Sleep Equity and the State of Sleep in the US

Sleep is essential for good health, yet millions of people in the United States and around the world do not get the sleep they need. Insufficient or poor-quality sleep can affect physical and mental health, learning, work, safety, and overall quality of life.

Healthy sleep is not simply a matter of personal choice. Work schedules, caregiving responsibilities, housing conditions, financial pressures, and access to healthcare can all influence how well people sleep. These differences highlight the importance of sleep equity, which means ensuring that everyone has a fair opportunity to achieve healthy sleep and circadian health.

Understanding sleep patterns and disparities across populations can help communities, healthcare systems, schools, employers, and policymakers identify barriers to healthy sleep and develop ways to address them. By recognizing sleep as both a personal and public health concern, we can work toward healthier, safer, and more supportive environments for everyone.

Millions of Americans experience sleep problems that can affect their health and daily lives. An estimated 50 to 70 million people in the United States have sleep disorders, while approximately one in three adults report getting less than the recommended amount of sleep.

Insufficient sleep and untreated sleep disorders can affect many aspects of daily life, including learning, work performance, driving safety, relationships, and overall wellbeing. They are also associated with an increased risk of several chronic health conditions.

Sleep health varies across the United States. Data from the Centers for Disease Control and Prevention (CDC) show differences in sleep duration across states, counties, age groups, and populations. These differences reflect not only individual sleep habits but also broader factors such as working conditions, housing, financial pressures, and access to healthcare.

Sleep concerns are also common around the world. A recent systematic review estimated that about 16% of adults worldwide live with chronic, clinically relevant insomnia, representing hundreds of millions of people.

Interestingly, research shows that people in East Asia have shorter sleep durations, while people in Oceania and West Europe have the longest sleep durations compared to other countries. Within Europe the Dutch and French report higher sleep satisfaction compared to their neighbouring countries.

The amount people sleep is also deeply tied to cultural beliefs and practices, and the attitudes that people share about sleep.

Globally, sleep and circadian health are shaped by many different modern life factors. Work hours, shift work, caregiving responsibilities, financial stress, technology use, and round-the-clock connectivity are common sleep disruptors in many countries. The complex nature of the world means that some communities are more impacted than others by external pressures such as climate instability, urban noise and light exposure, poor housing quality, crowding, conflict, displacement, poverty, and limited access to healthcare. 

While it is difficult to precisely measure sleep on a global level due to the differences between countries, the importance of sleep does not change.

Sleep is often discussed as an individual habit, but it is also a public health matter. Sleep affects how people function across the full 24-hour day, and how they show up for their work, relationships, roles and responsibilities in life.

Poor sleep and circadian disruption can contribute to: 

• Daytime sleepiness and fatigue
• Reduced attention, difficulty learning, and poor memory
• Reduced school and work performance
• Poorer decision-making
• Mood changes, emotional stress
• Drowsy driving, workplace safety risks
• Strain on families and caregivers
• Lower quality of life

Over time, insufficient or disrupted sleep may also contribute to chronic health problems or worsen existing conditions.

Sleep health is influenced by more than individual habits. Work schedules, school start times, housing conditions, neighborhood noise, and access to healthcare can all affect opportunities for healthy sleep.

Recognizing sleep as a public health issue can help communities, employers, schools, and policymakers create environments that support better sleep and overall wellbeing.

Sleep equity means that everyone should have a fair opportunity to achieve healthy sleep and circadian health, regardless of their circumstances.

However, not everyone has the same opportunity to get the sleep they need. Advice such as keeping a consistent sleep schedule can be helpful, but it may be difficult to follow for someone working rotating shifts or caring for a family member overnight. People living in crowded or noisy housing may also have less control over their sleeping environment.

These differences are often shaped by broader social and economic conditions. Income, employment, housing, and access to healthcare can all influence sleep health. Research has also identified differences in sleep outcomes across racial and ethnic groups, reflecting complex social and environmental influences.

Improving sleep equity means looking beyond individual habits. It includes making sleep health information and healthcare more accessible, while encouraging workplaces, schools, and communities to create conditions that support healthy sleep.

Everyone can take steps to improve their sleep, but those steps are more effective when people have the opportunity and support to put them into practice. Healthy sleep should not be a privilege determined by where someone lives or works.

Everyone can play a role in supporting better sleep and circadian health. A good place to start is by using our website and resources to learn how sleep affects health, safety, mood, work, school, caregiving, and daily life.

People can also take action by having meaningful conversations with healthcare professionals about sleep concerns for themselves or loved ones so they can get the care they need. Asking workplaces, schools, and other organizations to consider how their decisions affect sleep and circadian health can also raise awareness and make a difference.

And finally, connecting with and supporting organizations like WSCN that advocate for sleep health can help us keep working to advance sleep and circadian health for all.