The “Simple 7” is now the “Essential 8.” That’s since the American Heart Association (AMA) added sleep to its longstanding cardiovascular health checklist. The health and lifestyle factors of Life’s Simple 7 included physical activity, diet, weight, blood glucose, cholesterol, blood pressure, and cigarette smoking. Now, Life’s Essential 8 includes those factors plus 7 to 9 hours of sleep each day for adults. More for kids. Those recommendations are: 10 to 16 hours daily for ages 5 and younger, 9 to 12 hours for ages 6 to 12, and 8 to 10 hours for ages 13 to 18.

The new Essential 8 comes with updated guidelines that reflect a changing world. “Cigarette smoking,” for example, was replaced by “nicotine exposure” to include smoking, secondhand smoke, and e-cigarettes and other vaping devices that emit aerosol containing nicotine. Instead of gauging blood lipids using total cholesterol, the Essential 8 uses non-HDL cholesterol. And in the face of Type 2 diabetes risks, blood sugar measuring now includes hemoglobin A1c.

The addition of sleep serves as a complement to each of the original seven factors. AMA President Dr. Donald M. Lloyd-Jones says, “The new metric of sleep duration reflects the latest research findings: sleep impacts overall health, and people who have healthier sleep patterns manage health factors such as weight, blood pressure, or risk for Type 2 diabetes more effectively.”

Are the majority of Americans getting this optimal amount of sleep? It seems so. According to the most recent American Time Use Survey from the Bureau of Labor Statistics, Americans aged 15 and older spent an average of 8.95 hours sleeping per day in 2021. Though it’s not necessarily quality sleep. Gallup’s State of Sleep in America 2022 Report — a study of 3,000 U.S. adults — found that 38% of these adults under the age of 50 said their sleep was “fair” or “poor,” while 30% ages 50 to 64 said the same.

Digital tools play an increasing role in improving sleep. For a comprehensive approach to sleep, as well as the other factors listed in Life’s Essential 8, the AMA has a My Life Check tool that’s available online and as an app for both iOS and Android. The tool makes an assessment with questions related to heart health, offers recommendations for maintaining healthy habits, and tracks the user’s progress. Dr. Lloyd-Jones adds, “Advances in ways to measure sleep, such as with wearable devices, now offer people the ability to reliably and routinely monitor their sleep habits at home.”