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NSF 2005 Sleep in America Poll

Many of America's adults are sleeping poorly, and it's taking a serious toll on professional relationships, productivity, public safety and even the most intimate aspects of our lives, according to a new poll released by the National Sleep Foundation (NSF). The poll shows that sleep problems are widespread and on the rise, but they are often ignored.

NSF's Sleep in America poll finds 75 percent of adults frequently have a symptom of a sleep problem such as waking a lot during the night, or snoring. Although they say they have these symptoms, most ignore them and few think they actually have a sleep problem.

Many adults say they are often tired, fatigued or don't feel up to par; they are not satisfied with the quality of their sleep, but most don't take steps to improve it. Only about one-half of respondents are able to say on most nights, "I had a good night's sleep."

Poor sleep and sleepiness cause disruptions in nearly every facet of one's life.

• More than one in four respondents (26 percent) is at risk for sleep apnea, according to the findings. (Sleep apnea, or pauses in breathing during sleep, is a serious sleep disorder associated with hypertension and stroke; apneic episodes can happen several times during the night, disrupting sleep. Snoring can be a symptom of sleep apnea, as most people with apnea snore, but not everyone who snores has sleep apnea).
• 60 percent of adults licensed to drive say they have driven drowsy in the past year, an increase over recent years; four percent have had an accident or near accident because they were too tired, or actually dozed off while driving.
• Sleep-related issues are cited as the most common reason people are late for work cost three in ten working adults say they have missed work, events/activities or made errors at work because of sleep-related issues in the past three months.
• For partnered adults, sleep problems are doubly disruptive, as one partner's sleep problem can cause the other to lose, on average, nearly an hour of sleep a night. One or both partners are often too sleepy for sex, and many couples sleep apart because of a sleep problem.

"The 2005 Sleep in America poll shows that sleep is the great American divide. Half of the country sleeps pretty well - the other half has problems," says Richard L. Gelula, NSF's chief executive officer. "The data provide a compelling snapshot of how our lives are dramatically affected by the way we sleep. People who sleep well, in general, are happier and healthier. But when sleep is poor or inadequate, people feel tired or fatigued, their social and intimate relationships suffer, work productivity is negatively affected, and they make our roads more dangerous by driving while sleepy and less alert. This poll shows the sleepiness that permeates our society has serious consequences, and Americans' poor sleep is creating a public health and safety crisis in need of immediate attention," Gelula says.

Sleep problems affect relationships

The Sleep in America poll finds that among adults with spouses or other partners, sleep problems can be contagious and disruptive, and can cause relationships to suffer. A large majority of these respondents (77 percent) report that their partner has a sleep-related problem, and the most common problem is snoring. When disturbed by a bed partner's sleep problems, the other partner loses an average of 49 minutes of sleep a night -- 300 hours a year. Nearly one-fourth of partnered adults say they have sex less often or have lost interest in sex because they are too sleepy. The poll data also show:

• About the same number of respondents (78 percent) whose partner has any type of sleep problem say they also frequently experience a sleep problem.
• Two-thirds of partnered adults say their partner snores, while 6 out of 10 of all adults (59 percent) say they snore. More than one-half (57 percent) of those who snore say their snoring bothers others.
• One-third of partnered adults (33 percent) say they have problems in their relationship because of their partner's abnormal sleep.
• Three in ten adults with partners (31 percent) take measures to try to prevent their own sleep from being disturbed because of their partner's sleep problem. Most sleep in a separate bed, bedroom, or on the couch (23 percent).

"In my practice, I've found when couples are forced to sleep apart because of one partner's sleep problems, it often has a terrible effect on the relationship," says Meir Kryger, M.D., co-chair of NSF's 2005 poll task force. "It's a move of last resort; the partner whose sleep is disturbed feels there is no alternative, but both partners are often devastated by this action," adds Kryger. Dr. Kryger is director of the Sleep Disorders Center at St. Boniface Hospital Research Center at the University of Manitoba in Winnipeg; he is also an NSF director.

Sleep Problems - Common, Widespread, and Ignored

America's adults experience sleep problems on a regular basis, but they don't necessarily consider their poor sleep a problem. About 75 percent say they experienced a symptom of a sleep problem a few nights a week or more in the past year. But when asked directly if they think they have a sleep problem, an equal number, 76 percent, say no. More than half of those who think they have a sleep problem wouldn't talk to their doctor about it, and a majority (70 percent) say their doctor doesn't ask about sleep habits. About two in 10 say if they had a sleep problem they assume it would go away and would take no action.

• One-fourth of respondents say their sleep problems have some impact on their daily lives.
• About one-half (54 percent) of those polled say they experienced at least one symptom of insomnia a few nights a week or more in the past year. The most common symptoms are waking up feeling unrefreshed (38 percent) and waking up a lot during the night (32 percent). About one in ten respondents say their symptoms actually impact their daily activities. This "next day impact" means the respondents are at risk for insomnia, as opposed to only experiencing symptoms.
• Ten percent of adults say they have unpleasant tingling in their legs that worsen at night. These adults are at risk for restless legs syndrome (RLS), a sleep disorder that often results in uncomfortable leg sensations when they try to fall asleep. Because they are often restless at night, people with RLS can disturb the sleep of their bed partner.
• More than one in four respondents (26 percent) is at risk for sleep apnea, according to the findings. (Sleep apnea, or pauses in breathing during sleep, is a serious sleep disorder associated with hypertension and stroke; apneic episodes can happen several times during the night, disrupting sleep. Snoring can be a symptom of sleep apnea, as most people with apnea snore, but not everyone who snores has sleep apnea).

Although the symptoms for insomnia, RLS and sleep apnea are different, the Sleep in America poll shows that those likely to have these sleep problems share basic common experiences: They are more likely to sleep less than six hours a night, and get less than the minimum amount of sleep they say they need to function at their best. They have frequent daytime sleepiness that is impairing, have missed work or events in the past three months, and have significantly more problems in their relationships than those without the sleep problems. A majority of adults with these sleep problems/disorders say they get a good night's sleep only a few nights a month or less.

Sleep quantity and quality matter

America's adults average 6.9 hours of sleep each night, slightly less than the range of the 7-9 hours recommended by many sleep experts. However the 2005 poll also indicates that more people now say they are sleeping less than six hours on weekdays (16 percent) and weekends (10 percent) compared to respondents in NSF's 1998 poll which found 12 percent sleeping less than 6 hours on weekdays and eight percent getting that amount on weekends. On average, America's adults say they need a minimum of 6-1/2 hours of sleep a night to function their best the next day; and about three-quarters of respondents say they get the amount of sleep they need or more. However, one-half of those polled report feeling tired, fatigued or not up to par during their wake hours at least one day a week; nearly one out of five (17 percent) says this happens every day or almost every day.

Quality sleep is missing for many adults, according to the poll findings. One-quarter of those polled say they sleep well only a few nights a month or less. Poor sleepers are more likely than good sleepers to say that their intimate relationships are affected because they are too sleepy (34 percent vs. eight percent). Sleep problems are prevalent among these poor sleepers; 88 percent say they experience at least one symptom of insomnia and/or a sleep disorder (94 percent) at least a few nights a week.

On at least a few nights of the week, the most popular activity in the hour before bedtime is watching television for nearly 9 out of 10 adults, while just over a quarter (27 percent) say they had sex. What sleep experts would consider poor sleep hygiene is evident in other activities, such as being on the Internet (28 percent), doing work related to their job (18 percent), drinking an alcoholic beverage (13 percent) and exercising (11 percent).

Health/Medical conditions

The Sleep in America poll shows a relationship between sleep and health. Adults diagnosed with at least one common medical condition (among them high blood pressure, arthritis, heartburn/GERD or depression) are less likely to say they frequently get a good night's sleep and are nearly twice as likely to experience frequent daytime sleepiness than those who don't have the conditions. Those with the diagnosed medical problems are also more likely to be at risk for Restless Legs Syndrome (13 percent vs. four percent), insomnia (12 percent vs. five percent), or sleep apnea (35 percent vs. 11 percent).

NSF's poll also confirms an epidemic of obesity in America. Based on body mass index (BMI) measures, the poll finds nearly two-thirds of respondents (64 percent) are overweight or obese, conditions that clearly impact sleep. The data show that compared to adults of average weight, those considered obese are more likely to get less than six hours of sleep on weeknights (18 percent vs. 11 percent), and frequently have daytime sleepiness (37 percent vs. 26 percent). They also are nearly six times as likely to be at risk for sleep apnea (57 percent vs. 10 percent), and are nearly twice as likely to think they have a sleep problem (30 percent vs. 17 percent).

Other poll highlights:

Napping- more than one-half of respondents nap at least once a week; one-third report napping two or more times. The average nap lasts 50 minutes for those taking two or more naps a week; 30 percent of these adults nap for an hour or more. (NSF and many sleep experts recommend a nap between 20 – 45 minutes).

Sleep Aids and Caffeine - While the majority of America's adults do not use anything to help them sleep, 11 percent said they used alcohol, beer or wine at least a few nights a week. About eight in 10 adults say they drink at least one caffeinated beverage daily; one-quarter of them say they drink four or more caffeinated beverages daily. The NSF and many sleep experts recommend avoiding alcoholic beverages and caffeine close to bedtime.

"NSF's 2005 Sleep in America poll shows that sleep-related issues are affecting the lives of most adults in America; they are affected at home, at work, on the road, and in their social relations. And in spite of the rising trend in reported symptoms of sleep problems/disorders, the poll finds most doctors are not asking patients about their sleep," says Michele Narcavage, president of Awake In America. NSF and Awake In America believe one of the most important questions doctors and other health care providers should ask their patients is, "How often do you get a good night's sleep?" We also believe that a key to our nation's health and prosperity may be the collective response to that question.

NSF urges America's adults to:

• Learn to recognize symptoms of sleep problems and get them treated. Remember, one family member's sleep problem can affect others, especially bed partners.
• Pay attention to the quantity and quality of your sleep. Be sure to get the amount of sleep you need to function at your best the next day.

Health care providers must:

• Talk to their patients about sleep and recognize the relationship between sleep issues and other medical conditions.
• Ask your patients "How often do you get a good night's sleep?"

The National Sleep Foundation is an independent nonprofit organization dedicated to improving public health and safety by achieving greater understanding of sleep and sleep disorders, and by supporting education, sleep-related research, and advocacy. NSF is based in Washington, DC.