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Sleep Health

Sleep Health

Goal

Increase public knowledge of how adequate sleep and treatment of sleep disorders improve health, productivity, wellness, quality of life, and safety on roads and in the workplace.

Overview

Poor sleep health is a common problem with 25 percent of U.S. adults reporting insufficient sleep or rest at least 15 out of every 30 days.1 The public health burden of chronic sleep loss and sleep disorders, coupled with low awareness of poor sleep health among the general population, health care professionals, and policymakers, necessitates a well-coordinated strategy to improve sleep-related health.

Why Is Sleep Health Important?

Sleep, like nutrition and physical activity, is a critical determinant of health and well-being.2 Sleep is a basic requirement for infant, child, and adolescent health and development. Sleep loss and untreated sleep disorders influence basic patterns of behavior that negatively affect family health and interpersonal relationships. Fatigue and sleepiness can reduce productivity and increase the chance for mishaps such as medical errors and motor vehicle or industrial accidents.3, 4

Adequate sleep is necessary to:

  • Fight off infection
  • Support the metabolism of sugar to prevent diabetes
  • Perform well in school
  • Work effectively and safely

Sleep timing and duration affect a number of endocrine, metabolic, and neurological functions that are critical to the maintenance of individual health. If left untreated, sleep disorders and chronic short sleep are associated with an increased risk of:

  • Heart disease
  • High blood pressure
  • Obesity
  • Diabetes
  • All-cause mortality5, 6

Sleep health is a particular concern for individuals with chronic disabilities and disorders such as arthritis, kidney disease, pain, human immunodeficiency virus (HIV), epilepsy, Parkinson’s disease, and depression. Among older adults, the cognitive and medical consequences of untreated sleep disorders decrease health-related quality of life, contribute to functional limitations and loss of independence, and are associated with an increased risk of death from any cause.7

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Understanding Sleep Health

The odds of being a short sleeper (defined as someone who sleeps less than 6 hours a night) in the United States have increased significantly over the past 30 years.8 Competition between sleep schedules, employment, and lifestyle is a recent trend. Intermittent sleep disturbances due to lifestyle choices are associated with temporary fatigue, disorientation, and decreased alertness.

Sleep-disordered breathing (SDB), which includes sleep apnea, is another serious threat to health. SDB is characterized by intermittent airway obstruction or pauses in breathing. People with untreated SDB have 2 to 4 times the risk of heart attack and stroke.9, 10 Obesity is a significant risk factor for SDB, and weight loss is associated with a decrease in SDB severity.11

  • SDB in Children:African American children are at least twice as likely to develop SDB than children of European descent.12 The risk of SDB during childhood is associated with low socioeconomic status independent of obesity and other risk factors.13 Left untreated, SDB in children is associated with difficulties in school, metabolic disorders, and future heart disease risk.14
  • SDB in Older Adults:SDB may affect 20 to 40 percent of older adults and, if left untreated, is associated with a 2- to 3-fold increased risk of stroke and mortality.15, 16

Sleep health education and promotion strategies are needed to address disparities in sleep health across age, race, education, and socioeconomic groups. Health education and promotion programs can increase awareness of common sleep disorders, such as insomnia, restless leg syndrome, and SDB. Sleep health education programs in workplaces can promote better work schedule patterns and motivate managers and workers to adopt strategies that reduce risks to health and safety. Without sleep health education, individuals often prioritize other activities over sleep and accept constant sleepiness and sleep disruption as inevitable.

Emerging Issues in Sleep Health

Progress in the following areas will yield more information on sleep health over the coming decade:

  • Further evolution of biomedical sleep research
  • Quantification of health risks associated with untreated SDB across the lifespan
  • Findings from the first U.S.-based phase III SDB treatment trials in children and adults

References

1Centers for Disease Control and Prevention, Epidemiology Program Office. Perceived insufficient rest or sleep among adults: United States, 2008. MMWR. 2009 Oct 30;58(42):1175-9.

2Institute of Medicine, Committee on Sleep Medicine and Research. Sleep disorders and sleep deprivation: An unmet public health problem. Washington: National Academies Press; 2006.

3Philip P. Sleepiness of occupational drivers. Ind Health. 2005 Jan;43(1):30-3. [Review].

4Mountain SA, Quon BS, Dodek P, et al. The impact of housestaff fatigue on occupational and patient safety. Lung. 2007 Jul–Aug;185(4):203-9. [Review].

5Van Cauter E, Knutson KL. Sleep and the epidemic of obesity in children and adults. Eur J Endocrinol. 2008 Dec;159(suppl 1):S59-66. [Review].

6Van Cauter E, Holmback U, Knutson K, et al. Impact of sleep and sleep loss on neuroendocrine and metabolic function. Horm Res. 2007;67(suppl 1):2-9. Epub 2007 Feb 15. [Review].

7Paudel ML, Taylor BC, Ancoli-Israel S, et al.; Osteoporotic Fractures in Men (MrOS) Study. Rest/activity rhythms and mortality rates in older men: MrOS Sleep Study. Chronobiol Int. 2010 Jan;27(2):363-77.

8Knutson KL, Van Cauter E, Rathouz PJ, et al. Trends in the prevalence of short sleepers in the USA: 1975–2006. Sleep. 2010 Jan 1;33(1):37-45.

9Kato M, Adachi T, Koshino Y, et al. Obstructive sleep apnea and cardiovascular disease. Circ J. 2009 Aug;73(8):1363-70. [Review].

10Young T. Rationale, design and findings from the Wisconsin Sleep Cohort Study: Toward understanding the total societal burden of sleep disordered breathing. Sleep Med Clin. 2009 Mar 1;4(1):37-46.

11Leinum CJ, Dopp JM, Morgan BJ. Sleep-disordered breathing and obesity: Pathophysiology, complications, and treatment. Nutr Clin Pract. 2009 Dec;24(6):675-87. [Review].

12Rosen CL, Larkin EK, Kirchner HL, et al. Prevalence and risk factors for sleep-disordered breathing in 8- to 11-year-old children: Association with race and prematurity, J Pediatr. 2003 Apr;142(4):383-9.

13Spilsbury JC, Storfer-Isser A, Kirchner HL, et al. Neighborhood disadvantage as a risk factor for pediatric obstructive sleep apnea. J Pediatr. 2006 Sep;149(3):342-7.

14Redline S, Storfer-Isser A, Rosen CL, et al. Association between metabolic syndrome and sleep-disordered breathing in adolescents. Am J Respir Crit Care Med. 2007 Aug 15;176(4):401-8.

15Redline S, Yenokyan G, Gottlieb DJ, et al. Obstructive sleep apnea hypopnea and incident stroke: The sleep heart health study. Am J Respir Crit Care Med. 2010 Jul 15;182(2):269-77.

16Punjabi NM, Caffo BS, Goodwin JL, et al. Sleep-disordered breathing and mortality: A prospective cohort study. PLoS Med. 2009 Aug;6(8):e1000132.

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