Megan Brooks

June 14, 2016

DENVER — For the first time, the American Academy of Sleep Medicine (AASM) has issued consensus recommendations for the amount of sleep needed to promote optimal health in children and teenagers and to avoid the health risks of insufficient sleep.

"Sleep is essential for a healthy life, and it is important to promote healthy sleep habits in early childhood. It is especially important as children reach adolescence to continue to ensure that teens are able to get sufficient sleep," Shalini Paruthi, MD, moderator of the expert consensus panel that developed the recommendations, said in a statement.

To promote optimal health, the recommendations advise the following amount of sleep (per 24 hours) on a regular basis:

  • Infants 4 to 12 months: 12 to 16 hours of sleep (including naps);

  • Children 1 to 2 years of age: 11 to 14 hours (including naps);

  • Children 3 to 5 years of age: 10 to 13 hours (including naps);

  • Children 6 to 12 years of age: 9 to 12 hours; and

  • Teenagers 13 to 18 years of age: 8 to 10 hours.

The recommendations were published June 13 in the Journal of Clinical Sleep Medicine and will be discussed at a session here June 15 at SLEEP 2016: 30th Anniversary Meeting of the Associated Professional Sleep Societies.

In developing the recommendations, the expert panel reviewed 864 published scientific articles on the relationship between sleep duration and health in children, evaluated the evidence by using a formal grading system, and arrived at the final recommendations after multiple rounds of voting.

There have been previous "informal recommendations" on sleep in children, "but this was the first time for the American Academy of Sleep Medicine to go through a very formal, rigorous scientific method to arrive at results" on optimal sleep duration in children and teenagers, Dr Paruthi, from Saint Louis University School of Medicine in Missouri, noted in an interview with Medscape Medical News.

The recommendations are endorsed by the American Academy of Pediatrics, the Sleep Research Society, and the American Association of Sleep Technologists.

The panel found that sleeping the recommended number of hours on a regular basis is associated with overall better health outcomes, including improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health.

Conversely, sleeping fewer hours than recommended is associated with attention, behavior, and learning problems. Insufficient sleep also increases the risk for accidents, injuries, hypertension, obesity, diabetes, and depression.

For teenagers, the key may be helping them see the value of sleep in their lives, Dr Paruthi told Medscape Medical News. "That is, when they do sleep more and within the recommended ranges, they will perform better. We know that kids are consuming energy drinks, but really the best enhancer of performance is sleep, whether it's in the classroom or out on the field," she said.

One "striking" finding in the literature, Dr Paruthi said, is that insufficient sleep in teenagers is associated with increased risk for self-harm, suicidal thoughts, and suicide attempts.

The panel also found that regularly sleeping more than the recommended hours may be associated with adverse health outcomes, such as hypertension, diabetes, obesity, and mental health problems.

"More than a third of the US population is not getting enough sleep, and for children who are in the critical years of early development, sleep is even more crucial. Making sure there is ample time for sleep is one of the best ways to promote a healthy lifestyle for a child," Nathaniel Watson, MD, immediate past president of AASM, said in the statement.

Sleep has to be a priority for the entire family, Dr Paruthi said. "Parents have to be a role model for their children and get at least 7 hours of sleep nightly so that healthy sleep in childhood will last them into adulthood."

"We need to educate the next generation why they need to prioritize sleep," Russell Foster, PhD, director of the Sleep and Circadian Neuroscience Institute, University of Oxford, United Kingdom, told Medscape Medical News.

"We've rushed head long into this 24-7 world, and we simply aren't adapted to deal with it. The problem is we aren't going to put the 24-7 genie back in its bottle," commented Dr Foster, who gave the keynote address here.

The guideline development project was funded by the National Healthy Sleep Awareness Project, a partnership between the Centers for Disease Control and Prevention, AASM, and the Sleep Research Society.

J Clin Sleep Med. Published June 13, 2016. Consensus statement

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