Why Sleep Hygiene Isn’t Enough to Treat Insomnia
By Dr Amanda Gamble, Clinical Psychologist & Sleep Specialist
Sleep hygiene has become the most well-known advice for insomnia.
Go to bed at the same time… reduce caffeine… avoid screens… keep the bedroom cool…
These recommendations are everywhere — from social media to GP clinics to well-meaning friends.
And they do matter.
But here’s the truth:
Sleep hygiene is necessary… but not sufficient.
It forms the foundation of good sleep — but it is not the treatment for insomnia.
I often explain it like building a house:
Sleep hygiene = the concrete slab
CBT-I = the walls, structure, and roof
A house needs a solid foundation. But a foundation alone doesn’t keep the wind out, the rain off, or make a home you can live in.
Sleep hygiene is the same: it sets the base, but it cannot treat chronic insomnia on its own.
“I’ve tried sleep hygiene — it didn’t work.”
I hear this from clients all the time.
They come into treatment and say:
“I’ve already tried all the sleep hygiene tips — and nothing changed.”
And they’re right.
Because sleep hygiene:
improves sleep readiness
removes barriers to good sleep
supports your natural sleep drive
…but it doesn’t retrain the brain, the body, or the patterns that keep insomnia going.
For people with chronic insomnia, sleep hygiene alone is like:
owning gym clothes but not exercising
buying healthy food but not changing eating habits
laying a concrete slab and expecting a fully built house to appear
Even perfect sleep hygiene won’t fix insomnia that has become:
conditioned (bed = alertness)
anxiety-driven
habit-driven
biologically disrupted
cognitively reinforced
or chronically delayed
This is where CBT-I comes in.
Why CBT-I Works (And Why It’s the Gold Standard Treatment for Insomnia)
CBT-I (Cognitive Behavioural Therapy for Insomnia) is the most effective, evidence-based treatment for insomnia worldwide.
It’s recommended by:
sleep physicians
psychologists
neurologists
the American Academy of Sleep Medicine
and every major clinical guideline
Why?
Because CBT-I addresses the actual drivers of chronic insomnia — the things sleep hygiene can’t touch.
Here’s what comprehensive CBT-I includes:
✔ 1. Sleep Efficiency Training
Also known as “sleep restriction,” this temporarily narrows the sleep window to rebuild strong sleep pressure and deepen sleep.
This alone creates measurable change within weeks.
✔ 2. Stimulus Control
This retrains your brain so that the bed = sleep, not stress. It eliminates patterns like:
lying awake for hours
clock watching
associating the bedroom with frustration or worry
This is one of the most powerful parts of CBT-I.
✔ 3. Cognitive Strategies
CBT-I helps reduce:
nighttime worry
sleep anxiety
fear of not sleeping
catastrophic thinking (“I won’t cope tomorrow”)
Changing how the mind responds to wakefulness is crucial.
✔ 4. Wind-Down and Down-Regulation Skills
Clients learn evidence-based strategies to calm the nervous system at night, including:
diaphragmatic breathing
PMR
grounding skills
structured wind-down routines
This addresses the over-arousal that keeps many people awake.
✔ 5. Circadian Rhythm Resetting
For clients whose internal clock is misaligned, CBT-I uses:
timing of light exposure
consistent wake times
behavioural anchors
gradual phase shifts
This realigns the body clock in a predictable, systematic way.
✔ 6. Relapse Prevention
CBT-I teaches people to stabilise their gains so that:
future stress
travel
illness
or life changes
…don’t lead back into sleeplessness.
This is how CB-I creates lasting change.
So where does sleep hygiene fit in?
Sleep hygiene is the supporting act, not the main event.
It matters — but only in context:
Sleep hygiene prepares the soil.
CBT-I plants the seeds, grows the roots, and builds the structure.
Together, they create real, sustainable change.
When we combine both, clients see:
faster sleep onset
fewer night-time awakenings
more restorative sleep
less anxiety at night
more confidence in their sleep
better daytime functioning
This is why comprehensive CBT-I is the treatment of choice — not sleep hygiene alone.
If sleep hygiene hasn’t helped — that doesn’t mean you can’t sleep better
It simply means you need tools that work on a deeper, more powerful level.
If you're struggling with:
long-term insomnia
trouble falling or staying asleep
circadian rhythm issues
overthinking at night
anxiety-driven wakefulness
or sleep that hasn’t improved despite trying “all the tips”
…you’re the perfect candidate for CBT-I.
The good news?
Insomnia is highly treatable — even when it’s been there for years.
If you’re ready to go beyond sleep hygiene, help is available
Skilled Sleep provides comprehensive CBT-I for adults, teens, and children via secure telehealth across Australia.
Real sleep change is possible — and it starts with the right treatment.
