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United States Value:
Percentage of adults who reported sleeping, on average, fewer than seven hours in a 24-hour period
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Percentage of adults who reported sleeping, on average, fewer than seven hours in a 24-hour period
Percentage of adults who reported sleeping, on average, fewer than seven hours in a 24-hour period
Percentage of adults who reported sleeping, on average, fewer than seven hours in a 24-hour period
CDC, Behavioral Risk Factor Surveillance System
Percentage of adults who reported sleeping, on average, fewer than seven hours in a 24-hour period
CDC, Behavioral Risk Factor Surveillance System
US Value: 32.3%
Top State(s): Colorado: 26.8%
Bottom State(s): Hawaii: 39.4%
Definition: Percentage of adults who reported sleeping, on average, fewer than seven hours in a 24-hour period
Data Source and Years: CDC, Behavioral Risk Factor Surveillance System, 2020
Suggested Citation: America's Health Rankings analysis of CDC, Behavioral Risk Factor Surveillance System, United Health Foundation, AmericasHealthRankings.org, accessed 2023.
Insufficient sleep is a threat to public health. Sleep is critical to such basic functions 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, more poor mental and physical health days and increased risk of motor vehicle accidents, industrial accidents and medical errors. Drowsy driving caused 633 deaths in the United States in 2020, 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.
The prevalence of insufficient sleep is higher among:
The National Institute of Health recommends that adults sleep seven to eight hours nightly and school-aged children sleep between eight to 12 hours nightly. Everyone should follow a sleep schedule. It should be noted that 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 from 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 effectively minimized the hazards of insufficient sleep. 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 objectives regarding sleep health include:
Grandner, Michael A., Nicholas J. Jackson, Bilgay Izci-Balserak, Rebecca A. Gallagher, Renee Murray-Bachman, Natasha J. Williams, Nirav P. Patel, and Girardin Jean-Louis. 2015. “Social and Behavioral Determinants of Perceived Insufficient Sleep.” Frontiers in Neurology 6 (112): 1–14. https://doi.org/10.3389/fneur.2015.00112.
Jackson, Chandra L., Susan Redline, and Karen M. Emmons. 2015. “Sleep as a Potential Fundamental Contributor to Disparities in Cardiovascular Health.” Annual Review of Public Health 36 (March): 417–40. https://doi.org/10.1146/annurev-publhealth-031914-122838.
Kecklund, Göran, and John Axelsson. 2016. “Health Consequences of Shift Work and Insufficient Sleep.” BMJ 355 (8080). https://doi.org/10.1136/bmj.i5210.
Liu, Yong, Anne G. Wheaton, Daniel P. Chapman, Timothy J. Cunningham, Hua Lu, and Janet B. Croft. 2016. “Prevalence of Healthy Sleep Duration among Adults — United States, 2014.” MMWR. Morbidity and Mortality Weekly Report 65 (6): 137–41. https://doi.org/10.15585/mmwr.mm6506a1.
Medic, Goran, Micheline Wille, and Michiel E. H. Hemels. 2017. “Short- and Long-Term Health Consequences of Sleep Disruption.” Nature and Science of Sleep 2017 (9): 151–61. https://doi.org/10.2147/NSS.S134864.
Stewart, Timothy. 2022. “Overview of Motor Vehicle Crashes in 2020.” NHTSA Technical Report DOT HS 813 266. Washington, D.C.: National Center for Statistics and Analysis, National Highway Traffic Safety Administration. https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/813266.
Weaver, Matthew D., Jason P. Sullivan, Céline Vetter, Wei Wang, Conor S. O’Brien, Salim Qadri, Christopher P. Landrigan, Charles A. Czeisler, and Laura K. Barger. 2017. “Work Hour Policies Are Associated With Improved Safety Among Medical Residents.” Sleep 40 (Abstract Supplement): A441. https://doi.org/10.1093/sleepj/zsx050.1182.
America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
We have developed detailed analyses on the health of key populations in the country, including women and children, seniors and those who have served in the U.S. Armed Forces, in addition to a deep dive into health disparities across the country.