What are the American Thoracic Society (ATS) guidelines for managing insomnia?

Updated: Sep 11, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
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In 2015, the American Thoracic Society (ATS) released a policy statement stressing the importance of achieving good-quality sleep and avoiding sleep deprivation. Key recommendations include the following: [107]

  • Good-quality sleep is critical for good health and overall quality of life
  • Short sleep duration (6 hours or less per 24-hour period) is associated with adverse outcomes, including mortality
  • Long sleep duration (>9 to 10 hours per 24-hour period) may also be associated with adverse health outcomes
  • At a population level, the optimal sleep duration in adults for good health is 7 to 9 hours, although individual variability exists
  • Because drowsy driving is an important cause of fatal and nonfatal motor vehicle crashes, all drivers (occupational and nonoccupational) should receive education about how to recognize the symptoms and consequences of drowsiness
  • Better education is needed for the general public and healthcare providers regarding the effect of working hours and shift work on sleep duration and quality and the association of sleepiness with workplace injuries
  • Sleep disorders are common, cause significant morbidity, and have substantial economic impact, but they are treatable; however, many individuals with sleep disorders remain undiagnosed and untreated
  • Age-based recommendations for sleep duration in children should be developed; these should enable the child to awaken spontaneously at the desired time through implementation of regular wake and sleep schedules
  • For adolescents, school start times should be delayed to align with the physiologic circadian propensity of this age group
  • Healthcare providers should receive more education on sleep hygiene and encourage patients to maximize their sleep time
  • Public education programs should be developed to emphasize the importance of sleep for good health
  • Better education/awareness is needed of the importance of early identification of groups at high risk for obstructive sleep apnea (in children and adults)
  • Better education of physicians as to the effectiveness of cognitive-behavior therapy for insomnia rather than immediate implementation of hypnotics and sedatives, and structural changes to increase access to this therapy

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