Sleep research is often constrained by the need for normative control values, which may be costly. Published “normative” data is based on small samples. This study is a large meta-analysis of polysomnography parameters and establishes normative values based on control values obtained from many smaller studies. 

Establish normative sleep data for healthy adults stratified by age and sex.

We reviewed English language publications between 2007 and July 31, 2016 that reported polysomnography collected during an in-laboratory study in healthy controls that were scored using the 2007 criteria. We excluded studies with insufficient information. Estimates were pooled using a random effects meta-analysis. Influence of age and sex was ascertained using mixed effects meta-regressions.

169 studies were eligible (N=5273 subjects). For each decade, sleep onset latency increased 1.1 minutes (0.3–1.9), sleep efficiency decreased 2.1% (1.5–2.6), wake after sleep onset increased 9.7 minutes (6.9–12.4), arousal index increased 2.1 events/hour (1.5–2.6), percentage of N1 sleep increased 0.5% (0.1–0.8), apnea–hypopnea index increased 1.2 events/hour (0.9–1.4), minimum oxygen saturation decreased 1.8% (1.3–2.3), and the periodic limb movement index increased 1.2 events/hour (0.8–1.6). Percentages of N3 and REM sleep did not significantly decrease. Male sex was associated with reduced REM latencies (p=0.03) and oxygen saturations (p=0.002), and greater arousal indices (p=0.03) and respiratory event indices (p=0.0004). Compared to first night polysomnograms, studies from later nights reported significantly higher mean total sleep time, efficiency, and percentages of REM sleep.

 This study provides the largest sample size of normative polysomnographically measured sleep. These values serve as very useful control references for clinicians and future research.