New sleep duration recommendations

New sleep duration recommendations are being recommended by the National Sleep Foundation.

The National Sleep Foundation (NSF), along with a multi-disciplinary expert panel, issued its new recommendations for appropriate sleep durations. The report recommends wider appropriate sleep ranges for most age groups. The results are published in Sleep Health: The Official Journal of the National Sleep Foundation.

The National Sleep Foundation convened experts from sleep, anatomy and physiology, as well as pediatrics, neurology, gerontology and gynecology to reach a consensus from the broadest range of scientific disciplines. The panel revised the recommended sleep ranges for all six children and teen age groups. A summary of the new recommendations includes:

• Newborns (0-3 months): Sleep range narrowed to 14-17 hours each day (previously it was 12-18)
• Infants (4-11 months): Sleep range widened two hours to 12-15 hours (previously it was 14-15)
• Toddlers (1-2 years): Sleep range widened by one hour to 11-14 hours (previously it was 12-14)
• Preschoolers (3-5): Sleep range widened by one hour to 10-13 hours (previously it was 11-13)
• School age children (6-13): Sleep range widened by one hour to 9-11 hours (previously it was 10-11)
• Teenagers (14-17): Sleep range widened by one hour to 8-10 hours (previously it was 8.5-9.5)
• Younger adults (18-25): Sleep range is 7-9 hours (new age category)
• Adults (26-64): Sleep range did not change and remains 7-9 hours
• Older adults (65+): Sleep range is 7-8 hours (new age category)

"This is the first time that any professional organization has developed age-specific recommended sleep durations based on a rigorous, systematic review of the world scientific literature relating sleep duration to health, performance and safety," said Charles A. Czeisler, PhD, MD, chairman of the board of the National Sleep Foundation, chief of sleep and circadian disorders at Brigham and Women's Hospital, and Baldino Professor of Sleep Medicine at the Harvard Medical School. "The National Sleep Foundation is providing these scientifically grounded guidelines on the amount of sleep we need each night to improve the sleep health of the millions of individuals and parents who rely on us for this information."

A new range, "may be appropriate," has been added to acknowledge the individual variability in appropriate sleep durations. The recommendations now define times as either (a) recommended; (b) may be appropriate for some individuals; or (c) not recommended.

"The National Sleep Foundation Sleep Duration Recommendations will help individuals make sleep schedules that are within a healthy range. They also serve as a useful starting point for individuals to discuss their sleep with their health care providers," said David Cloud, CEO of the National Sleep Foundation.

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Sleep improved after weight loss

A study looks into mood and sleep after substantial weight loss and found that both improved in those studied.

Obese adults who lose at least 5 percent of their body weight report that they sleep better and longer after six months of weight loss, according to a new study. The results were presented Tuesday at the joint meeting of the International Society of Endocrinology and the Endocrine Society: ICE/ENDO 2014 in Chicago.

"This study confirms several studies reporting that weight loss is associated with increased sleep duration," said the study's lead investigator, Nasreen Alfaris, MD, MPH, a fellow in the Department of Medicine at the Perelman School of Medicine at the University of Pennsylvania, Philadelphia.

In addition, the study found that weight loss at 6 months improved sleep quality, as well as mood, regardless of how the individuals lost the weight.

The 390 study subjects participated in the Practice-Based Opportunities for Weight Reduction at the University of Pennsylvania (POWER-UP) trial. This 2-year study, funded by the National Institutes of Health, compared three behavioral interventions for weight loss in obese adults treated in primary care practices.

Subjects (311 women and 79 men) were randomly assigned to one of three programs that provided varying amounts of support to achieve the same diet and exercise goals. The groups were: (1) usual care, in which subjects received printed educational materials during quarterly visits with their primary care provider; (2) brief lifestyle counseling, which included quarterly visits with their primary care provider, combined with brief meetings with lifestyle coaches; or (3) enhanced brief lifestyle counseling, with meal replacements or weight loss medications added to the second intervention.

The researchers evaluated changes in weight, sleep duration and quality, and mood after 6 and 24 months of treatment. They compared subjects who lost 5 percent or more of their original body weight with those who lost less than 5 percent, regardless of their group assignment. The analyses controlled for several subject variables, including sex and age.

At month 6, subjects in both lifestyle counseling groups lost more weight on average (brief counseling: 7.8 lb; enhanced counseling: 14.7 lb) than those in the usual care group (4.4 lb), Alfaris reported.

Examining all three groups together, subjects who lost at least 5 percent of their weight at month 6 reported that they gained an average of 21.6 minutes of sleep a night, compared with only 1.2 minutes for those who lost less than 5 percent. Likewise, subjects who lost >5% of initial weight reported greater improvements on measures of sleep quality and mood (i.e., symptoms of depression), compared with subjects who lost <5%.

Only improvements in mood remained statistically significant at 24 months, according to Alfaris.

"Further studies are needed to examine the potential effects of weight regain in diminishing the short-term improvements of weight loss on sleep duration and sleep quality," she said.

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How long you sleep can influence depression and anxiety development

Research shows that a person's sleep duration can influence the development and symptom severity for anxiety and depression.

Short and long sleep duration, but not insomnia, predict a chronic course of depressive and anxiety disorders independent of symptom severity, research indicates.

Patients with persistent depression or anxiety were more likely to have insomnia than those without persistent disorders. However, insomnia was not independently associated with persistence after accounting for symptom severity.

“Our results also show that it is important to differentiate between insomnia and sleep duration, since there was no interaction effect between insomnia and sleep duration,” the researchers note in the Journal of Clinical Psychiatry.

They studied 1069 individuals aged an average of 42.7 years with DSM-IV-diagnosed depression or anxiety, 59% of whom had insomnia, diagnosed as a Women’s Health Initiative Insomnia Rating Scale score of 9 or above. At 2-year follow-up, persistent depressive and/or anxiety disorder, according to the Composite International Diagnostic Interview, was seen in 61.1% of patients.

Patients who reported sleeping an average of 10 hours or more per night were a significant 2.52 times more likely to have persistent (6-month diagnosis) depression and/or anxiety over 2 years of follow-up than patients who reported sleeping for a normal 7 to 9 hours per night. This was after adjusting for sociodemographic characteristics, chronic medical disorders, psychotropic medication, and symptom severity.

Those who reported short sleep durations of 6 hours or less per night were a significant 1.64 times more likely to have persistent depression and/or anxiety, but, as with insomnia, significance was lost after adjustment for symptom severity.

Both long and short sleep duration were also independently associated with a chronic course (no remission, and at least mild symptoms for 2 years of follow-up) of depression and/or anxiety, increasing the risk a significant 2.91-fold and 1.50-fold, respectively.

When the researchers looked at the effects of sleep duration on the course of depression and anxiety separately, they found that both long and short sleep duration predicted a chronic course of anxiety symptoms, with significant odds ratios of 7.73 and 1.62, respectively. The same was true for chronic depressive symptoms, with corresponding odds of 4.34 and 2.03.

Long and short sleep duration also predicted persistent depressive disorder, at significant odds ratios of 2.52 and 1.49, respectively, but neither predicted persistent anxiety disorder.

“[O]ur study adds significant information on the impact of sleep disturbances on the course of psychopathology,” say lead researcher Josine van Mill (EMGO Institute for Health and Care Research, Amsterdam, the Netherlands)and colleagues.

They add: “In clinical practice, routinely asking for sleep duration might identify subjects at risk for a chronic course.”

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How much sleep you get is not linked to tiredness

A new study claims that how much or how little sleep you get is not an indicated of how tired you feel.

NEW SWEDISH RESEARCH has shown that there is little or no relation between how much sleep people get at night and how fatigued they feel.

“The length of sleep is not a good measurement to analyse whether we get enough sleep or not,” Torbjoern Aakerstedt told AFP of the studies conducted at the Stress Research Institute of Stockholm University.

“It’s genetically conditioned and dependent on age and health,” he said.

Aakerstedt’s team has conducted three different studies, one of which investigated the sleep patterns of nearly 6,000 individuals.

The research suggests that the number of hours slept is of much less importance in determining how a person functions throughout the day.

“If you feel fine and dynamic during the day, you’ve probably slept enough,” said Aakerstedt.

The research, to be published later this year, found the average number of hours slept during a working week is six hours 55 minutes, with an extra hour’s sleep during holidays.

The researcher said that 20-year-olds should sleep eight hours on average, whilst 60-year-olds require only six.

“But there is no general average,” Aakerstedt added. “Twenty-year-olds can sleep even more, but still be tired during the day” as their brain is still developing.

Yet, although more sleep does not mean more energy, no one should sleep too little, as it affects one’s health, he said.

Too little sleep can result in a weak immune system, type 2 diabetes, heart disease, weight gain, workplace incidents and traffic accidents.

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