A Self-Help Book Is Better Than Sleep Hygiene Advice for Insomnia: A Randomized Controlled Comparative Study

Scand J Psychol. 2011 Dec;52(6):580-5. doi: 10.1111/j.1467-9450.2011.00902.x. Epub 2011 Jul 26.


The objective was to compare the effects of two types of written material for insomnia in a randomized trial with follow-up after three months. Insomniacs were recruited through newspaper advertisements to a web-based survey with validated questionnaires about sleep, anxiety, depression, and use of sleep medications. A self-help book focusing on cognitive behavioral therapy for insomnia was compared to standard sleep hygiene advice; 77 and 78 participants were randomized to self-help book or sleep hygiene advice, respectively. The response rate was 81.9%. The self-help book gave significantly better scores on the sleep questionnaires compared to sleep hygiene advice. The proportion using sleep medications was reduced in the self-help book group, whereas it was increased in the sleep hygiene group. Compared to pre-treatment, the self-help book improved scores on the sleep (effect sizes 0.61-0.62) and depression (effect size 0.18) scales, whereas the sleep hygiene advice improved scores on some sleep scales (effect sizes 0.24-0.28), but worsened another (effect size -0.36). In addition, sleep hygiene advice increased the number of days per week where they took sleep medications (effect size -0.50). To conclude, in this randomized controlled trial, the self-help book improved sleep and reduced the proportion using sleep medications compared to sleep hygiene advice. The self-help book is an efficient low-threshold intervention, which is cheap and easily available for patients suffering from insomnia. Sleep hygiene advice also improved sleep at follow-up, but increased sleep medication use. Thus, caution is warranted when sleep hygiene advice are given as a single treatment.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Bibliotherapy*
  • Cognitive Behavioral Therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Education as Topic*
  • Sleep Initiation and Maintenance Disorders / psychology
  • Sleep Initiation and Maintenance Disorders / therapy*
  • Sleep*
  • Surveys and Questionnaires
  • Treatment Outcome