What it takes to make sleep essential

Three years ago, the American Heart Association (AHA) made history by elevating sleep to the status of an “essential” pillar of cardiovascular health.¹ Yet, for the most part, this recognition has not translated into real-world reform. Sleep health remains largely absent from routine primary care, public funding is still inadequate, and most healthcare providers receive minimal sleep medicine education. Millions continue to suffer from undiagnosed sleep disorders like obstructive sleep apnea (OSA) and insomnia—fueling higher rates of cardiovascular disease, depression, lost productivity and rising healthcare costs.^2-8 Meanwhile, the public’s focus remains primarily on personal wellness-level solutions.

What needs to change: A multi-stakeholder mandate

To make sleep truly essential, we need coordinated action across the entire healthcare ecosystem. While some things are happening today, more is needed.

1. Policy

Current advocacy and successes:

• In 2024, New York City enacted a first-of-its-kind law to provide free sleep apnea screenings and home sleep apnea tests through its public health system. The law mandates the NYC Department of Health and Mental Hygiene to launch a program offering screenings for obstructive sleep apnea, particularly targeting uninsured individuals.⁹
• The AASM works to recruit members of Congress to their Congressional Sleep Health Caucus to raise awareness and support for sleep-related issues at the federal level.¹⁰
• Project Sleep’s annual Sleep Advocacy Forum connects patients, researchers and public health leaders directly with policymakers. In 2024, Project Sleep’s efforts resulted in 35 U.S. Representatives co-signing a letter urging the Centers for Disease Control and Prevention (CDC) to prioritize sleep medical research and public awareness. Similar letters between 2019 and 2023 helped build sustained Congressional engagement, contributing to outcomes such as the creation of a $1.5 million CDC grant program in 2020 to support public education and awareness initiatives related to chronic diseases, including sleep disorders.^11-13

What policymakers should do:

• Integrate sleep into preventive care policy: Sleep must be embedded in national and regional prevention strategies, alongside nutrition and exercise.
• Increase funding for sleep research: Federal and state agencies should prioritize sleep research at levels commensurate with its public health impact. This includes funding for basic science, population health studies, and implementation research to close the gap between evidence and practice.
• Modernize public health messaging: Public health campaigns should explicitly link sleep to outcomes like heart disease, stroke, and diabetes—using the same framing and urgency applied to tobacco use or obesity. This can help move sleep out of the “lifestyle” category and into the chronic disease prevention agenda.
• Support structural interventions: Policy should back interventions that support workplace sleep health programs and address social and environmental determinants of sleep, including housing, shift work, and noise exposure. Sleep screening programs and primary care provider education are also critical tools that can raise awareness of sleep disorders and improve access to timely diagnosis and treatment.

2. Insurance

Current advocacy and successes:

• The AASM advocates for Medicare coverage of PAP devices, simplified prior authorization processes and expanded telehealth access.¹⁰
• As of January 2025, Medicare Part D plans can now cover the GLP‑1 drug Zepbound when prescribed for obstructive sleep apnea, signaling increased recognition of pharmacological interventions in sleep care.¹⁴

What payers should do:

• Expand coverage for diagnostics and therapy: Insurers—including public payers—must ensure comprehensive coverage for diagnostics like home sleep apnea tests and evidence-based treatments such as PAP therapy, oral appliances and CBT-I.
• Align policies with clinical guidelines: Payers should eliminate unnecessary prior authorization barriers and update policies to reflect the latest clinical standards, enabling faster and easier access to care.
• Support preventive and digital solutions: Coverage should extend to preventive sleep health interventions, digital therapeutics, and telehealth solutions—particularly for underserved populations.

3. Medical education and healthcare delivery

Current advocacy and successes:

• The AASMs “Sleep Is Good Medicine” campaign provides resources and toolkits to help clinicians integrate sleep health into practice.¹⁵
• The AASM also launched a Women’s Sleep Health Task Force to address long-standing gaps in how sleep disorders affect and are treated in women. Through summits, scientific presentations and webinars, the initiative aims to elevate clinical awareness and foster more informed dialogue between healthcare professionals and patients.¹⁶

What educators and clinicians should do:

• Routinely screen for sleep disorders: Primary care providers and other frontline clinicians should make sleep assessments a standard part of every patient encounter, using validated screening tools and referral pathways.
• Invest in sleep medicine training: Medical schools, residency programs, and continuing education platforms must scale up training in sleep medicine so that more providers can identify and manage sleep disorders effectively.17
• Collaborate across disciplines: Providers should work in multidisciplinary teams—including sleep specialists, behavioural health providers and primary care providers—to deliver comprehensive sleep care.
• Engage in continuing education: Providers should stay current with evolving sleep science and practice guidelines, even if sleep medicine is not their specialty. This knowledge can significantly improve early detection and patient outcomes.

4. Public

Current advocacy and successes:

• Sleep Awareness Week, led by the National Sleep Foundation, has been reframing sleep into a health mandate. The theme, “Best Slept Self,” focuses on the important connection between a person’s sleep and their health and well-being as well as emphasizes the health risks of poor sleep.¹⁸
• Project Sleep’s “Sleep Apnea: Let’s Face It!” campaign highlights real patient stories to reduce stigma and empower people to seek diagnosis and treatment.¹⁹

What the public should do:

• Move beyond surface-level fixes: Public awareness campaigns must educate people about the real health risks of untreated sleep disorders, not just sleep hygiene tips or over-the-counter aids.
• Empower self-advocacy: Individuals should be encouraged to speak with healthcare providers about sleep concerns and seek professional evaluation and treatment for persistent sleep issues.
• Support grassroots advocacy: Patients and families can play a vital role by sharing their stories, participating in advocacy campaigns, and demanding policy action from elected officials and health systems.

Make sleep essential—now

If sleep is as essential as blood pressure or nutrition, then it’s time for every stakeholder—policymakers, payers, providers and the public—to treat it with the urgency it deserves. The evidence is clear, the tools exist, and the cost of inaction is too high.

Sleep isn’t a lifestyle choice, it’s a life essential. Let’s treat it like one—fund it, train for it and make it a core pillar of public health in reality.