Evaluation of Sleep Habits and Disturbances Among US Adults, 2017-2020

Abstract

ImportanceUnhealthy sleep behaviors and sleep disturbances are associated with higher risk of multiple diseases and mortality. The current profiles of sleep habits and disturbances, particularly the differences between workdays and free days, are unknown in the contemporary US.ObjectiveTo comprehensively evaluate sleep habits on workdays and free days and the prevalence of sleep disturbances among US adults.Design, Setting, and ParticipantsThis study is a cross-sectional analysis of US nationally representative data from the National Health and Nutrition Examination Survey (2017-2020) among adults aged 20 years or older. Data analysis was performed from February to May 2022.Main Outcomes and MeasuresThe main outcomes were means and/or distributions of sleep habits, including sleep duration and sleep-wake timing on workdays and free days, sleep debt (ie, the difference between sleep duration on free days and mean weekly sleep duration), and social jet lag (ie, the difference between the midpoint between sleep and wake time on workdays and free days). Prevalence of trouble sleeping (ie, participants told a doctor or other health professional that they have trouble sleeping) and daytime sleepiness (ie, self-reported feeling of being overly sleepy during the day ≥5 times per month) were also determined.ResultsA total of 9004 individuals (mean [SE] age, 48.3 [0.53] years; 4635 women [51.9%]; 3158 non-Hispanic White [62.8%]) were included in the current study. The mean sleep duration was 7.59 hours (95% CI, 7.54 to 7.64 hours) on workdays and 8.24 hours (95% CI, 8.17 to 8.31 hours) on free days (difference, 0.65 hour). The mean sleep and wake times were at 11:02 pm (95% CI, 10:57 pm to 11:17 pm) and 6:41 am (95% CI, 6:36 am to 6:45 am), respectively, on workdays and 11:25 pm (95% CI, 11:21 pm to 11:35 pm) and 7:41 am (95% CI, 7:37 am to 7:46 am), respectively, on free days (differences, 0.23 hour for sleep time and 1.00 hour for wake time). On workdays, 23.1% (95% CI, 21.3% to 24.9%) of adults slept less than 7 hours and 25.4% (95% CI, 24.1% to 26.6%) went to sleep at midnight or later; the corresponding percentages changed to 12.9% (95% CI, 11.6% to 14.1%) and 40.9% (95% CI, 38.4% to 43.5%), respectively, on free days. Furthermore, the mean sleep debt was 0.73 hours (95% CI, 0.68 to 0.77 hours), and mean social jet lag was 1.10 hours (95% CI, 1.05 to 1.15 hours); 30.5% (95% CI, 26.8% to 33.3%) of adults experienced 1 hour or more of sleep debt, and 46.5% (95% CI, 42.6% to 50.3%) experienced 1 hour or more of social jet lag. The prevalence of trouble sleeping was 29.8% (95% CI, 28.2% to 31.5%), and that of daytime sleepiness was 27.2% (95% CI, 25.0% to 29.5%).Conclusions and RelevanceIn 2017 to 2020, US adults showed variability in sleep habits between workdays and free days, with longer sleep duration and later sleep-wake phases on free days, and high percentages of US adults experienced long-term sleep deprivation, chronic social jet lag, and frequent sleep disturbances. These findings provide evidence to further investigate potential approaches to optimize overall US sleep health.

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

“…Data from NHANES 2017 to 2020, completed before the COVID-19 pandemic, showed that adults ≥20 years of age had shorter sleep duration on workdays (7.6 hours [95% CI, 7.5–7.6]) compared with free days (8.2 hours [95% CI, 8.2–8.3]). 6 Overall, 23.1% (95% CI, 21.3%–24.9%) of adults had short sleep on workdays compared with 12.9% (95% CI, 11.6%–14.1%) on free days, and 19.7% (95% CI, 18.5%–21.0%) of adults had long sleep on workdays compared with 38.5% (95% CI, 36.7%–40.3%) on free days. Females reported 7.7 hours of sleep (95% CI, 7.7–7.8) on workdays and 8.4 hours (95% CI, 8.3–8.5) on free days compared with 7.4 hours (95% CI, 7.4–7.5) and 8.1 hours (95% CI, 8.0–8.2) of sleep for males on workdays and free days, respectively.…”

Spatiotemporal light exposure modeling for environmental circadian misalignment and solar jetlag

“…52,56,57 In a study examining the National Health and Nutrition Examination Survey in the United States, among adults aged 20 years or older, 46.5% experienced at least 1 hour of social jetlag. 57 Social jetlag has also been implicated as a risk factor for a variety of adverse health outcomes including obesity and mental health symptoms. 48,58 Solar jetlag, which is objectively measured using solar jetlag scores from our light exposure model, is defined as the mismatch between the social clock and the sun clock and is a source of chronic environmental circadian misalignment.…”

Association of sleep patterns and cardiovascular disease risk is modified by glucose tolerance status

“…Working the night shift or long hours are known to cause changes in circadian rhythm, thus depriving individuals of a normal sleep cycle 38 . In a modern society of fast‐paced and stressful work, people commonly curtail sleep duration to fulfil professional goals or social obligations, resulting in chronic sleep loss and circadian disruption 39 . A sizeable portion of people, such as those with diabetes or other comorbidities, can also experience sleep problems originating from a medical or psychosocial cause 35 .…”

“…37 Although we did not detect significant interactions for other sleep 38 In a modern society of fast-paced and stressful work, people commonly curtail sleep duration to fulfil professional goals or social obligations, resulting in chronic sleep loss and circadian disruption. 39 A sizeable portion of people, such as those with diabetes or other comorbidities, can also experience sleep problems originating from a medical or psychosocial cause. 35 From this perspective, the optimisation of overall sleep health would call for a multifactorial solution.…”