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Cited by 568Sleep and related disordersSleep and Work-Related FatigueSleep and Wakefulness Research

Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion

Open access
Watson, Nathaniel F., Badr, M. Safwan, Belenky, Gregory, Bliwise, Donald L., Buxton, Orfeu M., Buysse, Daniel, Dinges, David F., Gangwisch, James +13 more·2015·Journal of Clinical Sleep Medicine
DOI 10.5664/jcsm.4950PMC PMC4513271
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Abstract

The American Academy of Sleep Medicine and Sleep Research Society recently released a Consensus Statement regarding the recommended amount of sleep to promote optimal health in adults. This paper describes the methodology, background literature, voting process, and voting results for the consensus statement. In addition, we address important assumptions and challenges encountered during the consensus process. Finally, we outline future directions that will advance our understanding of sleep need and place sleep duration in the broader context of sleep health.

Integrity signals

Registry

Crossref · 10.5664/jcsm.4950

Cites

374 of 374 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 71 cited sources checked · 0 supported · 0 flagged

  • Findingnone given

    There was consensus that the appropriateness of 9 or more hours of sleep on optimal adult health could not be ascertained with certainty.

    “There was consensus that the appropriateness of 9 or more hours of sleep on optimal adult health could not be ascertained with certainty.”
    Quote in the paperSubstantial claim
  • Findingown data

    Round 3 voting revealed uncertainty regarding the appropriateness of >9 hours of sleep for adult health.

    “Round 3 voting revealed uncertainty regarding the appropriateness of > 9 hours of sleep for adult health.”
    Quote in the paperSubstantial claim
  • Premisecitation

    All three meta-analyses of prospective studies found a significant association between short sleep duration and the incidence of type 2 diabetes.

    “All three found a significant association between short sleep duration and the incidence of type 2 diabetes.24,72,44”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [24] Cappuccio FP, D'Elia L, Strazzullo P, Miller MA. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 2010;33:414–20. source

      Not checked in the free run.

    • cites [72] Holliday EG, Magee CA, Kritharides L, Banks E, Attia J. Short sleep duration is associated with risk of future diabetes but not cardiovascular disease: a prospective study and meta-analysis. PloS One 2013;8:e82305. source

      Not checked in the free run.

    • cites [44] Shan Z, Ma H, Xie M, et al. Sleep duration and risk of type 2 diabetes: a meta-analysis of prospective studies. Diabetes Care 2015;38:529–37. source

      Not checked in the free run.

  • Premisenone given

    Substantial heterogeneity was present in sleep duration assessment instruments.

    “Substantial heterogeneity was present in sleep duration assessment instruments.”
    Quote in the paperSubstantial claim
  • Premisereasoning

    There is less evidence for an association of longer sleep duration and adverse health status, with only a few studies demonstrating an association of poorer general health or increased risk/presence of disease with ≥ 9 hours of sleep.

    “There is less evidence for an association of longer sleep duration and adverse health status, with only a few studies demonstrating an association of poorer general health or increased risk/presence of disease with ≥ 9 hours of sleep.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 19
  • May combine two claims. 25

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    After round 1 voting, the gender-specific votes were collapsed after voting results demonstrated the evidence did not meaningfully suggest different sleep duration recommendations between genders.

    “After round 1 voting, however, the gender-specific votes were collapsed after voting results demonstrated the evidence did not meaningfully suggest different sleep duration recommendations between genders.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Findingreasoning

    The panel was unable to come to a consensus regarding biologically plausible pathways by which long sleep could explicitly cause poor health.

    “the panel was unable to come to a consensus regarding biologically plausible pathways by which long sleep could explicitly cause poor health”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Consensus could not be reached regarding the appropriateness of sleep durations in the 6-7 hour range, but the median vote indicated this duration was in the inappropriate range.

    “Consensus could not be reached regarding the appropriateness of sleep durations in the 6-7 hour range, but the median vote indicated this duration was in the inappropriate range.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Findingown data

    There was consensus that 7-9 hours of sleep were appropriate to support optimal health in adults.

    “There was also consensus that 7-9 hours of sleep were appropriate to support optimal health in adults.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Findingown data

    There was consensus that 6 hours of sleep or less was inappropriate to support optimal health in adults.

    “there was consensus that 6 hours of sleep or less was inappropriate to support optimal health in adults.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The number of U.S. adults sleeping ≤ 6 hours in a 24-hour period nearly doubled from 38.6 million to 70.1 million.

    “This trend represents a near doubling in the number of U.S. adults sleeping ≤ 6 hours in a 24-hour period from 38.6 million to 70.1 million.51”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] Ford ES, Cunningham TJ, Croft JB. Trends in self-reported sleep duration among US adults from 1985 to 2012. Sleep 2015;38:829–32. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The Sleep Duration Consensus Conference panel comprised 15 members, including a moderator, in accordance with RAM recommendations.

    “In accordance with recommendations of the RAM, the Sleep Duration Consensus Conference panel comprised 15 members, including a moderator (who was also a member of both the Board of Directors of the American Academy of Sleep Medicine and the National Healthy Sleep Awareness Project Strategic Planning Group).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    One-hour increments were selected because these were the most commonly-reported units in epidemiologic and experimental studies.

    “One hour increments were selected because these were the most commonly-reported units in epidemiologic and experimental studies.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Panel members were required to complete Conflict of Interest disclosures before being officially accepted.

    “Panel members were sent a formal letter of invitation from the AASM and SRS, and were required to complete Conflict of Interest disclosures before being officially accepted.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Panel members were instructed not to discuss the evidence or their votes with each other to ensure independence.

    “Panel members were instructed not to discuss the evidence or their votes with each other to ensure independence.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Interpretationnone given

    At present, sleep duration is the most widely-studied, best-supported, and most straightforward sleep measure to address in relation to health.

    “At present, however, sleep duration is the most widely-studied, best-supported, and most straightforward sleep measure to address in relation to health.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    To avoid further conflicts, panel members were not permitted to participate in similar consensus activities by other organizations.

    “To avoid further conflicts, panel members were not permitted to participate in similar consensus activities by other organizations.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Between 1985 and 2012, mean sleep duration decreased and the percentage of adults sleeping ≤ 6 hours in a 24-hour period increased.

    “A recent Centers for Disease Control and Prevention (CDC) analysis shows that between 1985 and 2012 mean sleep duration decreased and the percentage of adults sleeping ≤ 6 hours in a 24-hour period increased.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [51] Ford ES, Cunningham TJ, Croft JB. Trends in self-reported sleep duration among US adults from 1985 to 2012. Sleep 2015;38:829–32. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The CDC presently considers the progressive decline in sleep duration a public health epidemic.

    “The CDC presently considers this progressive decline in sleep duration a public health epidemic.52”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [52] Centers for Disease Control and Prevention NCfCDaPaHP, Division of Adult and Community Health. Accessed March 27, 2015. Available from:http://www.cdc.gov/features/dssleep/.

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    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 in adults.

    “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 in adults.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In summary, elevated risk for both overall cardiovascular disease and hypertension is associated with sleep durations less than 6 hours, and possibly for sleep durations of 6-7 hours compared to sleep durations of 7-8 hours.

    “In summary, elevated risk for both overall cardiovascular disease and hypertension is associated with sleep durations less than 6 hours, and possibly for sleep durations of 6-7 hours compared to sleep durations of 7-8 hours.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Clinical, public policy, and public health activities would all benefit from a consensus recommendation addressing the amount of sleep necessary to support optimal health and functioning in an adult.

    “Thus, clinical, public policy, and public health activities would all benefit from a consensus recommendation addressing the amount of sleep necessary to support optimal health and functioning in an adult.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Public policy initiatives addressing operator fatigue and transportation safety are hindered by the absence of evidence-based guidance regarding healthy habitual sleep duration in adults.
    • Rests on an assumption: The lack of consensus regarding healthy sleep duration in adults undermines the message that sleep is essential for health.

  • May combine two claims.

    Premisecitation

    A meta-analysis of sleep obtained by healthy individuals across the lifespan showed children and adolescents have longer sleep times than adults, and older adults show no substantial age-related declines in sleep duration after the age of 60.

    “The age cutoffs were based on a meta-analysis of sleep obtained by healthy individuals across the lifespan that showed children and adolescents have longer sleep times than adults, and older adults show no substantial age related declines in sleep duration after the age of 60. 58”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [58] Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep 2004;27:1255–73. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Sleep timing, self-reported sleep quality, day-to-day variability in sleep duration, napping, and sleep disorders all influence health outcomes in cross-sectional and/or longitudinal studies.

    “Sleep timing, self-reported sleep quality, day-to-day variability in sleep duration, napping, and sleep disorders all influence health outcomes in cross-sectional and/or longitudinal studies.56,57”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [56] Buysse DJ. Sleep health: can we define it? Does it matter? Sleep 2014;37:9–17.

      Not checked in the free run.

    • cites [57] Czeisler C. Duration, timing and quality of sleep are each vital for health, performance and safety. Sleep Health 2015;1:5–8. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Twin studies show sleep duration heritability between 31% and 55%, suggesting substantial genetic influences on sleep need.

    “Twin studies show sleep duration heritability between 31% and 55%, suggesting substantial genetic influences on sleep need.23,48,49”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [23] Watson NF, Buchwald D, Vitiello MV, Noonan C, Goldberg J. A twin study of sleep duration and body mass index. J Clin Sleep Med 2010;6:11–7. source

      Not checked in the free run.

    • cites [48] de Castro JM. The influence of heredity on self-reported sleep patterns in free-living humans. Physiol Behav 2002;76:479–86. source

      Not checked in the free run.

    • cites [49] Partinen M, Kaprio J, Koskenvuo M, Putkonen P, Langinvainio H. Genetic and environmental determination of human sleep. Sleep 1983;6:179–85. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A meta-analysis of cross-sectional studies found a significant negative association between hours of sleep and body mass index; short sleep duration was significantly associated with obesity.

    “A meta-analysis of crosssectional studies found a significant negative association between hours of sleep and body mass index; short sleep duration was significantly associated with obesity.73”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [73] Cappuccio FP, Taggart FM, Kandala NB, et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep 2008;31:619–26. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    All panel members are experts in sleep medicine and/or sleep science.

    “All panel members are experts in sleep medicine and/or sleep science.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The first round of voting was completed without panel interaction to prevent panel members from influencing each other's votes.

    “The first round of voting is completed without panel interaction to prevent panel members from influencing each other's votes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Another meta-analysis found an association between both short and long sleep and hypertension in cross-sectional studies, but only for short sleep in longitudinal studies.

    “In contrast, another meta-analysis found an association between both short and long sleep and hypertension in cross-sectional studies, but only for short sleep in longitudinal studies.63”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [63] Guo X, Zheng L, Wang J, et al. Epidemiological evidence for the link between sleep duration and high blood pressure: a systematic review and meta-analysis. Sleep Med 2013;14:324–32. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    A panel of 15 experts in sleep medicine and sleep research used a modified RAND Appropriateness Method to develop an evidence-based recommendation statement regarding the sleep duration that promotes optimal health in adults aged 18 to 60 years.

    “A panel of 15 experts in sleep medicine and sleep research used a modified RAND Appropriateness Method 54 to develop an evidence based recommendation statement regarding the sleep duration that promotes optimal health in adults aged 18 to 60 years.55”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [54] Fitch K, Bernstein S, Aguilar M, et al. The RAND/UCLA Appropriateness Method User's Manual. Santa Monica, CA: RAND; 2001.

      Not checked in the free run.

    • cites [55] Watson NF, Badr MS, Belenky G, et al. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep 2015;38:843–4. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Accepted publications were graded for quality using Oxford criteria.

    “Accepted publications were graded for quality using Oxford criteria.60”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [60] Oxford Center for Evidence Based Medicine. Accessed May 15, 2015. Available from: http://www.cebm.net/ocebm-levels-of-evidence/.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Experimental sleep restriction reduces cellular and whole body insulin sensitivity, lowers glucose tolerance, and raises afternoon and evening levels of cortisol.

    “Experimental sleep restriction reduces cellular and whole body insulin sensitivity, lowers glucose tolerance, and raises afternoon and evening levels of cortisol, an insulin antagonist.64,65”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [64] Van Cauter E, Knutson KL. Sleep and the epidemic of obesity in children and adults. Eur J Endocrinol 2008;159Suppl 1:S59–66. source

      Not checked in the free run.

    • cites [65] Buxton OM, Pavlova M, Reid EW, Wang W, Simonson DC, Adler GK. Sleep restriction for 1 week reduces insulin sensitivity in healthy men. Diabetes 2010;59:2126–33. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Sleep duration is associated with mortality risk and with illnesses ranging from cardiovascular and cerebrovascular disease to obesity, diabetes, cancer, and depression.

    “Sleep duration is associated with mortality risk [38][39][40] and with illnesses ranging from cardiovascular 41 and cerebrovascular 42 disease to obesity, 43 diabetes, 44 cancer, 45,46 and depression.47”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [38][39][40]

      Not checked in the free run.

    • cites [41] Xie D, Li W, Wang Y, et al. Sleep duration, snoring habits and risk of acute myocardial infarction in China population: results of the INTERHEART study. BMC Public Health 2014;14:531. source

      Not checked in the free run.

    • cites [42] Ge B, Guo X. Short and long sleep durations are both associated with increased risk of stroke: a meta-analysis of observational studies. Int J Stroke 2015;10:177–84. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Total sleep duration per 24 hours is the critical factor relative to performance, since split-sleep schedules also show the same sleep dose-response effects.

    “total sleep duration per 24 hours is the critical factor relative to performance, since split-sleep schedules also show the same sleep dose-response effects.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [96] Mollicone DJ, Van Dongen HP, Rogers NL, Banks S, Dinges DF. Time of day effects on neurobehavioral performance during chronic sleep restriction. Aviat Space Environ Med 2010;81:735–44. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Level I evidence demonstrates that cognitive performance involving vigilance attention, cognitive processing speed and working memory, as well as physiological sleep propensity and drowsy driving are all sensitive to sleep duration below 7 hours.

    “Level I evidence demonstrates that cognitive performance involving vigilance attention, cognitive processing speed and working memory, as well as physiological sleep propensity and drowsy driving are all sensitive to sleep duration below 7 hours.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisenone given

    Three large prospective cohort studies assessed sleep duration and general cancer mortality, with none showing an association for either short or long sleep duration.

    “Three large prospective cohort studies assessed sleep duration and general cancer mortality, with none showing an association for either short or long sleep duration.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisenone given

    The sleep duration-mortality risk relationship appears relatively stable across demographic groups, with one exception: increased mortality risk associated with long sleep may be partially explained by age.

    “The sleep duration-mortality risk relationship appears relatively stable across demographic groups, with one exception: Increased mortality risk associated with long sleep may be partially explained by age.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Self-reported sleepiness does not show the dynamic of increasing cognitive deficits with longer exposure to sleep restriction and therefore cannot be used to track increasing performance deficits.

    “Self-reported sleepiness does not show the latter dynamic and therefore cannot be used to track increasing performance deficits.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Four studies showed no association between sleep duration and breast cancer, while one showed ≤6 hours of sleep was associated with increased risk of breast cancer compared to 7 hours of sleep.

    “Four studies showed no association between sleep duration and breast cancer, while one showed ≤ 6 hours of sleep was associated with increased risk of breast cancer compared to 7 hours of sleep.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [46] Kakizaki M, Kuriyama S, Sone T, et al. Sleep duration and the risk of breast cancer: the Ohsaki Cohort Study. Br J Cancer 2008;99:1502–5. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Adults reporting sleep durations of 6.75 to 7.5 hours and less than 6.75 hours had a 27% and 73% increase, respectively, in the risk of sleep onset during the MSLT, compared to adults reporting >7.5 hours of sleep.

    “adults reporting sleep durations of 6.75 to 7.5 hours, and less than 6.75 hours, had a 27% and 73% increase, respectively, in the risk of sleep onset during the MSLT, compared to adults reporting > 7.5 hours of sleep.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [99] Punjabi NM, Bandeen-Roche K, Young T. Predictors of objective sleep tendency in the general population. Sleep 2003;26:678–83. source

      Not checked in the free run.

  • May combine two claims.

    Premisereasoning

    The U-shaped relationship between sleep duration and mortality has been demonstrated repeatedly and has been replicated using objective sleep measurement with actigraphy.

    “This U-shaped relationship has been demonstrated repeatedly (but not universally) and has been replicated using objective sleep measurement with actigraphy.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    A third study only found an association between sleep duration and colorectal cancer in those who were overweight or snored, which may signify the impact of sleep apnea and its attendant intermittent hypoxemia.

    “A third study only found an association in those who were overweight or snored, which may signify the impact of sleep apnea and its attendant intermittent hypoxemia.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [103] Zhang X, Giovannucci EL, Wu K, et al. Associations of self-reported sleep duration and snoring with colorectal cancer risk in men and women. Sleep 2013;36:681–8. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Both meta-analyses found increased mortality risk associated with short sleep and long sleep durations.

    “Both meta-analyses found increased mortality risk associated with short sleep and long sleep durations.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [38] Gallicchio L, Kalesan B. Sleep duration and mortality: a systematic review and meta-analysis. J Sleep Res 2009;18:148–58. source

      Not checked in the free run.

    • cites [111] Cappuccio FP, D'Elia L, Strazzullo P, Miller MA. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep 2010;33:585–92. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Self-reported sleep duration of 7-8 hours was generally associated with the lowest mortality risk, and both short and long sleep duration were associated with increased risk.

    “self-reported sleep duration of 7-8 hours was generally associated with the lowest mortality risk, and both short and long sleep duration were associated with increased risk.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Illness associated inactivity likely increased both subjective reports of sleep duration and mortality risk.

    “it seems plausible that illness associated inactivity likely increased both subjective reports of sleep duration and mortality risk.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The only study to assess the relationship between sleep duration and mortality in healthy individuals showed no association; an association was evident only in those who were in poor health at the start of the study.

    “the only study to assess the relationship between sleep duration and mortality in healthy individuals showed no association; 40 an association was evident only in those who were in poor health at the start of the study.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [40] Magee CA, Holliday EG, Attia J, Kritharides L, Banks E. Investigation of the relationship between sleep duration, all-cause mortality, and preexisting disease. Sleep Med 2013;14:591–6. source

      Not checked in the free run.

41 of 41

  • The paper relies on this without support.

    Older adults are more likely to suffer from medical disorders that could confound associations between sleep duration and health outcomes.

    “Older adults are also more likely to suffer from medical disorders that could confound associations between sleep duration and health outcomes.”

  • The paper relies on this without support.

    Sleep restriction is the most common cause of sleepiness in society.

    “Sleep restriction is the most common cause of sleepiness in society, yet clinicians struggle to tell their adult patients how much sleep is necessary to improve alertness.”

  • The paper relies on this without support.

    Public policy initiatives addressing operator fatigue and transportation safety are hindered by the absence of evidence-based guidance regarding healthy habitual sleep duration in adults.

    “Public policy initiatives addressing operator fatigue and transportation safety are likewise hindered by the absence of evidence-based guidance regarding healthy habitual sleep duration in adults.”

  • The paper relies on this without support.

    The lack of consensus regarding healthy sleep duration in adults undermines the message that sleep is essential for health.

    “The sleep medicine and research community stresses the importance of sleep for health, but this message is likewise undermined by the lack of consensus regarding healthy sleep duration in adults.”

  • The paper relies on this without support.

    Sleep is a biological imperative.

    “Sleep is a biological imperative.”

  • The paper relies on this without support.

    Meeting our need for sleep duration, timing, regularity, and quality requires volitional behaviors partially dictated by genetic and physiologic factors.

    “Meeting our need for sleep duration, timing, regularity, and quality requires volitional behaviors partially dictated by genetic and physiologic factors.”
6 of 6

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Sleep need decreases with older age.

    “An important consideration in determining accumulated sleep debt is that sleep need itself decreases with older age.”

    From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [17]

    Section 2.3 (page not available) reports no substantial decline in sleep duration after age 60 and says adults aged 18–60 had shorter sleep durations than older adults. Those findings run counter to the claimed age-related decrease, although the passage measures sleep obtained rather than sleep need directly. (LLM, conf=0.76)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • Adults aged 18-64 require 7-9 h of sleep per night, whereas adults over 65 need 7-8 h, including naps.

    “Expert opinion suggests that adults aged between 18–64 require 7–9 h of sleep per night, whereas adults over 65 need 7–8 h, including naps [17].”

    From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [17]

    The Voting Summary (§5.0; page unavailable) says 7–9 hours is appropriate for adults. But the literature review (§2.3) limits the recommendation to ages 18–60, not 18–64 or adults over 65, and the methods (§2.2) specify nightly sleep without addressing naps. The paper therefore does not support the separate 7–8-hour recommendation for adults over 65 or the inclusion of naps. (LLM, conf=0.91)

    Experimental — accuracy not yet measured

  • Sleep need decreases with age, but only up to 60 years, after which sleep need remains stable.

    “This is because sleep need decreases with age, but only up to 60 years, after which sleep need remains stable.”

    From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [17]

    Section 2.3 (page unavailable) reports no substantial age-related decline in sleep duration after age 60 and says children and adolescents sleep longer than adults. It does not establish that sleep *need* decreases throughout adulthood up to 60; it distinguishes sleep obtained from sleep needed. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • The AASM/SRS position statement categorizes effects of insufficient sleep as general health, cardiovascular health, metabolic health, mental health, immunologic health, human performance, cancer, pain, and mortality.

    “The recent position statement from the American Academy of Sleep Medicine and Sleep Research Society12–15 broadly categorizes effects of insufficient sleep as pertaining to the following categories: general health, cardiovascular health, metabolic health, mental health, immunologic health, human performance, cancer, pain, and mortality.”

    From Sleep, Health, and Society (2017) · cites this paper as [13]

  • The downstream consequences of insufficient sleep duration and/or inadequate sleep quality are varied and impact many physiologic systems.

    “The downstream consequences of insufficient sleep duration and/or inadequate sleep quality (including sleep disorders and circadian misalignment of sleep) are varied and impact many physiologic systems.”

    From Sleep, Health, and Society (2017) · cites this paper as [13]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Citation 55 does not identify the consensus recommendation statement

    Minor

    The text cites reference 55 for the final consensus recommendation statement, but reference 55 is a different article. The recommendation statement is listed as reference 54.

1 of 1

Cites

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12 of the 386 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Oxford Center for Evidence Based Medicine. Accessed May 15, 2015. Available from: http://www.cebm.net/ocebm-levels-of-evidence/.

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Authors
Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., Kushida, C., Malhotra, R. K., Martin, J. L., Patel, S. R., Quan, S. F., Tasali, E., Twery, M., Croft, J. B., Maher, E., Barrett, J. A., Thomas, S. M., & Heald, J. L.
Affiliations
  • University of Washington (US)
  • Wayne State University (US)
  • Washington State University Spokane (US)
  • Emory University (US)
  • Pennsylvania State University (US)
  • University of Pittsburgh (US)
  • University of Pennsylvania (US)
  • Columbia University (US)
  • Stanford University (US)
  • Saint Louis University (US)
  • University of California, Los Angeles (US)
  • Harvard University (US)
  • University of Chicago (US)
  • National Institutes of Health (US)
  • American Academy of Sleep Medicine (US)
Corresponding author
Watson, Nathaniel F.
ORCID
Venue
Journal of Clinical Sleep Medicine
Publisher
Springer Science and Business Media LLC
Published
2015-08-15
Volume
11
Issue
8
Pages
931-952
ISSN
  • 1550-9389 (ISSN-L)
  • 1550-9397
DOI
10.5664/jcsm.4950
PMC
PMC4513271
OpenAlex
W1848122840
Semantic Scholar
b5833ccff040fc2272bb1591a53911db97a4351e
Cited by
568
References
386
Citations by year
2026: 47 · 2025: 56 · 2024: 71 · 2023: 70 · 2022: 66 · 2021: 79 · 2020: 48 · 2019: 27 · 2018: 32 · 2017: 43 · 2016: 19 · 2015: 10
FWCI
52.39
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Clinical Sleep Medicine (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institutes of Health (UL1TR000430)
  • National Heart, Lung, and Blood Institute (K23HL110216)
  • National Center for Chronic Disease Prevention and Health Promotion (1U50DP004930-01)
  • National Center for Advancing Translational Sciences
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
Keywords
sleep duration, healthy adults, sleep need, sleep health, voting procedures
MeSH terms
Academies and Institutes, Adult, Humans, Research, Sleep, Societies, Medical, Time Factors, United States, Consensus, Sleep Medicine Specialty

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

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