When you think about what's likely to keep you from getting a good night's sleep, you might picture noisy neighbors, a fussy child, or a snoring partner. But some things that aren't so easily dealt with – like your age, gender, and where you live – could also affect how well you sleep, according to a WebMD survey of more than 2,000 people.
How Does Age Affect Sleep?
Doctors have long known that sleep patterns change as we age. Older people have more disruptions to their sleep, get less sleep overall, and spend less time in the deepest stages of sleep.
But interestingly, more survey participants ages 65 and up reported "good" or "very good" sleep in the previous month (80%) than those of all other age groups except 35-44 (also 80%).
Those 45-54 were least likely to report high-quality sleep (67%), followed closely by people ages 55-64 and 25-34 (both 68%). Among the youngest group, ages 18-24, 76% said they slept well. (The survey used a nationally representative sample, which means the group was similar to the overall U.S. population in terms of age, gender, race, and location.)
But experts say sleep quality is subjective. Across all ages, most[ who took part in the survey failed to get the recommended 7-9 hours of sleep. Those 25-34 slept the least, with 70% reporting less than 7 hours of shut-eye. People over 65 were most likely to get enough sleep; 40% said they got more than 7 hours of sleep.
Here's how many hours of sleep that people in the survey averaged per night:
- Ages 18-24: 5.7 hours
- 25-34: 5.5
- 35-44: 5.8
- 45-54: 5.8
- 55-65: 5.8
- 65 and over: 5.9
What gets in the way of a full night's sleep? People 35 and over said getting up to use the bathroom most often kept them from sleeping well. For those 18-34, the biggest sleep disrupter was mental or emotional distress, such as worrying.
The pressures of work, parenting, and other daily duties can affect sleep, experts say. When we get older, physical changes and health problems come into play.
"From our late 20s to our 60s, often we have an increase in responsibilities such as children that could play a role," says Marri Horvat, MD, of Cleveland Clinic’s Sleep Disorders Center. "And as we age, the prevalence of medical conditions that impact our sleep, such as sleep apnea, become more prominent.”
Changes to our internal clocks, as our bodies produce less of the sleep hormone melatonin, are one reason older people sleep less soundly, she says. You may also become less active, both physically and socially, during the day, which can affect sleep habits. Even if you don't get a sleep disorder, you're more likely to have another condition, like chronic pain, that interferes with sleep.
None of this means you should expect to sleep badly once you reach a certain age, Horvat says.
"Often as people age, they think that poor sleep is normal," she says. "Patients will frequently tell me they have prostate, bladder, or diabetes [issues], and that’s why they wake up to urinate so often. But we find they have sleep apnea and treat it, and now they can sleep through the night.”
How Does Gender Affect Sleep?
Research has shown that female gender makes you more prone to insomnia. It affects more than 1 in every 4 women in the U.S., but fewer than 1 in 5 men. Studies have also found that women are more often affected by daytime sleepiness. They're also more likely to have memory and concentration problems due to sleep loss.
This matches up with the findings of WebMD's survey. In it, 32% of people who identified themselves as women reported poor sleep, compared to 22% of those who identified as men. Women are also less likely to get 7 or more hours of sleep per night: 34% said they hit this goal, vs. 40% of men.
There are several reasons for this, experts say. One is hormonal. Pregnancy, menopause, and perimenopause (the period leading up to menopause) can all disrupt sleep.
Symptoms like hot flashes, night sweats, and mood changes in particular may take a toll. Alon Avidan, MD, director of UCLA's Sleep Disorders Center, says rates of both insomnia and sleep apnea increase during menopause.
Another factor, he says, is that women still tend to shoulder more of the burden for child care and household responsibilities. This leads to more stress and less time for rest.
The WebMD survey included only 15 people who identified as nonbinary (neither all male nor all female). This group was less likely to report having poor sleep in the month before the survey than those who identified as either male or female. Only 13% of nonbinary people reported sleeping badly.
But nonbinary people in the survey were less likely to get 7 or more hours of sleep per night than those who identified as either male or female.
There's not much other sleep research on nonbinary people, but at least one study found poor sleep is common for both nonbinary and transgender people.
Some researchers say there's evidence that gay and lesbian people also may be more prone to sleep problems than others. WebMD's survey did not ask participants about their sexual orientation.
How Does Location Affect Sleep?
The region of the country where you live doesn't seem to have much effect on your sleep. In our survey, people living in the West were slightly more likely to report good sleep quality (76%) than those in other regions (72%-73%).
Here's the percentage of people in each region who said they usually sleep 7 or more hours a night:
- Midwest, 41%
- West, 41%
- Northeast, 34%
- South, 32%
In the survey, 83% of people living in urban areas said they got good-quality sleep, as did 65% of people in rural areas and 67% of those in suburban areas. But rural residents were slightly more likely to get 7 or more hours of sleep a night (39%) than people in urban areas (37%) or suburbs (34%).
Other research has had mixed results, Horvat says. Experts continue to research the link between geography and sleep.
Avidan says that among his patients, those living in cities generally don't sleep as well. This may be due to noise pollution or to safety concerns.
“People who live in neighborhoods where it's not safe may have a hard time with sleep," he says. "They're always on guard or need to worry about their safety. These people tend to have more insomnia related to anxiety.”
How Does Weight Affect Sleep?
Research has shown that people who are overweight or obese tend to have more sleep problems, such as:
- Sleep apnea
- Daytime fatigue
- Restless sleep
- Interrupted sleep
In WebMD's survey, those who are obese (defined as a body mass index, or BMI, of 30 or more) were more likely to say they slept badly. Poor sleep was reported among:
- 37% of obese people
- 31% of people who are overweight
- 30% of people with a healthy BMI
One study found that people who lost weight – and especially those who lost fat in the belly area – improved the quality of their sleep.
How Does Employment Status Affect Sleep?
Another factor that may affect how well you sleep is whether you work or attend school. In WebMD's survey, people who worked full time were most likely to say they had good-quality sleep (81%). Among other groups, good sleep was reported among:
- 74% of part-time workers
- 70% of retired people
- 69% of students
- 65% of self-employed people
- 60% of those who were unemployed and looking for work
- 58% of homemakers
- 58% of those who we unemployed and not looking for work
- 42% of those who are unable to work
It might seem contrary to belief that people who work more hours say they sleep better. But experts say there could be several reasons for this result
“People who are in school or employed often have access to health care to be formally evaluated about problems regarding their sleep, " Horvat says." It’s possible that having a regular schedule helps improve sleep quality. Having less financial strain or decreased stress could also play a role."
How Does Household Size Affect Sleep?
Few research studies have looked at how household size affects sleep, though one study found that married couples without children were least likely to report sleep problems.
But according to our survey, the number of people you live with might influence how well, and how much, you sleep. To the people surveyed, a bigger household equaled better shut-eye – at least up to a point.
In households with:
- 1 person: 66% reported good-quality sleep; 38% said they slept 7 more hours a night
- 2 people: the percentages were 68% and 39%
- 3 people: 78% and 31%
- 4 people: 76% and 32%
- 5 people: 85% and 47%
- 6 or more people: 64% and 41%
How Do Race and Ethnicity Affect Sleep?
We need more research into the links between race and sleep quality. But national studies have found that Black people in the U.S. are less likely than those in other racial and ethnic groups to get at least 7 hours of sleep a night. Some also found higher rates of what doctors call "short sleep" among Hispanic people and other minority groups than among white people.
Some researchers have said that this is likely an effect of discrimination and the disparities and stress it causes than of race or ethnicity itself.
In the WebMD survey, Asian people and those with a Hispanic background were most likely to say they slept well. Eighty-one percent of each group said their sleep quality was good, compared to 74% of Black people and 73% of white people.
Avidan says access to health care might play a role in the differences, but we simply don't have enough information to understand how race and ethnicity affect sleep. Historically, most research has focused on white Americans.
“It’s very likely that race and ethnicity impact sleep, he says. "It’s just that the number of studies that have been done are very limited.”
Photo Credit: adamkaz / Getty Images
Marri Horvat, MD, Cleveland Clinic Sleep Disorders Center, Cleveland, OH.
Alon Y. Avidan, MD, director, UCLA Sleep Disorders Center; professor, UCLA Department of Neurology, Los Angeles.
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