It takes a village, not questionnaires, to improve children's sleep health: A commentary on community-driven sleep health

Recent global calls to promote sleep health (e.g., Refs. [1,2]) have focused on three pillars: education and awareness, standardized data collection, and multi-sector policy integration. While these strategies are important, they often overlook the immediate barriers faced by children in low-resource settings. In communities where safe sleep surfaces, protection from disease vectors, and thermal comfort are lacking, sleep health cannot be meaningfully improved through educational campaigns, data collection, or information dissemination.

This commentary calls for a paradigm shift toward solutions grounded in real-world conditions—within the free-living environments of the people these efforts aim to support. These solutions must be practical and community-driven, emphasizing environmental and cultural realities over top-down mandates. They should prioritize immediate action and reflect local culture—either alongside or in place of expert consensus, which often represents professional perspectives rather than the lived experiences of those most affected.

1. Blind spots in current global sleep health discourse

Despite progress in broadening the scope of sleep medicine to define, assess, and promote sleep health, critical gaps remain in strategies aimed at improving population-level outcomes. Training healthcare providers and incorporating sleep health into academic curricula are commendable goals, but they are not feasible in regions with limited or nonexistent healthcare infrastructure. Similarly, public awareness campaigns and workplace policies assume systems capable of adopting such measures—systems often absent in low-resource settings.

Educational materials designed for literate populations in high-income countries frequently fail in contexts where literacy is low and access to digital media is limited. This disconnect significantly undermines the effectiveness of conventional health promotion strategies.

2. Community engagement as a catalyst for change

Sleep questionnaires, high-impact publications, and prolonged governmental deliberations may serve academic advancement, but they do little to address urgent community needs. Locally tailored interventions offer a powerful way to improve sleep health by aligning strategies with cultural, environmental, and infrastructural realities. These interventions meet the unique needs of each community, making them more accessible and relevant than standardized approaches.

Community engagement and stakeholder co-creation provide a transformative pathway for sleep health promotion. When applied effectively, these efforts translate abstract goals into tangible outcomes: safe sleeping environments, culturally adapted educational tools, and empowered families. By involving local stakeholders in both development and implementation, initiatives foster ownership and sustainability.

From a research perspective, such interventions create opportunities for iterative data collection while enabling communities to monitor progress, identify emerging challenges, and refine strategies over time. This continuous feedback loop enhances program effectiveness and informs broader policy development, ensuring future initiatives are grounded in real-world evidence and community experience.

3. Actionable strategies

Advancing sleep health in diverse global contexts requires moving from generalized approaches to targeted, community-informed strategies. Recognizing the limitations of conventional methods, the following practical, scalable actions can be implemented at local, regional, and national levels.

• 1.Co-develop ultra-brief, low-literacy tools that combine visuals with facilitator scripts to make information accessible.
• 2.Train “sleep champions”—teachers and community health workers—through micro-credentialing programs to promote sleep health locally.
• 3.Partner with schools and families to co-design culturally relevant content that resonates with local values and practices.
• 4.Conduct participatory workshops to adapt educational materials and delivery methods to community needs.
• 5.Establish community advisory boards to define locally meaningful sleep health indicators.
• 6.Train local volunteers to collect and interpret data, fostering collaborative learning and ownership.
• 7.Use equity mapping to identify and prioritize high-need areas for resource allocation.
• 8.Embed environmental interventions—such as mosquito nets and bedding—within educational efforts to maximize impact.

“It takes a village, not questionnaires, to improve children's sleep health.”

The path forward lies in empowering communities to co-create and own solutions that reflect their unique contexts, values, and needs. By integrating these principles, global sleep health initiatives can evolve from aspirational policy frameworks into lived realities—successfully connecting with local communities and meeting them where they are, in ways that speak to them.

As Mama, team leader for Sleeping Children Around the World [3], aptly puts it:

“Translating culture, not just language or expert knowledge.”

Ethical approval

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Funding statement

This work was supported by [insert funding source if applicable].

Declaration of competing interest

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Full responsibility for the editorial process for this article was delegated to another journal editor. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.