Prevalence of Healthy Sleep Duration among Adults — United States, 2014

From US CDC, February 19, 2016

To promote optimal health and well-being, adults aged 18–60 years are recommended to sleep at least 7 hours each night (1). Sleeping <7 hours per night is associated with increased risk for obesity, diabetes, high blood pressure, coronary heart disease, stroke, frequent mental distress, and all-cause mortality (2–4). Insufficient sleep impairs cognitive performance, which can increase the likelihood of motor vehicle and other transportation accidents, industrial accidents, medical errors, and loss of work productivity that could affect the wider community (5). 

CDC analyzed data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS) to determine the prevalence of a healthy sleep duration (≥7 hours) among 444,306 adult respondents in all 50 states and the District of Columbia. A total of 65.2% of respondents reported a healthy sleep duration; the age-adjusted prevalence of healthy sleep was lower among non-Hispanic blacks, American Indians/Alaska Natives, Native Hawaiians/Pacific Islanders, and multiracial respondents, compared with non-Hispanic whites, Hispanics, and Asians. 

State-based estimates of healthy sleep duration prevalence ranged from 56.1% in Hawaii to 71.6% in South Dakota. Geographic clustering of the lowest prevalence of healthy sleep duration was observed in the southeastern United States and in states along the Appalachian Mountains, and the highest prevalence was observed in the Great Plains states. More than one third of U.S. respondents reported typically sleeping <7 hours in a 24-hour period, suggesting an ongoing need for public awareness and public education about sleep health; worksite shift policies that ensure healthy sleep duration for shift workers, particularly medical professionals, emergency response personnel, and transportation industry personnel; and opportunities for health care providers to discuss the importance of healthy sleep duration with patients and address reasons for poor sleep health.

BRFSS* is a state-based, random-digit–dialed telephone survey of the noninstitutionalized U.S. population aged ≥18 years. BRFSS is conducted collaboratively by state health departments and CDC (6) among both landline and cell phone respondents, and data are weighted to state population estimates. Response rates for BRFSS are calculated using standards set by the American Association of Public Opinion Research Response Rate Formula #4.† The response rate is defined as the number of respondents who completed the survey as a proportion of all eligible and likely eligible persons. The median response rate for all states and territories in 2014 was 47.0% and ranged from 25.1% to 60.1%.

Survey respondents in 2014 were asked, “On average, how many hours of sleep do you get in a 24-hour period?” Hours of sleep were recorded in whole numbers by rounding 30 minutes or more up to the next whole hour and dropping 29 or fewer minutes. The age-adjusted prevalence and 95% confidence interval (CI) of the recommended healthy sleep duration (≥7 hours) was calculated by state and selected characteristics, and adjusted to the 2000 projected U.S. population aged ≥18 years. For comparisons of prevalence between subgroups, statistical significance (p<0.05) was determined by t-tests. All indicated differences between subgroups are statistically significant. Statistical software programs that account for the complex sampling design of the BRFSS were used for the analysis.

Among 444,306 respondents, 11.8% reported a sleep duration ≤5 hours, 23.0% reported 6 hours, 29.5% reported 7 hours, 27.7% reported 8 hours, 4.4% reported 9 hours, and 3.6% reported ≥10 hours. Overall, 65.2% reported the recommended healthy sleep duration (age-adjusted prevalence = 64.9%) (Table 1). The age-specific prevalence of sleeping ≥7 hours was highest among respondents aged ≥65 years (73.7%) compared with other age groups. The age-adjusted prevalence of healthy sleep duration was lower among Native Hawaiians/Pacific Islanders (53.7%), non-Hispanic blacks (54.2%), multiracial non-Hispanics (53.6%), and American Indians/Alaska Natives (59.6%) compared with non-Hispanic whites (66.8%), Hispanics (65.5%), and Asians (62.5%). 

Respondents who indicated they were unable to work or unemployed had lower age-adjusted healthy sleep duration prevalences (51.0% and 60.2%, respectively) than did employed respondents (64.9%). The prevalence of healthy sleep duration was highest among respondents with a college degree or higher (71.5%). The prevalence was higher among married respondents (67.4%) compared with those who were divorced, widowed, or separated (55.7%), or never married (62.3%).

Prevalence of healthy sleep duration varied among states and ranged from 56.1% in Hawaii to 71.6% in South Dakota (Table 2). Most of the Great Plains states were in the upper quintile for healthy sleep duration; states in the southeastern United States and along the Appalachian Mountains tended to be in the lower quintiles (Figure).

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AP: HAWAII LEADS NATION IN GETTING TOO LITTLE SLEEP