Communities where more adults report not getting enough sleep tend to have shorter average lifespans, and the link is nearly as strong as the one for smoking. That is the headline finding of research published in SLEEP Advances by a team at Oregon Health and Science University (OHSU).
The study drew on federal survey data covering 2019 to 2025 across more than 3,100 US counties. Among the modifiable behaviors the researchers tested, insufficient sleep ranked second only to smoking as a predictor of county-level life expectancy, ahead of physical inactivity, food insecurity and social connection.
Andrew McHill, PhD, associate professor at OHSU's School of Nursing, School of Medicine and Oregon Institute of Occupational Health Sciences, said in a university statement that he "didn't expect it to be so strongly correlated to life expectancy."
McHill, the paper's senior author, added, "People really should strive to get seven to nine hours of sleep if at all possible."
Also read: The nutrients your aging eyes need most - and the foods that deliver them
What the researchers measured
The team paired county-level life expectancy figures with responses to the CDC's Behavioral Risk Factor Surveillance System, a long-running population health survey. They then ran statistical models that controlled for smoking, physical inactivity, food insecurity, insurance status, unemployment, education, social connection, obesity and diabetes.
Sleep insufficiency, defined as less than seven hours per night, remained a significant predictor of shorter life expectancy across most states and years, the paper reports.
The pattern is a correlation at the population level, not proof that any one person's short nights will shorten their life. The authors also note that self-reported sleep data cannot capture how well people actually sleep, only how long.
Where the seven-hour line comes from
The seven-hour threshold matches guidance from the American Academy of Sleep Medicine and the Sleep Research Society, which the CDC also uses. The agency recommends at least seven hours per night for adults aged 18 to 60, and roughly one in three US adults falls short of that in recent surveys.
Also read: The Mediterranean diet may activate tiny proteins that protect your heart and brain
Chronic short sleep has been linked in earlier research to higher risks of obesity, type 2 diabetes, high blood pressure, heart disease and depression. The new analysis adds population-level evidence that those individual risks add up to a measurable gap in how long communities live.
Practical steps backed by NIH
The National Heart, Lung, and Blood Institute lists several evidence-based habits for better sleep.
Go to bed and wake up at the same time every day, and keep weekend variation to about an hour.
Keep the bedroom quiet, cool and dark.
Also read: A new AI blood test may flag your heart disease risk up to 15 years before symptoms
Avoid caffeine and nicotine in the hours before bed, and skip alcohol close to sleep.
Use the hour before bed for winding down, without bright screens or intense exercise.
Persistent trouble falling or staying asleep, loud snoring or daytime exhaustion despite enough time in bed warrant a conversation with a doctor.
Also read: Microplastics are turning up in human brain tissue, and no one yet knows what they do
Also read: Nearly half of dementia cases could be prevented, and most risk factors are in your control