Summary: A new nationwide analysis finds that getting fewer than seven hours of sleep per night is one of the strongest behavioral predictors of reduced life expectancy across U.S. counties. Sleep sufficiency eclipsed other lifestyle factors—including diet, physical activity, and social isolation—with only smoking showing a stronger link to shorter lifespan.
Researchers observed consistent year-to-year relationships between average sleep duration and life expectancy across nearly every state from 2019–2025. The study highlights the need to treat adequate sleep as a fundamental component of public health and long-term wellbeing rather than an optional luxury.
Key Facts
- Sleep Outperforms Other Behaviors: Insufficient sleep predicted shorter life expectancy more strongly than diet, exercise, or loneliness in county-level models.
- Nationwide Pattern: Statistically significant correlations appeared across most U.S. states in each year studied (2019–2025).
- Multiple Health Pathways: Sleep influences cardiovascular health, immune function, metabolism, and brain function—mechanisms that can affect long-term mortality risk.
Source: Oregon Health and Science University
A good night’s sleep is essential: New research from Oregon Health & Science University indicates insufficient sleep may be linked to shorter life expectancy.
The study, published in the journal SLEEP Advances, used county-level measures of life expectancy and comprehensive population survey data from the Centers for Disease Control and Prevention collected between 2019 and 2025. Researchers examined how reported sleep duration related to average lifespan while controlling for common behavioral risk factors.
Across multiple models, insufficient sleep stood out as a stronger behavioral predictor of shorter life expectancy than most other measured factors. Only smoking had a larger association with reduced lifespan. For the study, the CDC-defined threshold for sufficient sleep was seven or more hours per night, aligning with national sleep recommendations.
“I did not expect sleep to show such a robust correlation with life expectancy,” said senior author Andrew McHill, Ph.D., associate professor in the OHSU School of Nursing, the OHSU School of Medicine, and the Oregon Institute of Occupational Health Sciences. “These results reinforce that striving for seven to nine hours of sleep should be a public-health priority.”
The analysis was led primarily by graduate students in the Sleep, Chronobiology and Health Laboratory at the OHSU School of Nursing. The study reinforces existing evidence that adequate sleep supports multiple aspects of health, but the researchers noted surprise at how strongly sleep behavior predicted life expectancy compared with other lifestyle measures.
While this research did not directly test biological mechanisms, sleep is known to affect heart health, immune responses, metabolic regulation, and cognitive functioning—pathways that plausibly link sleep patterns to long-term disease risk and mortality. The consistent county-level associations across years and geographies suggest that improving sleep at the community level could have meaningful public-health benefits.
“Sleep is often deprioritized in daily life,” McHill added. “People may view lost sleep as something to catch up later, but these results suggest that regular, sufficient sleep contributes not only to daily wellbeing but also to longevity.”
In addition to McHill, co-authors include Kathryn E. McAuliffe, B.S., Madeline R. Wary, B.S., Gemma V. Pleas, B.A., Kiziah E.S. Pugmire, B.S., Courtney Lysiak, B.A., Nathan F. Dieckmann, Ph.D., and Brooke M. Shafer, Ph.D.
Funding: The research was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (Award numbers R01HL156948, R01HL169317 and T32HL083808), the OHSU School of Nursing, and the Oregon Institute of Occupational Health Sciences with funding from the Division of Consumer and Business Services of the state of Oregon (ORS 656.630).
Key Questions Answered:
A: At the county level, insufficient sleep was among the top behavioral predictors of shorter life expectancy, second only to smoking in its negative association.
A: Seven or more hours per night, consistent with recommendations from major sleep organizations.
A: Sleep influences cardiovascular health, immune function, metabolism, and brain health—factors that collectively affect long-term disease risk and mortality.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- The journal paper was reviewed in full by editorial staff.
- Additional context was provided by the publication’s staff for clarity.
About this sleep and life span research news
Author: Erik Robinson ([email protected])
Source: Oregon Health and Science University
Contact: Erik Robinson – Oregon Health and Science University
Image: The image is credited to Neuroscience News
Original Research: Open access. “Sleep insufficiency and life expectancy at the state-county level in the United States, 2019-2025” by Andrew McHill et al., published in SLEEP Advances. DOI: 10.1093/sleepadvances/zpaf090
Abstract
Sleep insufficiency and life expectancy at the state-county level in the United States, 2019-2025
Study Objectives
Millions of Americans regularly obtain less sleep than recommended, yet the relationship between sleep and life expectancy across U.S. counties has been unclear. This study aimed to quantify the association between insufficient sleep and county-level life expectancy across multiple years.
Methods
Using data from the 2019–2025 Behavioral Risk Factor Surveillance System (BRFSS) surveys, researchers tested associations between insufficient sleep and county-level life expectancy while controlling for common adverse health behaviors, including smoking, poor diet, and physical inactivity, across multiple years.
Results
Insufficient sleep was significantly and negatively correlated with life expectancy in most states from 2019–2025: counties with higher rates of insufficient sleep tended to have lower life expectancy. The association remained significant after controlling for traditional mortality predictors, with only smoking showing a stronger relationship to reduced life expectancy.
Conclusions
These findings underscore the importance of sufficient sleep across communities, regardless of income, health care access, or geographic classification. Promoting sleep health may be a viable public-health strategy to support longer, healthier lives.