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This chapter examines epidemiological evidence on associations between sleep and death in adults. It includes coverage of associations between sleep duration and mortality. Additional sections document evidence on associations with premature death for seven of the eight categories of sleep disorders included in the International Classification of Sleep Disorders: insomnia, parasomnia, hypersomnia, sleep-related breathing disorder, sleep-related movement disorder, circadian rhythm sleep disorder, and other sleep disorders. The chapter concludes with a brief discussion of the implications of these findings for health policy and health promotion. Consistent evidence suggests an increased risk of mortality at both the short and long ends of the sleep duration distribution, with evidence accumulating that the highest risk is among the long sleepers. However, debate remains with regard to the ‘independent’ contribution of sleep itself to premature death. In population health terms fatal accidents resulting from excessive daytime sleepiness or fatigue are probably the most serious sleep-related public health problems.

The epidemics of obesity and diabetes are increasing rapidly world-wide. Due to the potentially devastating consequences of these metabolic diseases, it is imperative that modifiable causes of both diabetes and obesity be identified as potential areas of intervention. Although changes in diet and exercise have played an important role, another possible explanation for the epidemic is reduced sleep duration and quality. Sleep loss may be the result of either a voluntary restriction of time spent in bed or as a result of a sleep disorder. This chapter presents potential pathways leading from insufficient or disturbed sleep to diabetes and obesity, including impaired glucose metabolism, increases in appetite, and reduction in energy expenditure following reductions in sleep duration and/or quality. It explores the evidence for an association between metabolic diseases and sleep duration and quality.

The impact of poor sleep in the developing child is tremendously underrated and virtually unexplored. Furthermore, it remains crucial to realize that relations between sleep duration and cognition, affect, and health are all multidirectional, and that sleep plays an important role. This chapter discusses the latest findings on such interrelations and highlights the risks associated with disrupted, shortened, or insufficient sleep. Studies have shown that children in our society are very unlikely to obtain sufficient sleep on a stable and regular schedule. Therefore, each healthcare provider should monitor periodically any condition that may affect sleep in a developing child. Since a child engages in sleeping activities more than in any other during the 24-hour cycle, the most forgotten, overlooked, or even actively ignored behaviour of this century is undoubtedly childhood sleep. If we aim for a successful society and economy where individual productivity is fostered and encouraged, then we need to preserve and promote sleep, so that dreams can be fulfilled.

This chapter reviews potential mechanisms by which sleep duration may impact weight regulation. It summarizes the epidemiologic data supporting an association between sleep and obesity, and discusses the challenges and limitations facing epidemiologic researchers in defining the causal relationship between sleep duration and weight.

This chapter is a primer on sleep epidemiology—the methods of assessment on how sleep is measured (e.g., self-report [such as the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale] vs. with use of objective tools such as actigraphy); validity of sleep measurements; the different dimensions of sleep health and disorders that are of interest (e.g., sleep duration, sleep quality, sleep fragmentation, insomnia, obstructive sleep apnea, social jetlag, snoring, narcolepsy, etc.); general sleep biology and physiology; and why sleep matters (i.e., the epidemiologic consequences of poor sleep health, e.g., connection to other health behaviors and health outcomes such as drug use; sexual risk behaviors; depression; dietary behaviors such as sugar-sweetened beverage consumption; cardiometabolic diseases like obesity, diabetes, and hypertension; and cancer outcomes such as breast cancer).