A Survey of Modern Life: Sleep
New Data on American Sleeping Patterns
This report is the third in a series of reports on the results from a set of consumer surveys on health-related behaviors and the influence of popular products and services. Fielded by Building H, a project to build health into everyday life, the surveys examined the influences of popular products and services — such as video streaming, food delivery services, automobiles, rideshare services, mapping services and mobile gaming — on these behaviors, finding that they are often negative. This report looks across the set of surveys at the question of sleep: how much are people getting, what’s limiting it, and how do activities like TV watching influence it. More information on the overall survey project can be found here.
Key Findings
- Only 42.8% of Americans report getting the recommended seven or more hours of sleep per night. 25.9% get between six and seven and 31.4% get less than six hours.
- Only 28.0% of Blacks reported getting seven or more hours of sleep per night, as compared with 45.8% of Whites. 41.1% of Blacks, versus 25.3% of Whites, reported getting less than six hours per night.
- 36% of people earning less than $25,000 per year reported an average of less than six hours of sleep per night, as compared with only 24.6% of people earning between $100,000 and $150,000.
- 54.7% of people using video streaming services and 50.9% of mobile game players reported losing sleep at least one night a week due to their use of these services.
Introduction
Building H developed a set of 10 surveys of American adults that looked at the prevalence of five important health-related behaviors and one potentially unhealthy behavior, use of selected consumer products and services, and attitudes toward corporate responsibility for health impacts.
Questions across two general surveys asked about sleep, physical activity, spending time with friends, getting outdoors, screen time and eating patterns. Additional surveys assessed the impact of different types of products and services — video streaming, mobile gaming, ride-hailing, food and grocery delivery services — on different health behaviors.
This report is based on the general surveys and questions about sleep that were included in the surveys on video streaming and mobile gaming.
The surveys were conducted using Google Consumer Surveys in December, 2020. Sample sizes varied from 500 adults (18 years or older) in the U.S. for the survey on video streaming to 5,000 respondents for the general surveys. Samples were chosen to represent the U.S. population distribution across ages, genders, races, and geographic regions.
General surveys questioned participants on both their experiences with and attitudes towards health behaviors (i.e. sleep, socialization, time spent outdoors, eating patterns and physical activity). The product specific surveys questioned participants who use specific products like video streaming or mobile gaming on how they interact with the products, and the products’ effects on health behaviors. For example, both the streaming and mobile game surveys asked participants how much time they spent with the products in the last month, how much sleep they have lost in the past month due to the products and how often they socialize with others while using the products.
Results
Sleep amounts and factors inhibiting sleep
42.8% of Americans report getting the recommended seven or more hours of sleep per night. 25.9% get between six and seven and 31.4% get less than six hours.
The most cited causes for limiting sleep were waking up early and not being able to get back to sleep (30.5%); trouble falling asleep (28.6%); staying up late watching TV (20.9%) and being too busy and not having enough time (18.3%). Staying up late using social media (12.9%) and staying up late playing video or computer games (6.7%) were less commonly cited.
In a survey about consumer attitudes towards health-related behaviors, 61.8% of respondents reported that they got enough (or plenty) of sleep; the remaining 38.2% reported feeling that they got too little (24.6%) or far too little (13.6%) sleep.
We looked at the relationships between amount of sleep and other daily activities and behaviors.
- Surprisingly, the amount of physical activity from daily activities and amount of sleep seem negatively correlated: those engaged in 3 or more hours a day of physical activity (excluding workouts) were twice as likely (52% vs. 25%) to report short sleep (6 hours or less) and more likely (48% to 27%) to report 7 or more hours of sleep per night.
- The differences associated with sleep at different levels of time spent outdoors do not seem statistically significant, except for those who report more than 8 hours a day of outdoor time: 56% of them report 6 hours or less of sleep per night.
- Time spent socializing does not seem to be correlated with sleep, except at the extreme. 53% of people spending more than 15 hours per week with friends report sleeping 6 hours a night or less.
Results by race, income, gender and region
The general surveys asked respondents about the races which they identify and the ranges into which their annual incomes fall. Google Consumer Surveys infers gender, age range and geographic region automatically. Short sleep is a challenge across all ages, races, genders and income levels, but some differences were observed:
- There was a profound difference in the amount of sleep by race: 28.0% of Blacks reported getting seven or more hours of sleep per night, as compared with 45.8% of Whites. 41.1% of Blacks, versus 25.3% of Whites, reported getting less than six hours per night.
- Income matters as well: 36% of people earning less than $25,000 per year reported an average of less than six hours of sleep per night, as compared with only 24.6% of people earning between $100,000 and $150,000.
- We observed a difference by region: 35.1% of people in the Northeast reported less than six hours per night, as compared with only 25.6% of those living in the West.
There were also some differences in the reasons for getting reduced sleep:
- The reasons vary considerably by age: 38.2% of people aged 18–24 reported difficulty falling asleep (as compared to 22.5% of people aged 65 and over). The numbers were effectively reversed for waking up early and not being able to get back to sleep: 21.2% of 18-year-olds and 44.4% of those 65 and over reported this problem.
- 33.3% of women reported difficulty falling asleep, as compared with 24.2% of men.
- Women (19.2%) were twice as likely as men (9.2%) to report limiting sleep due to video streaming four or more nights per week.
Influence of products and services
The surveys on the use of video streaming services like Netflix and Hulu and on mobile games like Pokémon GO specifically asked about the link to sleep.
- A majority (54.7%) of video streaming users reported that watching TV or movies caused them to lose some sleep at least once a week on average, with 36.6% reporting that they got less sleep for this reason two or more times a week. 14.5% reported their sleep being affected four or more nights a week.
- The volume of usage matters: 37.0% of those reporting watching more than four hours of video streaming per day also reported it limiting their sleep more than five nights per week, as compared with 7.3% of all streaming users and 1.5% of users reporting less than two hours per day of streaming.
- Mobile gaming affected one or more nights per week of sleep for 37.2% of users, with 22.3% reporting two or more nights affected and 11.1% reporting four or more nights.
The general surveys asked more generally about time spent on screens (for personal use, not for work) and we looked at the correlations between screen time and amount of sleep.
- Screen time and sleep appear to be associated: 53% of people spending more than 10 hours a day on screens for personal reasons reported short sleep (6 hours or less) vs. 22% of people spending 2–3 hours a day. Conversely, 48% of those spending 2–3 hours a day on screens reported the recommended seven or more hours of sleep, as compared with 25% of those who spend 10 or more hours on screens.
Discussion
The survey data on sleep confirm what’s known to be a serious problem of chronic sleep deficit in the U.S. The 31.4% reporting six hours or less of sleep per night roughly tracks a 2017 result (33%), though the 57.3% reporting less than seven hours per night appears to be considerably worse than CDC’s 2014 data, which shows that no state had more than 44% of residents reporting less than 7 hours. It’s possible, with the survey being conducted in December 2020, that the Covid-19 pandemic was having an effect, which suggests that the survey bears repeating to confirm the data.
There is something of an awareness gap about sleep: while 57% of Americans appear to be getting less than the recommended seven hours per night, only 38% feel that they’re getting too little (or far too little) sleep. This gap could also imply that the guideline doesn’t reflect people’s lived experience — that people are not observing any effects of too little sleep despite getting less than the recommended amount.
Racial and income gaps in the sleep data are troubling, with Blacks 61% as likely to get the recommended seven hours as Whites and 1.6 times more likely to report six hours or less. Similarly, people earning less than $25,000 were 1.5 times more likely to report sleep of less than six hours per night than people earning between $100,000 and $150,000. The fact that a third of women (as opposed to a quarter of men) report difficulty falling asleep stands out as well. These disparities merit further investigation, especially in light of the accumulating research that links short sleep to a variety of poor health outcomes. (For example, a recent study showed that short sleep in middle age was associated with a greater likelihood of developing dementia later in life.)
The causes of reduced sleep are less clear: the most common experiences were waking up early and having trouble falling back asleep and having trouble falling asleep in the first place, both of which could be the result of many factors. Media use (TV, social media, games) is a factor for a minority of people. While being too busy and not having enough time to sleep more was only reported by only 18% of respondents, people reporting extreme amounts of time spent on screens, in physical activity, outdoors or with friends also reported shorter sleep, suggesting that time is, unsurprisingly, a factor. In general, the causes of reduced sleep did not show clear differences among gender, race or income, with a few exceptions: women are more likely than men to have trouble falling asleep and somewhat more likely to stay up watching television. Blacks are more likely than Whites to stay up using social media, but the effect is not nearly large enough to explain the gap in the overall amount of sleep.
Conclusion
A majority of Americans are not getting the recommended amount of sleep and are, in fact, getting levels associated with higher prevalences of chronic diseases like diabetes, depression, asthma, dementia and heart disease. According to survey research, the percentage of Americans getting less than six hours of sleep per night has increased 15-fold since 1960.
The reasons for shorter sleep are multiple and complex — and our surveys only scratch the surface. Our research does show that activities like watching TV, playing games and using social media have some effect, thus there is a need for critical assessment of how the product environment can be better shaped to promote sleep. As a culture, we often celebrate the companies that create products and services that have the unfortunate side effects of making it harder for us to sleep — and Wall Street rewards them financially. Creating greater awareness of this impact is a first step in shifting that culture.
Finding the root causes of reduced sleep will require further research. Given the serious health consequences and the magnitude of the disparities in sleep across race, gender and income, sleep has become a major equity issue — and research that investigates the causes needs to be conducted in ways that will tease out the differences across different population groups.
Finally, the survey results highlight a surveillance gap. CDC’s data on sleep patterns are seven years old. In addition to the research that’s needed to understand the causes, the seriousness of the issue demands more frequent surveillance, stratified by population.
Acknowledgments
Thomas Goetz, Sara Singer, Carlo Martinez and Brittany Sigler all contributed to the conceptualization and development of the surveys; Carlo Martinez contributed data analysis.
