New research from Oregon Health & Science University finds that not getting enough sleep is a major predictor of shorter life expectancy across U.S. counties, second only to smoking. The analysis used CDC survey data across multiple years to compare how local sleep habits line up with average life spans, and it highlights sleep as a public-health factor on par with diet and exercise.
The study examined county-level data from surveys taken between 2019 and 2025 to measure how many residents reported getting at least seven hours of sleep per night. Researchers then compared those proportions with average life expectancy in each county while adjusting for familiar risk factors like smoking, poor diet, physical inactivity and loneliness. This approach let them map a relationship between local sleep habits and longevity across thousands of communities. The finding was consistent enough to be striking to the research team.
“I didn’t expect it to be so strongly correlated to life expectancy,” McHill said in the press release, noting that although sleep’s importance to health is well-established, its association with lifespan exceeded expectations. That comment underscores how sleep, often treated as a lifestyle add-on, may actually track closely with population health outcomes. The takeaway is blunt: pockets where short sleep is common tend to show shorter lives on average.
Sufficient sleep was defined in the paper as at least seven hours nightly, matching guidance from the American Academy of Sleep Medicine and the Sleep Research Society. Counties where a higher share of adults reported fewer than seven hours tended to show lower life expectancy, and that pattern appeared across most states and the years studied. The models controlled for several known mortality drivers, so sleep stood out even after accounting for those influences. Still, the analysis stops short of proving cause and effect.
The authors point out several important limits. The work relies on self-reported sleep duration, which can be biased and noisy, and the survey design cannot reveal biological mechanisms linking sleep and lifespan. Other unmeasured local factors could be shaping both sleep patterns and life expectancy in parallel, leaving room for alternative explanations. The study also focused on duration only and did not capture other key aspects of sleep health, like quality, timing or night-to-night regularity.
Despite those caveats, the county-by-county framing is new and useful because it shows that sleep patterns line up with real-world differences in how long people live across diverse communities. That geographic detail helps public-health planners and clinicians see where sleep might be a lever to pull in population health strategies. It also reframes sleep as more than a personal comfort issue; it’s a community-level signal tied to longevity.
“We’ve always thought sleep is important, but this research really drives that point home: People really should strive to get seven to nine hours of sleep if at all possible,” McHill said, urging attention to realistic sleep goals. The authors argue that promoting adequate sleep should be part of prevention efforts alongside smoking cessation, better nutrition and regular exercise. In short, sleep deserves the same practical prioritization as those traditional pillars of health.
The project was carried out primarily by graduate students in OHSU’s Sleep, Chronobiology and Health Laboratory, and funding came in part from the National Heart, Lung and Blood Institute as well as institutional support from OHSU. That backing enabled the team to comb through multi-year CDC survey results and produce a comprehensive county-level picture. Future work will need objective sleep measures and studies designed to test causal pathways between sleep and longevity.
