About this worksheet
Sleep hygiene is the foundation layer of CBT for Insomnia (CBT-I) and the first-line intervention for garden-variety poor sleep across every clinical population. Environment (dark, cool, quiet), timing (consistent wake time first, bedtime second), wind-down (60–90 minutes off-screens, off-work, off-arguments), stimulants (caffeine cutoff, alcohol reality-check), and daytime factors (morning light, exercise timing, nap discipline). This worksheet is the printable checklist version — one page, no filler, the moves that actually have evidence behind them. Give it to any client whose sleep is a factor in their presentation (which is most of them). It's not a treatment for chronic insomnia on its own — for that, the client needs the full CBT-I protocol with sleep restriction and stimulus control — but as a starting point and a reference sheet, it does more clinical work than a conversation about sleep can.
When to use it
- First-line intervention for any client whose sleep is a symptom or exacerbating factor — depression, anxiety, ADHD, trauma, chronic pain.
- As psychoeducation before starting CBT-I, so the foundation is in place before sleep restriction begins.
- For clients who report 'poor sleep' but haven't examined the basics — most of them get meaningful improvement from hygiene alone.
- Not sufficient for chronic insomnia on its own — refer to full CBT-I when symptoms persist despite good hygiene.
How to use it
- 1
Walk the checklist together
Client marks each item as already-doing, sometimes, or not-doing. The 'not-doing' rows are the working list.
- 2
Pick two changes, not ten
Sleep hygiene fails when clients try to change everything at once. Two changes, held for two weeks, then re-evaluate.
- 3
Anchor to wake time first
Consistent wake time — including weekends — is the single most-evidenced move. Bedtime follows from wake time, not the reverse.
- 4
Track for two weeks
Pair with a sleep diary. Subjective 'I slept badly' is often unreliable; the diary shows the actual pattern.
- 5
Escalate if needed
If two rounds of hygiene changes don't move the needle, the client likely needs full CBT-I (stimulus control + sleep restriction) or a medical workup.
Frequently asked questions
What is sleep hygiene?+
The foundation-layer set of behavioral and environmental practices that support good sleep — consistent wake time, wind-down, dark cool room, caffeine cutoff, morning light, exercise timing. First-line behavioral intervention for poor sleep.
Is sleep hygiene enough for insomnia?+
For garden-variety poor sleep, often yes. For chronic insomnia (3+ nights/week for 3+ months), no — the client needs the full CBT-I protocol with stimulus control and sleep restriction. Hygiene is the foundation, not the treatment.
What's the single most important sleep hygiene rule?+
Consistent wake time, seven days a week. It anchors the circadian rhythm more reliably than any other single move. Bedtime should follow from wake time, not lead it.
How long before improvements show up?+
Two to four weeks with consistent changes. Sleep systems are slow — a week isn't enough to draw conclusions from.
Is this worksheet free?+
Yes. Free printable PDF for clinicians. Sign in to TherapistAssist to send it as a secure client link or add your practice name.
Worksheet — Sleep Hygiene Checklist — provided by TherapistAssist for clinical use. Not a substitute for assessment or treatment.
