Sleep Characteristics Across the Lifespan in 1.1 Million Persons From the General Population of the Netherlands, UK and USA

Objectives. The study has three main objectives: 1) to obtain reliable reference charts for sleep duration; 2) estimate the prevalence of sleep complaints in the general population across the lifespan; and 3) to identify risk indicators of poor sleep. Design. Systematic review and meta-analysis of individual participant data (IPD). Data sources. Studies identified through systematic literature search in Embase, Medline and Web of Science (August 9th 2019), and through personal contacts with colleagues in the UK and US. Eligibility criteria. Studies eligible for IPD meta-analysis had to be published between 2000 and 2017 with data on sleep characteristics assessed with questionnaires that sampled ≥100 participants from the general population of the Netherlands. Large population-based studies/surveys from UK and US were included for comparisons. Data synthesis. For IPD analysis, data were obtained for 36 out of 47 eligible studies. Two researchers independently coded sleep variables: (time in bed (TIB), sleep duration (Total Sleep Time, TST), sleep efficiency (TST/TIB*100)), self/caregiver-reported sleep quality, insomnia symptoms and other sleep complaints, as well as socio-demographic characteristics (sex, age, education, ethnic origin, employment and partnership status) and health risk indicators (smoking and body mass index). All variables were coded following a standardized protocol. For comparison, complementary sleep data from the UK Biobank and the National Health Interview Survey in the USA were included. Where available, actigraphic sleep estimates were obtained using validated algorithms. Results. We assembled IPD from 200,358 persons (age range 1-100 years, 55% female) from the Netherlands, 471,759 persons (40 to 69 years old, 55.5% female) from the UK, and 409,617 persons (≥18 years, 55.8% female) from the US. Age-specific percentile curves for TST demonstrate that overall 24.5% of the studied population slept less than age-specific recommendations, but only 5.8% slept outside of the “acceptable range” for sleep duration. Short sleep duration was most prevalent in teenagers, as 51.5% reported TST less than the recommended 8-10 hours and 18% report daytime sleepiness. In adults (≥18yrs), poor sleep quality (13.3%) and insomnia symptoms (9.6-19.4%) were more prevalent than short sleep duration (6.5% with TST65 years, and those spending 9 or mo