Promoting Rest: Coaching Your Patients in Healthy Sleep Habits

We live in an increasingly ill-rested society. With busy schedules, more time spent on screens, increasingly sedentary lifestyles, and various stressors, American adults face a challenge. How do we wind down and get quality sleep at the end of the day? As nurses, we are uniquely positioned to help our patients with their sleep. Whether at the bedside or in a clinic, a nurse can pick up on a patient's struggles in this area and coach them in simple non-pharmacological interventions that can have a positive impact on their rest.

Blue Light Reduction

These days, we spend more time on screens than ever before. Smartphones are a main offender; their portability, versatility, and convenience are hard to beat. We watch movies on them, play games, text friends, post to social media, and read blogs. The screen of our smartphone or tablet is often the last thing many of us see before turning out the light at the end of the day.

The light emitted by LED screens like those used in smartphones includes blue light, which has been shown to suppress the release of melatonin, an important inducer, and sustainer of sleep. Interestingly, the receptors responsible for triggering a suppression of melatonin in response to blue light are most sensitive in the evening. Exposure to blue light before bedtime can suppress the release of melatonin and its level in the brain during the night, thereby delaying sleep, reducing its quality, and causing morning sleepiness. Patients can be encouraged to utilize blue light-reducing settings on their smartphone or computer, although there is evidence that the brightness should also be reduced to truly minimize the effect of blue light on sleep. Glasses with lenses that block blue light are another option to consider¹.

Naturally, the best approach would be to avoid the use of smartphones or other screens in the hours before bedtime. Patients could be encouraged to designate a time each evening to turn off their smartphone for the night. An alternate activity, like reading a book by the light of a soft lamp, could help reduce the suppression of melatonin, thereby improving sleep.

A Consistent Sleep Schedule

For various reasons, many of us develop an inconsistent sleep schedule. Perhaps we stay up late one night and get only five hours of sleep, then sleep in later the next morning. Or perhaps we try to catch up for missed sleep on the weekend. When it comes to healthy sleep, consistency is key.

The recommended amount of sleep for adults is at least seven hours, with a maximum of eight hours. Additionally, falling asleep at the same time each night and waking at the same time each morning is important for maintaining a healthy circadian rhythm². As a nurse, you can encourage your patient to set a consistent bedtime and to make seven hours of sleep their goal.

Exercise and Sleep

As nurses, we understand that exercise is profoundly important for overall health. Among other benefits, it reduces the risk of conditions such as cardiovascular disease and diabetes and can have a positive impact on mental health. There is also evidence that exercise can have a positive impact on sleep. While being mindful of encouraging patients with underlying health conditions or concerns to consult their provider before starting an exercise regimen, nurses can encourage patients to incorporate exercise into their daily routines.

A meta-analysis of various studies examined the impact of aerobic or strength-training activities on the sleep of adults and older adults. There is evidence that either form of exercise improved the sleep of participants in three ways: less sleep medication was needed, the time to onset of sleep was reduced, and the quality of sleep was improved. Exercise potentially improves sleep through a combination of endorphin production, increased energy use, or an effect on body temperature. The net result is improved sleep quality, which can positively impact overall health³.

Our Role as Nurses

There are other non-pharmacological measures that can help improve sleep, but these three areas are excellent places to start. By coaching our patients to limit blue light exposure, create a consistent sleep schedule, and implement an exercise plan, we, as nurses, can help to promote healthy sleep and, by extension, better health outcomes.

References/Resources

1 The Inner Clock - Blue Light Sets the Human Rhythm: Journal of Biophotonics: National Center for Biotechnology Information/National Library of Medicine

2 Sleep Tips: 6 Steps to Better Sleep: Mayo Clinic

3 Exercise Training Improves Sleep Quality in Middle-aged and Older Adults with Sleep Problems: A Systematic Review: Journal of Physiotherapy: Science Digest