Category Archives: Sleep

Evidence Base for Safe Sleep Interventions


Many interventions can increase knowledge about factors that may contribute to sleep-related death in infants and improve the application of this knowledge to reduce the impact of these factors. Evaluations of these interventions in the published literature look at increases in target audiences’ knowledge and at changes in behavior. Some evaluations look at the association between the intervention and subsequent rates of SUID. This page links to the evidence base of interventions that have had an effect on increasing safe sleep behaviors and thus reducing sleep-related infant deaths.

There are multiple examples of innovative approaches that impact safe sleep behaviors reported in both the peer-reviewed literature and through national level resource centers help to inform the methodology of this project.

The evidence is summarized below, based on three sources: (1) What Works: Changing Knowledge and Behavior to Reduce Sudden Unexpected Infant Death developed by NCEMCH and housed in the MCH Library’s SUID/SIDS Gateway; (2) Promising Practices for Cultural and Linguistic Competence in Addressing SIDS and Other Infant Death developed by NCCC; and (3) ASTHO’s promising practices summary of states addressing SUID/SIDS within the CoIIN for Infant Mortality activities.

Interventions within single formal infant care service related sectors.

Hospital Safe Sleep Initiative
Franklin County, OH Infant Safe Sleep Task Force. 
 Provided training and monitoring of safe sleep practices in birthing hospitals in county. Also provided training for child care provider. 
Service Sector: 
Birthing hospitals. 
Hospital audits showed supine placement increased from 50% to 96%; cribs with blankets decreased from 22% to 1%; cribs with toys from 13% to 1%. Evaluations of trainings were positive.1

Model Behavior: The Most Important Modeling Job of Your Life
First Candle, funded by NICHD.
Description: Training for nurses in Missouri NICUs and well-baby nurseries for CEUs. Presentations made at 22 national and 23 regional nursing conferences.
Service Sector: Birthing hospitals. 
80% of the participants scored 90% or better on the post-test.2 Percent of nurses reporting using back-only position in first 24 hours for healthy newborns increased from 26% to 50.2% and those who endorsed supine sleep increased from 45% to 70.8%.3

Safe Sleep Nursing Policy
Wesley Medical Center community teaching hospital, Wichita, KS. 
Developed a nursing policy on safe sleep that required education of families during post-partum room orientation, not at discharge.
Service Sector: 
Birthing hospitals.
Findings: Supine placement increased from 25% to 58%. 91% families reported having viewed the video, 95% planned to place their baby supine to sleep, and 0% reported plans to co-sleep.4

Michigan Demonstration Project
Tomorrow’s Child/Michigan SIDS and 7 urban hospitals in MI.
Description: Project drafted new policies/procedures and provided in-service trainings to nurses. Monitored implementation with audits on units.
Service Sector: Birthing hospitals.
Findings: Increase from 84.8% to 94.2% of nurses who knew AAP recommendations. Nurses who held the opinion that back sleep is safest increased from 79.5% to 89.2%. Infants sleeping supine increased from 80.7% to 91.9%. Mothers told about infant safe sleep increased from 62.7% to 91.4%.5

Healthy Childcare America Back to Sleep Campaign
AAP Healthy Childcare America.
Description: A new childcare curricula focused on child care settings was evaluated with unannounced observations and questionnaires.
Service Sector: Childcare.
Findings: 3 months after the intervention exclusive use of supine sleep position increased from 65% to 70.4% in control group and 87.8% in the intervention group. Childcare provider awareness of AAP recommendations increased from 59.7% to 64.8% in control group and 80.5% in intervention group.6

WIC Education Study
Children’s Hospital National Medical Center in Washington, DC.
Description: In local WIC program a health educator-led short educational interventions to discuss safe sleep practices with African American families as a prerequisite to obtaining food vouchers.
Service Sector: WIC.
Findings: Pre-training, 90% of parents co-slept, 21% planned to bed share, and 57.7% placed infant supine. After intervention, 85.3% planned to use supine position.7

Interventions within single sectors that are part of caregivers natural networks of support.

Church Peer Educators
County public health department of Alameda, CA
Description: Project recruited peer health educators from African American churches to demonstrate safe sleep messages at church events and at caregiver service centers.
Service Sector: Faith-based organizations.
Findings: Increased delivery of safe sleep messages by trusted, culturally concordant messengers.8

Culturally Competent Media Messages
The North Carolina Healthy Start Foundation.
Description: Developed a series of media messages and training materials with a focus on grandmothers. Approach not only to inform grandmothers but to support parents’ sense of self-efficacy.
Findings: The overall campaign of which this was a part resulted in an increase on PRAMS data of supine sleeping from 43% to 76% over 5 years.9

Always Right Program
Medical and Health Research Association and NYC Department of Health.
Description: Project worked with high schools for pregnant/parenting teens, using discussion and peer interaction that respected parents’ power to make their own decisions about safe sleep.
Service Sector: Schools.
Findings: Changed policy and implementation in schools’ childcare settings, safe sleep messages integrated into various lessons/classroom discussions.10

Sisters United Initiative
Arkansas Office of Minority Health and Arkansas Children’s Hospital.
Description: African American sororities trained members for their chapters and communities about rates of SUID in their communities and safe sleep.
Service Sector: Culturally specific community organizations.
Findings: Sorority chapters have websites and Facebook accounts to promote safe sleep; chapters leveraged funding from NICHD grants to host 22 safety showers for at-risk pregnant women.11

Interventions where an organization with the goal of promoting safe sleep engages multiple partners to deliver safe sleep messages.

SIDS Risk Reduction Education
The SIDS Alliance of Illinois in partnership with the Chicago Department of Public Health, and the CJ Foundation for SIDS.
Description: Provided SIDS risk reduction education to largely black neighborhoods in Chicago. Education for family members and caregivers took place at partner sites.
Service Sectors: Community locations.
Findings: Increases in knowledge and reported use of some safe sleep practices from a pre to post survey within the community.12

Upstate Community Partners Program
Greenville, South Carolina Department of Health.
Description: Trained community partners to talk with families to help assess caregivers safe sleep knowledge and practices and refer caregivers for education or for eligibility for a pack n play.
Service Sectors: Childcare, disability services, schools, early intervention, home visitors, literacy organizations, parent support organizations, faith-based organizations, coroner’s office, and Department of Social Services.
Findings: Partners check in with families over the course of the first year. The program reports that all babies involved in the program survived to their first birthdays.13

Interventions that create an integrated systems approach.

Public/Private Safe Sleep Initiative
Tomorrow’s Child/Michigan SIDS and MI Department of Health.
Description: State-wide public/private safe sleep initiative to create better coordination to promote safe sleep and to engage community members in creation of materials and messages.
Service Sectors: state and local agencies with full set of public and private safe sleep partners.
Findings: An official positive safe sleep message for use in all public agencies with support from the breastfeeding community, and governor; legislative appropriations; private philanthropy; ongoing structure to meet new challenges and sustain efforts.1

Also Read: How To Fall Asleep Fast

National Action Plan to Increase Safe Infant Sleep

Safe Infant Sleep

The NAPPSS Coalition is pleased to present the National Action Plan to Increase Safe Infant Sleep: A Blueprint from the National Action Partnership to Promote Safe Sleep. The framework for the plan was developed under the guidance of an Expert Leadership Group. National Action Partners generated ideas at a national action forum upon which the action steps for implementing the plan are based. Together, these groups form the NAPPSS Coalition comprised of more than 50 national advocacy organizations, professional associations, faith communities, and business groups with the active involvement of federal partners, including the Maternal and Child Health Bureau and NICHD’s Safe to Sleep® campaign.

The National Action Plan was developed and will be implemented within the context of the layers of the NAPPSS Social-Ecological Model that informs the project. Brief Background Information about Sudden Unexpected Infant Death, Safe Sleep Practices, and Breastfeeding, puts the National Action Plan in context, and explains why we all must make safe sleep everybody’s business. A set of definitions serves as a resource for understanding the terms as they are used in the National Action Plan. Key terms are also highlighted in the plan; roll over the terms with your mouse to get their definition.

Also Read: How To Fall Asleep Fast

How to USE

This plan is an evolving document. This page is designed to be continually updated by the NAPPSS action teams, state and federal partners, and everyone who works to ensure that all babies sleep safely—each night and each naptime—and wake up healthy and strong. Begin by reading the plan’s vision, mission, and principles. Then, you can expand each of the goals, strategies, and actions and let us know how your work on promoting safe sleep practices and breastfeeding fits into this national framework.


We envision a world where all babies sleep safely—each night and each naptime—and wake up healthy and strong.


The National Action Partnership to Promote Safe Sleep (NAPPSS) will develop and implement a practical National Action Plan to Increase Safe Infant Sleep and partner to support breastfeeding among infant caregivers by activating systems, supports, and services to systematically work together to make safe infant sleep a national norm.


Our National Action Partnership will be guided by six principles to help make safe infant sleep a reality for all families. Specifically, the Partnership will:

  1. Ensure that actions are designed to support all individuals and are effective for populations who experience the highest rates of sleep-related infant deaths.
  2. Incorporate values and principles of cultural and linguistic competence to ensure that actions are respectful and effective for infant caregivers from all backgrounds.
  3. Engage infant caregivers and their communities in designing, implementing, and evaluating actions
    to promote safe Sleep practices.
  4. Activate the systems and services that touch families to work together to ensure that all babies sleep safely each night and each naptime.
  5. Honor caregiver’s experiences of caring for infants by integrating the promotion of Safe Sleep and breastfeeding to reduce SUID/SIDS deaths.
  6. Recognize that families are the ultimate decision-makers each day and night in the moments of personal choice about how to care for their infants.

Interactive GOALS

To read the strategies and actions under each of the three goals below, please click on the goal itself or the down arrow to the right. After you expand the goal, you will see all the strategies and actions displayed.

Click on each action to access a fillable form to let us know what you and/or your organization are doing to promote this action. NAPPSS staff will collect these actions and will further populate this plan with your input. To close expanded goals. strategies, and actions, click on the corresponding text again or the up arrow to the right. Roll over hot-linked words to see their definitions.

Check back often, as we add more actions from the field—remember, this is a living document that will grow with time and use.

What to Do NEXT

If you’ve read the plan and added information on what you are doing for the actions under the 3 goals above, you might be asking what next? The NAPPSS team will incorporate your information into the National Action Plan. This information will help to influence the work of the NAPPSS Action Teams and will serve as a resource to others in the field. Armed with this resource, the NAPPSS team will focus on the next phase of the project—moving from awareness to action. As a colleague in the field, whether a NAPPSS Coalition Member, and NAPPSS Action Team Partner, or a Friend of NAPPSS, the project will be in communication with you to let you know of opportunities for collaboration in the project and for ways to advance project goals. If you have not already done so, please sign up to receive updates from the project.

You can also check back with this online page to see what’s happening nationally, regionally, and locally with each of the actions. As we learn more about what all of you are doing, we will add information to these sections, and the National Action Plan will evolve into a roadmap for making safe infant sleep a national norm.

How To Fall Asleep Fast

How To Fall Asleep Fast

Staying awake into the wee hours of the morning in a bid to at least find a “position” that can warrant you an even an hour of sleep like other people, is always a very frustrating feeling. What is worse is that the feeling, on numerous occasions, you always have to deal with it yourself. This can lead to emotional and mental meltdowns that can affect one’s health status and the way you usually attack your daily routines.

The effects of lack of sleep into your health and way of life are endless. Therefore, you need to get ahead of your lack of sleep and find ways to sleep the moment you hit your bed immediately. It is, for this reason, this article will look into ways to help you fall asleep fast.

Use Your Mind to Breathe

The nervous and circulatory system work together to help human beings have healthy sleeping behaviors. Other aspects play a part in this, but these two are the main players in how you sleep. The ability to make both systems to work coherently to for a peaceful night sleep by maintaining good breathing patterns is primary to sleeping fast.

Deep, slow bouts of breath help in relaxation which makes your nervous system respond to its surrounding. fThis allow your body to relax and be calm. The state of tranquility makes it conducive for you to focus on your sleep.

The 4-7-8 technique by Dr. Andrew Weil takes you to slumber in 60 seconds. The technique is straightforward.

It involves breathing in and out while you are holding the end of your tongue against the ridge at the rear of your upper teeth so that when you exhale it makes a “whooshing” sound.

  • 4: inhale for four seconds with your mouth closed
  • 7: sustain the breath for seven seconds
  • 8: then breath out gently through your mouth to produce the “whooshing” sound for eight seconds.

At first, the technique is effective when practiced while sitting. As you progress, you can start by practicing while you are lying on your back. The process best works if done in four cycles when you are beginning, and then you can increase the sequences as you start to grasp the technique.

Use The Best Mattress of The Right Density

Majority of people do not care about the firmness of a mattress when purchasing one. According to Dennis Pork From,  In order to get the best mattress of 2020, the density of your mattress plays a massive part in helping you learn how to fall asleep fast. It is incredible how the thickness and firmness of a mattress affect how someone falls asleep.

According to research, sleeping positions, age, body physiology, and other factors affects how people enjoy their sleep on various types of mattresses. Different people, depending on their sleeping tendencies and biological constitution, need to find the right mattress firmness to suit their sleeping style for a good night rest.

Mattress shops like Amerisleep are offering mattresses in different firmness to cater to their diverse customer base in terms of sleeping tendencies. The company provides the AS5 mattress that provides the tenderest of feelings when you sleep on them. They are ideal for people who sleep holding each other. It helps ease the pressure on their shoulder and hips. The mattress is also perfect for those who enjoy their sleep on their side. Another type is the AS1 which is very dense and firm. This type of mattress offers a sense of firmness to its users that is great among back and stomach sleepers.

The AS3 offers a perfect balance of firmness and tenderness that suits people with a variety of sleeping positions. It is also recommended for couples with different tastes of firmness.

Go Caveman

Dark and cold surroundings are ideal for a nice sleep. But finding a dark and cool place in this technologized world can be very difficult. Homes and bedrooms are fitted with intricate lighting and temperature regulating systems that make achieving such conditions difficult. Lighting from gadgets is known to be melatonin inhibitors which can make sleeping hard.

Therefore, to fall asleep swiftly, it is wise to structure your sleeping space like an ancient cave. Caves are synonymous with darkness and bats. But you do not have to make your room creepy to help you fall asleep fast. You can start by switching off all your gadgets and lights when its bedtime. If your room is incapable of being dark, you can use eye masks.

Prepare your body to anticipate sleeping time by dimming lights thirty minutes in advance.

Keep Chill

Chilly temperature is always a great catalyst of sleep. It is possible you have realized that chilly surroundings are conducive to fall asleep in. Research has found out that cool temperature helps people sleep faster and deeper. Furthermore, cold temperature is a good reason to pull your blanket over your head so that you can keep warm. By keeping warm, you can fall asleep faster.

A study in Australia showed that people suffering from lack of sleep always have high core temperature in the evening and their inability to maintain the core body temperature affects how fast they fall asleep.

The optimum room temperature to sleep in is around 65 degrees. But this may vary depending on your preference.

Immersing yourself in a warm bath before entering your bed help reduce your core body temperature which helps your sleeping process.

Deceive Your Brain

Paradoxical intention is the tuning of the brain to do the exact opposite of what it set out to do in the first place. Insomniacs tend to over-anticipate sleep which may make the quality of sleep poor when they finally get to sleep. Therefore, sleep instructors use this technique on insomniacs to suppress their anticipation to sleep by encouraging them to stay awake for as long as possible. Urging them to stay awake for long, reduces anxiety levels which makes it easy to fall asleep.

Daydream to Your Advantage

People who experience sleeping problems are always affected by unpleasant thoughts. Insomniacs tend to dwell on their day by unpacking their thoughts bit by bit when on the bed. This tendency is unhealthy for someone who is trying to fall asleep.

Relieving unwanted thoughts when you are lying idle in bed, staring into nothing can be very difficult. Therefore, to mitigate these thoughts, it is wise to picture positive images or occurrences like daydreaming but purposeful daydreaming.

You can achieve this by:

  • Setting up a calming situation in your mind and look into it deeply. This can be a picnic that you enjoyed with family and friends, a tranquil forest.
  • You can picture yourself doing something good in loops. The repeated vision of yourself doing something positive repeatedly helps keep you calm and sleepy.

This technique may sound like wishful thinking, but when used appropriately, it works wonders. It is okay to wander off during the visualization process. It fine to give yourself sticks for instances like those but it is good to return to your peaceful vision without overstressing yourself. It is also a good stress-reliever in the middle of a stressful day.

Eat Sufficient Carbs Diet at Night

Carbs are known to be healthy and easy to digest. A healthy digestion system is essential for a good night sleep as compared to complex, spicy diets. However, the carb diet also has its downsides.

The research found out that some carbs such as white bread, noodles are not that easy to absorb and could affect how you sleep. Therefore, when you are cutting on carbs, it is healthy to eat a portion during meals and not to over-do it.

The trick is to keep the rations enough to avoid bloating and indigestion. The recommended time to eat your carbs before bedtime is four hours. This time is enough for the food to be digested so that you do not have to go o bed with indigestion. Therefore, eating your carbs less than four hours to bed is out of the question because it is not healthy for your body.

Minimize Naps During Day Time

Poor sleeping habits make insomniacs to sleep during the day because they are unable to sleep during the night. They compensate for this deficiency by having daytime naps. The naps then become everyday routines. Sleeping during the day deprives someone the sleep they would sleep at night.

Therefore, when someone tries to sleep at night, they have troubles sleeping. This can be countered by a victim finding other recreational activities that are beneficial to their body but do not require sleeping during the day.


The inability to get quality sleep and ways of correcting it require patience and dedication. Furthermore, it is not a straightforward journey that you start today and finish tomorrow. There are occasions you will achieve the goals you have set and sometimes, you will not meet the goals. Therefore, frustrations are a part of the journey, and they should not discourage you in your journey finding ways to help you fall asleep fast. Whenever you fail, you should stand up and forge ahead with your journey.