I am revisiting the topic of sleep-a natural function that cleverly evades me. Now that summer is here, the additional hours of daylight will affect our sleep patterns. Sleep is an important part of staying healthy, but how much do we actually need?
Not getting enough sleep, sleeping too much, and experiencing a poor quality of sleep are associated with disease risk-particularly noncommunicable diseases-including cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes mellitus.
Sleep guidelines
The Japanese Health Service Bureau developed Sleep Guidelines for Health Promotion 2014, challenging residents to adopt "good sleep." The guidelines are written in Japanese, and Noda wrote a summary of the 12 messages given to citizens to improve sleep for health, with different target goals for the young, middle-aged adults, and older adults.1
The young were advised not to stay up late because they would not get an adequate amount of sleep; the middle-aged generation was told to get as much sleep as they could because they were usually shortchanged hours due to work; and older adults were encouraged to not obsess over the amount they slept because it was likely more than enough.1
The Japanese embarked on this initiative because the World Health Organization's Global Action Plan for the Prevention and Control of Noncommunicable Diseases for 2013-2020 did not include strategies related to sleep management.2 Data sources vary and are too contradictory to state with any certainty who in the world gets the least amount of sleep on average, but there was enough concern from Japanese officials to create and disseminate these guidelines. The target was initially healthcare professionals who advised patients, but outreach was eventually directed to residents to evaluate their own sleep patterns and improve individual sleep issues.
Sleep duration recommendations
In 2014, the National Sleep Foundation (NSF) issued new sleep duration recommendations developed by a multidisciplinary panel of experts from 12 stakeholder organizations and societies.3 In reviewing the literature, panelists rated overall health (benefits from sleep) as well as cognitive, physical, and emotional health. A consensus was reached, and recommendations were defined based on a synthesis of the scientific evidence and expert opinion.
The panel members determined the recommended number of hours, the number of hours that may be appropriate, and a recommended limit (no less or no more) of hours for nine distinct age categories from newborns (ages 0 to 3 months) to older adults (age 65 or older). For the adult group ages 26 to 64, 7 to 9 hours per night is recommended; 6 to 10 hours may be appropriate, and less than 6 or more than 10 hours is not recommended. Where do you fall in this range?
Digital distractions
Going to sleep is increasingly difficult in our age of technology. There are so many devices to interfere with one's ability to go to sleep and to sleep enough hours to awaken rested and rejuvenated. How many electronic devices are in your bedroom? How many of them have little red or blue lights that are constantly on, creating less than a completely darkened room? Do you watch TV in your bedroom before going to sleep? Do you take your cell phone to bed with you? Do you turn off the screen and notifications for sleep or leave them on?
There are numerous guidelines for lifestyle behaviors related to diet and physical activity to prevent noncommunicable diseases. Add an assessment of sleep to a patient's history of a present illness-it might be revealing. Take a look at the suggestions by the NSF, available online at http://www.sleep.org, that can help you and your patients achieve good, restful sleep. Sweet dreams!
Jamesetta A. Newland, PhD, FNP-BC, FAANP, DPNAP
EDITOR-IN-CHIEF [email protected]
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