Study Finds Almost One-Third of US Adults May Have at Least 1 Hour of Sleep Debt

US adults are experiencing more long-term sleep deprivation, chronic social jet lag, and sleep disturbances, according to new research published in JAMA. Among study participants, 29.8% experienced trouble sleeping and 27.2% experienced daytime sleepiness.

“The prevalence of trouble sleeping and daytime sleepiness was both higher than prior estimates,” the study authors wrote. “On the basis of data from adults aged 18 years and older from the National Health Interview Survey from 2002 to 2012, the prevalence of trouble sleeping increased from 17.5% to 19.2%, and excessive daytime sleepiness increased from 9.80% to 12.7%.”

Sleep-wake patterns were much later on free days, with individuals going to bed at 11:25 pm and waking up at 7:41 am on average. On workdays, wake time was 1 hour earlier at 6:41 am, yet bedtime was only 23 minutes earlier, at 11:02 pm, creating an infrequent sleep pattern.

Sleep-wake timing and regular sleep habits are important for healthy sleep. Although it is common for people to compensate for sleep debt accrued during the work week on the weekend, it can result in chronic sleep loss and irregular circadian function. Sleep debt was defined as the difference between mean weekly sleep duration and duration of sleep on free days (or non-workdays).

“Suboptimal sleep is associated with poor cognitive functioning, mental health, and cardiometabolic health,” the study authors wrote. And “as a result of modern lifestyles, sleep habits of adults vary across workdays and free days.”

The aim of this study was to evaluate the frequency of sleep disturbances in US adults and of sleep habits of adults on workdays and free days. Researchers performed a cross-sectional analysis of 9004 US adults, aged 20 years and older, who were represented in the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020.

The NHANES study determined fewer than 7 hours of sleep to be short sleep, whereas long sleep equated to 9 hours or more. The data showed that adults slept for an average of 7.59 hours on workdays, which increased to 8.24 hours on the weekend.

However, a mean 23.1% of adults did not get more than 7 hours of sleep on workdays. Among US adults, 30.5% experienced 1 hour of sleep debt, whereas 46.5% experienced social jet lag.

Generally, 40.9% of participants also went to bed at midnight or later and 47.7% of individuals were found to wake up later (after 8:00 am.) It was also found that non-Hispanic Black individuals, full-time workers, and regular shift workers had more short sleeps during workdays, long sleep duration on free days, a later bedtime, higher sleep debt, and/or heavier social jet lag.

The study includes some limitations, the first being that data were self-reported and prone to recall bias. Additionally, it was assumed that individuals worked 5 days and had 2 free days and may not include some participant subgroups. Finally, the degree of circadian disruption cannot be fully accounted, and survey questions were not validated.

Sleep debt may be associated with obesity, diabetes, cardiovascular health, mood disorders, and other conditions that have also been associated with irregular sleep duration.

“These results underscore that sleep disturbances remain a major challenge for promotion of healthy sleep in the US…[and] provide evidence to further investigate potential approaches to optimize overall US sleep health,” the study authors wrote.

Reference

Di, Hongkun, Guo, Yanjun, Daghlas, Iyas, et al. Evaluation of Sleep Habits and Disturbances Among US Adults, 2017-2020. JAMA Netw Open. 2022;5(11):e2240788. doi:10.1001/jamanetworkopen.2022.40788