AHA Scientific Statement
Sleep duration and quality: Impact on lifestyle behaviors and cardiometabolic health

Sleep duration, and in particular short sleep, and sleep disorders are related to adverse cardiometabolic risk, including obesity, hypertension, type 2 diabetes mellitus, and cardiovascular disease. A decline in average sleep duration has been observed over time in the United States, which may considerably impact population health.
A shorter sleep duration may be a conscious choice for some, as they prioritise other activities, but in a considerable portion it may have a medical or psychosocial origin. An estimated 5-15% of the US population suffers from insomnia, and sleep apnea is another common sleep disorder, seen in around 30% in men and between 9 to 28% in women of between 30 and 70 years old.

Evidence mostly based on self-reported data suggests a curvilinear relationship between habitual sleep duration and various medical conditions; both short and long sleep durations show an association with conditions like obesity, hypertension and diabetes mellitus. Short sleep is generally defined as <7 hours/night, and long sleep as ≥9 hours/night.

This Scientific Statement from the American Heart Association calls for health organisations to include evidence-based sleep recommendations in their guideline for optimal health.

Before formulating clinical recommendations, the document reviews the epidemiological and clinical evidence relating sleep duration and some sleep disorders to major risk factors for CVD and CVD. In light of obesity risk, evidence on the impact of sleep duration on energy intake and expenditure and body weight is outlined. The available data on the effect of lifestyle interventions such as weight loss on sleep disorders is also summarised, as is the effect of treatment of sleep disorders on cardiometabolic risk factors.

The Scientific Statement considers that clinical awareness of and action on sleep-related issues and disorders needs to be increased. Measures to be taken could include public health campaigns and better integration of existing simple assessment tools to screen for sleep apnea risk into routine clinical care and public health settings.  

The evidence is not conclusive, and many questions remain, including potential racial differences in the relationship between sleep duration and health measures that may explain health disparities seen in society. The Scientific Statement ends with a list of research priorities, based on outstanding questions that deserve to be addressed.


Find this AHA Scientific Statement online at Circulation