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Friday, July 03, 2015

Healthy Sleep

The American Thoracic Society (ATS) has released a policy statement with recommendations for clinicians and the general public on achieving good-quality sleep and getting enough sleep.


"Sleep plays a vital role in human health, yet there is a lack of sufficient guidance on promoting good sleep health," said Sutapa Mukherjee, MBBS, PhD, chair of the ATS committee that produced the document.
"In this statement, with an eye towards improving public health, we address the importance of good quality sleep with a focus on sleep health in adults and children; the effects of work schedules on sleep; the impact of drowsy driving; and the diagnosis and treatment of obstructive sleep apnea and insomnia."
The statement is published in the June 15 issue of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.
Key recommendations include the following: 
  • Good-quality sleep is critical for good health and overall quality of life.
  • Short sleep duration (6 hours or less per 24-hour period) is associated with adverse outcomes, including mortality.
  • Long sleep duration (>9 to 10 hours per 24-hour period) may also be associated with adverse health outcomes.
  • The optimal sleep duration in adults for good health at a population level is 7 to 9 hours, although individual variability exists.
  • Because drowsy driving is an important cause of fatal and nonfatal motor vehicle crashes, all drivers (occupational and nonoccupational) should receive education about how to recognize the symptoms and consequences of drowsiness.
  • Better education is needed for the general public and healthcare providers regarding the effect of working hours and shift work on sleep duration and quality and the association of sleepiness with workplace injuries.
  • Sleep disorders are common, cause significant morbidity, and have substantial economic impact, but they are treatable. However, many individuals with sleep disorders remain undiagnosed and untreated.
  • Age-based recommendations for sleep duration in children should be developed. These should enable the child to awaken spontaneously at the desired time through implementation of regular wake and sleep schedules.
  • For adolescents, school start times should be delayed to align with physiologic circadian propensity of this age group.
  • Healthcare providers should receive more education on sleep hygiene and encourage patients to maximize their sleep time.
  • Public education programs should be developed to emphasize the importance of sleep for good health.
  • Better education/awareness is needed of the importance of early identification of groups at high risk for obstructive sleep apnea (in children and adults).
  • Better education of physicians as to the effectiveness of cognitive-behavior therapy for insomnia rather than immediate implementation of hypnotics and sedatives, and structural changes to increase access to this therapy.
Dr Mukherjee has disclosed no relevant financial relationships. Some of the other guideline authors have disclosed the following: consultant to Apnex Medical and Apnicure; paid expert witness, independent medical examiner, or both in workers' compensation and disability cases involving fatigue and sleep apnea, and recipient of research grant from the National Sleep Foundation; speaker for Respiratory Homecare Solutions Canada; president of iONSLEEP, member of advisory committees of SleepMed and Sleep Solutions Inc., consultant to Inspire Medical Systems, and recipient of research grant from Inspire Medical Systems.
Am J Respir Crit Care Med. Published June 15, 2015. Abstract

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