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2014 SLEEP HEALTH INDEX
Copyright © 2014 by The National Sleep Foundation
The National Sleep Foundation
1010 N. Glebe Road, Suite 310
Arlington, VA 22203
(703) 243-9274
Sleepfoundation.org
Sleep.org
2014 SLEEP HEALTH INDEX
Contributors Project Team
Max Hirshkowitz, PhD, Sleep Health Index TM Chair, is the Vice Chairman of the National Sleep
Foundation and a Tenured Associate Professor at Baylor College of Medicine and VAMC Sleep
Center.
Natalie Dautovich, PhD, is the National Sleep Foundation’s Environmental Fellow and an
Assistant Professor at the University of Alabama.
Sunshine Hillygus, PhD, Index Consultant, is an Associate Professor of Political Science at Duke
University and Director of the Duke Initiative on Survey Methodology.
Kristen Knutson, PhD, is the National Sleep Foundation’s Sleep in America® Poll Fellow and an
Assistant Professor in the Section of Pulmonary & Critical Care at the University of Chicago,
Department of Medicine.
Kaitlyn Whiton, MHS, is the Director of Scientific Affairs and Research at the National Sleep
Foundation.
Survey Instrument Expert Panel
William “Jet” Broughton, MD, is a professor of Internal Medicine at the University of South
Alabama.
Sudhansu Chokroverty, MD, is the Co-Director of Neurology at the New Jersey Neuroscience
Institute, JFK Medical Center.
Kenny Lichstein, PhD, is a Professor of Clinical Health and Clinical Geropsychology at the
University of Alabama.
Terri Weaver, PhD, RN, is the Dean and a Professor at the University of Illinois at Chicago
College of Nursing.
Polling Firm
Margie Engle-Bauer is a Senior Project Director at Princeton Research Associates International.
Julie Gasior is a Senior Data Manager at Princeton Research Associates International.
Research Assistants
Jenna Faulkner contributed as a Health Research Intern during the Fall of 2014 while pursuing a
neuroscience degree at Brigham Young University.
Taylor Nelson contributed as a Health Research Intern during the Summer of 2014 while
pursuing a psychology degree at Virginia Tech.
2014 SLEEP HEALTH INDEX
Contents
Introduction ................................................................................................. 1
David Cloud
Executive Highlights ....................................................................................... 2
Sleep Schedule & Habits .................................................................................. 3
Kristen Knutson, PhD
Sleep Environment ........................................................................................ 5
Natalie Dautovich, PhD
Sleep Problems ............................................................................................. 6
Max Hirshkowitz, PhD
Sleep knowledge, beliefs and values .................................................................... 7
Sunshine Hillygus, PhD
Methodology ................................................................................................ 9
Julie Gasior
Appendix..................................................................................................... 13
2014 SLEEP HEALTH INDEX
1
Introduction
In 1991, the National Sleep Foundation began chronicling America’s sleep with the introduction
of the Sleep in America © poll. Now, the National Sleep Foundation is pleased to introduce the
inaugural edition of the Sleep Health Index TM to track sleep trends.
The National Sleep Foundation took extraordinary care to ensure that the Index accurately gauges
the true status of sleep health in America. The Sleep Health Index TM surveys sleep habits,
lifestyles, sleep environment, problems with sleep, and attitudes, knowledge and beliefs about
sleep.
The process began with a panel of sleep experts and methodologists convened to develop the survey
instrument. A series of cognitive interviews and pretests were administered to minimize bias and
improve comprehension. The administration of the poll was conducted in both English and
Spanish by Princeton Data Source and included a sample of 1,250 U.S. adults using a 50:50
landline to cell phone ratio.
We are excited to release the first year’s findings and look forward to future iterations. It is our
hope that the Sleep Health Index TM will advance the dialogue on our nation’s sleep health.
David M. Cloud, MBA
Chief Executive Officer
National Sleep Foundation
2014 SLEEP HEALTH INDEX
2
Executive Highlights
The 2014 Sleep Health Index TM is the inaugural edition of a population-level poll to track our
nation’s changing sleep habits, problems, behaviors and beliefs. Over time, the National Sleep
Foundation will be able to track the changes in American’s sleep health in order to improve the
population’s health.
The 2014 index represents the sleep health baseline for America. Key findings include:
Sleep schedule
o Americans report sleeping an average of 7 hours and 36 minutes a night
o On workdays, the average bedtime was 10:55 PM and average wake time was 6:38
AM
o Average sleep time was 40 minutes longer on non-work days
o Americans aged 18-29 reported latest bedtimes
o Sleep duration did not differ between men and women
Sleep quality
o 35% of Americans report their sleep quality as “poor” or “only fair”
o Sleep quality did not differ between men and women
o African Americans were more likely to report poor or fair sleep quality than non-
Hispanic whites
o Individuals who reported having only fair or poor general health were more likely
to report poor/fair sleep quality
Sleep environment
o 47% of people reported their sleep environment is very quiet
o 36% of people described their sleeping room as very dark
o A higher percentage (56%) reported sleeping on a very comfortable mattress or
surface
Sleep problems
o 17% of respondents have been told by a physician that they have a sleep disorder
o 11.6% of the sample reported a diagnoses of sleep apnea
o 40% of respondents indicated snoring a few nights per week or more
o Individuals with insomnia-like complaints were more likely to report snoring
Sleep knowledge, values and beliefs
o 36% of respondents correctly answered all three knowledge questions
o Greater sleep knowledge did not correspond to higher sleep quality
o Only 18% of individuals would choose to sleep if they had an extra hour in the day
2014 SLEEP HEALTH INDEX
3
Sleep Schedules and Habits
Kristen Knutson, PhD
Poll respondents were asked what time they most often went to bed on workdays (or weekdays) and
non-workdays (or weekends). The interval between bedtime and wake time was used to estimate
sleep duration for both workdays and non-workdays. Respondents were also asked to rate their
sleep quality in general, with the following response options: “Excellent”, “Very Good”, “Good”,
“Only fair”, or “Poor”.
On average, participants went to bed at 10:55PM (95% Confidence Interval (CI) 10:47PM,
11:03PM) on work days and 11:26PM (95%CI 11:17PM, 11:35PM) on non-work days in the past
week. On average, they woke at 6:38AM (95% CI 6:29AM, 6:47AM) on work days and at 7:46AM
(95% CI 7:37AM, 7:54AM) on non-work days. Estimated sleep duration averaged 7.6 hours
(95% CI 7.5, 7.7) on work days and 8.3 (8.2, 8.4) hours on non-work days. The average
difference in sleep duration between work and non-work days was 40 minutes (95% CI 32, 47
minutes).
Some age differences were observed. Compared to 18-29 year olds, those aged 30-49 years, 50-64
years and 65 years and older went to bed 1.1, 1.2, and 1.4 hours earlier, respectively, on work days
(all p<.001). The difference between these age groups was greater on non-workdays when those
aged 30-49 years, 50-64 years and 65 years and older went to bed 1.2, 1.5 and 2.0 hours earlier
than 18-29 year olds. Similar differences are observed for wake times. Sleep duration on work
days differed only between those aged 18-29 years and those 65 years and older, where the older
group slept approximately 30 minutes more. On non-work days, however, sleep duration was
significantly shorter for those aged 50-64 years (32 minutes less) and 65 years and older (24
minutes less) compared to 18-29 year olds.
Other demographic and health characteristics were examined in relation to timing and duration of
sleep. There were no statistically significant differences in bedtimes, wake times or sleep duration
between men and women. African Americans went to bed 34 minutes later on work days (p=.04)
and those identifying as “other” race/ethnicity went to bed 45 minutes later on work days (p=.002)
than non-Hispanic whites. On non-work days those identifying as “other” race/ethnicity went to
bed 58 minutes later (p<.001) than non-Hispanic whites. Wake times on work days did not differ
among race/ethnicity groups, but on non-work days, Hispanic/Latinos and those of “other”
race/ethnicity woke later, by 29 minutes (p=.02) and 1 hour and 15 minutes (p<.001),
respectively. Estimated sleep duration did not differ among the racial/ethnic groups on work days
or non-work days. Those who worked full- or part-time, compared to all others, woke earlier on
work days (by 34 minutes, p<.001) which corresponded with a shorter sleep duration on work days
(by 37 minutes, p<.001), but woke later on non-work days (by 20 minutes, p=.03). Bed times did
not differ by employment status. Those reporting high levels of stress had a shorter average sleep
duration on work days (by 45 minutes, p<.001) and on non-work days (by 30 minutes, p=.005).
2014 SLEEP HEALTH INDEX
4
General sleep quality was described as “excellent” by 12%, “very good” by 18%, “good” by 35%,
“only fair” by 23% and “poor” by 12% of the respondents. People aged 50-64 years were more
likely to report poor/fair sleep quality compared to those aged 18-29 years (Odds Ratio (OR) 1.48,
p=.05). Sleep quality did not differ between men and women. African Americans were more
likely to report poor/fair sleep quality than non-Hispanic whites (OR 1.52 (p=.05) but
Hispanic/Latinos and those identifying “other” race/ethnicity did not differ from whites. Those
who reported having only fair or poor general health were also more likely to report poor/fair
sleep quality (OR 5.8, p<.001). Similarly, those who reported low life satisfaction (OR 4.0,
p<.001) and those reporting high levels of stress (OR 3.3, p<.001) were also more likely to report
poor/fair sleep quality (OR 4.0, p<.001).
2014 SLEEP HEALTH INDEX
5
Sleep Environment Natalie Dautovich, PhD
When asked about the quality of their sleep
environment, only a minority of Americans
reported that their sleep environment is very quiet,
dark, and comfortable. Specifically, when asked to
consider all sources of noise, both inside and
outside of the room, only 47% of people reported
that their sleep environment is very quiet.
Similarly, only 36% of people described the room
in which they sleep as very dark after considering
light sources such as nightlights, overhead lights,
street lights, and electronics. A higher percentage of
those surveyed reported sleeping on a very
comfortable mattress or surface (56%).
In total, the results suggest that the majority of Americans are not sleeping in an environment that is
very quiet or dark. A very small majority of Americans report sleeping on a mattress or surface that is
very comfortable. As noise, light, and discomfort can be barriers to healthy sleep, the results suggest
that the majority of those surveyed do not have an overall sleep environment that promotes healthy
sleep.
56%33%
8%
2%
How Comfortable i s Your
Mat tress?
Very comfortable Fairly comfortable
Not so comfortable Not at all comfortable
36%
48%
12%
3%
How Dark i s Your Room?
Very dark Fairly dark
Not so dark Not at all dark
47%
42%
6% 4%
How Quiet I s Your
Room?
Very quiet Fairly quiet
Not so quiet Not at all quiet
2014 SLEEP HEALTH INDEX
6
Sleep Problems
Max Hirshkowitz, PhD
Participants were asked, in general, how would you rate your sleep quality? Would you say it’s…
excellent, very good, good, only fair, or poor? 35% indicate sleep as fair or poor. Of those rating
sleep quality below good, 67% also indicate overall health as fair or poor. Thus, overall sleep
quality and health largely correlate; however, 27% of individuals with less than good sleep quality
report otherwise good to excellent health.
The index also included
questions concerning difficulty
initiating sleep and maintaining
sleep. For individuals with fair
or poor sleep quality, only 45%
could be accounted for by
insomnia complaints. However,
if we look through the lens from
the other end, 64% of
respondents with sleep-onset
difficulty and 74% with sleep
maintenance difficulty reported
less than good sleep quality.
Furthermore, 56% of the sleep-
maintenance/impaired-quality
subset also indicated snoring a
few nights or more per week. Among those polled, 17% recounted being told by a physician that
they had a sleep disorder (such as, insomnia or apnea). Of those individuals, 68% indicated that
the disorder was sleep apnea. Because of the representativeness of the poll, we can estimate that
approximately 11.6% of the U.S. population has been diagnosed with obstructive sleep apnea.
Physician designated sleep disorders were most common in the 30 and over age group.
As a sensitive but nonspecific marker for sleep-related breathing impairments, we asked
individuals if the snored… every night or almost every night, a few nights a week, rarely, or never?
“I don’t know” was also included in the response set. 40% of those polled indicated snoring a few
nights per week or more, and 13% said every night. Also, if you have insomnia-like complaints you
are more likely to also report snoring (43% vs. 36%). Finally, which comes as no surprise to
anyone, men report snoring more than women.
12%
18%
35%
23%
12%
Sleep Quality
Excellent Very good Good Only fair Poor
2014 SLEEP HEALTH INDEX
7
Sleep Knowledge, Values &
Beliefs Sunshine Hillygus, PhD
Sleep Knowledge
Poll respondents were asked about their sleep knowledge with three statements to be identified as
true or false. All items were correctly identified as false by a majority of respondents.
Overall, however, only 36% of respondents correctly answered all three items. Women were a bit
more likely than men to get all three items correct (39% vs. 33%), with men more likely to
incorrectly identify as false the statements `alcohol improves sleep quality’ and ‘successful people
need less sleep.’ Americans who reported they had discussed their sleep with a doctor or medical
professional were also more likely to get all 3 items correct compared to those who had not (40%
vs. 34%).
Sleep Knowledge ≠ Sleep Quality
Greater sleep knowledge does not, however, correspond to higher sleep quality. Only 65% of
those who rated their sleep quality as ‘excellent’ or ‘very good’ correctly answered at least 2 of 3
knowledge items, compared to 73% of those with lower sleep quality. Likewise, 81% of those who
got less sleep on weekdays than they say they needed answered at least 2 of 3 knowledge items
correctly, compared to just 67% of those who got enough sleep. Americans who struggle with poor
sleep might be more motivated to learn facts about sleep health.
52%
73% 73%
0%
20%
40%
60%
80%
100%
"Adults need fewer hours of
sleep the older they get"
"Successful people need less
sleep than the average
person"
"Alcohol improves sleep
quality"
Sleep Knowledge:
Percent Correctly Identifying Each Statement as False
2014 SLEEP HEALTH INDEX
8
Sleep Priority
Previous surveys have found that Americans overwhelmingly say sleep is important to their health
and wellbeing.1 Yet, when asked how they would spend an extra hour of the day, just 18% choose
sleep—respondents were more likely to select `exercise’ (22%) or `spending time with friends or
family’ (35%). However, as seen in the figure below, sleep quality was strongly related to that
choice—28% of those reporting `Poor’ sleep quality said they would spend an extra hour on sleep,
compared to just 10% of those reporting `Excellent’ sleep quality.
Similarly, those who were `extremely’ or ‘very’ stressed in the last month were far more likely to
select sleep compared to those with less stress (30% vs. 13%). Women were also more likely than
men to select sleep as the way they would spend an extra hour in the day (20% vs. 15%).
1 For example, the 2014 Sleep in America Poll found that 97% of parents said that sleep was `extremely’ or `very’
important to their child’s health/well-being.
10%
13%
16%
22%
28%
0%
5%
10%
15%
20%
25%
30%
Excellent Very Good Good Only fair Poor
Sleep Quality
Percentage Who Would Choose Sleep with an
Extra Hour in Day, by Sleep Quality
2014 SLEEP HEALTH INDEX
9
Methodology Julie Gasior
Summary
The 2014 Sleep Health Index consisted of a nationally representative sample of 1,253 adults living
in the continental United States. Telephone interviews were conducted by landline (n=627) and
cell phone (n=626). The survey was conducted by Princeton Survey Research Associates
International (PSRAI). Interviews were conducted in both English and Spanish by Princeton Data
Source between September 8 and 29, 2014. Statistical results are weighted to correct known
demographic discrepancies. The margin of sampling error for the complete set of weighted data is
±3.1 percentage points.
Design and Data Collection Procedures
Sample Design
A combination of landline and cellular random digit dial (RDD) samples were used to represent
all adults in the continental United States who have access to either a landline or cellular
telephone. Both samples were provided by Survey Sampling International, LLC (SSI) according to
PSRAI specifications.
Numbers for the landline sample were drawn with equal probabilities from active blocks (area code
+ exchange + two-digit block number) that contained three or more residential directory listings.
The cellular sample was not list-assisted, but was drawn through a systematic sampling from
dedicated wireless 100-blocks and shared service 100-blocks with no directory-listed landline
numbers.
Contact Procedures
Interviews were conducted between September 8 and 29, 2014. As many as five attempts were
made to contact every sampled telephone number. Sample phone numbers were released in
representative batches, which provides better control over sample release and contact procedures.
Calls were staggered over times of day and days of the week to maximize the change of making
contact with potential respondents. Each phone number received at least one daytime call when
necessary.
For the landline sample, interviewers asked to speak with the youngest adult male or females
currently at home based on a random rotations. If no male/female was available, interviewers
asked to speak with the youngest adult of the other gender. This systematic respondent selection
technique has been shown to produce samples that closely mirror the population in terms of age
and gender when combined with cell interviewing.
2014 SLEEP HEALTH INDEX
10
For the cellular sample, interviews were conducted with the person who answered the phone.
Interviewers verified that the person was an adult and in a sage place before administering the
survey. All cell respondents were offered $5 for their participation.
Weighting and Analysis
Weighting is generally used in survey analysis to compensate for sample designs and patterns of
non-response that might bias results. The sample was weighted to match national adult general
population parameters. A two-stage weighting procedure was used to weight this dual-frame
sample.
The first stage of weighting corrected for different probabilities of selection associated with the
number of adults in each household and each respondent’s telephone usage patterns (i.e. whether
respondents have only a landline telephone, only a cell phone or both kinds of telephone). This
weighting also adjusts from the overlapping landline and cell sample frames and the relative sizes
of each frame and each sample.
This first-stage weight for the ith case can be expressed as
𝑊𝑇𝑖 = [(𝑆𝐿𝐿𝐹𝐿𝐿
×1
𝐴𝐷𝑖× 𝐿𝐿𝑖) + (
𝑆𝐶𝑃𝐹𝐶𝑃
× 𝐶𝑃𝑖) − (𝑆𝐿𝐿𝐹𝐿𝐿
×1
𝐴𝐷𝑖× 𝐿𝐿𝑖 ×
𝑆𝐶𝑃𝐹𝐶𝑃
× 𝐶𝑃𝑖)]−1
Where SLL = the size of the landline sample
FLL = the size of the landline sample frame
SCP = the size of the cell sample
FCP = the size of the cell sample frame
ADi = number of adults in household i
LLi=1 if respondent has a landline phone, otherwise LL=0.
CPi=1 if respondent has a cell phone, otherwise CP=0.
The second stage of weighting balanced sample demographics to population parameters. The
sample is balanced to match national population parameters for sex, age, education, race Hispanic
origin, region (U.S. Census definitions), population density, and telephone usage. The basic
weighting parameters came from the U.S. Census Bureau’s 2012 American Community Survey
data.2 The population density parameter was derived from 2010 Census data. The telephone usage
parameter came from an analysis of the July-December 2013 National Health Interview Survey.3
2 ACS analysis was based on all adults excluding those living in institutional groups quarters (GCs) 3 Blumberg SJ, Luke JV. Wireless substitution: Early release of estimates from the National Health Interview Survey,
July-December, 2013. National Center for Health Statistics. July 2014.
2014 SLEEP HEALTH INDEX
11
Weighting was accomplished using the SPSSINC RAKE, and SPSS extension module that
simultaneously balances the distributions of all variables using the GENLOG procedure. Weights
were trimmed to prevent individual interviews from having too much influence on the final
results. The use of these weights in statistical analysis ensures that the demographic characteristics
of the sample closely approximate the demographic characteristics of the national population.
Table 1 compares weighted and unweight sample distributions to population parameters.
Effects of Sample Design on Statistical Inference
Post-data collection statistical adjustments require analysis procedures that reflect departures from
simple random sampling. PSRAI calculates the effects of these design features so that an
appropriate adjustment can be incorporated into tests of statistical significance when using these
data. The so-called "design effect" or deff represents the loss in statistical efficiency that results
from unequal weights. The total sample design effect for this survey is 1.29.
PSRAI calculates the composite design effect for a sample of size n, with each case having a weight,
wi as:
In a wide range of situations, the adjusted standard error of a statistic should be calculated by
multiplying the usual formula by the square root of the design effect (√deff). Thus, the formula for
computing the 95% confidence interval around a percentage is:
where p̂ is the sample estimate and n is the unweighted number of sample cases in the group
being considered.
The survey’s margin of error is the largest 95% confidence interval for any estimated
proportion based on the total sample— the one around 50%. For example, the margin of error for
formula 1
formula 2
2
1
1
2
n
i
i
n
i
i
w
wn
deff
n
ppdeffp
)ˆ1(ˆ96.1ˆ
2014 SLEEP HEALTH INDEX
12
the entire sample is ±3.1 percentage points. This means that in 95 out every 100 samples drawn
using the same methodology, estimated proportions based on the entire sample will be no more
than 3.1 percentage points away from their true values in the population. It is important to
remember that sampling fluctuations are only one possible source of error in a survey estimate.
Other sources, such as respondent selection bias, questionnaire wording and reporting
inaccuracy, may contribute additional error of greater or lesser magnitude.
Response Rate
Table 2 reports the disposition of all sampled telephone numbers ever dialed from the original
telephone number samples. The response rates estimate the fraction of all eligible sample that was
ultimately interviewed. The response rate for the landline samples was 7.9 percent. The response
rate for the cellular samples was 8.3 percent. Response rates and sample disposition reporting
adhere to American Association of Public Opinion Research (AAPOR) standards.
2014 SLEEP HEALTH INDEX
13
Appendix
Table 1: Sample Demographics
Parameter Unweighted Weighted
Gender
Male 48.2 46.3 48.4
Female 51.8 53.7 51.6
Age
18-24 13.1 11.9 13.2
25-34 17.4 10.8 16.5
35-44 17.1 11.3 16.7
45-54 18.5 15.2 18.7
55-64 16.2 19.5 16.5
65+ 17.7 31.4 18.3
Education
HS Grad or less 41.4 39.7 41.7
Some College/Assoc Degree 31.6 26.9 30.7
College Graduate 27.0 33.4 27.5
Race/Ethnicity
White/not Hispanic 66.2 70.9 66.5
Black/not Hispanic 11.5 10.8 11.6
Hisp - US born 7.4 6.9 7.4
Hisp - born outside 7.4 6.5 7.5
Other/not Hispanic 7.5 4.8 7.0
Region
Northeast 18.3 18.0 18.4
Midwest 21.6 24.3 21.8
South 37.4 37.7 37.6
West 22.7 20.0 22.2
County Pop. Density
1 - Lowest 19.9 23.8 20.4
2 20.0 21.0 20.2
3 20.1 18.5 19.9
4 20.0 18.0 19.6
5 - Highest 20.0 18.8 19.9
Household Phone Use
LLO 6.9 5.7 6.6
Dual 51.2 65.5 52.5
2014 SLEEP HEALTH INDEX
14
CPO 41.9 28.7 40.9
Table 2. Sample Disposition
Landline Cell
1,321 175 OF = Out of Frame
1,297 175 Non-residential/Business
24 0 Cell in landline frame
20,068 6,428 NWC = Not working/computer
18,922 6,354 Not working
1,146 74 Computer/fax/modem
2,184 626
UHUONC = Non-contact, unknown if household/unknown other
(NA/busy all attempts)
2,767 4,150 UONC = Non-contact, unknown eligibility
2,744 4,144 Voice mail
23 6 Other non-contact (deaf/disabled/deceased)
3,848 5,037 UOR = Refusal, unknown if eligible
3,691 3,934 Refusals
157 1,103 Callbacks
28 35 O = Other (language barrier)
0 306 SO = Screen out
0 306 Child's cell phone
144 114 R = Refusal, known eligible (breakoffs and qualified CBs)
627 626 I = Completed interviews
30,987 17,497 T = Total numbers dialed
25.7% 60.9% e1 = (I+R+SO+O+UOR+UONC)/(I+R+SO+O+UOR+UONC+OF+NWC)
100.0% 70.7% e2 = (I+R)/(I+R+SO)
58.3% 57.5%
CON = [I + R + (e2*[O + UOR])]/[I + R + (e2*[O + UOR + UONC]) +
(e1*e2*UHUONC)]
13.5% 14.5% COOP = I/[I + R + (e2*[O + UOR])]
7.9% 8.3%
AAPOR RR3=I/[I+R+[e2*(UOR+UONC+O)]+[e1*e2*UHUONC]] =
CON*COOP
2014 SLEEP HEALTH INDEX
15
Topline Results
NATIONAL SLEEP FOUNDATION SLEEP INDEX SURVEY
FINAL TOPLINE RESULTS
October 8, 2014
N=1,253 national adults age 18+
Margin of Error: plus or minus 3 percentage points
Interviewing dates: September 8-29, 2014
Interviewing: English and Spanish
NOTES: An asterisk indicates less than 1% Percentages are rounded and may not add to 100%
LANDLINE INTRO:
Hello, I am _____ calling for Princeton Survey Research Associates in Princeton, New Jersey. We’re
taking an important survey for the National Sleep Foundation. I’d like to ask a few questions of
the [RANDOMIZE: “YOUNGEST MALE, 18 years of age or older, who is now at home” AND
“YOUNGEST FEMALE, 18 years of age or older, who is now at home?”]
[IF NO MALE/FEMALE, ASK: May I please speak with the YOUNGEST FEMALE/MALE, 18
years of age or older, who is now at home?] GO TO MAIN INTERVIEW
CELL PHONE INTRODUCTION: Hello, I am ___ calling for Princeton Survey Research. We are
conducting an important national survey for the National Sleep Foundation. I know I am calling
you on a cell phone. If you would like to be reimbursed for your cell phone minutes, we will pay
eligible respondents $5 for participating in this survey. This is not a sales call. (IF R SAYS
DRIVING/UNABLE TO TAKE CALL: Thank you. We will try you another time…).
VOICE MAIL MESSAGE (LEAVE ONLY ONCE -- THE FIRST TIME A CALL GOES TO
VOICEMAIL): I am calling for Princeton Survey Research. We are conducting a national survey
of cell phone users. This is NOT a sales call. We will try to reach you again.
SCREENING INTERVIEW:
S1. Are you under 18 years old, OR are you 18 or older?
IF S1=2, READ INTRODUCTION TO MAIN INTERVIEW: We’re interested in learning more
about people with cell phones. If you are now driving a car or doing any activity requiring your
full attention, I need to call you back later. The first question is… [GO TO MAIN INTERVIEW]
INTERVIEWER: IF R SAYS IT IS NOT A GOOD TIME, TRY TO ARRANGE A TIME TO
CALL BACK. OFFER THE TOLL-FREE CALL-IN NUMBER THEY CAN USE TO
COMPLETE THE SURVEY BEFORE ENDING THE CONVERSATION.
2014 SLEEP HEALTH INDEX
16
IF S1=1,9 THANKS AND TERMINATE: This survey is limited to adults age 18 and over. I won’t
take any more of your time…
Introduction
Q1. First, how would you rate your overall health? Would you say your health is…(READ)
18 Excellent
29 Very Good
34 Good
13 Only fair
5 Poor
* (DO NOT READ) Don’t know
* (DO NOT READ) Refused
Q2. In general, how would you rate your sleep quality? Would you say it’s…(READ)
12 Excellent
18 Very Good
35 Good
23 Only fair
12 Poor
* (DO NOT READ) Don’t know
* (DO NOT READ) Refused
Q3. All things considered, how satisfied are you with your life as a whole? Would you
say…(READ)
16 Extremely satisfied
49 Very Satisfied
24 Fairly satisfied
7 Only a little satisfied
3 Not at all satisfied
1 (DO NOT READ) Don’t know
1 (DO NOT READ) Refused
Q4. Overall, how stressed have you felt in the past month? Would you say …(READ)
10 Extremely stressed
16 Very stressed
27 Fairly stressed
31 Only a little stressed
16 Not at all stressed
* (DO NOT READ) Don’t know
* (DO NOT READ) Refused
2014 SLEEP HEALTH INDEX
17
Q5. Imagine you had an extra hour in the day, would you want to…(READ IN ORDER)
22 Exercise
11 Read
35 Spend time with friends or family
17 Sleep
12 Work or housework
2 (DO NOT READ) Don’t know
1 (DO NOT READ) Refused
Sleep Schedule
READ TO ALL: Next, I have a few questions about your sleep in the past 7 days. It’s okay if it was
not a typical week; please still answer just about this past week.
Q6. Thinking about just the past 7 days, what time did you most often GO TO BED on
workdays? Please answer about weekdays if you did not work last week. [INTERVIEWER
NOTE: IF RESPONDENT NOT WORKING: clarify you are asking about weekdays.]
2 Prior to 8 pm
3 8:00-8:59 pm
16 9:00-9:59 pm
28 10:00-10:59 pm
22 11:00-11:59 pm
16 12:00-12:59 am
13 1:00 am or later
1 (DO NOT READ) Don’t know/Refused
Q7. What about on non-work days or weekends?
2 Prior to 8 pm
2 8:00-8:59 pm
8 9:00-9:59 pm
22 10:00-10:59 pm
22 11:00-11:59 pm
20 12:00-12:59 am
21 1:00 am or later
1 (DO NOT READ) Don’t know/Refused
2014 SLEEP HEALTH INDEX
18
Q8. What time did you most often wake up for the day on work days or weekdays?
10 Prior to 5 am
20 5:00-5:59 am
29 6:00-6:59 am
18 7:00-7:59 am
10 8:00-8:59 am
12 9:00 am or later
1 (DO NOT READ) Don’t know/Refused
Q9. What about on non-work days or weekends?
5 Prior to 5 am
8 5:00-5:59 am
16 6:00-6:59 am
23 7:00-7:59 am
17 8:00-8:59 am
30 9:00 am or later
1 (DO NOT READ) Don’t know/Refused
Q10. During the past 7 days, how many days did you wake up feeling well-rested?
20 0 Days/None
14 1-2 Days
19 3-4 Days
45 5 or more Days
1 (DO NOT READ) Don’t know
1 (DO NOT READ) Refused
Q11. During the past 7 days, how many days did you take a nap for at least 15 minutes?
47 0 Days/None
23 1-2 Days
13 3-4 Days
17 5 or more Days
* (DO NOT READ) Don’t know
* (DO NOT READ) Refused
2014 SLEEP HEALTH INDEX
19
Q12. How many nights did you have trouble FALLING asleep?
55 0 Nights/None
20 1-2 Nights
9 3-4 Nights
16 5 or more nights
1 (DO NOT READ) Don’t know
* (DO NOT READ) Refused
Q13. And how many nights did you have trouble STAYING asleep?
47 0 Nights/None
19 1-2 Nights
10 3-4 Nights
23 5 or more nights
1 (DO NOT READ) Don’t know
* (DO NOT READ) Refused
READ TO ALL: Still thinking about the past 7 days…
Q14. How many days did poor or insufficient sleep significantly impact your daily activities, like
your work performance, socializing, exercising, or other typical activities?
53 0 Nights/None
19 1-2 Nights
14 3-4 Nights
12 5 or more nights
2 (DO NOT READ) Don’t know
* (DO NOT READ) Refused
Q15. How many days did you fall asleep without intending to, such as dozing off in front of the
TV or in a car?
57 0 Days/None
22 1-2 Days
11 3-4 Days
9 5 or more days
1 (DO NOT READ) Don’t know
* (DO NOT READ) Refused
2014 SLEEP HEALTH INDEX
20
Sleep Routine
Q16. How many nights did you take over-the counter or prescription medication to help you
sleep?
83 0 Nights/None
4 1-2 Nights
3 3-4 Nights
10 5 or more nights
* (DO NOT READ) Don’t know
* (DO NOT READ) Refused
Q17. How many nights did you share a bed with…(INSERT. READ IN ORDER)
0 Nights/
None
1-2
nights
3-4
nights
5 or more
nights DK/Ref.
a. A pet? 77 4 2 17 *
b. A child or children? 86 6 3 6 *
c. A spouse or partner? 42 4 5 48 *
Q18. How many nights did you use your computer, tablet or smartphone in the 30 minutes
BEFORE trying to go to sleep?
38 0 Nights/None
10 1-2 Nights
11 3-4 Nights
42 5 or more nights
* (DO NOT READ) Don’t know
0 (DO NOT READ) Refused
Q19. How many nights did you send or read text messages, emails or other electronic
communications AFTER you had initially fallen asleep?
79 0 Nights/None
8 1-2 Nights
4 3-4 Nights
8 5 or more nights
* (DO NOT READ) Don’t know
0 (DO NOT READ) Refused
2014 SLEEP HEALTH INDEX
21
Sleep Beliefs/Knowledge
Q20. For each of the following, please tell me if you think it is completely true, somewhat true,
somewhat false, or completely false? (First/Next)….(INSERT. READ IN ORDER)
READ AS NECESSARY: Do you think this is completely true, somewhat true, somewhat
false, or completely false?
Completely
True
Somewhat
True
Somewhat
False
Completely
False
DK/
Ref
a. Adults need fewer hours
of sleep the older they
get.
13 31 25 28 3
b. Successful people need
less sleep than the average
person.
6 17 25 48 4
c. Alcohol improves sleep
quality.
5 14 18 55 8
Sleep Environment
Next I have just a few questions about your sleep environment.
Q21. How quiet is the room in which you sleep? Please take into account all sources of noise,
both inside and outside the room. Is it…(READ)
47 Very quiet
42 Fairly quiet
6 Not so quiet
4 Not at all quiet
* (DO NOT READ) Don’t know
* (DO NOT READ) Refused
Q22. How dark is the room in which you sleep? Please take into account light coming from
nightlights, overhead lights, street lights, and electronics. Is it…(READ)
36 Very dark
48 Fairly dark
12 Not so dark
3 Not at all dark
* (DO NOT READ) Don’t know
* (DO NOT READ) Refused
2014 SLEEP HEALTH INDEX
22
Q23. How comfortable is the mattress or surface on which you sleep? Is it…(READ)
56 Very comfortable
33 Fairly comfortable
8 Not so comfortable
2 Not at all comfortable
* (DO NOT READ) Don’t know
* (DO NOT READ) Refused
Sleep Disorders
Q24. According to what you know or others tell you, how often do you snore? Do you
snore….(READ)
27 Every night or almost every night
13 A few nights a week
28 Rarely
23 Never (INTERVIEWER NOTE: CODE I don’t
snore here)
8 (DO NOT READ) Don’t know
* (DO NOT READ) Refused
Q25. Have you ever been told by a doctor that you have a sleep disorder, such as insomnia or
sleep apnea?
17 Yes
83 No
* (DO NOT READ) Don’t know
0 (DO NOT READ) Refused
Q26. Which sleep disorder is that? (OPEN END)
Based on those who have been told by doctor they have a sleep disorder (n=215)
67 Sleep Apnea
27 Insomnia
4 Other responses
5 (DO NOT READ) Don’t know
May total more than 100% due to multiple responses
Q27. Have you ever discussed your sleep with a doctor or medical professional?
32 Yes
68 No
* (DO NOT READ) Don’t know
* (DO NOT READ) Refused
2014 SLEEP HEALTH INDEX
23
Q28. How many hours of sleep do you need per day to be well-rested and feel your best?
10 5 hours or less
19 6 hours
26 7 hours
33 8 hours
9 9 or more hours
2 (DO NOT READ) Don’t know
* (DO NOT READ) Refused
Demographics
READ TO ALL: Finally, I have just a few remaining background questions.
Sex. RECORD RESPONDENT’S GENDER
48 Male
52 Female
Age. What is your age? (RECORD EXACT AGE AS TWO-DIGIT CODE.)
22 18-29
31 30-49
28 50-64
18 65 and older
1 (DO NOT READ) Refused
D2. Are you currently married or living with a partner?
59 Yes
40 No
* (DO NOT READ) Don’t know/Refused
D3. What best describes your employment situation today? (READ IN ORDER)
57 Employed full or part time
5 Unemployed
6 A student
17 Retired
8 On disability
6 Or, a homemaker or stay at home parent?
1 (DO NOT READ) Don’t know/Refused
2014 SLEEP HEALTH INDEX
24
D4. What is the highest level of school you have completed or the highest degree you have
received? (DO NOT READ) [INTERVIEWER NOTE: Enter code 3-HS grad if R
completed training that did NOT count toward a degree]
4 Less than high school (Grades 1-8 or no formal schooling)
5 High school incomplete (Grades 9-11 or Grade 12 with no
diploma)
32 High school graduate (Grade 12 with diploma or GED
certificate0
19 Some college, no degree (includes some community college)
12 Two year associate degree from a college or university
17 Four year college or university degree/Bachelor’s degree (e.g.,
BS, BA, AB)
1 Some postgraduate or professional school, no postgraduate
degree
9 Post-graduate or professional degree, including master’s,
doctorate, medical, or law degree (e.g., MA, MS, PhD, MD, JD)
1 (DO NOT READ) Don’t know/Refused
D5. Are you, yourself, of Hispanic or Latino background, such as Mexican, Puerto Rican,
Cuban, or some other Spanish background?
15 Yes
85 No
1 (DO NOT READ) Don’t know/Refused
D6. What is your race? Are you white, black, Asian or some other race? (IF RESPONDENT
SAYS HISPANIC ASK: Do you consider yourself a white Hispanic or a black Hispanic?
CODE AS WHITE (1) OR BLACK (2). IF RESPONDENTS REFUSED TO PICK
WHITE OR BLACK HISPANIC, RECORD HISPANIC AS “OTHER,” CODE 4)
75 White
14 Black or African-American
5 Asian
5 Other or mixed race
2 (DO NOT READ) Don’t know/Refused
D7. Were you born in the United States, on the island of Puerto Rico, or in another country?
Based on those who are Hispanic (n=169) 47 U.S.
2 Puerto Rico
50 Another country
1 (DO NOT READ) Don’t know/Refused
2014 SLEEP HEALTH INDEX
25
D8. Last year – that is, in 2013 – what was your total family income from all sources, before
taxes? Just stop me when I get to the right category. (READ)
20 Less than $20,000
20 $20,000 to less than $40,000
14 $40,000 to less than $60,000
11 $60,000 to less than $80,000
7 $80,000 to less than $100,000
14 $100,000 or more
15 (DO NOT READ) Don’t know/Refused
HH2. How many children, age 6 and younger, currently live in your household?
78 No children age 6 or younger
12 1 child
10 2 or more children
* (DO NOT READ) Don’t know/Refused
END OF INTERVIEW: That’s all the questions I have. Thanks for your time and participation in
this important study.
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