The relationship between sleep hygiene practices and nocturnal sleep for midlife women with and without insomnia

Abstract

In this study sleep hygiene practices and perceived and somnographic sleep indicators were analyzed for 92 women with insomnia and 29 women with no insomnia ages 40 to 55. Women recorded practices and perceptions in diaries during 6 days of polysomnographic sleep monitoring. Self-reported practices included smoking cigarettes, drinking alcohol, drinking caffeine, and exercising. Optimal sleep hygiene practices include abstaining from tobacco and alcohol or caffeine intake while getting regular exercise and maintaining a regular schedule for sleeping. Perceptions included sleep onset latency, awakenings, restfulness after sleeping, and sleep quality. Somnographic measures included bedtime, latency to Stages 1 and 2, Stage 0, and getting up time. Regular bedtimes and regular getting up times were defined as less than 30 minutes variation day to day. Women in both groups reported similar practices except for differences in alcohol and caffeine intake. More women with insomnia (52%) than without insomnia (31%) abstained from alcohol each day (95% CI =.01,.41). Less than 10% in both groups reported drinking alcohol everyday. More than 80% in both groups reported drinking one or more servings of caffeine per day, but women with insomnia averaged one less serving of caffeine per day than women without insomnia (p $<$.05). Few women in either group reported smoking ($<$10%). Less than 25% reported 30 minutes of exercise each day, although about one-half of each group reported exercising an average of 30 minutes per day. Very few women had regular bedtimes ($<$5%) or regular getting up times ($<$10%) for all five days assessed. Women with insomnia showed less variation in day to day sleep hygiene practices, but greater variation in sleep perceptions as measured by mean standard deviations. Women with insomnia showed significantly smaller variations in alcohol intake (p =.05) and bedtimes (p =.02) and greater variations in reported SOL (p =.005) and sleep quality (p =.002) than women without insomnia. Regression analyses showed that combinations of sleep hygiene practices explained small amounts of the variances in sleep indicators. In summary, sleep hygiene practices were similar between women with and without insomnia except for caffeine and alcohol. Women with insomnia showed less variation in sleep hygiene practices, but greater variation in sleep perceptions compared to women with quality sleep.