Preventing Chronic Disease | Raising Awareness of Sleep as a Healthy Behavior - CDC
Raising Awareness of Sleep as a Healthy Behavior
Geraldine S. Perry, DrPH, RDN; Susheel P. Patil, MD, PhD; Letitia R. Presley-Cantrell, PhD
Suggested citation for this article: Perry GS, Patil SP, Presley-Cantrell LR. Raising Awareness of Sleep as a Healthy Behavior. Prev Chronic Dis 2013;10:130081. DOI: http://dx.doi.org/10.5888/pcd10.130081.Sleep is an essential component of health, and its timing, duration, and quality are critical determinants of health (1). Sleep may play an important role in metabolic regulation, emotion regulation, performance, memory consolidation, brain recuperation processes, and learning (2). Because of the importance of these functions, sleep should be viewed as being as critical to health as diet and physical activity. However, public health practitioners and other health care providers have not focused major attention on the importance of sleep to health. In this essay, we briefly summarize the scientific literature about hours of sleep needed and why sleep is an important public health issue. We also suggest areas for expanding sleep research and strategies for increasing awareness of the importance of sleep and improving sleep health. Finally, we call for action to bring sleep to the forefront of public health.
Among adults, the reasons for sleep loss appear to be related mainly to lifestyle, work schedules (shift work and long hours), or sleep disorders (1). Approximately 20% of workers are engaged in shift work, which often leads to longer work hours (1). Among adolescents, insufficient sleep is associated with greater use of social media technology, and among younger children it is associated with depressive symptomatology, family disagreements, and safety issues around home, school and neighborhood (6).
One major consequence of insufficient sleep is daytime sleepiness, which reduces alertness and causes slow reaction time, leading to occupational and medical errors, workplace injuries, impaired driving, and motor vehicle accidents (1). In 2009, almost 5% of adults in 12 states reported that during the previous 30 days they had nodded off or fallen asleep while driving (3). In 2005, drowsy driving contributed to 100,000 motor vehicle accidents and 15,000 deaths (10).
The public health burden of sleep deprivation is enormous. There are substantial public health investments in all areas related to sleep, from obesity and other chronic conditions to motor vehicle accidents. Insufficient sleep, unlike other health risk factors such as smoking, excessive alcohol consumption, obesity, and physical inactivity, has historically received much less attention in the public health and clinical settings. Insufficient sleep is an important public health risk factor that would benefit from further investigation.
Although little evidence exists on the effectiveness of sleep screening and counseling on sleep behavior, screening and counseling has been shown to improve the health behaviors of patients in other areas, such as dietary habits, smoking cessation, and physical activity (13). Therefore, giving providers information about screening and counseling for appropriate sleep time and needs could better equip primary care and public health professionals with the knowledge needed to screen and counsel patients to promote sleep as a healthy behavior (1). However, further investigation is needed on the effectiveness of sleep screening and sleep counseling.
The IOM report calls for several approaches to reduce the public health burden of insufficient sleep through increasing public awareness of the importance of sleep and improving diagnosis and treatment of sleep disorders (1). Reaching these goals will require 1) improved public education on the need for sleep and the consequences of insufficient sleep; 2) more training for public health professionals and health care providers on screening and counseling; and 3) improved evidence of the burden of insufficient sleep acquired through surveillance and monitoring tools.
Federal agencies, public health partners, and private organizations are collaborating to employ IOM strategies. For example, The National Sleep Awareness Roundtable (NSART) (www.nsart.org), a national coalition of government, professional, volunteer, and other organizations, is collaborating to raise awareness about sleep among the public, increase the understanding of the importance of sleep, and reduce the public health and safety impact of sleep deprivation and sleep disorders by improving communication and collaboration among local, state, and federal agencies. NSART member organizations have contributed to sleep awareness by providing training workshops on healthy sleep for primary care providers, by producing free local initiatives to educate primary care health providers on sleep and sleep disorders, by promoting Drowsy Driving Prevention Week and National Sleep Awareness Week to educate the public, and by publishing research findings. Several of the Centers for Disease Control and Prevention’s surveillance systems have added questions on sleep to provide state and national data on the burden of insufficient sleep (14–16); however, more national data are needed on young children (aged 0–12 years). The 2020 Health Objectives (17) added sleep as one of its new areas, focusing on increasing the proportion of adults and students in grades 9 through 12 who get sufficient sleep, decreasing the number of vehicular crashes resulting from drowsy driving, and increasing the proportion of persons with sleep apnea symptoms who are evaluated.
- Research on the effectiveness of screening and counseling efforts
- Education of employers on the health effects of long shifts and insufficient sleep
- Delaying school start time for high school students
- Educating the public on the risks of drowsy driving
- Improving surveillance of sleep health, especially among young children
Author Affiliations: Susheel P. Patil, Johns Hopkins Sleep Disorders Center, Baltimore, Maryland; Letitia R. Presley-Cantrell, Centers for Disease Control and Prevention, Atlanta, Georgia.
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