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, Nathaniel F Watson, M Safwan Badr, Gregory Belenky, Donald L Bliwise, Orfeu M Buxton, Daniel Buysse, David F Dinges, James Gangwisch, Michael A Grandner, Clete Kushida, Raman K Malhotra, Jennifer L Martin, Sanjay R Patel, Stuart F Quan, Esra Tasali, Consensus Conference Panel, Nathaniel F Watson, M Safwan Badr, Gregory Belenky, Donald L Bliwise, Orfeu M Buxton, Daniel Buysse, David F Dinges, James Gangwisch, Michael A Grandner, Clete Kushida, Raman K Malhotra, Jennifer L Martin, Sanjay R Patel, Stuart F Quan, Esra Tasali

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.

© 2015 Associated Professional Sleep Societies, LLC.

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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Cardiovascular Health
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Metabolic Health
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Immunologic Health
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Human Performance
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Cancer
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Pain
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Mortality
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    1. Suzuki E, Yorifuji T, Ueshima K, Takao S, Sugiyama M, Ohta T, Ishikawa-Takata K, Doi H. Sleep duration, sleep quality and cardiovascular disease mortality among the elderly: a population-based cohort study. Prev Med. 2009 Aug-Sep;49(2–3):135–41.
    1. Tamakoshi A, Ohno Y JACC Study Group. Self-reported sleep duration as a predictor of all-cause mortality: results from the JACC study, Japan. Sleep. 2004 Feb 1;27(1):51–4.
    1. Xiao Q, Keadle SK, Hollenbeck AR, Matthews CE. Sleep Duration and Total and Cause-Specific Mortality in a Large US Cohort: Interrelationships With Physical Activity, Sedentary Behavior, and Body Mass Index. American Journal of Epidemiology. 2014 Oct 3;180(10):997–1006.
    1. Yeo Y, Ma SH, Park SK, Chang SH, Shin HR, Kang D, Yoo KY. A prospective cohort study on the relationship of sleep duration with all-cause and disease-specific mortality in the Korean Multi-center Cancer Cohort study. J Prev Med Public Health. 2013 Sep;46(5):271–81.

Source: PubMed

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