Maurice Ohayon1, Emerson M Wickwire2, Max Hirshkowitz3, Steven M Albert4, Alon Avidan5, Frank J Daly6, Yves Dauvilliers7, Raffaele Ferri8, Constance Fung9, David Gozal10, Nancy Hazen11, Andrew Krystal12, Kenneth Lichstein13, Monica Mallampalli14, Giuseppe Plazzi15, Robert Rawding16, Frank A Scheer17, Virend Somers18, Michael V Vitiello19. 1. Stanford Sleep Epidemiology Research Center, Division of Public Mental Health and Population Sciences, Stanford University School of Medicine, Palo Alto, CA, USA. Electronic address: research@sleepfoundation.org. 2. Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA; Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. 3. Division of Public Mental Health and Population Sciences, School of Medicine, Stanford University, Stanford, CA, USA; Department of Medicine, Baylor College of Medicine, Houston, TX, USA. 4. Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA. 5. UCLA Sleep Disorders Center, UCLA Neurology Clinic, Department of Neurology, UCLA, Los Angeles, CA, USA. 6. Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME, USA. 7. Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France. 8. Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy. 9. David Geffen School of Medicine at UCLA, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. 10. Department of Pediatrics, The University of Chicago Medicine Comer Children's Hospital, University of Chicago, Chicago, IL, USA. 11. Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA. 12. Neurosciences Medicine, Duke Clinical Research Institute, Durham, NC, USA. 13. Sleep Research Project, Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA. 14. Scientific Affairs, Society for Women's Health Research, Washington, DC, USA. 15. Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy. 16. Department of Biology, Gannon University, Erie, PA, USA. 17. Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Boston, MA, USA. 18. Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA. 19. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
Abstract
OBJECTIVES: To provide evidence-based recommendations and guidance to the public regarding indicators of good sleep quality across the life-span. METHODS: The National Sleep Foundation assembled a panel of experts from the sleep community and representatives appointed by stakeholder organizations (Sleep Quality Consensus Panel). A systematic literature review identified 277 studies meeting inclusion criteria. Abstracts and full-text articles were provided to the panelists for review and discussion. A modified Delphi RAND/UCLA Appropriateness Method with 3 rounds of voting was used to determine agreement. RESULTS: For most of the sleep continuity variables (sleep latency, number of awakenings >5minutes, wake after sleep onset, and sleep efficiency), the panel members agreed that these measures were appropriate indicators of good sleep quality across the life-span. However, overall, there was less or no consensus regarding sleep architecture or nap-related variables as elements of good sleep quality. CONCLUSIONS: There is consensus among experts regarding some indicators of sleep quality among otherwise healthy individuals. Education and public health initiatives regarding good sleep quality will require sustained and collaborative efforts from multiple stakeholders. Future research should explore how sleep architecture and naps relate to sleep quality. Implications and limitations of the consensus recommendations are discussed.
OBJECTIVES: To provide evidence-based recommendations and guidance to the public regarding indicators of good sleep quality across the life-span. METHODS: The National Sleep Foundation assembled a panel of experts from the sleep community and representatives appointed by stakeholder organizations (Sleep Quality Consensus Panel). A systematic literature review identified 277 studies meeting inclusion criteria. Abstracts and full-text articles were provided to the panelists for review and discussion. A modified Delphi RAND/UCLA Appropriateness Method with 3 rounds of voting was used to determine agreement. RESULTS: For most of the sleep continuity variables (sleep latency, number of awakenings >5minutes, wake after sleep onset, and sleep efficiency), the panel members agreed that these measures were appropriate indicators of good sleep quality across the life-span. However, overall, there was less or no consensus regarding sleep architecture or nap-related variables as elements of good sleep quality. CONCLUSIONS: There is consensus among experts regarding some indicators of sleep quality among otherwise healthy individuals. Education and public health initiatives regarding good sleep quality will require sustained and collaborative efforts from multiple stakeholders. Future research should explore how sleep architecture and naps relate to sleep quality. Implications and limitations of the consensus recommendations are discussed.
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