Sleep health: can we define it? Does it matter?

Abstract

Good sleep is essential to good health. Yet for most of its history, sleep medicine has focused on the definition, identification, and treatment of sleep problems. Sleep health is a term that is infrequently used and even less frequently defined. It is time for us to change this. Indeed, pressures in the research, clinical, and regulatory environments require that we do so. The health of populations is increasingly defined by positive attributes such as wellness, performance, and adaptation, and not merely by the absence of disease. Sleep health can be defined in such terms. Empirical data demonstrate several dimensions of sleep that are related to health outcomes, and that can be measured with self-report and objective methods. One suggested definition of sleep health and a description of self-report items for measuring it are provided as examples. The concept of sleep health synergizes with other health care agendas, such as empowering individuals and communities, improving population health, and reducing health care costs. Promoting sleep health also offers the field of sleep medicine new research and clinical opportunities. In this sense, defining sleep health is vital not only to the health of populations and individuals, but also to the health of sleep medicine itself.

Keywords: Sleep; health measurement; outcomes; public policy.

Figures

Figure 1

Conceptual model of sleep health. This model, similar to those proposed by many other authors, posits that various dimensions of sleep-wake function can affect distal outcomes of health and function. Intermediate processes may include epigenetic, molecular, and cellular processes that in turn affect systems-level processes. These processes, ranging from inflammation to altered function of neural circuits, are more proximally related to health outcomes. The model also recognizes that the relationships between sleep-wake function and molecular, cellular, systems and organism-level outcomes are reciprocal; just as sleep affects function and health, so too function and health influence sleep-wake function.