ATS: New Sleep Quality, Duration Recommendations

First-in-Class Drug Approved for Insomnia
First-in-Class Drug Approved for Insomnia
The American Thoracic Society has issued a statement with recommendations for clinicians and the general public on obtaining good quality sleep and an adequate quantity of sleep.

The American Thoracic Society has issued a statement with recommendations for clinicians and the general public on obtaining good quality sleep and an adequate quantity of sleep. The statement has been published in the American Journal of Respiratory and Critical Care Medicine

The recommendations focus on sleep health in adults and children, the effects of work schedules, the impact of driving, and the diagnosis and treatment of obstructive sleep apnea and insomnia. 

The following statements were formed based on the experience of a panel of clinicians and scientists with expertise in sleep health and a comprehensive literature review. Some key recommendations and conclusions include: 

  • Good quality sleep is critical for good health and overall quality of life.
  • The amount of sleep needed by an individual varies significantly with age across the lifespan.
  • Children are not merely smaller adults with regard to sleep and differ importantly from adults, thereby requiring specific attention to sleep maturational processes.
  • Disparities exist in sleep health related in part to modifiable factors for adequate sleep quality and quantity.
  • Short sleep duration (≤6 hours per 24 hour period) is associated with adverse outcomes including mortality.
  • Long sleep duration (>9–10 hours per 24 hour period) may also be associated with adverse health outcomes.
  • The optimal sleep duration for adults for good health at a population level is 7–9 hours, although individual variability exists.
  • Drowsy driving is an important cause of fatal and non-fatal motor vehicle crashes. It is recommended that all drivers (occupational and non-occupational) receive education about how to recognize the symptoms and consequences of drowsiness.
  • Adolescents may be a particularly susceptible group to drowsy driving; therefore, we recommend inclusion of sleep awareness during their driving education.
  • Occupational demands are a frequent cause of insufficient sleep and can contribute to accident risk in the workplace. Better education for the general public and health care providers regarding the impact of working hours and shift work on sleep duration and quality and the association of sleepiness with workplace injuries is recommended.
  • Sleep disorders are common, cause significant morbidity and have substantial economic impact, but are treatable.
  • Many individuals with sleep disorders remain undiagnosed and untreated.
  • Better education of professional transportation operators regarding obstructive sleep apnea (OSA), other sleep disorders and medications that may interfere with alertness is recommended.
  • Currently health care providers receive very little formal education on the importance of sleep to health or on the evaluation and management of common sleep disorders.

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Experts suggest developing age-based recommendations for sleep duration for children to enable the child to wake spontaneously at the desired time by following regular wake and sleep schedules. The panel also suggest that school start times be delayed to align with physiological circadian propensity for adolescents.

Health care providers are recommended to learn more about sleep hygiene and to encourage patients to maximize their sleep time. It is also recommended that public education programs be developed to emphasize the importance of sleep for good health; better education for the general public and physicians regarding the importance of early identification of high-risk OSA groups; better education of physicians as to the effectiveness of cognitive behavior therapy for insomnia instead of immediate hypnotics/sedatives prescribing; and structural changes to increase access to this treatment, which include training of a wider range of providers and insurance coverage.

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