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Posts Tagged ‘Sleep Hygiene’

Sleep – Good Sleep Hygiene and Common Sleep Disorders. By Our Student Pharmacist, Madeline VanLoon.

Why do we sleep?

If the average person sleeps for approximately eight hours every night, it can be predicted that they will sleep for one-third of their life. This is time well spent, however. Sleep is essential for maintaining good health and prolonging life.

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On an average night, we will cycle through different stages of sleep. Stages consist of Rapid Eye Movement (REM) sleep, and four non-REM stages of sleep. The deeper stages of sleep are restorative and critical for learning.

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What happens when we don’t sleep?

Sleep deprivation can lead to:

  • fatigue
  • depression
  • difficulty learning new things
  • high blood pressure
  • high blood sugar
  • cardiovascular disease
  • obesity
  • infections

Sleep deprivation can even shorten your overall lifespan. Daytime sleepiness can make you less productive, and also can be dangerous while driving or carrying out other daily tasks.

Good Sleep Hygiene

The best way to improve your sleep is to make sure that you are using “good sleep hygiene,” which is basically a set of good habits that prepare your body for a good night’s rest. The Centers for Disease Control and Prevention (CDC) recommends the following best practices:

  • Go to bed at the same time every night, including on the weekends.

  • Make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature.

  • Remove electronic devices such as TVs, computers, and smartphones from the bedroom.

  • Avoid large meals, caffeine, and alcohol before bedtime.

  • Increase your exercise. Being physically active during the day can help you fall asleep more easily at night.

Sleep Disorders – Insomnia

Insomnia is defined as a dissatisfaction with sleep quantity or quality, complaints of poor daytime functioning, and at least one of the following: difficulty falling asleep, difficulty staying asleep, or waking up early in the morning with the inability to return to sleep. These conditions must occur at least three nights per week, for at least three months, despite good sleep hygiene and no known other causes. Certain medications and medical conditions can cause insomnia.

Treating insomnia

  • First, resolve any underlying causes for insomnia.

  • Next, use non-drug treatment options, including good sleep hygiene.

  • Talk to your doctor or pharmacist about over-the-counter sleep aids.

  • NOTE: Data shows that medications to help insomnia are only modestly helpful, and may carry more risks than benefits. Be cautious while taking these medications.


  • Avoid using alcohol to help you sleep – it may fragment your sleep, and chronic use may lead to dependence.

  • Avoid antihistamines such as diphenhydramine (Benadryl) and doxylamine (Unisom) if you are over 65. You may be more susceptible to dry mouth, confusion, constipation, dizziness, and fatigue.

  • Avoid long term use of antihistamines to sleep – tolerance may develop in 4-7 days of daily use, and may not continue working for you after that.

  • Melatonin may help regulate circadian rhythm, but it is not FDA regulated.

Sleep Disorders – Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a condition where breathing while sleeping is stopped periodically throughout the night due to a blockage in the upper airway. This condition results in an extensive list of daytime and nighttime symptoms, including:

Daytime Symptoms of OSA:

  • Sleepiness

  • Fatigue

  • Aches

  • Dry mouth

  • Nasal congestion

  • Depression

  • Erectile dysfunction

  • Cognitive impairment

Nighttime Symptoms of OSA:

  • Disrupted sleep

  • Loud snoring

  • Snorts and gasps

  • Frequent awakenings

  • Increased nighttime urination

While these are all uncomfortable symptoms, the most concerning consequence of OSA is the risk of heart problems like heart failure and irregular heartbeat.

Risk Factors for OSA

If you have three of the following eight risk factors for OSA, you may be at high risk for developing the condition:

  • Snoring

  • Tired

  • Observed while breathing stopped

  • High blood pressure

  • BMI greater than or equal to 35

  • Age over 50

  • Neck circumference (distance around neck) greater than 40 cm

  • Male gender

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Treatment for OSA

The best treatment for OSA is using a Continuous Positive Airway Pressure (CPAP) machine every night. The machine allows the airway to remain open, allowing for consistent breathing throughout the night, and is superior to treatment with medications. If you believe you are experiencing OSA, talk to your doctor about treatment options.


CPAP side effects. Sleep Association. https://www.sleepassociation.org. Accessed June 22, 2020.

Explain that insomnia meds are only modestly effective. Pharmacist’s Letter. 2020. https://pharmacist.therapeuticresearch.com. Accessed June 23, 2020.

Management of obstructive sleep apnea in adults. UpToDate. Wolters Kluwer. Available at https://www.uptodate.com. Accessed June 22, 2020.

Obstructive sleep apnea and cardiovascular disease in adults. UpToDate. Wolters Kluwer. Available at https://www.uptodate.com. Accessed June 22, 2020.

Pathophysiology of obstructive sleep apnea in adults. UpToDate. Wolters Kluwer. Available at https://www.uptodate.com. Accessed June 22, 2020.

Sleep and sleep disorders: tips for better sleep. Centers for Disease Control and Prevention. https://www.cdc.gov/sleep/. Accessed June 22, 2020.

Sleep Apnea Information Page. National Institute for Neurologic Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Sleep-Apnea-Information-Page. Accessed June 22, 2020.


  1. https://ideepsleep.com/tips-to-try-for-a-peaceful-sleep/

  2. https://www.sleepassociation.org/about-sleep/what-is-sleep/

  3. https://www.terrycralle.com/best-cpap-machines/

Sleep Hygiene and Me. By Our April Student Pharmacist, T’Bony Jewell.


Have you ever had trouble falling asleep or staying asleep?

Many of our daily activities and parts of our routine contribute to our ability to fall and stay asleep. Certain foods and drinks contain substances that can either help us fall asleep or may keep us awake. Other medical conditions such as chronic obstructive pulmonary disease (COPD and other restrictive airway diseases), acid reflux disease, and congestive heart failure may affect our ability to achieve adequate rest due to “variations in airway resistance” and changes in our posture during sleep.

According to the National Sleep Foundation, sleep hygiene is defined as, “a variety of practices and habits that are necessary to have good nighttime sleep quality and full daytime alertness.”

Here are some things you can do (or not do) to help decrease time to falling asleep and help you stay asleep.


  • Establish a regular routine. Your body gets used to recurring activities. Doing the same thing every night, such as eating dinner, showering, then reading a book can help you slowly relax as you get ready for bed.
  • Make your sleep environment comfortable.
  • Turn off cellphones and televisions.
  • Use soft lighting.
  • Adjust the temperature in the room.
  • Light cardio or aerobic exercise, such as walking or cycling, can aid in restful sleep.


  • Take naps throughout the day, especially close to bedtime. Your circadian rhythm or sleep-wake cycle can be thrown off making it harder for your body to know when to produce hormones like melatonin that aid in sleep induction.
  • Drink caffeine or use other stimulants close to bedtime. These substances can over power your natural ability to fall asleep.
  • Engage in strenuous activity (i.e. furniture lifting).
  • Use your bedroom for activities such as studying or catching up on work. Your body may begin to associate the bedroom with stimulating activities and may not begin to relax or put you in a restful state.

People with other medical conditions:

If you have GERD or acid reflux:

  • Don’t eat spicy foods close to bedtime. If you do, drink plenty of water and pre-treat with recommended medications like ranitidine or famotidine 30 minutes before your meal.
  • Raise the head of your bed to keep food from re-entering the esophagus where it causes heart burn.

If you have congestive heart failure or CHF:

  • Restrict the amount of sodium and water you consume. This helps to prevent the buildup of fluid around the lungs that can make it difficult to breathe.

If you have COPD or other restrictive airway disease:

  • Take your medications as directed by your physician, even when you feel well. Your controller inhalers usually have a steroid or other medication to decrease the inflammation in the airway making it easier to breathe.
  • Adjust your posture in bed to get the best air flow to your lungs.

Follow these tips and you’ll be sleeping like a baby.


Getting the Z’s You Need: A Message About Sleep Hygiene From Our Sleep-Deprived Student Pharmacist, Amy Reed.

According to the Centers for Disease Control and Prevention (CDC), insufficient sleep is a public health epidemic. From a study in 2009, 35.3% of adults reported getting less than 7 hours of sleep nightly. The National Sleep Foundation suggests that healthy adults need 7–9 hours of sleep per day, and school-age children might require 10–11 hours of sleep.

Insufficient sleep can lead to a predisposition to chronic diseases such as diabetes, cardiovascular disease, depression, and obesity. Lack of sleep can also lead to nodding off in the middle of the day or even falling asleep at the wheel of a vehicle. The National Department of Transportation estimates drowsy driving to be responsible for 1,550 fatalities and 40,000 non-fatal injuries annually in the United States.

So what are some things that you can do to ensure a good night’s sleep every night of the week?

  • Go to bed around the same time each night. Adjust to a regular sleep-wake schedule, even on the weekends.
  • Get regular exercise, but NOT right before bedtime. Your body will need to calm down after a vigorous workout, which can make it difficult to fall asleep right away.  If you only have time to exercise at night, try gentle exercises like yoga/stretching.
  • Do not eat a large meal or forget to eat before bed. Eating a heavy meal before bed is not a great idea since your stomach will be active for several hours to digest all of its contents. But an empty stomach can also make it hard to fall asleep. If you are hungry and it is close to bedtime, try eating a low calorie snack with little to no sugars (yogurt, veggies, pretzels, etc.).
  • Do not take naps. If you must nap, make sure that it is only for about 15-30 minutes in the early afternoon (not too close to when you normally go to sleep).
  • Do not drink alcohol after dinner. It may help you fall asleep, but when the alcohol wears off you may become restless and wake up.
  • Avoid tobacco and caffeine close to bedtime. If possible, do not consume caffeinated beverages within 8 hours of going to bed.
  • Keep a notebook next to your bed. If you have something on your mind or something that you need to do, write it down and deal with it tomorrow.
  • Avoid working/studying/watching TV in bed. Reserve the bedroom for sleep.
  • Try to wind down at the end of the day. Do not do household chores or work right before bed. Give your body an hour to slow down and prepare for rest. Quiet activities, like reading, will help you to relax. Turn off electronic devices with screens; these lights can keep your body in an awake-state rather than calming you down.
  • Make sure you are sleeping in a relaxing environment. A good bedroom environment is quiet, dark, and not too hot or too cold.

Sweet dreams!

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