Sleep is foundational to health, and American children — particularly adolescents — face “a nationwide sleep crisis,” according to “The MAHA Report: Making Our Children Healthy Again,” an assessment released May 22 by President Trump’s Make America Healthy Again Commission. The report aims to highlight concerning trends in pediatric health across the United States and identify opportunities for systemic change.
A national call to action
Spanning more than 70 pages, the MAHA Report serves as a “call to action” for “policy interventions, institutional reforms, and societal shifts” to address the declining health of American children. The assessment highlights four broad drivers contributing to the rise in childhood chronic disease: ultra-processed foods, environmental chemicals, sedentary behavior in a digital age, and overmedicalization. The report explores each of these areas and provides recommendations for reform and action.
Childhood sleep duration crisis
Along with the decline of physical activity, the report identifies declining sleep as one of the factors contributing to the crisis of childhood behavior in the digital age, especially among adolescents. Data gathered by the Centers for Disease Control and Prevention show that 77% of high school students failed to get sufficient sleep on an average school night in 2021, and this trend has been getting worse. CDC data also show that 35% of children failed to get sufficient sleep during an average day in 2020 – 2021 based on reporting by their parents. The report notes that chronic insufficient sleep has severe consequences such as impairing glucose tolerance, contributing to insulin resistance, and exacerbating mental health disorders.
Struggle to sleep in a digital age
The report presents the nationwide sleep crisis in children within the context of a “sedentary, technology-driven lifestyle” that is contributing to the development of chronic physical and mental health disease. In addition to sleep deficits, the report raises concerns about other psychosocial factors such as chronic stress and loneliness. It also concludes that these problems are being exacerbated by technology use involving smartphones, social media, and gaming.
Importance of light and circadian rhythms
The report also emphasizes that human circadian rhythms are regulated by sunlight and disrupted by artificial light. This internal “body clock” regulates the timing of alertness, sleepiness, and other biological functions, making it essential for sleep health. The report notes that morning sunlight synchronizes the body clock, boosting mood and metabolism. In contrast, nighttime light exposure suppresses melatonin production, delaying sleep onset and contributing to insufficient sleep. It also increases the risks of metabolic disorders.
Next steps for the MAHA Commission
The report concludes with 10 recommendations for research initiatives to close research gaps and guide efforts to combat chronic disease in children. One of these recommendations is to “launch a coordinated national lifestyle-medicine initiative” involving randomized trials “covering integrated interventions in movement, diet, light exposure, and sleep timing.” Based on this report, the MAHA Commission will now develop a strategy to submit to the president in August.
AASM sleep health advocacy
Earlier this year, the AASM advocated for the MAHA Commission to emphasize sleep and make sleep a national health priority. The AASM also sent a letter to Health and Human Services Secretary Robert F. Kennedy, Jr., and all other members of the MAHA Commission, outlining why sleep is essential to health.
The AASM commends the commission for recognizing that sleep is foundational to health and identifying the current sleep crisis in children and teens. The AASM is advocating for robust federal investments in sleep and circadian research and clinical sleep medicine to help address this problem and transform the health of American children.
