APRIL 2016

THE COUNCIL OF STATE GOVERNMENTS

CAPITOL RESEARCH
HEALTH

Sleep Matters: Over One-Third of U.S. Adults Are Sleep Deficient

In February, the Centers for Disease Control and
Prevention released the Prevalence of Healthy Sleep
Duration among AdultsUnited States, 2014 report,
which found that nearly 35 percent of U.S. adults ages
18-60 are not getting the recommended seven hours
of sleep per night.1 The data was recorded in the 2014
Behavioral Risk Factor Surveillance System survey of
444,306 individuals from all 50 states and the District
of Columbia. While the focus has long been on
children receiving their recommended hours of sleep
per night, the CDC recommends increased focus on
educating the public about the importance of adults
maintaining a healthy sleep regimen.
Sleep deprivation is associated with increased physical and emotional health risks. Those who do not
receive the recommended amount of sleep per night
are at higher risk for developing chronic conditions
such as obesity, diabetes, high blood pressure, coronary heart disease, stroke and mental distress, and
are generally at a greater risk for mortality.2 To get
more sleep, the CDC recommends behavior changes
such as creating a sleep schedule and ensuring the
bedroom is dark, quiet, at a comfortable temperature
and free of electronic devices. Further, adults should
avoid consuming large meals, nicotine, alcohol and
caffeine shortly before attempting to sleep. Adults
who continue to struggle to establish a healthy sleep
routine might find consulting their doctor or a sleep
specialist, or receiving psychological or behavioral
therapy useful.3

The average hours of sleep Americans get

each night vary across states.
Of the respondents in the CDC survey, 11.8 percent reported sleeping five hours or less per night
and 23 percent of respondents reported sleeping
six hours, less than the recommended seven hours.
States in the Midwest region have the healthiest
sleep regimens.
States in the South, particularly in the Appalachian
region, have the lowest average sleep duration.

The Council of State Governments

The state with the lowest average of sleep duration

per night is Hawaii, where 56.1 percent of citizens
get the recommended amount of sleep per night.
Hawaii is followed by Kentucky (60.3 percent),
Maryland (61.1 percent), Alabama (61.2 percent),
Georgia (61.3 percent), Michigan (61.3 percent),
Indiana (61.5 percent), South Carolina (61.5 percent), New York (61.6 percent), and West Virginia
(61.6 percent).
The state with the healthiest sleep pattern is
South Dakota, where 71.6 percent of citizens get
the recommended amount of sleep per night.The
remaining top ten states with the healthiest sleep
patterns are Colorado (71.5 percent), Minnesota
(70.8 percent), Nebraska (69.6 percent), Idaho
(69.4 percent), Montana (69.3 percent), Utah
(69.2 percent), Kansas (69.1 percent), Vermont (69
percent), and Iowa (69 percent).

The implications of sleep deprivation

extend beyond individual health and can
impact public safety and the workforce.
The CDC recommends that workplace policies
should ensure that employees have the opportunity
to get their full-recommended hours of sleep per
night. This is particularly relevant to professions
that often require long irregular hours, such as
medical professionals and first call responders and
those employed in the transportation industry.
Sleep-deprivation related incidents can result in a
loss in productivity in the workforce and increased
medical expenses, leaving a mark on the economy.
The CDC encourages health care providers to
promote healthy sleep regimens to patients and to
assess the causes of sleep deprivation.

Drowsy drivers are two times more likely

to make errors when operating a motor
vehicle.6
The National Highway Traffic Safety Administration, or NHTSA, notes that sleep-related crashes
are not only due to falling asleep at the wheel, but
also due to drowsiness. Drowsiness causes crashes
because a lack of sleep impairs alertness, attention,
reaction time, judgement and decision-making.
New Jersey and Arkansas have drowsy driving laws
under which drivers can be charged with vehicular
homicide or negligent homicide, respectively, if
their sleep deprivation causes a crash fatality. A
pending New York bill includes a vehicular homicide offense for fatalities caused by drowsy driving
as well as a misdemeanor offense for driving while
drowsy.7
NHTSA reports that there were 846 fatalities
caused by drowsy driving in 2014.8
Between 2005 and 2009, NHSTA estimates that

there were 83,000 crashes related to drowsy driving

annually, including an average of nearly 886 fatal
crashes.9
The AAA Foundation for Traffic Safety reports
that 7 percent of all crashes and 16.7 percent of all
fatal crashes are caused by drowsy-driving.10

In addition to varying across geographic

locations, the average hours of sleep
Americans get each night also vary
across racial and ethnic groups, age
groups, employment statuses, levels of
educational attainment, and relationship
statuses.11
Non-Hispanic blacks, American Indians/Alaska
Natives, Native Hawaiians/Pacific Islanders and
multiracial respondents on average sleep less than
non-Hispanic whites, Hispanics and Asians.
Of the respondents ages 65 years and older, 73.7
percent reported getting seven hours or more of
sleep per night.
Of those unable to work or who are unemployed,
51 percent and 60.2 percent, respectively, get the
recommended amount of sleep per night. The
employed population tends to get more rest, with
64.9 percent reporting getting the recommended
amount of seven or more hours per night.
Of those with a college education or higher, 71.5
percent report getting the recommended amount
of sleep per night.
Married people get more sleep than divorcees,
widows, separated people or single individuals who
have never been married. Of the married population, 67.4 percent get the recommended amount,
compared to 55.7 percent of divorcees, widows and
separated couples, and 62.3 percent of the single
and never married population.
Samantha-Jane Harris, CSG Graduate Fellow

1 Liu, Yong, Wheaton, Anne G., Chapman, Daniel P., Cunningham Timothy J., Lu, Hua, Croft Janet B. Prevalence of Healthy Sleep Duration among AdultsUnited States, 2014. MMWR Morbidity
and Mortality Weekly Report 2016; 65: 137-141. http://goo.gl/sYC60c
2 Ibid.
3 Ibid.
4 Ibid.
5 Ibid.
6 National Highway Traffic Safety Administration. Research on Drowsy Driving.
http://goo.gl/lrntvH
7 National Conference of State Legislatures. Summaries of Current Drowsy Driving Laws. September 2015. http://goo.gl/S8op4p
8 National Highway Traffic Safety Administration.
9 Ibid.
10 Ibid.
11 Liu, et al.

THE COUNCIL OF STATE GOVERNMENTS

PERCENTAGE OF ADULTS WHO GET 7 HOURS OF MORE OF SLEEP PER NIGHT

State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana

7 or more hours
Reporting falling asleep while
of sleep per
driving within the last 30 days*
night (%)
61.2
65
66.7
62.6
66.4
71.5
64.8
62.4
67.8
64.2
61.3
56.1
69.4
65.6
61.5
69
69.1
60.3
63.7
67.1
61.1
65.5
61.3
70.8
63
66
69.3

2.1

3.9*
4.5

3*
2.8*
2.6*

4.1*
5.7*

2.9*

3.6

3.8*
3.7
4.4*
3.3
3.5*
3.1

3.3

Data from CDC report of 10 states behaviors in 2011-2012

*Data from CDC report of 19 states behaviors in 2009-2010
Table Sources:
Liu, Yong, Wheaton, Anne G., Chapman, Daniel P., Cunningham Timothy J., Lu, Hua, Croft Janet B.
Prevalence of Healthy Sleep Duration among AdultsUnited States, 2014. MMWR Morbidity and
Mortality Weekly Report 2016; 65: 137-141. http://goo.gl/sYC60c
Wheaton AG, Shults RA, Chapman DP, Ford ES, Croft JB. Drowsy Driving and Risk Behaviors 10 States

7 or more hours
Reporting falling asleep while
of sleep per
driving within the last 30 days*
night (%)

State
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota

69.6
63.8
67.5
62.8
68
61.6
67.6
68.2

3.2
2.8*

3.6*

Ohio

62.1

Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming*
Median (All 50 States)*

64.3
68.3
62.5
63.3
61.5
71.6
62.9
67
69.2
69
64
68.2
61.6
67.8
68.7
64.9

1.8

3.8
6.1*

3.9
3.4

and Puerto Rico, 20112012. MMWR Morbidity and Mortality Weekly Report 2014;
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6326a1.htm?s_cid=mm6326a1_w
Wheaton AG, Shults RA, Chapman DP, Presley-Cantrell LR, Croft JB. Drowsy Driving 19 States and the
District of Columbia, 20092010. MMWR Morbidity and Mortality Weekly Report 2013.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6151a1.htm

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