The Geography of Insufficient Sleep in the Contiguous United States (CONUS)

Mingzheng Yang, Lei Zou, Hongxu Ma, Zongrong Li, Wanhe Li

Insufficient sleep is becoming increasingly prevalent, partially because of the accelerated pace of modern life, and is linked to a wide range of adverse physical and mental health outcomes. While several social, physical, and environmental factors are known to influence sleep duration, the underlying mechanisms and their geographic variability remain poorly understood. The growing availability of geospatial data,such assatellite observations, nationwide health surveys, and census datasets, offers new opportunities to observe sleep behaviors and potential determinants at large geographical scales with improved precision and efficiency. This study explores the geographical patterns of insufficient sleep and their associations with social, physical, and environmental factors. We obtained the latest county-level insufficient sleep rates in the Contiguous U.S. and explored their relationship with outdoor nighttime light exposure, day length, greenness, climate, air pollution, mental and physical health conditions, and social-demographic characteristics. Results reveal a distinct geographic boundary extending from the Southwest to the Northeast that
delineates two regions: the Southeastern High-Prevalence of Insufficient Sleep Zone and the Northwestern Low-Prevalence of Insufficient Sleep Zone. Statistical and machine learning models
demonstrate that insufficient sleep is significantly associated with environmental exposures (precipitation, temperature, air pollution), sociodemographic characteristics (race-ethnic
minorities), and health-related variables (obesity, diabetes, and physical distress). By integrating spatial data science and public health perspectives, this study advances understanding of the
environmental and social determinants of sleep behaviors, offering valuable insights to guide location-based interventions and policies that can potentially promote healthier sleep across
communities.