2014 Sleep Health Index-FINAL_0.PDF

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


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.


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


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


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


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).


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).


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


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


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


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 èxercise’ (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 Èxcellent’ sleep quality.

Similarly, those who were èxtremely’ 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 èxtremely’ 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


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.


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.


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


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.


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


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


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.


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



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




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



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



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


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


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



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




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



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



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



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




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



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



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




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



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




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



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)



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



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


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




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



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


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?



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)


D5. Are you, yourself, of Hispanic or Latino background, such as Mexican, Puerto Rican,

Cuban, or some other Spanish background?

15 Yes

85 No


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


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



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


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.

2014 Sleep Health Index-FINAL_0.PDF

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Transcript of 2014 Sleep Health Index-FINAL_0.PDF