What Causes Americans’ Sleep Problems?
Many Americans don’t get as much good-quality sleep as they need, even though they spend enough time in bed, according to a new WebMD survey of 2,000 people.
Over 7 in 10 of those surveyed (73%) rated their sleep over the previous month as “good” or “very good.” And 63% spent at least 7 hours in bed each night. (Experts say most adults need 7-9 hours of sleep each night.)
At the same time, just a little over a third of people surveyed (36%) said they actually slept for at least 7 hours. On average, they snoozed for just 5.7 hours per night – far short of what you need for optimum health.
It might not seem like a big deal to miss a few hours of shut-eye. But sleeping less than 7 hours a night is linked to a higher risk of conditions like:
- Heart disease
- Stroke
- Diabetes
- Mood disorders
- Obesity
Sleep-related problems cost Americans some $16 billion a year in medical bills, according to some estimates.
“The impact of poor sleep is wide-ranging,” says Marri Horvat, MD, of Cleveland Clinic’s Sleep Disorders Center. “Depending on the cause, [it] can impact a variety of organs, from your skin to your heart and brain.” It’s also linked to a risk of premature death, she says.
WebMD’s survey used a nationally representative sample of adults, which means the group was similar to the U.S. population in terms of age, gender, race, and geographic location.
How Well Do Americans Sleep?
The survey found that people have trouble both getting to sleep and staying asleep. The average time they spent in bed was 7.61 hours, so they spent an average of nearly 2 hours awake after bedtime.
Here are some of the reasons why:
Time to get to sleep. Doctors say most adults without sleep problems should be able to fall asleep about 20 minutes after they hit the pillow. But in WebMD’s survey, 43% of people said it takes them over 30 minutes to snooze after they get into bed. Only 23% get to sleep in 20 minutes or less. The average amount of time it took people to fall asleep was 29.8 minutes.
Waking up at night. Only 10% of respondents said they never woke up in the middle of the night during the 30 days before the survey, and 16% said it happened on more than 20 nights.
On average:
- People reported waking up during the night nearly nine times per month.
- They woke up early and were unable to get back to sleep on 7.3 nights.
But why might those who slept too few hours still report that they rested well? It’s likely because people define sleep quality in different ways, Horvat says.
“Some feel that the duration of sleep makes their sleep quality good or bad, others feel it’s the ability to stay asleep, and yet others look at their daytime symptoms to determine if they slept well,” she says.
What Causes Sleep Problems?
The reasons we don’t get enough sleep range from minor, like a barking dog, to serious, like sleep apnea.
Sleep disorders. Many people in the survey reported they’d been diagnosed with one or more sleep disorders:
- 17% had insomnia
- 14% had obstructive sleep apnea
- 13% had restless legs syndrome
- 8% had either narcolepsy or hypersomnia (excessive daytime sleepiness)
These conditions are treatable, so see your doctor if one of them is affecting your sleep quality.
Obesity. Doctors say this health condition can also affect how well you sleep. (At the same time, poor-quality sleep can lead to weight gain.) About 15% of people in the WebMD study said they’ve been diagnosed with obesity, defined as having a body mass index (BMI) of 30 or more.
Other health conditions. Some people in the study reported having been diagnosed with other mental or physical health conditions known to affect sleep:
- 27% have an anxiety disorder
- 27% have depression
- 16% have a long-term condition that causes physical pain
- 14% have gastroesophageal reflux disease, or GERD
- 11% have a condition that causes itching, like psoriasis or eczema
Getting up to pee. Survey respondents said this most interfered with their sleep during the previous month. One-third (33%) cited it as a main reason for interrupted sleep.
Waking at night to pee (your doctor might call this nocturia) is more common in older people, though it can affect anyone. Many things can cause it, including:
- An enlarged prostate gland
- Urinary infections
- Drinking too much fluid at night, or drinking alcohol or caffeine after dinnertime
- Pregnancy
If it’s keeping you from getting enough sleep, tell your doctor.
Other sleep disturbers. Some of the other things that people in the survey named as top reasons for poor sleep quality were:
- Emotional or mental distress, like sadness or worrying, cited by 24%
- Feeling too hot, including having hot flashes or night sweats, even when the room is cool, 16%
- Physical pain, 16%
- Being disturbed by someone else, such as a bedmate, child, or pet, 16% (This didn’t include snoring, which was cited by 5%.)
- Issues in the environment like noise, light, or temperature, 13%
- Bad or intense dreams, 10%
Sleep schedule. While 71% of those surveyed said they usually go to bed in the late evening, defined as between 9:01 p.m. and 5 a.m., nearly a third (29%) have bedtimes in the morning, afternoon, or early evening. Experts say that night shift workers and others who sleep during the day tend to get less sleep than those with more conventional bedtimes. That’s due partly to disruptions of your internal body clock, and partly to the fact that it’s simply harder to sleep during the day.
“A poor sleep environment due to loud noises and other environmental factors can lead to unrefreshing sleep,” says Camilo Andrés Ruiz, DO, medical director of Choice Physicians of South Florida.
We don’t prioritize sleep. While the WebMD survey didn’t address this issue, experts say many Americans choose to focus on work, family, or school demands that make it hard to get enough sleep.
In particular, Ruiz says, “young adults tend to curtail their sleep time due to work hours or lifestyle habits.”
That may be at least in part because many of us don’t recognize what an important role sleep plays in our heath and our lives, Ruiz says. “There is an unmet public health need [for] sleep education,” he says.
How Does Poor-Quality Sleep Affect You?
Not only does poor sleep quality raise your risk for physical health issues, it can lead to memory and thinking problems and affect your quality of life, Ruiz says. On a more immediate level, “loss of sleep time can lead to work performance, cognition, and alertness issues,” he says
Many of those who took part in the WebMD study reported that a lack of enthusiasm or motivation (common side effects of sleep loss) made it harder for them to do their daily tasks on an average of 5.6 days out of the month. During the 30 days before the survey:
- 29% said this happened to them on 1-3 days
- 27% said it occurred on 4-7 days
- 23% said it affected them more than 8 days
People in the survey also said they had trouble staying awake while they were eating, socializing, or driving at night an average of four times during the month.
With so much at stake, it’s important to make sleep a priority in your life. Follow these suggestions [DS1] for good sleep hygiene. See your doctor if your sleep problems last for more than a month or interfere with your daily life.
