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Insufficient Rest or Sleep in Adults, United States, 2008

11.1% of U.S. adults reported insufficient sleep or rest for all 30 of the preceding 30 days. Sufficient sleep is not a luxury—it is a necessity—and should be thought of as a "vital sign" of good health.

Chart: Percentage of Adults Who Reported 30 Days of Insufficient Rest or Sleep in Past 30 Days, by State. 7.9% to 9.6%: 11 states; 9.7% to 10.4%: 11 states; 10.5% to 11.4%: 12 states; 11.5% to 13.0%: 10 states; 13.1% to 19.3%: 10 states. Includes the 50 states, District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands.

The importance of chronic sleep insufficiency is under-recognized as a public health problem, despite being associated with numerous physical and mental health problems, injury, loss of productivity, and mortality (1,2). Approximately 29% of U.S. adults report sleeping <7 hours per night (3) and 50--70 million have chronic sleep and wakefulness disorders (1). A CDC analysis of 2006 data from the Behavioral Risk Factor Surveillance System (BRFSS) in four states showed that an estimated 10.1% of adults reported receiving insufficient rest or sleep on all days during the preceding 30 days (4). To examine the prevalence of insufficient rest or sleep in all states, CDC analyzed BRFSS data for all 50 states, the District of Columbia (DC), and three U.S. territories (Guam, Puerto Rico, and U.S. Virgin Islands) in 2008.

BRFSS is a state-based, random-digit--dialed telephone survey of the noninstitutionalized U.S. civilian population aged ≥18 years, which is conducted by state health departments in collaboration with CDC (5). In 2008, response rates among all 50 states, DC, and territories ranged from 35.8% to 65.9% (median: 53.3%), based on Council of American Survey and Research Organizations (CASRO) guidelines. Cooperation rates§ ranged from 59.3% to 87.8% (median: 75.0%).

Among the 403,981 adult respondents, an estimated 30.7% reported no days of insufficient rest or sleep in the preceding 30 days, 41.3% reported 1--13 days, 16.8% reported 14--29 days, and 11.1% reported 30 days. Females (12.4%) were more likely than males (9.9%) and non-Hispanic blacks (13.3%) were more likely than other racial/ethnic groups to report insufficient rest or sleep. As displayed in the map on this page, the distribution of reported days of insufficient rest or sleep varied among states and territories. The lowest age-standardized prevalences of 30 days of insufficient rest or sleep in the preceding 30 days were observed in North Dakota (7.4%), California (8.0%), DC (8.5%), Wisconsin (8.6%), and Oregon (8.8%); the highest were observed in Puerto Rico (14.0%), Oklahoma (14.3%), Kentucky (14.4%), Tennessee (14.8%), and West Virginia (19.3%)

According to the National Sleep Foundation, adults need 7--9 hours of sleep each night. Health-care professionals should evaluate patients who report chronic insufficient rest or sleep and advise them of effective behavioral strategies including keeping a regular sleep schedule; avoiding stimulating activities within 2 hours of bedtime; avoiding caffeine, nicotine, and alcohol in the evening; sleeping in a dark, quiet, well-ventilated space; and avoiding going to bed hungry.Pharmacologic intervention also might be warranted. Although few formal clinical practice guidelines are available for assessing and treating sleep insufficiency and sleeping disorders, a multidisciplinary team, including a sleep specialist, might be required for proper treatment (1).

Map: Age-Adjusted* Percentage of Adults Who Reported 30 Days of Insufficient Rest or Sleep† during the preceding 30 days, United States,§ 2008


  1. Institute of Medicine. Sleep disorders and sleep deprivation: an unmet public health problem. Washington, DC: The National Academies Press; 2006.
  2. Banks S, Dinges DF. Behavioral and physiological consequences of sleep restriction. J Clin Sleep Med 2007;3:519--28.
  3. Schoenborn CA, Adams PF. Sleep duration as a correlate of smoking, alcohol use, leisure-time physical inactivity, and obesity among adults: United States, 2004--2006. Available at Accessed October 22, 2009.
  4. CDC. Perceived insufficient rest or sleep---four states, 2006. MMWR 2008;57:200--3.
  5. CDC. Public health surveillance for behavioral risk factors in a changing environment: recommendations from the Behavioral Risk Factor Surveillance Team. MMWR 2003;52(No. RR-9).

† The percentage of persons who completed interviews among all eligible persons, including those who were not successfully contacted.

§ The percentage of persons who completed interviews among all eligible persons who were contacted.

¶ Additional guidance on good sleep practices from the National Sleep Foundation is available at .

Data Source:

CDC. Perceived Insufficient Rest or Sleep Among Adults --- United States, 2008. MMWR 58(42);1179-1179.

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