Last month, to commemorate World Sleep Day on March 15, Phillips Healthcare released the results of its annual global sleep survey. This is a really interesting survey that investigates sleep habits, attitudes, and perceptions on an international scale. In 2019, more than 11,000 people in a dozen nations responded to questions about how they sleep, and the factors that affect their nightly rest.
A quick snapshot of the survey:
- This year’s participating countries are Australia Brazil, Canada, China, France, Germany, India, Japan, the Netherlands, Singapore, South Korea, and the United States.
- The survey group was roughly divided between men (51 percent) and women (49 percent).
- The average age of respondents was just slightly over 37 years.
- Sixty-one percent of respondents live with a partner, and 59 percent live with at least one child.
- Sixty percent work full time.
I’m always interested in reporting about sleep on a global scale. First, let’s take a look at some of the survey’s basic findings. Then, I’ll highlight a few of the insights that really jumped out at me.
How well (and how much) are we sleeping across the globe?
Despite large majorities of adults in every nation saying they recognize sleep as having a significant impact on health, a majority of adults also report their sleep is not satisfactory. An average of 62 percent of adults across the 12 nations said they do not sleep well, either somewhat or not at all. Just 10 percent reported sleeping extremely well.
An even greater majority of adults—a global average of 67 percent—reported waking up at least 1 time per night. And 60 percent experience daytime sleepiness at least 2 times a week.
As a sleep doc, this particular stat was particularly disappointing to read: A sizeable group—44 percent—of adults around the world say their sleep has gotten worse over the past five years, compared to 26 percent reporting their sleep has improved in that timeframe.
Not surprising to me, the average sleep amounts for adults around the globe vary somewhat significantly between weekdays and weekends. The average sleep time for weeknights is 6.8 hours a night; on the weekends, that number jumps to 7.8. I’ll look at little closer at this pattern of weekend catch-up sleep—and whether it works—in just a moment.
What’s getting in the way of sleeping well?
The survey investigated the lifestyle factors that people believe are affecting their sleep. The top 5 obstacles to sleep, according to survey respondents, are:
Worry and stress (54 percent)
No surprise here. Stress consistently registers as among the most common and significant sleep hazards.
Sleep environment (40 percent)
Work and school schedules (37 percent)
Increasingly, for many people, the boundaries between work and non-work time are becoming less clear. That poses very real challenges for sleep.
Entertainment (36 percent)
There’s the mental stimulation that comes from watching TV or playing video games in the evening hours. Even more hazardous to sleep? The light that comes along with these entertaining pastimes. Screens and digital devices have high concentrations of blue light, which suppress melatonin and put circadian rhythms out of sync. I’ve been working with the eyewear company Luminere to develop blue-light blocking glasses—check them out here!
Health conditions (32 percent)
Sleep disorders—including insomnia, sleep apnea, shift-work sleep disorder, and restless leg syndrome—are among the top health conditions adults around the globe pointed to as the source of their sleep problems. Chronic pain conditions are also a major health issue that interferes with nightly rest, according to the survey.
There are some interesting differences between countries, when it comes to the lifestyle factors affecting sleep.
Most worried? Canada (63 percent) and Singapore (61 percent) had the highest reports of stress and worry getting in the way of sleep.
Most uncomfortable? Respondents in China (51 percent) reported most often having their sleep environments impact their sleep. Survey participants in Japan (20 percent) reported the lowest impact of sleep environment on their rest.
Most caffeinated? China (31 percent), Canada (23 percent), the United States (22 percent) and Singapore (22 percent) were the countries with the highest number of respondents saying that consuming caffeine close to bedtime affected the quality of their sleep.
Most pet-friendly sleepers? Adults in India (36 percent) and the United States (30 percent) were most likely to sleep with a pet in their bed. An average of 20 percent of adults across all 12 nations reported usually sleeping with a pet.
Let’s dig a little deeper into the study results, and into some of the takeaways that jumped out at me.
About 1 in 4 of us use meditation to help sleep
I’m one of them! This year’s survey found that 26 percent of respondents from around the globe reported using meditation as a technique for improving their sleep. Some good news? That’s a significant jump from the Phillips’ 2018 survey, in which 19 percent reported using mediation for sleep.
I’m a big proponent of mediation and other mind-body therapies for sleep. They’re simple and easy to adopt, and can make a significant difference in how well you sleep (and how you feel during your waking day). I’ve written before about using mediation to help with sleep. And recent studies have shown mindfulness can help reduce the intensity of negative emotions, improve symptoms of physical pain, and improve both the physical and psychological responses to stress. All of these benefits can contribute to better sleep.
A new study looked at the US population and found just under 30 percent of adults with sleep problems using mind-body therapies to help improve their rest. According to this research, the most popular forms of mind-body therapies being used for sleep are yoga, spiritual mediation and mindfulness meditation.
Another new study on the impact of mind-body therapies for sleep—this one from researchers in China—also caught my eye recently. Scientists analyzed the findings of 49 studies published between 2004 and 2018, all of which investigated mind-body treatments for insomnia. They found several popular mind-body therapies—mediation, yoga, tai chi, and qigong—all had a positive impact on sleep quality and insomnia symptoms. Of these therapies, meditation showed a larger effect than the other mind-body techniques.
One thing I tell my patients: there is no wrong time of day for mediation, and using simple mindfulness mediations throughout the day can help you sleep better at night. I do a short mediation in the shower, which helps me start my day feeling centered, focused and relaxed. Of course, bedtime is a great time to meditate, too.
Most of us think health issues impact our sleep—but many aren’t seeking medical help
The Phillips survey found that 76 percent of respondents from around the globe reported at least one heath condition having a negative impact on their sleep. Those conditions included sleep disorders—insomnia, snoring, shift-work sleep disorder, RLS, and narcolepsy—and chronic pain. Insomnia (37 percent) and snoring (29 percent) were the most common health conditions cited by respondents worldwide. Sleep apnea came in at 10 percent.
What’s worrisome here? Sixty percent of survey respondents said they hadn’t consulted a physician about their sleep problem. Without sleep screening or an evaluation by a sleep specialist, many sleep- and health-disruptive conditions go undiagnosed—or misdiagnosed. For example: of the nearly 30 percent of survey takers who said snoring affected their sleep, it’s likely that some number of them have obstructive sleep apnea. And all of them should talk with their doctor about their snoring, to evaluate whether a sleep apnea screening is warranted. That goes for both men and women. I wrote recently about sleep apnea in women—the latest research on how OSA affects women, and important differences in the symptoms that women and men experience.
We’re STILL relying on weekends to catch up on sleep
No surprise here, right? Weekdays are jam-packed with responsibilities that crowd into the late nights and early mornings, making it tough for many adults to get full amount of sleep they need. Making up for that weekly sleep loss—repaying our sleep debt—often falls to the weekend.
The survey found people sleeping an average of 1 full additional hour on the weekends compared to weeknights. The problem is, science is increasingly showing the ways that weekend catch-up sleep doesn’t work—and might cause harm over the long-term. A study released earlier this year found that people who experienced limited sleep for 5 weeknights and then were allowed to sleep as much as they wanted on the weekend actually gained weight and had their insulin sensitivity—an important bio-marker of metabolic health—drop significantly. In other words, the weekend catch-up sleep didn’t protect sleepers against the effects of their limited weekday sleep on their weight and metabolism. In fact, as the researchers found, the catch-up sleep appeared to make weight and metabolic issues worse. The average amount of additional sleep people in this study received on weekend nights? Slightly more than 1 additional hour, compared to the weeknights.
Needing to sleep more on the weekends, even by an hour, is a clear sign you’re not getting enough sleep during the week. In addition to weight gain and metabolic issues, weekend recovery sleep has been linked to diminished cognitive performance, including difficulty paying attention. When you shift your sleep time on the weekends, you disrupt your daily circadian rhythms—and that can have a cascade of negative effects on your mood, your cognitive health and performance, your appetite and metabolism, and your long-term health.
The takeaway? One you’ve heard me say before, and will hear me say again. Consistency in a sleep routine, across weeknights and weekends, is the single most important investment you can make in sleeping well and protecting your health from the effects of poor sleep.
Michael J. Breus, PhD, DABSM
The Sleep Doctor™