Lack of sleep linked to major hidden health risk, study reveals

Lack of sleep is one of the strongest predictors of shorter life expectancy in the US, second only to smoking.

This is according to a new nationwide analysis published in the journal SLEEP Advances, led by lead author Andrew McHill, Ph.D., associate professor at Oregon Health & Science University (OHSU).

To explore how sleep habits relate to life expectancy, researchers examined data from surveys conducted by the CDC between 2019 and 2025 in more than 3,000 U.S. counties, according to a news release.

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Sufficient sleep was defined as at least seven hours per night, according to guidelines from the American Academy of Sleep Medicine and the Sleep Research Society.

The researchers compared the average life expectancy in each county with the proportion of residents who reported getting enough sleep, controlling for traditional predictors of mortality such as smoking, diet, physical inactivity and loneliness.

Counties where more people reported lack of sleep tended to have lower life expectancy. This pattern held true across most states and years studied, even taking into account other lifestyle factors.

“I didn’t expect it to be so strongly correlated with life expectancy,” McHill said in the news release, noting that although the importance of sleep for health is well established, its association with life expectancy exceeded expectations.

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“We’ve always thought that sleep is important, but this research really drives that point home: People should really strive to get seven to nine hours of sleep, if possible.”

The research is based on a large body of evidence linking sleep duration to health outcomes, including mortality risk, heart health, immune strength and brain function.

However, this is the first analysis to map the relationship between sleep duration and life expectancy at a detailed, county-by-county level over multiple years, establishing a consistent association across diverse communities, the release states.

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The study had some limitations, including its reliance on self-reported survey data, which may be subject to reporting bias. It also cannot establish causality and does not explain the biological factors behind the results, the researchers noted.

Although the statistical models controlled for several lifestyle factors, other unmeasured variables could influence both sleep patterns and life expectancy.

According to the study, sleep duration alone does not capture other dimensions of sleep health, such as quality or regularity, which can also affect long-term outcomes.

The authors emphasized that these findings highlight the importance of prioritizing sleep as a fundamental pillar of health, along with diet and exercise.

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“This research shows that we should prioritize sleep at least as much as what we eat or how we exercise,” McHill said. “Getting a good night’s sleep will improve how you feel, but also how long you live.”

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The study was conducted primarily by graduate students in the OHSU School of Nursing’s Sleep, Chronobiology and Health Laboratory.

The research was funded in part by the National Heart, Lung, and Blood Institute of the National Institutes of Health, along with institutional support from OHSU.