One Third of Americans Get Insufficient Sleep

Fran Lowry

February 19, 2016

One third of Americans do not get enough sleep, putting them at risk for serious health problems, a new study shows.

"To promote optimal health and well-being, adults aged 18-60 years are recommended to sleep at least 7 hours each night," Yong Liu, MD, and colleagues from the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), write in a report published online February 19 in the Morbidity and Mortality Weekly Report.

Sleeping less than 7 hours per night has been linked to an increased risk for obesity, diabetes, high blood pressure, coronary heart disease, stroke, frequent mental distress, and all-cause mortality and also impairs cognitive performance, which increases the likelihood of motor vehicle and industrial accidents, medical errors, and loss of work productivity, Dr Liu and colleagues write.

The researchers analyzed data from the 2014 Behavioral Risk Factor Surveillance System to determine the prevalence of healthy sleep duration (>7 hours per night) among 444,306 adults in all areas of the United States.

Of these respondents, 65.2% reported that they slept for 7 hours or more each night.

Adults in Hawaii slept the least and adults in South Dakota slept the most. In Hawaii, only 56% reported getting more than 7 hours per night compared with 72% of adults in South Dakota.

Healthy sleep duration was lower among non-Hispanic blacks (54%), Hawaiians/Pacific Islanders (54%), multiracial non-Hispanics (54%), and American Indians/Alaska Natives (60%) than among non-Hispanic whites (67%), Hispanics (66%), and Asians (63%).

A lower proportion of adults (56% - 62%) reported getting at least 7 hours of sleep per night in states clustered in the southeastern region of the United States and the Appalachian mountains. Previous studies have shown that these regions also have the highest prevalence of obesity and other chronic conditions.

By contrast, most of the Great Plains states led the nation for healthy sleep duration, with 69% to 72% of respondents reporting at least 7 hours of sleep per night.

People with a college degree or higher reported the highest prevalence of healthy sleep duration (72%). The prevalence of healthy sleep duration was lower among those who were divorced, widowed, or separated (56%) or never married (62%).

Respondents who reported that they were unable to work or unemployed had lower healthy sleep duration (51% and 60%, respectively) compared with employed respondents (65%).

The authors note that their report has at least two limitations. Sleep duration was obtained by self-report and not corroborated by any objective measures, such as polysomnography, or sleep journals. Additionally, the survey did not include institutionalized individuals.

Still, the finding that a third of adults in the United States are not getting sufficient sleep affords opportunities for promoting healthy sleep habits, as well as reducing racial, ethnic, and economic disparities; changes in work shift policies; and routine medical assessment of patients' sleep concerns in healthcare systems, the authors write.

"Keeping a 10-day sleep journal or diary about sleep times, napping, and behaviors that affect sleep, such as exercise, alcohol use, and caffeine consumption, might be helpful before discussing sleep problems with a physician," they suggest.

"As a nation we are not getting enough sleep," Wayne Giles, MD, director of the Division of Population Health at the CDC, said in a statement. "Lifestyle changes such as going to bed at the same time each night; rising at the same time each morning, and turning off or removing televisions, computers, mobile devices from the bedroom, can help people get the healthy sleep they need."

The authors and Dr Giles have disclosed no relevant financial relationships.

MMWR Morb Mortal Wkly Rep. 2016;65:137-141. Full text

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