Sleep Training

by Shelby Wise, BSPS, PharmD Candidate

“Like training for a marathon, it takes time to form good sleep habits”

Have you ever had a night of wakefulness… or maybe two nights… or maybe many nights of unrest? This is the story for many people. A third of us are getting less sleep than we biologically need.(1) The lack of sleep is not just frustrating but can lead to a host of downstream negative effects — everything from contributing to illnesses, like heart disease and depression, and mistakes on the job or on the road.(1) Sleep is a vitally necessary process that helps our bodies heal and grow, mentally and physically.(2) Since sleep contributes so much to our wellbeing, every health professional should ask questions about sleep and be knowledgeable about how to get high-quality sleep. Pharmacists are among the most trusted and accessible health professionals in society.(3)(4) We have the responsibility to care about a person’s entire wellbeing, so it is important that we not neglect this essential biological process during our encounters with patients.

Training for anything is no easy task and forming good sleep habits takes time! Living in a society enamored with instant gratification, it is hard to communicate that continual, daily training is often required to reach goals. Instead, there is a desire for a quick fix or a magic pill. Yes, there are medications that can help with sleeplessness, but sleep aids are not risk-free and often costly. And don’t induce high-quality sleep. While pharmacists play a role by making pharmacologic recommendations that can provide a quick fix, we should be helping our patients train for a good night of sleep.

1. Create an Environment for Success

The presence of lights can be harmful when establishing a sleep routine, especially blue lights commonly admitted from electronic devices and white lights that boost alertness.(5) A good practice is to avoid the use digital devices in bed. To avoid the temptation, don’t bring them into the bedroom when it is time for sleep. There are other things you can do to make your environment conducive to sleep including the level of comfort of your bed, limiting outside noise, cool (but not cold) temperatures, and finding a comfortable sleep position.(6) Additionally, your mind should be trained to associate your bed with sleep, not reading, watching TV, or hanging out.

2. Set the Right Time Aside

Falling asleep takes time and you should make sure your patients know to plan for enough time to get the rest they need. They should start with taking little steps at a time to reach their sleep goals. For example, if they normally sleep from 11:30 pm to 6:30 am, but wish to start going to bed at 10:00 pm to get a full 8 hours, they will need to gradually change their bedtime. One way to facilitate this process is by using a bedtime timer; these smartphone apps can send an alert that it’s time to start winding down and going to bed soon. While everybody may differ, setting aside at least 30 minutes of undistracted time to fall asleep might be helpful. This can reduce the stress some people feel because they believe they should be falling asleep quickly.

3. Set Sleep Goals

It is important to have specific sleep goals. Pharmacists can help patients develop realistic expectations and form new habits by using motivational interviewing. For each age group, there are different biological needs for sleep.

Recommended Sleep Requirements by Age (7)

Newborn (0–3 months) 14–17 hours

Infant (4–12 months) 12–16 hours

Toddler (1–2 years) 11–14 hours

Preschool (3–5 years) 10–13 hours

School Age (6–12 years) 9–12 hours

Teen (13–17 years) 8–10 hours

Adult (18+ years) 7 – 8 hours

4. Put Good Sleep into Perspective

Providing accurate information to our patients is key to helping them understand the importance of why they should train their bodies and minds to get good sleep every night. There are both short-term and long-term benefits of sleep. In one study, two populations of people were taught a task — a keyboard sequence — to test motor skills. One group repeated the exercise 12 hours later, after a night of sleep, and the other group repeated the exercise 12 hours after remaining awake; the latter did significantly worse. This was after just 1 night of sleep deprivation! Imagine what chronic sleep deprivation does. This provides evidence that our bodies need appropriate sleep for optimal daily functioning.(8) Additionally, not receiving the appropriate amount of sleep is a risk factor for several chronic health conditions, such as heart disease which is the leading cause of mortality in the United States and worldwide.(9)(10)

5. Try Something New

While good habits and setting goals are important, we all have different needs. It’s Ok to experiment with different techniques and strategies. For some people, their thoughts prevent them from getting to sleep. In these cases, techniques for calming oneself when preparing for sleep might help. Engaging in a meditative practice, like guided imagery or a body scan, can be helpful and reduce the stressors that can keep people awake at night. Aromatherapy has been shown to subjectively improve the sleep experience by preparing the mind for sleep. In one study in patients recovering in cardiac care unit after coronary artery bypass graft surgery, patients reported getting better sleep when using aromatherapy.(11)

Using these five tips, you can help patients improve their sleep health without resorting to medications that provide only a temporary fix and do not induce high-quality sleep. The most important lesson: sleep training is not an easy task to undertake, but one well-worth the effort.

1. CDC – Sleep Home Page – Sleep and Sleep Disorders [Internet]. 2020 [cited 2022 Feb 27]

2. Sleep Deprivation and Deficiency | NHLBI, NIH [Internet]. [cited 2022 Feb 27]. Available from: https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency

3. Pharmacists Remain Among Most Trusted and Ethical Professionals [Internet]. Pharmacy Times. [cited 2022 Feb 27].

4. Tsuyuki RT, Beahm NP, Okada H, Al Hamarneh YN. Pharmacists as accessible primary health care providers: Review of the evidence. Can Pharm J CPJ. 2018;151(1):4–5.

5. The Color of the Light Affects the Circadian Rhythms | NIOSH | CDC [Internet]. 2021 [cited 2022 Feb 28].

6. Bjorvatn B, Waage S, Pallesen S. The association between insomnia and bedroom habits and bedroom characteristics: an exploratory cross-sectional study of a representative sample of adults. Sleep Health. 2018;4(2):188–93.

7. CDC – How Much Sleep Do I Need? – Sleep and Sleep Disorders [Internet]. 2019 [cited 2022 Feb 28].

8. Walker MP, Brakefield T, Morgan A, Hobson JA, Stickgold R. Practice with sleep makes perfect: sleep-dependent motor skill learning. Neuron. 2002;35(1):205–11.

9. How Sleep Works | NHLBI, NIH [Internet]. [cited 2022 Feb 28].

10. CDC FastStats- Leading Causes of Death [Internet]. National Center for Health Statistics 2022 [cited 2022 Feb 28].

11. Emami-Sigaroudi A, Salari A, Nourisaeed A, Ahmadnia Z, Ashouri A, Modallalkar SS, et al. Comparison between the effect of aromatherapy with lavender and damask rose on sleep quality in patients undergoing coronary artery bypass graft surgery: A randomized clinical trial. ARYA Atheroscler. 2021;17(1):1–9.