Demographic Factors May Impact Sleep Difficulties in Adults

Almost 15% of US adults have trouble falling asleep, with difficulties varying across sociodemographic and geographic categories including age, family income, and urbanization level.

Approximately 14.5% of adults had trouble falling asleep and 17.8% had trouble staying asleep, according to data from the 2020 National Health Interview Survey (NHIS). In addition, sleep difficulties varied by age, sex, race and ethnicity, family income, and urbanization level.

The National Center for Health Statistics released a report outlining data on sleep difficulties experienced by US adults in 2020 from the NHIS, a nationally representative household survey. The survey assessed trouble falling or staying asleep most days or every day in the past 30 days among adults in the United States. Demographic and geographic characteristics were examined.

Trouble Falling Asleep

The survey found that 14.5% of adults had trouble falling asleep most days or every day in 2020 and that the percentage who had trouble falling asleep decreased with older age: 15.5% among adults aged 18 to 44 years compared with 12.1% among adults aged 65 and over. In addition, more women (17.1%) had trouble falling asleep compared with men (11.7%).

Sleep difficulties also varied by race and ethnicity. Non-Hispanic White adults had the greatest trouble falling asleep (15.5%) compared with Hispanic (14.3%), non-Hispanic Black (13.7%), and non-Hispanic Asian (8.1%) adults.

The proportion of adults who had trouble falling asleep decreased as family income increased, with 21.9% among adults with family incomes below 100% of the federal poverty level (FPL) compared with 12.6% for those with family incomes of at least 200% of the FPL.

As education level increased, trouble falling asleep varied. Only 10.4% of adults with a bachelor’s degree or higher had trouble falling asleep compared with 17% of adults with less than a high school diploma.

Urbanization level was linked with trouble sleeping as well. Only 12.7% of adults living in large central metropolitan areas had trouble falling asleep compared with 17.1% living in nonmetropolitan areas.

Trouble Staying Asleep

The NHIS found that 17.8% of US adults had trouble staying asleep most days or every day in the past 30 days. Contrary to the results for trouble falling asleep, younger adults aged 18 to 44 had less trouble staying asleep (13.8%) compared with adults aged 45 to 64 years (21.8%) and adults aged 65 and older (20.3%)

Again, women were more likely to face sleep difficulties. About 20.7% of women had trouble staying asleep compared with 14.7% of men.

Among the racial and ethnic groups evaluated, non-Hispanic White adults (21%) and non-Hispanic Black adults (15.4%) were the most likely to have trouble staying asleep. People with higher family incomes (16.9%) were also less likely to have trouble staying asleep than families with incomes below the poverty line (22.1%).

Education level influenced ability to stay asleep as well, but the differences were less significant. About 16.3% of adults with a bachelor’s degree had trouble staying asleep vs 16.6% of adults with less than a high school diploma.

Similar to the previous results, difficulty staying asleep was more common among rural, nonmetropolitan residents (22.4%) than among residents of metropolitan areas (14.4%).

These overall findings showed consistently greater proportions of women, adults with lower income, and rural residents had difficulty both falling and staying asleep. Sleep difficulties varied more significantly with age, race and ethnicity, and education level. However, non-Hispanic White adults had the greatest difficulties and adults with a bachelor’s degree or higher had the least difficulties for their respective categories.


These findings may indicate disparities in sleep duration and quality related to sex, race and ethnicity, and other demographic factors, the authorsn noted. However, they suggest that their findings detailing patterns of poor sleep quality among subgroups be used to inform future research on improvements in sleep health exploring these patterns further.

Reference

Adjaye-Gbewonyo D, Ng AE, Black LI. Sleep difficulties in ddults: United States, 2020. CDC. June 2022. Accessed June 27, 2022. https://bit.ly/3NP2LzY