Forty-five percent of Americans say that poor or insufficient sleep affected their daily activities at least once in the past 7 days, according to the National Sleep Foundation (NSF) inaugural Sleep Health Index. The Sleep Health Index is a new annual general population poll that tracks Americans’ sleep behaviors and trends. The Index uncovers valuable insights into Americans’ sleep beliefs, habits, knowledge, and disorders, and demonstrates areas for sleep health improvement.

Americans Report Good Sleep Quantity, But Not Quality

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Americans report sleeping an average of 7 hours and 36 minutes a night; on average going to bed at 10:55 PM and waking at 6:38 AM on workdays, and sleeping roughly 40 minutes longer on non-workdays or weekends.

Despite sleeping within the recommended number of hours a night, 35% of Americans report their sleep quality as “poor” or “only fair.” Twenty percent of Americans reported that they did not wake up feeling refreshed on any of the past 7 days.

Those Who Report Poor Quality Sleep Also Report Poor Quality Health

Overall health was highly associated with sleep quality; 67% of those with less than good sleep quality also report “poor” or “only fair” health, with 27% reporting otherwise “good” health. Low life satisfaction and high stress were also related to sleep quality. Groups that reported poorer sleep quality were those with an annual income of less than $20,000, those with education levels of high school or less, and Americans between 30 and 64 years old compared to younger American adults ages 18-29.

“The findings from the Sleep Health Index demonstrate a need for sleep health improvement,” says David Cloud, NSF CEO, in a release. “Sleep is an important factor in overall health. We suggest that Americans and their doctors talk about sleep as a vital sign of health and well-being.”

Gender Divides Sleep Issues

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Women are more likely to report insomnia symptoms; men are more likely to say they snore, supporting previous data that have shown women are more commonly diagnosed with insomnia and men with sleep apnea.

“It is well-established that men are at much greater risk of obstructive sleep apnea than women and this could explain the differences in snoring, which can be a sign of sleep apnea,” says Kristen Knutson, NSF poll fellow. “The increased rates of insomnia in women are not fully understood but may be related to increased anxiety or depression or simply gender differences in willingness to report a problem.”

Surprisingly, 24% of women say they have woken up feeling well-rested zero of the past 7 days, compared to 16% of men, despite reporting similar sleep times.

More People Have Been Diagnosed with Sleep Apnea Than Previously Thought

The Index found that a higher proportion of individuals were told by a doctor that they have sleep apnea than previous reports.

“The Index found that 11.6% of the US population had been told by their physician that they have sleep apnea,” says the vice-chair of the NSF board, Max Hirshkowitz.

Most Americans Nap: Does This Mean We Need More Sleep?

The Index indicates that more than one-half of the US population has taken a nap within the past 7 days. The number of naps varied by individual—23% took a nap 1-2 days, 13% took a nap 3-4 days, 17% took a nap at least 5 days—but the frequency of napping suggests that a large number of Americans may need more sleep.

“Getting enough sleep improves your health, strengthens your immune system, improves your mood, and boosts productivity; chronic poor sleep is linked to poor health, mood disorders, and low productivity,” Knutson says. “Improving sleep in various demographics could make a positive impact on public health.”