Insufficient Sleep in United States

United States

Insufficient sleep is a threat to public health. Sleep is critical for basic functions such as cognitive processing, mood regulation, blood sugar level and immune system response. Insufficient sleep is a risk factor for many chronic diseases, including cancer, depression, diabetes, hypertension and obesity.

Insufficient sleep is also associated with reduced productivity and quality of life and more poor mental and physical health days, as well as increased risk of motor vehicle accidents, industrial accidents and medical errors. Drowsy driving caused 684 deaths in the United States in 2021 or 1.6% of all motor vehicle fatalities.

A 2016 report by the Rand Corporation estimated insufficient sleep cost $411 billion in missed work days and reduced productivity. 

Research shows shift work schedules decrease sleep quality, which increases the risk of developing chronic sleep problems. Age, race and socioeconomic status are also strongly associated with insufficient sleep. 

According to America’s Health Rankings data, the prevalence of insufficient sleep is higher among:

• Men compared with women.
• Adults ages 18-64 compared with those ages 65 and older, who have the lowest prevalence of insufficient sleep.
• Hawaiian/Pacific Islander, Black, multiracial and American Indian/Alaska Native adults compared with Asian, white and Hispanic adults.
• Adults with lower levels of education compared with college graduates.
• Adults with an annual household income less than $25,000 compared with those with incomes of $75,000 or more. 
• Adults who have difficulty with self-care, cognition or independent living compared with adults without a disability. 
• LGBQ+ adults compared with straight adults. 
• Adults who have served in the U.S. armed forces compared with adults who have not served. 

The National Institutes of Health recommends that adults sleep seven to eight hours nightly and school-aged children sleep between eight and 12 hours nightly. Everyone should follow a sleep schedule. Making up for lost sleep through naps may provide short-term boosts of energy but does not provide the health benefits gained by regular adequate nighttime sleep.

Limiting use of electronic devices before bedtime may improve sleep quality — the blue light emitted by electronic devices can interfere with the body’s circadian rhythm. 

Policy solutions to address insufficient sleep in the U.S. are limited, though some industries have taken steps to reduce the hazards of insufficient sleep among their workers. For example, in 2011, the Accreditation Council for Graduate Medical Education limited the number of hours medical residents can work consecutively, which led to increased safety among employees and patients.

Healthy People 2030 has several objectives regarding sleep health, including:

• Increasing the proportion of adults who get enough sleep. 
• Reducing the rate of motor vehicle crashes due to drowsy driving.

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