Sleep characteristics across the lifespan in 1.1 million people from the Netherlands, United Kingdom and United States: a systematic review and meta-analysis

Desana Kocevska, Thom S Lysen, Aafje Dotinga, M Elisabeth Koopman-Verhoeff, Maartje P C M Luijk, Niki Antypa, Nienke R Biermasz, Anneke Blokstra, Johannes Brug, Wiliam J Burk, Hannie C Comijs, Eva Corpeleijn, Hassan S Dashti, Eduard J de Bruin, Ron de Graaf, Ivonne P M Derks, Julia F Dewald-Kaufmann, Petra J M Elders, Reinoldus J B J Gemke, Linda GrievinkLauren Hale, Catharina A Hartman, Cobi J Heijnen, Martijn Huisman, Anke Huss, M Arfan Ikram, Samuel E Jones, Mariska Klein Velderman, Maaike Koning, Anne Marie Meijer, Kim Meijer, Raymond Noordam, Albertine J Oldehinkel, Joost Oude Groeniger, Brenda W J H Penninx, H Susan J Picavet, Sara Pieters, Sijmen A Reijneveld, Ellen Reitz, Carry M Renders, Gerda Rodenburg, Femke Rutters, Matt C Smith, Amika S Singh, Marieke B Snijder, Karien Stronks, Margreet Ten Have, Jos W R Twisk, Dike Van de Mheen, Jan van der Ende

Research output: Contribution to journalArticleAcademicpeer-review

134 Citations (Scopus)


We aimed to obtain reliable reference charts for sleep duration, estimate the prevalence of sleep complaints across the lifespan and identify risk indicators of poor sleep. Studies were identified through systematic literature search in Embase, Medline and Web of Science (9 August 2019) and through personal contacts. Eligible studies had to be published between 2000 and 2017 with data on sleep assessed with questionnaires including ≥100 participants from the general population. We assembled individual participant data from 200,358 people (aged 1-100 years, 55% female) from 36 studies from the Netherlands, 471,759 people (40-69 years, 55.5% female) from the United Kingdom and 409,617 people (≥18 years, 55.8% female) from the United States. One in four people slept less than age-specific recommendations, but only 5.8% slept outside of the 'acceptable' sleep duration. Among teenagers, 51.5% reported total sleep times (TST) of less than the recommended 8-10 h and 18% report daytime sleepiness. In adults (≥18 years), poor sleep quality (13.3%) and insomnia symptoms (9.6-19.4%) were more prevalent than short sleep duration (6.5% with TST < 6 h). Insomnia symptoms were most frequent in people spending ≥9 h in bed, whereas poor sleep quality was more frequent in those spending <6 h in bed. TST was similar across countries, but insomnia symptoms were 1.5-2.9 times higher in the United States. Women (≥41 years) reported sleeping shorter times or slightly less efficiently than men, whereas with actigraphy they were estimated to sleep longer and more efficiently than man. This study provides age- and sex-specific population reference charts for sleep duration and efficiency which can help guide personalized advice on sleep length and preventive practices.

Original languageEnglish
Pages (from-to)113-122
Number of pages10
JournalNature Human Behaviour
Issue number1
Early online date16-Nov-2020
Publication statusPublished - Jan-2021

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