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The Four Macros of Optimal Sleep:

While simplistic, one way (of many ways) to think about the question of, “What is good sleep?“, is: good sleep has four main macros. Most people have heard about the three main macros of food (protein, fat, carbohydrate). For sleep, there may be four main macros, which you can remember using the acronym, QQRT™: 1) Quantity, 2) Quality, 3) Regularity, and 4) Timing. Let’s explore these together.


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- Current health recommendations, as recommended by the National Sleep Foundation (NSF), and Centers for Disease Control and Prevention (CDC) for adults (18-65) are for somewhere between 7-9 hours of sleep per night, and around 7-8 hours for people aged 65 + years (1)


- The American Academy of Sleep Medicine (AASM) recommends various hours of sleep for different age groups. For infants, as much as 15-16 hours of sleep is recommended per day. For young children, 9-12 hours is recommended. For teenagers, they should aim for around 8-10 hours (2)


- A modest percentage of individuals in the general population require less (around 6 hours) or more (around 9 hours) than the average person (34& 5)


- Ideally, you should be going to bed and waking up at the same time on weekdays and weekends. This time would be +/- 0-20 minutes on either side of a person's nightly sleep. Having a regular bedtime and wake time is important for various body and brain functions. The body's internal clock, or circadian rhythm, can be thrown off by factors including artificial light, jet lag, and caffeine/energy drinks (11)

- Sleep regularity is not just about one's preference or convenience to sleep. Rather, the regularity of one's bedtime and wake time is a significant health consideration. Maintaining regular sleep patterns appears to have a substantial impact on reducing the risk of mortality (12


- Emphasized by the CDC, sleep quality is just as important as the quantity of sleep one achieves. A lack of good quality sleep impairs clear thinking, memory information, learning ability, and overall day-to-day functioning (6 & 7)

 - Good quality sleep positively influences several brain and key body functions; including blood sugar regulation, mood regulation, athletic performance, and improved immune system and mental function (& 9)

- Sleep experts agree on a few factors that impact healthy individuals positively over the life span.  This includes i) fewer awakenings throughout the night, ii) less time spent awake after initially falling asleep, iii) the electrical quality of your deep NREM sleep, and iv) reflecting the recognition of insomnia sufferers, how restored and refreshed by your sleep do you feel upon awakening (10) (15).


- Sleeping in sync with one's chronotype - or the body's natural preference for wakefulness and sleep. There are 3 chronotypes: 1) Owl, 2) Lark, or 3) Neutral. Variations in chronotypes are linked to genetics, age, and other environmental factors. By understanding and leaning into one's chronotype, one can enhance their sleep quality (13)

- Modern lifestyles, which center around artificial light, can lead to later chronotypes. In turn, late chronotypes report lower sleep quality, higher chronic fatigue, emotional problems, metabolic disorders, and higher substance use risks (14) 



1) PubMed. "National Sleep Foundation's sleep time duration recommendations: methodology and results summary." [Online]. Available: 

2) PubMed. "Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion" [Online]. Available:

3) PubMed. "A Rare Mutation of β1-Adrenergic Receptor Affects Sleep/Wake Behaviors" [Online].  Available:

4) PubMed. "A novel BHLHE41 variant is associated with short sleep and resistance to sleep deprivation in humans" [Online]. Available:

5) PubMed. "Sleep characteristics of self-reported long sleepers" [Online]. Available:

6) PubMed. "Research on Sleep Quality and the Factors Affecting the Sleep Quality of the Nursing Students" [Online]. Available:

7) PubMed. "Short- and long-term health consequences of sleep disruption" [Online]. Available:

8) PubMed. "Sleep and hypertension" [Online]. Available:

9) PubMed. "Sleep and Athletic Performance" [Online]. Available:

10) PubMed. "National Sleep Foundation's sleep quality recommendations: first report" [Online]. Available:

11) PubMed. "The genetics of circadian rhythms, sleep and health" [Online]. Available:

12) PubMed. "Sleep regularity is a stronger predictor of mortality risk than sleep duration: A prospective cohort study" [Online]. Available:

13) PubMed. " Genetic Basis of Chronotype in Humans: Insights From Three Landmark GWAS" [Online]. Available:

14) PubMed. "Associations between chronotype, morbidity and mortality in the UK Biobank cohort." [Online]. Available:

15) PubMed. "Nonrestorative Sleep as a Distinct Component of Insomnia." [Online]. Available: 10.1093/sleep/33.4.449

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