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. 2015 Aug 1;38(8):1161-83.
doi: 10.5665/sleep.4886.

Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

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Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

Consensus Conference Panel et al. Sleep. .

Abstract

The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health.

Keywords: adult; consensus; health; recommendation; sleep duration.

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Figures

Figure 1
Figure 1
Panel members used the following sentence to generate their individual vote for Rounds 1 and 2 on each subcategory (when necessary), category and each hour range of sleep: “Based on the available evidence, [X] hours of sleep is associated with optimal health within the [X] subcategory in the [X] category.” Choice options ranged from 1–9 with 1 = “Strongly Disagree,” 5 = “Neither Agree nor Disagree,” and 9 = “Strongly Agree.” Round 1 voting (A) occurred without influence from other Panel members, Round 2 voting (B) occurred at the face-to-face meeting in Chicago after category content expert presentations and group discussion, final consensus statement voting (C) occurred after group discussion and review of the Round 2 voting results. Consensus statement voting involved panel members using the following modified sentence to generate their vote: “Based on the available evidence, [X] hours of sleep is associated with optimal adult health.” In regards to color coding of the figure, if there was consensus among the panel that < 5 hours of sleep was not associated with, for example, cardiovascular health, the relevant area in Figure 1 would be colored red (e.g., the panel reached consensus that it feels the following statement is inappropriate: “Based on the available evidence, < 5 hours of sleep is associated with optimal health within the hypertension subcategory within the cardiovascular health category”). For expository purposes, subcategories were collapsed to provide overall category specific results. A vertical line was placed on the figures to denote the 7 hour mark.
Figure 2
Figure 2
Biopsychosocial model of sleep duration drivers (adapted with permission from Grandner, Hale, Moore & Patel, 2010).
Figure 3
Figure 3
Two conceptualizations of sleep duration (adapted with permission from Marshall et al. Sleep Med Rev 2008;12:289–298). The green line represents an optimal dose of sleep where the odds of incident disease are lowest. The orange line represents a sleep saturation model, where longer sleep is not necessarily associated with poor health, and may be beneficial in some circumstances (e.g., recovery from sleep deprivation or illness).

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References

    1. Rechtschaffen A, Bergmann BM. Sleep deprivation in the rat: an update of the 1989 paper. Sleep. 2002;25:18–24. - PubMed
    1. Shaw PJ, Tononi G, Greenspan RJ, Robinson DF. Stress response genes protect against lethal effects of sleep deprivation in Drosophila. Nature. 2002;417:287–91. - PubMed
    1. Van Dongen HP, Maislin G, Mullington JM, Dinges DF. The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep. 2003;26:117–26. - PubMed
    1. Pilcher JJ, Huffcutt AI. Effects of sleep deprivation on performance: a meta-analysis. Sleep. 1996;19:318–26. - PubMed
    1. Belenky G, Wesensten NJ, Thorne DR, et al. Patterns of performance degradation and restoration during sleep restriction and subsequent recovery: a sleep dose-response study. J Sleep Res. 2003;12:1–12. - PubMed

APPENDIX B. REFERENCE LIST OF FINAL EVIDENCE

General Health
    1. Bliwise DL, King AC, Harris RB. Habitual sleep durations and health in a 50-65 year old population. J Clin Epidemiol. 1994 Jan;47(1):35–41. - PubMed
    1. Centers for Disease Control and Prevention (CDC) Effect of short sleep duration on daily activities–United States, 2005-2008. MMWR Morb Mortal Wkly Rep. 2011 Mar 4;60(8):239–42. - PubMed
    1. Chen X, Gelaye B, Williams MA. Sleep characteristics and health-related quality of life among a national sample of American young adults: assessment of possible health disparities. Qual Life Res. 2014 Mar;23(2):613–25. - PMC - PubMed
    1. Chiu HF, Xiang YT, Dai J, Chan SS, Yu X, Ungvari GS, Caine ED. Sleep duration and quality of life in young rural Chinese residents. Behav Sleep Med. 2013;11(5):360–8. - PubMed
    1. Furihata R, Uchiyama M, Takahashi S, Suzuki M, Konno C, Osaki K, Konno M, Kaneita Y, Ohida T, Akahoshi T, Hashimoto S, Akashiba T. The association between sleep problems and perceived health status: a Japanese nationwide general population survey. Sleep Med. 2012 Aug;13(7):831–7. - PubMed
Cardiovascular Health
    1. Abe T, Aoki T, Yata S, Okada M. Sleep duration is significantly associated with carotid artery atherosclerosis incidence in a Japanese population. Atherosclerosis. 2011 Aug;217(2):509–13. - PubMed
    1. Altman NG, Izci-Balserak B, Schopfer E, Jackson N, Rattanaumpawan P, Gehrman PR, Patel NP, Grandner MA. Sleep duration versus sleep insufficiency as predictors of cardiometabolic health outcomes. Sleep Med. 2012 Dec;13(10):1261–70. - PMC - PubMed
    1. Amagai Y, Ishikawa S, Gotoh T, Kayaba K, Nakamura Y, Kajii E. Sleep duration and incidence of cardiovascular events in a Japanese population: the Jichi Medical School cohort study. J Epidemiol. 2010;20(2):106–10. - PMC - PubMed
    1. Ayas NT, White DP, Manson JE, Stampfer MJ, Speizer FE, Malhotra A, Hu FB. A prospective study of sleep duration and coronary heart disease in women. Arch Intern Med. 2003 Jan 27;163(2):205–9. - PubMed
    1. Bansil P, Kuklina EV, Merritt RK, Yoon PW. Associations between sleep disorders, sleep duration, quality of sleep, and hypertension: results from the National Health and Nutrition Examination Survey, 2005 to 2008. J Clin Hypertens (Greenwich) 2011 Oct;13(10):739–43. - PubMed
Metabolic Health
    1. Appelhans BM, Janssen I, Cursio JF, Matthews KA, Hall M, Gold EB, Burns JW, Kravitz HM. Sleep duration and weight change in midlife women: the SWAN sleep study. Obesity (Silver Spring) 2013 Jan;21(1):77–84. - PMC - PubMed
    1. Ayas NT, White DP, Al-Delaimy WK, Manson JE, Stampfer MJ, Speizer FE, Patel S, Hu FB. A prospective study of self-reported sleep duration and incident diabetes in women. Diabetes Care. 2003 Feb;26(2):380–4. - PubMed
    1. Beccuti G, Pannain S. Sleep and obesity. Curr Opin Clin Nutr Metab Care. 2011 Jul;14(4):402–12. - PMC - PubMed
    1. Beihl DA, Liese AD, Haffner SM. Sleep duration as a risk factor for incident type 2 diabetes in a multiethnic cohort. Ann Epidemiol. 2009 May;19(5):351–7. - PubMed
    1. Björkelund C, Bondyr-Carlsson D, Lapidus L, Lissner L, Månsson J, Skoog I, Bengtsson C. Sleep disturbances in midlife unrelated to 32-year diabetes incidence: the prospective population study of women in Gothenburg. Diabetes Care. 2005 Nov;28(11):2739–44. - PubMed
Mental Health
    1. Babson KA, Trainor CD, Feldner MT, Blumenthal H. A test of the effects of acute sleep deprivation on general and specific self-reported anxiety and depressive symptoms: an experimental extension. J Behav Ther Exp Psychiatry. 2010 Sep;41(3):297–303. - PMC - PubMed
    1. Bae SM, Lee YJ, Cho IH, Kim SJ, Im JS, Cho SJ. Risk factors for suicidal ideation of the general population. J Korean Med Sci. 2013 Apr;28(4):602–7. - PMC - PubMed
    1. Benito-León J, Louis ED, Bermejo-Pareja F. Cognitive decline in short and long sleepers: a prospective population-based study (NEDICES) J Psychiatr Res. 2013 Dec;47(12):1998–2003. - PMC - PubMed
    1. Chang JJ, Salas J, Habicht K, Pien GW, Stamatakis KA, Brownson RC. The association of sleep duration and depressive symptoms in rural communities of Missouri, Tennessee, and Arkansas. J Rural Health. 2012 Summer;28(3):268–76. - PMC - PubMed
    1. Chen MC, Burley HW, Gotlib IH. Reduced sleep quality in healthy girls at risk for depression. J Sleep Res. 2012 Feb;21(1):68–72. - PMC - PubMed
Immunologic Health
    1. Axelsson J, Rehman JU, Akerstedt T, Ekman R, Miller GE, Höglund CO, Lekander M. Effects of sustained sleep restriction on mitogen-stimulated cytokines, chemokines and T helper 1/ T helper 2 balance in humans. PLoS One. 2013 Dec 11;8(12):e82291. - PMC - PubMed
    1. Boudjeltia KZ, Faraut B, Stenuit P, Esposito MJ, Dyzma M, Brohée D, Ducobu J, Vanhaeverbeek M, Kerkhofs M. Sleep restriction increases white blood cells, mainly neutrophil count, in young healthy men: a pilot study. Vasc Health Risk Manag. 2008;4(6):1467–70. - PMC - PubMed
    1. Chiang JK. Short duration of sleep is associated with elevated high-sensitivity C-reactive protein level in Taiwanese adults: a cross-sectional study. J Clin Sleep Med. 2014 Jul 15;10(7):743–9. - PMC - PubMed
    1. Cohen S, Doyle WJ, Alper CM, Janicki-Deverts D, Turner RB. Sleep habits and susceptibility to the common cold. Arch Intern Med. 2009 Jan 12;169(1):62–7. - PMC - PubMed
    1. Faraut B, Boudjeltia KZ, Dyzma M, Rousseau A, David E, Stenuit P, Franck T, Van Antwerpen P, Vanhaeverbeek M, Kerkhofs M. Benefits of napping and an extended duration of recovery sleep on alertness and immune cells after acute sleep restriction. Brain Behav Immun. 2011 Jan;25(1):16–24. - PubMed
Human Performance
    1. Abe T, Komada Y, Inoue Y. Short sleep duration, snoring and subjective sleep insufficiency are independent factors associated with both falling asleep and feeling sleepiness while driving. Intern Med. 2012;51(23):3253–60. - PubMed
    1. Abe T, Komada Y, Nishida Y, Hayashida K, Inoue Y. Short sleep duration and long spells of driving are associated with the occurrence of Japanese drivers' rear-end collisions and single-car accidents. J Sleep Res. 2010 Jun;19(2):310–6. - PubMed
    1. Akerstedt T, Ingre M, Kecklund G, Anund A, Sandberg D, Wahde M, Philip P, Kronberg P. Reaction of sleepiness indicators to partial sleep deprivation, time of day and time on task in a driving simulator–the DROWSI project. J Sleep Res. 2010 Jun;19(2):298–309. - PubMed
    1. Banks S, Dinges DF. Behavioral and physiological consequences of sleep restriction. J Clin Sleep Med. 2007 Aug 15;3(5):519–28. Review. - PMC - PubMed
    1. Carter N, Ulfberg J, Nyström B, Edling C. Sleep debt, sleepiness and accidents among males in the general population and male professional drivers. Accid Anal Prev. 2003 Jul;35(4):613–7. - PubMed
Cancer
    1. Bellavia A, Âkerstedt T, Bottai M, Wolk A, Orsini N. Sleep duration and survival percentiles across categories of physical activity. Am J Epidemiol. 2014 Feb 15;179(4):484–91. - PubMed
    1. Forsythe LP, Helzlsouer KJ, MacDonald R, Gallicchio L. Daytime sleepiness and sleep duration in long-term cancer survivors and non-cancer controls: results from a registry-based survey study. Support Care Cancer. 2012 Oct;20(10):2425–32. - PubMed
    1. Girschik J, Heyworth J, Fritschi L. Self-reported sleep duration, sleep quality, and breast cancer risk in a population-based case-control study. Am J Epidemiol. 2013 Feb 15;177(4):316–27. - PubMed
    1. Ikehara S, Iso H, Date C, Kikuchi S, Watanabe Y, Wada Y, Inaba Y, Tamakoshi A JACC Study Group. Association of sleep duration with mortality from cardiovascular disease and other causes for Japanese men and women: the JACC study. Sleep. 2009 Mar;32(3):295–301. - PMC - PubMed
    1. Jiao L, Duan Z, Sangi-Haghpeykar H, Hale L, White DL, El-Serag HB. Sleep duration and incidence of colorectal cancer in postmenopausal women. Br J Cancer. 2013 Jan 15;108(1):213–21. - PMC - PubMed
Pain
    1. Andrews NE, Strong J, Meredith PJ, D'Arrigo RG. Association between physical activity and sleep in adults with chronic pain: a momentary, within-person perspective. Phys Ther. 2014 Apr;94(4):499–510. - PubMed
    1. Buxton OM, Hopcia K, Sembajwe G, Porter JH, Dennerlein JT, Kenwood C, Stoddard AM, Hashimoto D, Sorensen G. Relationship of sleep deficiency to perceived pain and functional limitations in hospital patient care workers. J Occup Environ Med. 2012 Jul;54(7):851–8. - PMC - PubMed
    1. Edwards RR, Almeida DM, Klick B, Haythornthwaite JA, Smith MT. Duration of sleep contributes to next-day pain report in the general population. Pain. 2008 Jul;137(1):202–7. - PMC - PubMed
    1. Haack M, Lee E, Cohen DA, Mullington JM. Activation of the pros-taglandin system in response to sleep loss in healthy humans: potential mediator of increased spontaneous pain. Pain. 2009 Sep;145(1–2):136–41. - PMC - PubMed
    1. Haack M, Mullington JM. Sustained sleep restriction reduces emotional and physical well-being. Pain. 2005 Dec 15;119(1–3):56–64. - PubMed
Mortality
    1. Amagai Y, Ishikawa S, Gotoh T, Doi Y, Kayaba K, Nakamura Y, Kajii E. Sleep duration and mortality in Japan: the Jichi Medical School Cohort Study. J Epidemiol. 2004 Jul;14(4):124–8. - PubMed
    1. Azevedo Da Silva M, Singh-Manoux A, Shipley MJ, Vahtera J, Brunner EJ, Ferrie JE, Kivimäki M, Nabi H. Sleep duration and sleep disturbances partly explain the association between depressive symptoms and cardiovascular mortality: the Whitehall II cohort study. J Sleep Res. 2014 Feb;23(1):94–7. - PMC - PubMed
    1. Bellavia A, Âkerstedt T, Bottai M, Wolk A, Orsini N. Sleep duration and survival percentiles across categories of physical activity. Am J Epidemiol. 2014 Feb 15;179(4):484–91. - PubMed
    1. Burazeri G, Gofin J, Kark JD. Over 8 hours of sleep–marker of increased mortality in Mediterranean population: follow-up population study. Croat Med J. 2003 Apr;44(2):193–8. - PubMed
    1. Cappuccio FP, D'Elia L, Strazzullo P, Miller MA. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep. 2010 May;33(5):585–92. - PMC - PubMed

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