the science of switching off – a Doctor’s perspective

Modern life has blurred the line between wakefulness and rest. Notifications, work demands, artificial light and constant stimulation can leave us physically exhausted while our brains and bodies remain alert. We may be in bed for eight hours, but that doesn't necessarily mean we're getting eight hours of restorative sleep.

Sleep is a cornerstone of our health. It is an active biological process essential for physical recovery, cognitive function and emotional regulation. We also know that consistency matters, not just quantity. In a study of more than 60,000 UK Biobank participants, higher sleep regularity was associated with a 20–48% lower risk of all-cause mortality compared with the least regular sleepers. (1) Importantly, this was an observational association and doesn't prove that improving sleep regularity directly reduces mortality. At the same time, sleep problems are remarkably common, with 29% of more than 160,000 UK Biobank participants in England reporting insomnia symptoms. (2)

This is where bedtime rituals become interesting. The brain learns through repetition and association. When the same behaviours happen in the same context night after night, they can become familiar signals that the day is ending. A simple sequence - dimming the lights, taking a shower, doing your skincare, using a familiar fragrance and getting into bed, creates predictability.

This is closely related to stimulus control, a behavioural component of cognitive behavioural therapy for insomnia (CBT-I), which aims to strengthen the association between the bed and sleep while reducing associations between the bedroom and wakeful activities. A 2024 systematic review and network meta-analysis found that stimulus control can improve insomnia symptoms, including reducing the time taken to fall asleep and time spent awake during the night. (4)(5)

The goal isn't to make ourselves sleep on command, but to create a predictable transition from wakefulness towards rest.

No single product can “fix” sleep. Sleep is influenced by biology, environment, behaviour and psychology, so a pillow spray can't compensate for chronic stress, an irregular sleep schedule or an overstimulating bedtime. However, it can become part of a consistent wind-down ritual.

Fragrance is an interesting sensory cue because our brains continually form associations between what we experience and what happens next. When the same scent is repeatedly paired with dim lighting, skincare, getting into bed and sleep, it can become part of a familiar pre-sleep context.

There is also some evidence behind aromatherapy itself. A 2026 systematic review and meta-analysis of 11 randomised controlled trials involving 628 adults found a statistically significant improvement in sleep quality with lavender essential oil. However, this isn't the same as proving that a particular pillow spray treats insomnia. (9) Aromatherapy is best viewed as a complementary part of a wider sleep routine rather than a treatment in itself.

Melatonin is often called the “sleep hormone”, but physiologically it is better understood as a signal of biological night. Produced by the pineal gland in response to signals from the SCN, melatonin naturally rises in the evening and falls again with morning light.

Supplementary melatonin introduces additional melatonin into the body at a chosen dose and time. It acts primarily through MT1 and MT2 receptors, helping regulate sleep and circadian timing. Depending on when it is taken, it can also potentially shift the phase of the circadian clock.

This is why timing matters. A 2024 systematic review and meta-analysis of 26 randomised controlled trials found that both dose and timing influence melatonin's effects, highlighting that it is a chronobiological signal rather than simply a sedative. (7)(8)

Melatonin has a legitimate place in medicine, but it isn't a universal solution for poor sleep. In the UK, NICE takes a targeted approach, with prolonged-release melatonin considered for some adults aged 55 and over with persistent insomnia rather than as a general sleep aid. (6) Prescription sleeping medicines such as zopiclone, zolpidem and certain benzodiazepines can reduce central nervous system activity and make it easier to initiate or maintain sleep. Although clinically useful, they are generally used short term because of risks including tolerance and dependence. For chronic insomnia, CBT-I remains central, while medication may sometimes be appropriate when behavioural approaches aren't possible, haven't been sufficient or as a temporary adjunct under medical supervision.