9: Sleep
- Page ID
- 130023
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Sleep is an essential part of life. The National Sleep Foundation (2020) recommends that the average adult should sleep 7-9 hours per night. People who get the recommended amount of sleep are more likely to flourish in their day-to-day life (National Sleep Foundation, 2025). Despite knowing how important sleep is, many helping professionals and college students struggle to get adequate sleep. 77.4% of one sample population of hundreds of nurses had a poor quality of sleep, with night shift nurses having more sleep problems than others (Khatony et al., 2020). In a different study, 87% of intensive care unit (ICU) nurses experienced poor sleep quality which affected their professional quality of life (Mansouri et al., 2025). Related to college students, 60% of surveyed students reported experiencing sleep disturbances which affected their physical and psychological health (Lund et al., 2010).
Many factors can impact sleep. One significant factor is the use of electronic devices. A study reported that 97.3% of medical students used a blue light-emitting device at bedtime with a mean duration of screen time being 1 hour and 50 minutes per night. More than half of the students had their sleep interrupted to check messages (Jniene et al., 2019). Healthcare workers are at risk for sleeping disturbances for several reasons including shift work, work-related schedules, stress, and the type of care they provide for other people. Other factors that can impact sleep include one's activity level, alcohol use, caffeine use, stress, and environment.
In the past decade, both the American Nurses Association and the American Academy of Nursing have released position statements on the importance of addressing fatigue, sleep, work, and safety for nurses (Weaver, 2024). Research supports that there is a strong link between sleep disturbances and burnout in nurses (Ren et al., 2025). Nurses who are not getting enough sleep are also at increased risk for many infections like the common cold, pneumonia, bronchitis, sinusitis, and gastrointestinal infections (Hartveit Hosøy et al., 2025). Sleep also impacts the care that healthcare workers can provide others, directly impacting safety for both the nurse and patient as well as overall quality of care. Likewise, poor sleep has many negative impacts on students, including impaired memory, reduced cognitive function, decreased motivation and focus, and increased stress and anxiety (TrueLearn, 2025). Some good news is that while the average college student has a significant need for improved sleep, this population is also more responsive to sleep related interventions (Saruhanjan, et al., 2020).
How does God feel about sleep? In Genesis 2:2 (NLT), we read that "On the seventh day God had finished his work of creation, so he rested from all his work." Even God rested! With all that in mind, this week the focus is on sleep!
Activity
Who doesn't love a good sleep? This week, we are going to assess the length and quality of our sleep using the Pittsburgh Sleep Quality Index (PSQI). This evidence-based assessment helps people measure their sleep quality. From these results, you will identify ways to modify your sleeping patterns. This will mostly be done by setting some sleep-related goals for the week and tracking them. And hopefully, with these modifications, your overall wellness will be improved as well!
Figure \(\PageIndex{1}\): Sleep is essential for your wellbeing. (Photo by Jasmine Pang from Pexels.)
Materials Suggested
- Paper, pencil, or electronic device for documenting
- Optional: Sleep aids such as eye masks, ear plugs, noise machines, or sleep tracking devices like a smart watch
Directions
Pittsburgh Sleep Quality Index
The Pittsburgh Sleep Quality Index (Buysse et al., 1989) is an evidence-based assessment that helps people measure their sleep quality. It contains 19 questions (plus a few more if you sleep with a partner) with a scoring rubric as well.
Take the assessment using one of the links below:
- Electronic access to Pittsburgh Sleep Quality Index (PSQI) (recommended for ease of use of results)
- Print version of Pittsburg Sleep Quality Index PSQI
Note: If you use the print version, you will also need the scoring rubric as well.
For both the digital or print version, a final PSQI score less than or equal to (<) 5 is associated with good sleep quality. A score greater than (>) 5 is associated with poor sleep quality.
Evidence-Based Sleep Interventions
There are numerous evidence-based interventions that can help with the quality of your sleep. An example of a research study that investigated different inventions tested relaxation, music therapy, and the use of earplugs/eye masks (Ashghab et al., 2024). But there are many more options to consider!
This exercise will help you set a few goals for the week. Consider each of the following interventions and what it could look like for you to try it out this week. If it is something you want to commit to, place a checkmark in the check column. As you go, write specific goals for you and your plans as appropriate, such as "Last coffee for the day is at 12pm" or "Set bed time alert for 11pm."
This chart is also available as a PDF download: Sleep Interventions
| Intervention | Check | Comments about specific goal |
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Physical Environment |
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Turn off all lights when going to sleep |
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Change lights remaining on in sleeping area to red-light or non-blue light |
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Adjust electronic devices off of blue light for night use |
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Regulate room temperature |
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Insert ear plugs |
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Wear an eye mask |
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Aromatherapy: Use lavender or damask rose extract |
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Sleep with phone away from bed |
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Set phone to “sleep mode” each night |
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Turn off all non-essential notifications for phone apps |
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Activity Considerations |
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Set a consistent time to go to bed with a phone alert for this time |
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Set a consistent time to wake up |
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Avoid napping during the day |
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No caffeine for at least 6 hours before bed |
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No alcohol for at least 3 hours before bed |
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Work out for at least 20 minutes during the day at least 1 hour before bed |
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No use of blue light electronics (phone, tablet, computer, TV) at least 1 hour before bed |
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Start a routine that excludes electronics or TV for consistent approach to bedtime |
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Relaxation Techniques |
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Pre-bed muscle relaxation or body scan |
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Sleep yoga |
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Sleep-focused meditation |
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No going to bed feeling stressed, angry, upset, or nervous. Resolve feelings before getting into bed. |
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No thinking, planning, or worrying in bed. |
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Other |
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Resources for Interventions
To assist you in coming up with some sleep interventions or learning more about the different interventions mentioned in the chart, here are some additional resources that may be of assistance (see Gupta et al., 2023 for more specifics about many of these interventions):
Physical Environment:
- Temperature control: Regulate room temperature to personal preference for comfort
- Lighting control: Turn off all lights; use blackout curtains; wear an eye mask
- Sound control: Use ear plugs; use a sound/noise machine
- Different type of sheets
- Use aromatherapy like lavender or damask rose extract
Activity Considerations:
- Try to set a schedule that allows for a consistent time of going to bed and getting out of bed each day
- Avoid daytime napping or reduce the nap to less than 2 hours
- Avoid caffeine for at least 6 hours prior to bedtime (Drake et al., 2013)
- Avoid alcohol at least 3 hours prior to bedtime or consider abstaining altogether (Bryan & Singh, 2025)
- Avoid exercising to the point of sweating within 1 hour of going to bed; Keep track of when and how exercise impacts your sleep
- Avoid use of any blue light (phone, computer, tablets, TV) for at least 1 hour before bed
Relaxation Techniques:
- Avoid going to bed feeling stressed, angry, upset or nervous; try to avoid thinking, planning, or worrying in bed
- Apps/websites that can help you relax including Calm, Balance, relaxing music playlists on Spotify, Apple Music, or YouTube
- Muscle relaxation
- Body scan meditations
Video \(\PageIndex{1}\): 10 Minute Sleep Meditation. ("10 Minute Sleep Meditation A Guided Talk Down Body Scan" by Great Meditation from YouTube.)
Video \(\PageIndex{2}\): 5 Minute Body Scan. ("5 Minute Body Scan Meditation" by Medistate Mind from YouTube.)
- Sleep yoga:
Video \(\PageIndex{3}\): 8 Minute Evening Yoga. ("8 Minute Evening Yoga - Wind Down & Chill Out Yoga" by Yoga with Kassandra from YouTube.)
Video \(\PageIndex{4}\): 5 Minute Yoga for Bedtime. ("5 min Yoga For Bedtime - Yoga Stretch For DEEP SLEEP" by Yoga with Kassandra from YouTube.)
- Sleep meditation or relaxation imagery through guided meditation
Video \(\PageIndex{5}\): Sleep Meditation. ("Guided 20 Minute Sleep Meditation" by Great Meditation from YouTube.)
- Spotify (note: account may be required for access):
See some of the previous modules that related to quality sleep:
After considering the different resources for intervention, write three different sleep goals that you can incorporate this week. In addition, you will be tracking and logging your sleep each day using a sleep diary. Fill out the sleep diary as directed each morning and night for one consecutive week.
Print version of a Sleep Diary
Reflection:
1. Describe any changes you noticed in the following areas with focusing on sleep this week:
Emotional, Environmental, Intellectual, Occupational, Physical, Social, and/or Spiritual
2. What benefits did you feel with focusing on sleep?
3. What, if any, barriers did you experience focusing on sleep?
4. Do you have any additional thoughts and/or future plans for focusing on sleep?
5. What are your current stressors and do you have a wellness goal for this week?
References
Ashghab, A., Vahedian-Azimi, A., Vafadar, Z., Mollahadi, M., & Sepandi, M. (2024). Nursing interventions to improve the sleep quality of hospitalized patients: A systematic review and meta-analysis. Intensive Care Research, 4, 55-71. https://doi.org/10.1007/s44231-024-00056-9
Bryan, L., & Singh, A. (2025, July 16). Alcohol and sleep. Sleep Foundation. https://www.sleepfoundation.org/nutrition/alcohol-and-sleep
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh sleep quality index (PSQI): A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193-213. https://doi.org/10.1016/0165-1781(89)90047-4
Drake, C., Roehrs, T., Shambroom, J., & Roth, T. (2013). Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed. Journal of Clinical Sleep Medicine, 9(11), 1195–1200. https://doi.org/10.5664/jcsm.3170.
Gupta, C. C., Sprajcer, M., Johnston-Devin, C., & Ferguson, S. A. (2023). Sleep hygiene strategies for individuals with chronic pain: A scoping review. BMJ Open, 13, Article e060401. https://doi.org/10.1136/bmjopen-2021-060401
Hartveit Hosøy, D., Ørner, P. B., Pallesen, S., Saxvig, I. W., Bjorvatn, B., & Waage, S. (2025). Night work and sleep debt are associated with infections among Norwegian nurses. Chronobiology International, 42(3), 309-318. https://doi.org/10.1080/07420528.2025.2455147
Jniene, A., Errguig, L., El Hangouche, A. J., Rkain, H., Aboudrar, S., El Ftouh, M., & Dakka, T. (2019). Perception of sleep disturbances due to bedtime use of blue light-emitting devices and its impact on habits and sleep quality among young medical students. BioMed Research International, Article 7012350. https://doi.org/10.1155/2019/701235
Khatony, A., Zakiei, A., Khazaie, H., Rezaei, M., & Janatolmakan, M. (2020). International nursing: A study of sleep quality among nurses and its correlation with cognitive factors. Nursing Administration Quarterly, 44(1), E1-E10. https://doi.org/10.1097/NAQ.0000000000000397
Lund, H. G., Reider, B. D., Whiting, A. B., & Prichard, J. R. (2010). Sleep patterns and predictors of disturbed sleep in a large population of college students. Journal of Adolescent Health, 46(2), 124-132. https://doi.org/10.1016/j.jadohealth.2009.06.016
Mansouri, P., Rivaz, M., Soltani, R., & Tabei, P. (2025). The relationship between professional quality of life and sleep quality among nurses working in intensive care units: A cross-sectional study. BMC Nursing, 24, Article 34. https://doi.org/10.1186/s12912-025-02693-x
National Sleep Foundation. (2020, October 1). How much sleep do you really need? https://www.thensf.org/how-many-hours-of-sleep-do-you-really-need/
National Sleep Foundation. (2025, March 6). National Sleep Foundation’s 2025 Sleep in America poll. https://www.thensf.org/wp-content/uploads/2025/03/NSF_SIA_2025-Report_final.pdf
Ren, W., Li, W., Ji, C., Kong, F., Chao, L., Yang, Q., Zhang, W., & Du, X. (2025). The association between sleep and burnout in psychiatric nurses: A survey from China. BMC Nursing, 24, Article 639. https://doi.org/10.1186/s12912-025-03238-y
Saruhanjan, K., Zarski, A.-C., Bauer, T., Baumeister, H., Cuijpers, P., Spiegelhalder, K., Auerbach, R. P., Kessler, R. C., Bruffaerts, R., Karyotaki, E., Berking, M., & Ebert, D. D. (2020). Psychological interventions to improve sleep in college students: A meta-analysis of randomized controlled trials. Journal of Sleep Research, 30(1), Article e13097. https://doi.org/10.1111/jsr.13097
TrueLearn. (2025, January 27). The impact of sleep on adult learning and memory. https://truelearn.com/resource-library/the-impact-of-sleep-on-adult-learning/?srsltid=AfmBOopBcfAQLURCn4K39izuRyn0NyeOpLrNQas3RKmfZXbelEZOX0E5
Weaver, S. H. (2024, October 2). Call to action for nurses to prioritize sleep. Healthy Nurse, Healthy Nation. https://www.healthynursehealthynation.org/our-resources/blogs/2024/call-to-action-for-nurses-to-prioritize-sleep/