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Not Enough Sleep Hours

Insufficient sleep is associated with numerous chronic conditions, as well as poor mental health outcomes. The built environment can help to mitigate internal and external stressors, including chronic stress, physical inactivity, and noise pollution, that are all associated with insufficient quantity and quality of sleep.


Insufficient sleep is defined as getting less than seven hours of sleep, on average, during a 24-hour period. Insufficient sleep is associated with occurrence and onset of chronic conditions, such as, diabetes, heart diseases, hypertension, obesity, and depression. Moreover, insufficient sleep is responsible for acute accidents, such as motor vehicle crashes and industrial errors, which cause substantial injury, disability, and mortality each year. Finally, insufficient sleep can reduce productivity and quality of life.

Human Health Mechanism

Similar to digestion, sufficient quantity and quality of sleep is essential for removing toxins from the brain and from the body. Everything from blood vessels to the immune system uses sleep as a time for repair, not getting enough quality sleep disturbs those processes and does not allow for sufficient healing. Animal studies even show that some of the proteins linked with Alzheimer’s disease are removed twice as fast from the brain during sleep.

Indicator Measurement

Data are available through the Center for Disease Control and Prevention (CDC) PLACES public dashboard and are collected from the Behavioral Risk Factor Surveillance System (BRFSS), which is a state-based, telephone interview survey. BRFSS provides the prevalence of not getting enough sleep hours by modeling the percentage of adults who report usually getting insufficient sleep (<7 hours for those aged ≥18 years, on average, during a 24-hour period).

Related Health Outcomes & Exposures

Diabetes, Heart Disease, High Blood Pressure, Obesity, Frequent Physical Distress, Frequent Mental Distress, Cancer, Physical Inactivity, Noise Pollution


Click here for References
  1. Not Enough Sleep Hour Data Source: CDC PLACES: Not Enough Sleep Hours. Data year 2020. Accessed April 2023.
  2. Billings ME, Hale L, Johnson DA. Physical and Social Environment Relationship with Sleep Health and Disorders. Chest. 2020;157(5):1304-1312. doi:10.1016/j.chest.2019.12.002
  3. CDC PLACES: Measure Definitions: Unhealthy Behaviors: Not Enough Sleep Hours. Published October 20, 2021. Accessed November 10, 2023.
  4. Mayne SL, Mitchell JA, Virudachalam S, Fiks AG, Williamson AA. Neighborhood environments and sleep among children and adolescents: A systematic review. Sleep Med Rev. 2021;57:101465. doi:10.1016/j.smrv.2021.101465
  5. Wein H. Good Sleep for Good Health. NIH News in Health. Published March 29, 2021. Accessed November 10, 2023.