Poor Sleep Has Social Causes and Consequences

Poor sleep is often considered an individual problem, but it’s also a public health issue. People who have restless nights can cause motor vehicle crashes and workplace mistakes. In addition to these social consequences, poor sleep has social causes such as family and workplace stresses.

Sleep Problems Are Widespread

The Centers for Disease Control and Prevention estimates that anywhere from 50 million to 70 million U.S. adults have sleep disorders or wakefulness disorders (excessive sleepiness during the day). In fact, over a third of adult respondents to a 2009 nationwide study reported less than seven hours of sleep during a typical 24-hour period (seven to nine hours per night are recommended). Young and middle-age adults report less sleep. Among racial and ethnic groups, Black Americans report sleeping few hours.

Sleep deprivation makes even routine daily tasks more difficult. Especially severe, 1,550 deaths and over 40,000 injuries in the United States annually are due to sleepy drivers, according to the National Department of Transportation.

Public Health Costs of Poor Sleep

In addition to the public health costs of traffic accidents, poor sleep reduces labor productivity and can increase costly mistakes at work. Sleep loss and night shift accidents have been partially to blame for dramatic environmental health disasters such as the grounding of the Exxon Valdez oil tanker in Alaska and the chemical plant disaster in Bhopal, India.1 A strong relationship also exists between medical errors, sleep loss, and shift duration among medical residents, who may be required to work up to 96 hours in a week.

The full economic impact of poor sleep is not known. But even when focusing only on medical care costs, it’s estimated that tens of billions of dollars are spent annually on medications and doctor and hospital visits due to sleep problems.2

Social Factors and Poor Sleep

While sleep quality can affect work, the reverse is also true: Workplace stress can “follow workers home” and cause restlessness.3 To shed light on the effect on sleep of workplace stresses, researchers from the University of Michigan’s Population Research Center analyzed data from the nationwide Americans’ Changing Lives study. Results suggest that feeling bothered or frequently upset at work has the strongest effect on sleep, even more so than low job security.

Family relationships also matter for sleep—both immediate family such as spouse and children, and also more distant associations with parents and siblings. Results from the National Survey of Midlife Development in the United States suggest that frequent family tension and inadequate emotional support are strongly associated with troubled sleep. And while social relationships generally promote good health, this is not the case with troubled family relationships. More frequent contact within strained families has negative effects on sleep.4

Promoting Restfulness

Good sleep is required for good health. Public health programs targeted at both workplace and family stressors may reduce troubled sleep. Such efforts could increase labor productivity and reduce workplace accidents and medical care costs.

This article is part of PRB’s CPIPR project, funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Hunter is liaison from the University of Colorado’s Population Center to CPIPR. NICHD-funded researchers highlighted in this article are Sarah Burgard of the University of Michigan Population Research Center and Jennifer Ailshire, formerly with the University of Michigan’s Population Research Center and currently a post-doctoral researcher at the University of Southern California.



  1. Harvey R. Colten and Bruce M. Altevogt, eds., for the Institute of Medicine (U.S.) Committee on Sleep Medicine and Research, Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem (Washington, DC: National Academies Press, 2006).
  2. Sarah A. Burgard and Jennifer A. Ailshire, “Putting Work to Bed: Stressful Experiences on the Job and Sleep Quality,” Journal of Health and Social Behavior 50, no. 4 (2009): 476-92.
  3. Jennifer A. Ailshire and Sarah A. Burgard, “Family Relationships and Troubled Sleep Among U.S. Adults Examining the Influences of Contact Frequency and Relationship Quality,” Journal of Health and Social Behavior 53, no. 2 (2012): 248-62.