081
  29. Fatima Y, Doi SAR, Mamun AA. Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis. Obesity Reviews: an official journal of the International Association for the Study of Obesity. 2015; 16(2): 137-49
  30. 30.0 30.1 30.2 Hall WA, Nethery E. What does Sleep Hygiene have to offer Children's Sleep Problems? Paediatric Respiratory Reviews. 2018; 31: 64-74
  31. 31.0 31.1 31.2 31.3 Busch V, Altenburg TM, Harmsen IA, Chinapaw MJ. Interventions that stimulate healthy sleep in school-aged children: a systematic literature review. European Journal of Public Health. 2017; 27(1): 53-65
  32. 32.0 32.1 32.2 Jiang X, Hardy LL, Baur LA, Ding D, Wang L, Shi H. Sleep duration, schedule and quality among urban Chinese children and adolescents: Associats with routine after-school activities. PloS One. 2015; 10: 1-12
  33. Brambilla P, Giussani M, Pasinato A, Venturelli L, Privitera F, Miraglia Del Giudice E, Sollai S, Picca M, Di Mauro G, Bruni O, Chiappini E. Sleep habits and pattern in 1-14 years old children and relationship with video devices use and evening and night child activities. Italian Journal of Pediatrics. 2017; 43: 1–11.
  34. Michels N, De Henauw S, Eiben G, Hadjigeorgiou C, Hense S, Hunsberger M, Konstabel K, Molnár D, Moreno LA, Siani A, De Bourdeaudhuij I, Pigeot I. Effect of the IDEFICS multilevel obesity prevention on children's sleep duration. Obesity Reviews. 2015; 16(2): 68-77
  35. 35.0 35.1 35.2 35.3 Galland BC, Gray AR, Penno J, Smith C, Lobb C, Taylor RW. Gender differences in sleep hygiene practices and sleep quality in New Zealand adolescents aged 15 to 17 years. Sleep & Health. 2017; 3(2): 77-83
  36. 36.0 36.1 36.2 36.3 Bartel KA, Gradisar M, Williamson P. Protective and risk factors for adolescent sleep: a meta-analytic review. Sleep Medicine Reviews in Press. 2015; 21: 72-85
  37. Tan E, Healy D, Gray AR, Galland BC. Sleep hygiene intervention for youth aged 10 to 18 years with problematic sleep: a before-after pilot study. BMC Pediatrics. 2012; 12: 189
  38. Hendricks MC, Ward CM, Grodin Lk, Slifer KJ. Multicomponent cognitive behavioural intervention to improve sleep in adolescents: a multiple baseline design. Behavioural and Cognitive Psychotherapy. 2014; 42(3): 368-73
  39. Scott H, Woods HC. Fear of missing out and sleep: Cognitive behavioural factors in adolescents' nighttime social media use. Journal of Adolescence. 2018; 68(2): 61-65
  40. Polasek TM, Patel F, Jensen BP, Sorich MJ, Wiese MD, Doogue MP. Predicted metabolic drug clearance with increasing adult age. British Journal of Clinical Pharmacology. 2013; 75: 1019-28
  41. Costa BM, Hayley A, Miller P. Adolescent energy drink consumption: an Australian perspective. Appetite. 2016; 105: 638-642
  42. Cain N, Gradisar M. Electronic media use and sleep in school-aged children and adolescents: a review. Sleep Medicine. 2010; 11(8): 735-742
  43. 43.0 43.1 43.2 43.3 43.4 43.5 Brown FC, Buboltz WC, Soper B. Relationship of Sleep Hygiene Awareness, Sleep Hygiene Practices, and Sleep Quality in University Students. Behavioral Medicine. 2002; 28(1): 33–38.
  44. Adams SK, Williford DN, Vaccaro A, Kisler TS, Francis A, Newman B. The young and the restless: Socializing trumps sleep, fear of missing out, and technological distractions in first-year college students. International Journal of Adolescence and Youth. 2017; 22(3): 337-348
  45. Herschner SD, Chervin RD. Causes and consequences of sleepiness among college students. Nature and Science of Sleep. 2014; 6: 73-84
  46. 46.0 46.1 46.2 46.3 Al-Kandari S, Alsalem A, Al-Mutairi S, Al-Lumai D, Dawoud A, Moussa M. Association between sleep hygiene awareness and practice with sleep quality among Kuwait University students. Sleep Health. 2017; 3(5): 342-347
  47. Clark E. Sleep quality effects of a brief intervention in college students. Yeshiva University. 2010; 1-55
  48. Qi H, Liu R, Zhou J, Feng Y, Feng L, Feng Z, Yan F. Investigating sleep quality and sleep hygiene awareness among Chinese adults: an association and network analysis study. Sleep and Breathing. 2023; 27: 2049-2058
  49. 49.0 49.1 49.2 49.3 49.4 49.5 Shimura A, Sugiura K, Inoue M, Misaki S, Tanimoto Y, Oshima A, Tanaka T, Yokoi K, Inoue T. Which sleep hygiene factors are important? comprehensive assessment of lifestyle habits and job environment on sleep among office workers. Sleep Health. 2020; 6(3): 288-298
  50. 50.0 50.1 50.2 50.3 50.4 50.5 50.6 50.7 Rottapel RE, Zhou ES, Spadola CE, Clark CR, Kontos EZ, Laver K, Chen JT, Redline S, Bertisch SM. Adapting sleep hygiene for community interventions: a qualitative investigation of sleep hygiene behaviors among racially/ethnically diverse, low-income adults. Sleep Health and Behaviors. 2020; 6(2): 205-213
  51. 51.0 51.1 51.2 51.3 Chung K-F, Lee C-T, Yeung W-F, Chan M-S, Wing-Yue Chung E, Lin W-L. Sleep hygiene education as a treatment of insomnia: a systematic review and meta-analysis. Family Practice. 2018; 35(4): 365-375
  52. Clusters K, Van den Bulck J. Television Viewing, Internet Use, and Rise Time in Adults: Implications for Sleep Hygiene Recommendations From an Exploratory Cross-Sectional Study. Behavioral Sleep Medicine. 2012; 10(2): 96-105
  53. Tandon A, Kaur P, Dhir A, Mäntymäki M. Sleepless due to social media? Investigating problematic sleep due to social media and social media sleep hygiene. Computers in Human Behavior. 2020; 113: 106487
  54. 54.0 54.1 54.2 54.3 Lin S-Y, Chung KKH. Chronotype and trait self-control as unique predictors of sleep quality in Chinese adults: The mediating effects of sleep hygiene habits and bedtime media use. PloS One. 2022; 17(4)
  55. Murawski B, Wade L, Plotnikoff RC, Lubans DR, Duncan MJ. A systematic review and meta-analysis of cognitive and behavioral interventions to improve sleep health in adults without sleep disorders. Sleep Medicine Reviews. 2018; 40: 160-169
  56. Williams S. Improved Sleep Quality and Quantity Through Sleep Hygiene Education in Adults. Nursing Student Papers. 2017
  57. Barber L, Jenkins JS. Creating Technological Boundaries to Protect Bedtime: Examining Work-Home Boundary Management, Psychological Detachment and Sleep. Stress & Health: Journal of the International Society for the Investigation of Stress. 2014; 30(3): 259-264
  58. 58.0 58.1 58.2 Lastella M, Roach GC, Halson SL, Sargent C. Slaap/wake behaviours of elite athletes from individual and team sports. European Journal of Sport Science. 2015; 15(2): 94-100
  59. 59.00 59.01 59.02 59.03 59.04 59.05 59.06 59.07 59.08 59.09 59.10 59.11 59.12 59.13 59.14 Vitale KC, Owens R, Hopkins SR, Malhotra A. Sleep Hygiene for Optimizing Recovery in Athletes: Review and Recommendations. International Journal of Sports Medicine. 2019; 40(8): 535-543
  60. 60.0 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 Nédélec M, Halson S, Delecroix B, Abaidia A-E, Ahmaidi S, Dupont G. Sleep Hygiene and Recovery Strategies in Elite Soccer Players. Sports Medicine. 2015; 45(11): 1547-1559
  61. O'Donnell S, Driller MW. Sleep-hygiene education improves sleep indices in elite female athletes. International Journal of Exercise Science. 2017; 10(4): 522-530
  62. Fullagar H, Skorski S, Duffield R, Meyer T. The effect of an acute sleep hygiene strategy following a late-night soccer match on recovery of players. Chronobiology International. 2016; 33(5): 490-505
  63. 63.0 63.1 Caia J, Scott TJ, Halson SL, Kelly VG. The influence of sleep hygiene education on sleep in professional rugby league athletes. Sleep Health. 2018; 4(4): 364-368
  64. 64.00 64.01 64.02 64.03 64.04 64.05 64.06 64.07 64.08 64.09 64.10 64.11 Halson S. Sleep in elite athletes and nutritional interventions to enhance sleep. Sports Medicine. 2014; 44: 13-23
  65. Res PT, Groen B, Pennings B. Protein ingestion before sleep improves postexercise overnight recovery. Medical Science of Sports and Exercise. 2012; 44(8): 1560-9
  66. Duffield R, Murphy A, Kellert A, Reid M. Recovery from repeated on-court tennis sessions: combining cold-water immersion, compression, and sleep recovery interventions. International Journal of Sports Physiology and Performance. 2014; 9(2): 273-82
  67. Cheng SH, Shih CC, Lee IH, Hou Y-W, Chen KC, Chen K-T, Yang YK, Yang YC. A study on the sleep quality of incoming university students. Psychiatry Research. 2012; 197: 270–274.