Episode 6 - Steps to better sleep for pharmacy students with Dr. Sarah Melton and Dr. Jeff Gray.

On this episode of White Coat Radio, we learn the steps to better sleep for pharmacy students. Dr. Sarah Melton, a board certified psychiatric and ambulatory care pharmacist, and Dr. Jeff Gray, who specializes in the care of advanced age patients with acute and chronic conditions are both professors in the Department of Pharmacy Practice at East Tennessee State University Bill Gatton College of Pharmacy in Johnson City, Tennessee. They offer insights into the effects of poor sleep hygiene on learning and performance, as well as practical advice for sleeping well.  Note: This episode discusses medication and health conditions and is for informational purposes only. Proper diagnosis and treatment of health conditions depends on a number of factors. Your doctor or other licensed health care provider is the best person to address your individual health care needs.   Transcript: Dan Vanzant Welcome to White Coat Radio, a podcast from East Tennessee State University Gatton College of Pharmacy in Johnson City, Tennessee. Each episode, we cover a wide range of topics about the pharmacy school experience, from study tips to deep dives with faculty and student pharmacists. I'm one of your hosts, Dan VanZant. Michele Williams And I'm Michele Williams. In this episode, we'll be talking about sleeping well as a pharmacy student with Doctor Sarah Melton and Doctor Jeffrey Gray. Doctor Melton is a professor of pharmacy practice at Gatton. She's a board‑certified psychiatric and ambulatory care pharmacist. Doctor Jeffrey Gray is an associate professor, also in the Department of Pharmacy Practice here at Gatton, and an adjunct professor in the Department of Community and Behavioral Health at the ETSU College of Public Health. Michele Williams He specializes in care of advanced‑age patients with chronic and acute conditions. Doctor Melton and Doctor Gray, welcome to White Coat Radio. Sarah Melton Thanks for having us. Jeff Gray It's good to be here. Thank you. Michele Williams Doctor Melton, you're an expert in psychiatric and neurological conditions, and Doctor Gray, you have a wealth of knowledge in patient care and wellness. And both of you have many years of experience working with students. So what interests you about the topic of sleep, particularly with students? Sarah Melton Well, I’ve been in academia probably for 20 years now and worked with hundreds of students during that time who come to me with difficulty sleeping and asking for advice, or they’ve come with anxiety and depression and we link it back to not sleeping well. So it’s really been an interest of mine because I know with better sleep there’s better performance. Sarah Melton And I think it's our goal to provide information so that everybody does sleep the best so they can perform the best. Jeff Gray Yes. And for me, I teach a class during the P2 year, and I'm always amazed on an annual basis how many students—when I put them into a project where they investigate a topic they're not necessarily familiar with—choose sleep deprivation or insomnia or something related to the quality of their sleep, because they recognize it impacts potentially their performance and other things they desire to do. Jeff Gray And so I know there's a desire among students to learn more about this topic. Michele Williams Yeah. I talk with students a lot about sleep deprivation, especially with regard to studying for exams. So I'm really excited about this topic and looking forward to learning more from both of you. And it's tempting for students, I think, to forgo sleeping—especially the night before an exam—just so they can get those few more hours of studying in. Michele Williams And also because it's difficult to sleep when they're worried. What types of things can result from depriving yourself of sleep? Sarah Melton Well, we know that students aged 19 to 25 need at least 7 to 9 hours of sleep a night—so on average, eight hours. In the third year, I have our students do a two‑week sleep diary, which is very interesting. What I’ve noticed is that most of our students get much less than eight hours. And before exams, maybe they’re getting 2 to 3 hours, and sometimes some students don’t go to bed at all. Sarah Melton And when they're deprived, we see dramatic decreases in cognitive function. Some studies have shown it’s like you're drinking alcohol. And who wants to take an exam when you're under the influence, right? So that's one big thing we notice for sure. Jeff Gray Yes. I personally witnessed a student last week—this student had been involved in an engineering camp. They had minimal sleep during the week but probably enough to manage. But on Friday night, the last night of the camp, they decided to stay up all night socializing. The final camp day was Saturday, and I watched this individual all day long—knowing they’d had hardly any sleep. Their performance was way off, compared to earlier in the week. They were not as engaged. Had they had an exam that day, I’m certain they wouldn’t have performed well. Jeff Gray But your question also touches on chronic deprivation. Chronic lack of sleep increases risks of cardiovascular disease, hypertension, stroke—much higher risks than individuals with adequate sleep. And with athletes, inadequate sleep increases risk of accidents and injuries. Sometimes students find that motivating. Michele Williams Yeah, and what their needs are to strive for better sleep. Sarah Melton Well, another thing we frequently see with chronic sleep deprivation is increased anxiety and depression. And if you're anxious or depressed, you're not going to be productive or perform well. We also see a link with obesity and weight gain, which many people don’t realize. Michele Williams I notice when students come to me after an exam they didn’t do well on saying, “I don’t know what happened—I was so prepared, and then I just went blank,” I always ask, “How much did you sleep the night before?” Often the answer is none or just a couple hours. They don’t connect the dots that they would perform better if they slept more and studied less that last night. Sarah Melton I totally agree. It’s super important to ask. Jeff Gray Yes, there's often a disconnect. Students want consistent sleep but don’t realize how it affects exam performance, athletic events, or other activities. Michele Williams Pharmacy school can really cause students to feel they don’t have enough hours in the day. They feel like sleep is a luxury. So what are some realistic things busy pharmacy students can do to improve the quality of their sleep? Sarah Melton We call this sleep hygiene. Just like brushing your teeth every day, these are daily habits for better sleep. Number one: Go to bed and get up at the same time every day. The brain likes patterns. Students often sleep less during the week and try to catch up on weekends—our brains don't work that way. Number two: No caffeine after 3 or 4 PM. Students laugh at this, but caffeine disrupts sleep. Energy drinks are especially harmful. Jeff Gray I don’t think students realize how much caffeine they’re consuming—many drinks today have several days' worth of caffeine in one serving. Sarah Melton We once had a student drinking 28 Mountain Dews a day! They were referred for anxiety and insomnia—they didn’t need medication; they needed a caffeine taper. Sarah Melton Alcohol: binge drinking on weekends severely disrupts sleep. Some drink alcohol to help fall asleep, but chronically this harms sleep patterns. Jeff Gray Over‑the‑counter products can also interfere with sleep—pseudoephedrine, decongestants, antihistamines taken at the wrong time can be stimulating. Michele Williams So students should ask: What am I ingesting? How much caffeine? Any allergy meds? Alcohol? It’s not always just stress. Sarah Melton Exactly. Also, avoid exercising right before bed—it increases alertness. Avoid TV and screens before bed. If you can’t fall asleep, don’t stare at the clock—turn it away. Your room should be cool, dark, quiet—some like white noise. Jeff Gray Where we’re recording now would be a great sleep environment—dim lighting, quiet, gentle HVAC noise. Sarah Melton But naps? Not always a good idea. Napping late makes it harder to sleep at night. Consolidated nighttime sleep is best. Jeff Gray Yes—sleep hygiene is an all‑day process, not just what happens before bed. Dan Vanzant As a parent, I’ve seen more people recommending melatonin. Have you seen an uptick in students using melatonin or self‑medicating? Jeff Gray Students definitely self‑medicate. Hopefully they're informed. I work with older adults—many use melatonin. I rarely recommend it for anyone over 40 unless there’s a schedule disruption, like jet lag. Sarah Melton Evidence shows melatonin is only effective in a few populations: intellectual disabilities, developmental delays, blindness, jet lag. Otherwise, it’s not very effective—though some swear by it. Other OTC sleep aids like diphenhydramine or doxylamine cause next‑day hangover and cognitive impairment. Not ideal for exam days. Jeff Gray Best practice: Don’t try new medications the night before an exam. Follow the same routine you used while studying. Michele Williams That makes so much sense. Dan Vanzant Doctor Melton, you mentioned blue light. People say not to use devices before bed. Any thoughts? Sarah Melton We recommend no phone, computer, iPad, or TV for one hour before bed. Light is activating. Create a calming routine instead—bath, pajamas, brushing teeth, reading. Blue‑light‑filter glasses can help too. Jeff Gray Students still need electronics to study, but that 30–60 minute window helps. Dan Vanzant What about fitness trackers and tech that monitors sleep? Sarah Melton Fitness trackers are helpful—especially for seeing how long it takes to fall asleep (we want 15–20 min), number of awakenings, hours slept. Jeff Gray My mattress even tracks my sleep! It was eye‑opening to see how restless nights matched how I felt the next day. Tracking patterns can reveal how alcohol, cold medicine, or activities affect sleep. Sarah Melton There’s a great free app: CBT‑I Coach (Cognitive Behavioral Therapy for Insomnia). It guides sleep diaries and teaches cognitive strategies for sleep. No ads. I recommend it often. Dan Vanzant That’s great. We’ll link it in the notes. Michele Williams This has been fascinating. Dan Vanzant Doctor Gray and Doctor Melton, thank you so much. This has been great information for students about sleep and sleep hygiene. Sarah Melton Thanks for having us. Jeff Gray My pleasure.