Which is the recommended nonpharmacologic strategy for episodic insomnia disorder?

• A. Benzodiazepines nightly
• B. Naps during the day are encouraged
• C. Sleep hygiene measures
• D. Daily exercise is avoided

Answer: (C)

Managing episodic insomnia primarily with sleep hygiene measures—the habits and environmental factors that support stable sleep. This approach targets the routines and surroundings that influence how quickly you fall asleep and how soundly you sleep, and it’s preferred as a safe, first-line nonpharmacologic strategy. Practical steps include keeping a consistent sleep-wake schedule, using the bed only for sleep (not work or screen time), crafting a dark, quiet, cool sleeping environment, avoiding caffeine and large meals near bedtime, and limiting screen exposure before bed. Limiting daytime naps can also help maintain a strong sleep drive for nighttime sleep. These changes help reduce sleep onset latency and nighttime awakenings and form the foundation of treatment, sometimes augmented by cognitive behavioral therapy for insomnia if symptoms persist. Medications like benzodiazepines carry dependence and side effects and aren’t the recommended nonpharmacologic option, daytime naps can disrupt the sleep-wake cycle, and regular exercise actually improves sleep quality when timed appropriately, not something to avoid.