title: National Sleep Foundation's sleep quality recommendations: first report.
abstract: To provide evidence-based recommendations and guidance to the public regarding indicators of good sleep quality across the life-span.
  
  
  
  The National Sleep Foundation assembled a panel of experts from the sleep community and representatives appointed by stakeholder organizations (Sleep Quality Consensus Panel). A systematic literature review identified 277 studies meeting inclusion criteria. Abstracts and full-text articles were provided to the panelists for review and discussion. A modified Delphi RAND/UCLA Appropriateness Method with 3 rounds of voting was used to determine agreement.
  
  
  
  For most of the sleep continuity variables (sleep latency, number of awakenings >5minutes, wake after sleep onset, and sleep efficiency), the panel members agreed that these measures were appropriate indicators of good sleep quality across the life-span. However, overall, there was less or no consensus regarding sleep architecture or nap-related variables as elements of good sleep quality.
  
  
  
  There is consensus among experts regarding some indicators of sleep quality among otherwise healthy individuals. Education and public health initiatives regarding good sleep quality will require sustained and collaborative efforts from multiple stakeholders. Future research should explore how sleep architecture and naps relate to sleep quality. Implications and limitations of the consensus recommendations are discussed.
authors.affiliation: Stanford Sleep Epidemiology Research Center, Division of Public Mental Health and Population Sciences, Stanford University School of Medicine, Palo Alto, CA, USA. Electronic address: research@sleepfoundation.org.
authors.forename: Maurice
authors.initials: M
authors.lastname: Ohayon
authors.affiliation: Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA; Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Emerson M
authors.initials: EM
authors.lastname: Wickwire
authors.affiliation: Division of Public Mental Health and Population Sciences, School of Medicine, Stanford University, Stanford, CA, USA; Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Max
authors.initials: M
authors.lastname: Hirshkowitz
authors.affiliation: Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Albert
authors.affiliation: UCLA Sleep Disorders Center, UCLA Neurology Clinic, Department of Neurology, UCLA, Los Angeles, CA, USA.
authors.forename: Alon
authors.initials: A
authors.lastname: Avidan
authors.affiliation: Department of Biomedical Sciences, College of Osteopathic Medicine, University of New England, Biddeford, ME, USA.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Daly
authors.affiliation: Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Dauvilliers
authors.affiliation: Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Ferri
authors.affiliation: David Geffen School of Medicine at UCLA, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
authors.forename: Constance
authors.initials: C
authors.lastname: Fung
authors.affiliation: Department of Pediatrics, The University of Chicago Medicine Comer Children's Hospital, University of Chicago, Chicago, IL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Gozal
authors.affiliation: Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Hazen
authors.affiliation: Neurosciences Medicine, Duke Clinical Research Institute, Durham, NC, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Krystal
authors.affiliation: Sleep Research Project, Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Lichstein
authors.affiliation: Scientific Affairs, Society for Women's Health Research, Washington, DC, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Mallampalli
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Plazzi
authors.affiliation: Department of Biology, Gannon University, Erie, PA, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Rawding
authors.affiliation: Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Boston, MA, USA.
authors.forename: Frank A
authors.initials: FA
authors.lastname: Scheer
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Virend
authors.initials: V
authors.lastname: Somers
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Vitiello
mesh_terms: D055317:Evidence-Based Practice; D005582:Foundations; D017408:Guidelines as Topic; D006801:Humans; D012890:Sleep; D056508:Sleep Medicine Specialty / Q000458:organization & administration; D014481:United States
keywords: Aging; Sleep architecture; Sleep efficiency; Sleep quality