Symptoms of sleep disturbances among children at two general pediatric clinics. Santa Monica, CA: RAND; 2001. Maher, M. J., Rego, S. A., & Asnis, G. M. (2006). |, Insufficient sleep has an estimated economic impact of more than, Lack of sleep or poor sleep results in unplanned absences from work that, Drowsy driving is responsible for more than, Having a sleep disorder during pregnancy may. This finding suggests a U-shape curve to sleep among adolescents in which too little or too much sleep is associated with mental health problems and substance abuse. Positron emission tomography study of human brain functional development. Taylor, R. W., Haszard, J. J., Jackson, R., Morrison, S., Beebe, D. W., Meredith-Jones, K. A., Elder, D. E., & Galland, B. C. (2023). Global Smart Sleep Tracking Products Market Analysis 2019-2028. Teeth grinding. National Library of Medicine, Biotech Information. Privacy Policy. Citation: 1.0 INTRODUCTION Healthy sleep requires adequate duration, appropriate timing, good quality, regularity, and the absence of disturbances and disorders. Based on this evidence, the panel decided to focus on the relationships between sleep duration and the following 10 health categories: cardiovascular health, developmental health, human performance, general health, immunology, longevity, mental health, metabolic health, pain, and cancer. In one cross-sectional survey of 27,939 adolescents, participants who slept 78 hours reported less feelings of hopelessness, less tobacco use, less alcohol use, less illicit drug use, fewer suicidal thoughts, and fewer suicidal attempts compared to participants who reported sleeping 67 hours per night.51 Of note, this study showed a negative correlation between more sleep and less concerning behaviors, but after 9 hours of sleep, an increase in these behaviors was noted. sharing sensitive information, make sure youre on a federal Dr. Rosen has consulted as a medical advisor for Jazz Pharmaceuticals. The panel recommendations were based on literature characterized by several strengths. Children (Basel). For teenagers aged 13 to 18 years of age, there was consensus that < 8 hours or > 10 hours of sleep on a regular basis was inappropriate. Wang H, Sekine M, Chen X, Yamagami T, Kagamimori S. Lifestyle at 3 years of age and quality of life (QOL) in first-year junior high school students in Japan: results of the Toyama Birth Cohort Study. Terms of Use and The charge to the Consensus Conference panel was to determine a sleep duration recommendation for healthy children. 71.2% of adults take 5 milligrams of melatonin or less. Sharma, S., & Kavuru, M. (2010). Pitch us your story idea, share your expertise with SleepFoundation.org, or let us know about your sleep experiences right here. The panel also discussed consideration of nap duration for age appropriate children. Inclusion in an NLM database does not imply endorsement of, or agreement with, Associations between Aircraft Noise Exposure and Self-Reported Sleep Duration and Quality in the United States-Based Prospective Nurses Health Study Cohort. Our editors and medical experts rigorously evaluate every article and guide to ensure the information is factual, up-to-date, and free of bias. Keywords: Multiple rounds of evidence review, discussion and voting were conducted to arrive at the final recommendations. 6, 2015 Sleep is essential for optimal health. |, Among U.S. counties, Boulder County in Colorado has the, 4.8 of 10 U.S. of workers say they are regularly tired during the day, and 6.9 of 10 say they are tired when their work day is done, according to a SleepFoundation.org survey. (2014). The disease control center recommends 9-10 hours of sleep for teenagers and more than 10 hours of sleep for school age children 1. Centers for Disease Control and Prevention. 12 to 16 hours per 24 hours, including naps. Martinez-Gomez D, Eisenmann JC, Gomez-Martinez S, et al. Investigate downstream mechanisms linking habitual sleep duration to health and functioning. Curr Opin Pulm Med. All values are per 24 hours. "More than a third of . Pediatric Sleep Duration Consensus Statement: A Step Forward. Centers for Disease Control and Prevention. 2016 Jan;17:52-6. doi: 10.1016/j.sleep.2015.10.003. There was consensus that 8 to 10 hours was appropriate for optimal health. Studies that mimic typical sleep-wake cycles and lifestyles in each age group are needed. The recommendati (2006). Bennet, L., Walker, D. W., & Horne, R. (2018). 11 to 14 hours per 24 hours, including naps. Healthy sleep requires adequate duration, appropriate timing, good quality, regularity, and the absence of disturbances and disorders. Unauthorized use of these marks is strictly prohibited. Based on your answers, we will calculate your free There were a few U-shape curves that showed that both, too little and too much sleep were associated with poorer outcomes. Anderson B, Storfer-Isser A, Taylor HG, Rosen CL, Redline S. Associations of executive function with sleepiness and sleep duration in adolescents. 2018 Dec 11;1(2):e11193. Esposito, S., Laino, D., DAlonzo, R., Mencarelli, A., Di Genova, L., Fattorusso, A., Argentiero, A., & Mencaroni, E. (2019). A 10% increase in body weight may make you, People with irritable bowel syndrome (IBS) are, Jet lag most often affects people when they, 94.8% of adults lose at least an hour of sleep to pain in a given week, according to a SleepFoundation.org survey. After discussion, panel members completed Round 2 voting for the age groups within the domain, following the same procedures from Round 1 voting. that each overnight stretch gets a little longer. Sleep is a necessity for health. PMC The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Paruthi S, Brooks LJ, D'Ambrosio C, et al. @article{Paruthi2016RecommendedAO, title={Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine. Merck Manual Consumer Version. At the conference, members reviewed the results of Round 1 voting for a domain, and then the domain experts presented a review of the best available evidence for that domain. You will be subject to the destination website's privacy policy when you follow the link. In school-aged children, there are conflicting data, but children sleeping at least 10 hours report less health complaints and children with < 8 hours of sleep have increased reports of ADHD behaviors. All panel members are experts in sleep medicine and/or sleep science. Other studies used an experimental design to compare the effects of sleep deprivation or sleep extension to the control condition. Waking up too early the consequences of preterm birth on sleep development. Ravid S, Afek I, Suraiya S, Shahar E, Pillar G. Kindergarten children's failure to qualify for first grade could result from sleep disturbances. Gruber R, Cassoff J, Frenette S, Wiebe S, Carrier J. Sleep architecture and glucose and insulin homeostasis in obese adolescents. Association of sleep patterns with psychological positive health and health complaints in children and adolescents. https://www.cdc.gov/nchs/data/databriefs/db230.pdf. Substantial heterogeneity was present in the sleep duration assessment instruments. How much sleep you need changes as you age. Are April 2016, the American Academy of Pediatrics endorsed the subsequent publications: Paruthi S, Brooks LJ, D'Ambrosio C, et allen. Experimental studies of sleep restriction or sleep extension showed that participants sleeping more than 9 hours (mean 9.8 hours) had better emotional lability scores and less restless/impulsive behaviors per teacher reports compared to those sleeping an average of 8.4 hours.48 In a similar study, children with a mean of 9.3 hours of sleep had significantly higher positive affect scores and parent-reported emotional regulation compared to children sleeping a mean of 8.1 hours.49 In contrast, no group differences were detected in negative affective scores and child-reported emotional regulation ratings. However, two large prospective birth cohorts indicated that over a 24-hour period, healthy infants slept slightly > 13 to slightly > 14 hours.8,9 Furthermore, infants sleeping for lesser amounts of time had a greater likelihood of quality of life issues later in childhood.9, For children in the 1 to < 3 years and 3 to < 6 years age ranges, there were only a small number of studies to review. The panel reviewed existing literature to achieve consensus, and realized that serious gaps in knowledge exist in the pediatric population. A. National Institutes of Health, National Library of Medicine. 3 to 5 years. The Relationship between Sleep Habits and Mental Health in Iranian RESULTS Complete sleep data were available for 519 children (87.8%) with a mean age of 7.3 years (SD 0.2). Many studies in the metabolic domain specifically targeted the relationship between sleep duration and overweight/obesity. Hyattsville, MD: National Center for Health Statistics., Retrieved October 22, 2020, from, Centers for Disease Control and Prevention. Studies are needed to identify how genetics relate to individual sleep need and the response and resilience to sleep loss. It noted that sleep also must be appropriately timed and without disturbances. Eric Suni has over a decade of experience as a science writer and was previously an information specialist for the National Cancer Institute. Intervention studies are needed to help clarify whether modifying sleep duration improves health outcomes in children. The 16-year-old who stayed up until midnight may become a 36-year-old who gets drowsy by 10 p.m. 1 - 3 Healthy sleep comprises many dimensions, including adequate duration, good quality, appropriate timing, and the absence of sleep disorders. Hafner, M., Stepanek, M., Taylor, J., Troxel, W. M., & van Stolk, C. (2017). JAMA, 262(11), 14791484., Retrieved March 27, 2023, from. The https:// ensures that you are connecting to the Nutt, D., Wilson, S., & Paterson, L. (2008). Epub 2011 Sep 30. government site. Association between short time in bed, health-risk behaviors and poor academic achievement among Norwegian adolescents. Also, measures of sleep duration often do not capture information about the regularity of sleep patterns, the timing of sleep, or the quality of sleep, all of which could directly affect sleep duration and health outcomes. Except for self-reported tiredness, there were no differences between sleeping 89 hours and sleeping more than 9 hours. Examining Use of Mobile Phones for Sleep Tracking Among a National Sample in the USA. Early childhood sleep patterns and cognitive development at age 6 years: the Generation R Study. Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion. Associations between sleep duration patterns and behavioral/cognitive functioning at school entry. Paciencia I, Barros H, Arajo J, Ramos E. Association between sleep duration and blood pressure in adolescents. Avoid large meals, caffeine, and alcohol before bedtime. (2015). Mindell J, Lee C. Sleep, mood, and development in infants. Association between Chronotype and Physical Behaviours in Adolescent Girls. Longitudinal associations between reported sleep duration in early childhood and the development of body mass index, fat mass index and fat free mass index until age 7. A systematic review of the impact of wildfires on sleep disturbances. If your baby sleep log shows that her daytime and nighttime hours fall short of what she should be getting in a 24-hour period, and you see telltale signs of an overtired baby including persistent fussiness, trouble settling down to sleep at night and short catnaps instead of full naps, to name a few talk to your pediatrician about how to help your little one get enough sleep. For instance, impulsivity scores were significantly higher among children ages 78 years sleeping < 7.7 hours compared to those sleeping > 7.7 hours, but no group differences were found in total ADHD global scores.50 Likewise, there were no relationships between children sleeping less than 10 hours and their affective scores or reported peer/family relationships, but those sleeping 10 hours reported better overall health.15, In contrast, the literature review showed a clearer relationship between sleep duration and mental health among adolescents, 1318 years of age. Epub 2017 Jun 5. Division of Sleep Medicine at Harvard Medical School. US Department of Health and Human Services, Sleep Health Objectives. Does sleep duration predict metabolic risk in obese adolescents attending tertiary services? QuickStats: Percentage of Adults Aged 18 Years Who Took Medication To Help Fall or Stay Asleep Four or More Times in the Past Week, by Sex and Age Group National Health Interview Survey, United States, 20172018. (2021, June 15). More studies were available that addressed general health outcomes in older children including those with polysomno-graphic data during unconstrained sleep.12,13 In the 6 to < 13 years age group, the panel observed that this was a period of rapid physical and mental development with more sleep appropriate for children at the lower end and less sleep for those at the higher end of the age range. Some studies utilized a case-control study design. The Sleep duration is a frequently investigated sleep measure in relation to health outcomes. Adolescents sleeping 9 hours of sleep had significantly better life satisfaction scores, fewer general health complaints, and better quality relationships with family compared to those sleeping less.15 Of greatest concern in the adolescent population are associations between short sleep duration and suicidal thoughts/behaviors and substance abuse. Multiple surveys also gathered health outcomes such as height, weight, and lists of medical problems, by parental or child report; relying on these reports may be a source of measurement error. Mong, J. sharing sensitive information, make sure youre on a federal Fallone G, Acebo C, Seifer R, Carskadon MA. The recommendati More than one-third of U.S. adults sleep less than seven hours per night, on average. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC. Manipulating sleep duration alters emotional functioning and cognitive performance in children. Parent- or self-reported duration may over- or underestimate sleep duration measured objectively by actigraphy or polysomnography. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. 2Children's Hospital of Philadelphia, Philadelphia, PA, 3Liaison for the American Academy of Pediatrics, 5University of British Columbia School of Nursing, Vancouver, BC, 7Vanderbilt University Medical Center, Nashville, TN, 9Munson Sleep Disorders Center, Traverse City, MI, 11Rainbow Babies & Children's Hospital, Cleveland, OH, 12Barrow Neurologic Institute at Phoenix Children's Hospital, Phoenix, AZ, 13Methodist Healthcare Sleep Disorders Center, Memphis, TN. JAMA network open, 6(3), e233005. Prevalence of healthy sleep duration among adultsUnited States, 2014. Accessibility HHS Vulnerability Disclosure, Help official website and that any information you provide is encrypted The extraction sheet and full text of all accepted publications were made available to the panel members for review. All What to Expect content that addresses health or safety is medically reviewed by a team of vetted health professionals. StatPearls Publishing., Retrieved from, Division of Sleep Medicine at Harvard Medical School. 58.2% of respondents with SAD use sleep aids, compared to 26.3% of those without SAD, according to a SleepFoundation.org survey. For example, some studies included participants aged 818 years, and it is unknown how the results would have differed had the participants' data been grouped as pre-adolescent vs adolescent with a different age cut-off. The scope of the recommendation was limited to children aged 018 years. 2023 Apr 25;10(5):779. doi: 10.3390/children10050779. BMJ Clinical Evidence, 2014, 2303. Another consideration was the lack of studies in children on sleep extension. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. The first round of voting is completed without panel interaction to prevent panel members from influencing each other's votes. Thirty-seven of the studies associated sleep duration with accidents, suicidal ideation, insomnia, stress, depression, or anxiety. Infant. Keep in mind that youll need to gently rouse your baby if she sleeps longer than four hours during those early weeks. Journal of Occupational and Environmental Medicine is an indispensable guide to good health in the workplace for physicians, nurses, and researchers alike. All scientific data and information must be backed up by at least one reputable source. To receive your free score and profile, provide a few more details about yourself and create an account. There was also consensus that no recommendations could be made in infants < 4 months of age, due to the paucity of published outcomes in infants this young. PSG measurements of sleep duration may not be an accurate measure of typical sleep duration given the different sleep environment (lab) and weak correlations with parental or child self-reported duration. Recommended amount of sleep for pediatric populations: A consensus Valent F, Brusaferro S, Barbone F. A case-crossover study of sleep and childhood injury. This decision was based on the lack of evidence in this 04 month old age group. Magee CA, Gordon R, Caputi P. Distinct developmental trends in sleep duration during early childhood. Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health. B. Results also differed by gender and ethnicity. In summary, limited information indicates that there is a continuous decline in the amount of sleep required for normal general health. Sleep, 39(7), 13531359. (2007, December 18). Uncertainty existed in the 13 to 14 hour duration range. Longitudinal study of moderate weight change and sleep-disordered breathing. Citation pearl growing was used to capture additional important publications that were not identified by the search. The other 37 studies associated sleep duration with cardiovascular, metabolic, pulmonary, allergy/atopy, and obesity-related conditions. Small preliminary studies have begun to explore the effects of sleep extension on health and functioning in children. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. The number of participants varied from as few as 20 to just over 5,500. JAMA, 284(23), 30153021. Ortega FB, Ruiz JR, Castillo R, et al. However, there is some suggestion that in girls regularly sleeping more than 9.5 hours, hypertension risk is increased. B., Maher, E., Heald, J. L. (2015). The Journal of pediatrics, 140(1), 97102., Retrieved March 29, 2023, from. MedlinePlus: National Library of Medicine (US). (2020, June). Unable to load your collection due to an error, Unable to load your delegates due to an error. Sleep is increasingly recognized as a critical component of healthy development and overall health. Sleep duration and cognitive performance in adolescence. Survey questions often had good face validity, but most were not formally validated with psychometric analyses. |, Drinking more than two servings of alcohol per day for men and more than one serving per day for women can, 51.2% of U.S. adults who sleep more than normal over Thanksgiving cite overeating and alcohol consumption as the reason, according to a SleepFoundation.org survey. The recommendations of the panel are intended to be a first step towards promoting adequate sleep duration for all children. There were often methodological issues about assumptions of directionality of relationships and variation in reference categories used for normal sleep duration. The covariates differed widely by study and there was significant heterogeneity in outcomes. The occurrence of sleep-disordered breathing among middle-aged adults. Sleep and metabolism: an overview. The final recommendations were submitted to the AASM, Sleep Research Society (SRS), American Academy of Pediatrics (AAP), and American Association of Sleep Technologists (AAST) Boards of Directors for their endorsements. Careers. 2023. J Clin Sleep Med. Recommended Hours of Sleep Per Day. The conference proceeded in this manner for each domain. Writers and editors caught stealing content or improperly citing sources are immediately terminated, and we will work to rectify the situation with the original publisher(s), Although Sleep Foundation maintains affiliate partnerships with brands and e-commerce portals, these relationships never have any bearing on our product reviews or recommendations. PSG directly records sleep, however, other factors such as first night effect or logistics such as set wake up times to end PSG recordings may be in place and thus not accurately reflect a typical night of sleep. Healthy Sleep in Children and Teens: Duration, Individual Need and Timing. 11, No. Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. There was substantial overlap of age groups within the literature, and this was discussed during the in-person conference. |. Narcolepsy. In general, the total sleep time is high in infants and toddlers, with gradual reduction over time as one approaches pre-adolescence and adolescence. Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm Birth. Accessed Oct 22, 2020 from, Retrieved March 27, 2023, from, Nugent CN, Black LI. Sleep-promoting medications in children: physician prescribing habits in Southwestern Ontario, Canada. Accessibility Each panel member was assigned to a particular health domain and asked to identify the most informative studies based on study design and evidence quality. Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. The Journal of physiology, 596(23), 56875708. Bjorvatn, B., Grnli, J., & Pallesen, S. (2010). The panel discussed that the sleep needs of a 3-year old preschooler may be vastly different than the sleep needs of a 6-year old first-grader. Epub 2022 Oct 23. Matsumoto Y, Sasaki H, Masutomi H, Ishihara K, Shibata S, Hirao K, Furutani A. Child Adolesc Psychiatry Ment Health. The AFINOS study. Some studies may have had insufficient adjustment for confounders. A healthy baby in this age range should get a total of about 14 to 17 hours of sleep over the course of a 24-hour day. First published in 1899 as a small reference book for physicians and pharmacists, the Manual grew in size and scope to become one of the most widely used comprehensive medical resources for professionals and consumers. Lewin DS, Wolfson AR, Bixler EO, Carskadon MA. government site. Beebe DW, Rose D, Amin R. Attention, learning, and arousal of experimentally sleep-restricted adolescents in a simulated classroom. A cross-sectional study. Additionally, naps may be important. Consensus Conference Panel; Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E; Non-Participating Observers; Twery M, Croft JB, Maher E; American Academy of Sleep Medicine Staff; Barrett JA, Thomas SM, Heald JL. Are You Getting Enough Sleep? - Centers for Disease Control and Prevention This site needs JavaScript to work properly. 76.6% of adults who have lost sleep to wildfires cite anxiety as the reason. Accepted publications were graded for quality using the Oxford criteria.7 All accepted publications were reviewed in detail and the data listed in Table 1 were extracted. Longitudinal reallocations of time between 24-h movement behaviours and their associations with inflammation in children and adolescents: the UP&DOWN study. The American journal of gastroenterology, 98(7), 14871493. Longitudinal associations of sleep curtailment with metabolic risk in mid-childhood. Additionally, without prospective, long-term studies, pediatric sleep duration data on outcomes such as longevity are lacking. Infants 4 months to 12 months. Sleep medicine, 11(10), 10311034. American College of Obstetricians and Gynecologists. In the future, biomarkers may allow clinicians to provide more accurate sleep schedule recommendations to children, parents, and policy makers to facilitate policy decisions (e.g., school start times and teen driving). For children aged 6 years to < 13 years, there was consensus that sleep duration of 9 to 12 hours was appropriate and that > 13 hours was inappropriate. SleepFoundation.org does not provide medical advice, diagnosis, or treatment options. MeSH Evaluation of Temporal Trends in Racial and Ethnic Disparities in Sleep Duration Among US Adults, 2004-2018. Astill RG, Van der Heijden KB, Van IJzendoorn MH, Van Someren EJW. Effect of Sleep Changes on Health-Related Quality of Life in Healthy Children: A Secondary Analysis of the DREAM Crossover Trial. Recommended Amount of Sleep for Pediatric Populations: A Consensus In summary, based on very limited and less than ideal quality evidence, it would seem that sleep durations less than 8 hours are associated with worse overall immunological health, and that optimal sleep is between 89 hours for older children and adolescents. Carvalho Bos S, Gomes A, Clemente V, et al. Sleep Foundation Score The majority of studies suggested a shorter sleep duration was associated with either an increased risk of hypertension or actual hypertension. Thus the variance in sleep duration appeared quite limited and the dichotomizing of measures into problem/no problem reduced the information available for testing. Li, J., Somers, V. K., Xu, H., Lopez-Jimenez, F., & Covassin, N. (2022). Sleep duration, schedule and quality among urban Chinese children and adolescents: associations with routine after-school activities. Children (4 months to 14 years) High School Students Adults Last Reviewed: September 12, 2022 Source: National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health Many studies reported more than one outcome. 8600 Rockville Pike Federal government websites often end in .gov or .mil. Prevalence of different parasomnias in the general population. In a modification to RAM, the Consensus Conference included a third round of voting, which considered all available evidence and the previous voting results, to establish a single recommendation for the amount of sleep needed to promote optimal health for each age group in children.