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For people with Down syndrome, family members, caregivers and professionals.

Sleep Hygiene

October 2017 | Chris Molitor, MD - Family Medicine Resident, Advocate Lutheran General Hospital

Technology and handheld gadgets have become an everyday part of our lives. Flat-screen TVs, iPads, Netflix, smart phones, and Kindle e-readers are common devices many people use and enjoy in their spare time. However, you may not realize that these devices, especially when used before bed, can make it harder to get a restful night of sleep. In fact, many of our daytime and evening activities can affect our “sleep hygiene” and ability to sleep.

What is sleep hygiene?

The term “sleep hygiene” has been used in recent years to describe pre-bedtime habits and activities that promote good sleep. An individual can improve his/her sleep hygiene by refraining from activities that promote excessive evening alertness or interrupt the natural process of falling asleep. Listed below are things that can negatively impact the quality of sleep.

What activities can contribute to poor sleep hygiene?

  • Consuming products containing caffeine – coffee, tea, energy drinks, soda—especially within a few hours of bedtime
  • Consuming products that have stimulant properties – tobacco / nicotine, chocolate, certain herbal supplements or medications
  • Watching TV or using tablets / phones in bed
  • Vigorous exercise before bedtime
  • Daytime napping, especially too close to bedtime

Why is sleep hygiene important

  • Sleep is when our bodies rest, grow, and repair. Adequate sleep is essential for good health.
  • Consequences of poor sleep hygiene include:
    • Excessive daytime fatigue
    • Difficulty falling asleep or staying asleep
    • Decrease in energy

Sleep hygiene specifically in people with Down syndrome (DS)

Current medical research indicates that individuals with DS may have different sleep patterns than individuals without DS. (This is separate from Obstructive Sleep Apnea which is more common in people with DS). Those with DS may have more difficulty entering “REM Sleep,” the period of deep sleep that is essential for rest, recovery, and optimal daytime functioning. Therefore, it’s important to use the strategies listed below to help your loved one get the restorative sleep that they need.

Strategies to improve sleep

  • Maintain a regular sleep schedule. Our bodies adapt better when go to bed and wake up at approximately the same time each day.

  • A regular routine before going to bed is helpful. Many of our patients benefit from a picture schedule of their pre-bedtime routine. The schedule might include pictures of the person brushing their teeth, in the bathroom, finding their pajamas, etc. (See attached example).

  • Avoid “sleeping pills” or medications that promote drowsiness unless prescribed by your doctor. These medications may cause you to fall asleep but can interfere with how rested you feel when you wake up.

  • Refrain from consuming caffeine, alcohol, or stimulants within several hours of sleep.

  • Don’t eat a large meal before bedtime. Your body needs 1-2 hours to digest first.

  • Use the bed / bedroom only for sleep. This helps our brain to associate these locations with sleep, and can make it easier to fall asleep. Using the bedroom for exercise, watching TV, reading, eating, etc. can confuse our bodies when it’s time for bed.

  • Most people sleep best when the bedroom is cool, quiet, and dark. Avoid loud noises and extremes of temperature.

  • Avoid napping during the day; this can make it harder to sleep at night.

  • Don’t drink large amounts of liquid in the evening – waking up to use the restroom interrupts sleep.

  • If you or your loved one continue to have difficulty with sleep despite trying some of these strategies, it is advisable to discuss with your doctor. Your doctor may recommend that you create a sleep journal to keep track of bedtime / wake time and hours slept to help evaluate your sleeping patterns. Your doctor may also determine that you need to undergo polysomnography, more commonly known as a “sleep study,” to identify factors that are impairing your ability to sleep well.

Sample Bedtime Routine

image of a visual support for a bedtime routine


1. Chicoine B, McGuire D. The Guide to Good Health for Teens & Adults with Down Syndrome. Bethesda, MD: Woodbine House; 2010.

2. Nisbet L, Phillips N, Hoban T et al. Characterization of a sleep architectural phenotype in children with Down syndrome. Sleep Breath 2015, 19: 1065-1071.

3. Schutte-Rodin S, Broch L, Buysse D, et al. Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults. Journal of Clinical Sleep Medicine, 2008, 4: 487-504.

4. Maness D, Khan M. Nonpharmacologic Management of Chronic Insomnia. Am Fam Physician. 2015 Dec 15;92(12):1058-1064.

Find More Resources

We offer a variety of resources for people with Down syndrome, their families and caregivers and the professionals who care for and work with them. Search our collection of articles, webinars, videos, and other educational materials.

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Please note: The information on this site is for educational purposes only and is not intended to serve as a substitute for a medical, psychiatric, mental health, or behavioral evaluation, diagnosis, or treatment plan by a qualified professional. We recommend you review the educational material with your health providers regarding the specifics of your health care needs.