Lifestyle and Behavioral Enhancements of Sleep: A Review

Background: Sleep is a foundational pillar of health, influenced by numerous genetic, behavioral, lifestyle, and environmental factors. As non-pharmacologic strategies gain prominence, evidence-based approaches are needed to guide clinical practice. Methods: This expert narrative review synthesizes findings from observational studies, randomized trials, meta-analyses, and clinical guidelines, emphasizing the importance of lifestyle and behavioral interventions for sleep enhancement. Topics include sleep hygiene, circadian rhythm regulation, cognitive behavioral therapy for insomnia (CBT-I), exercise, nutrition, substance use, menopause, and consumer sleep technology. Results: Key findings support the importance of circadian alignment through light exposure, sufficient sleep quantity and timing, and behavior modification in sleep health. Exercise and weight management benefit general sleep quality and specific conditions like obstructive sleep apnea. While nutrition shows mixed direct effects on sleep, Mediterranean and low-glycemic diets are associated with fewer insomnia symptoms. CBT-I is a first-line treatment for chronic insomnia. Substances such as alcohol, cannabis, and caffeine exert varied and potentially deleterious effects on sleep regulation. Conclusion: Sleep is critical in health. Multidimensional behavioral interventions offer significant potential for improving both sleep quality and quantity. Clinicians should integrate these low-risk strategies into patient care to address the growing burden of sleep disorders and to promote overall well-being.