Across the United States, a sweeping new body of research is drawing a stark line between how much we sleep and how long we live. By zooming in at the county level, scientists are finding that communities where people routinely get too little rest are also places where life expectancy is shorter, even after accounting for income, geography, and the upheaval of COVID.
Instead of treating sleep as a lifestyle extra, the data now place it alongside smoking and other classic risk factors as a powerful predictor of premature death. The message is blunt: in county after county, insufficient sleep is not just a symptom of deeper problems, it is emerging as a driver of how long people can expect to live.
What the new county-level research actually shows
The latest work on sleep and longevity does something earlier studies rarely managed, it looks across virtually the entire country and compares how people sleep with how long they live in the specific communities where they reside. Researchers conducted a nationwide analysis of U.S. counties, pairing self reported sleep duration with local life expectancy to see whether short nights translated into shorter lives. The pattern was clear, counties with higher rates of adults getting less than seven hours of sleep had lower average life expectancy, a relationship that held up even when the data were sliced by region, income, and other demographic factors, as described in a broad analysis of sleep habits and longevity.
What makes this county-level approach so powerful is that it moves beyond individual anecdotes and small clinical samples into the realm of population health. By using a large county by county dataset, the researchers could rank sleep alongside other well known risks and see where it truly stood. One report on this work notes that a large county by county analysis published in the journal Sleep Advantages suggests that sleep is not just another wellness metric, it is one of the factors most predictive of mortality at the community level.
How much sleep is tied to shorter life expectancy
At the heart of the new findings is a simple threshold, fewer than seven hours of sleep a night. Across more than 3,000 U.S. counties, researchers found that adults who routinely slept less than this benchmark faced a higher risk of dying sooner, and that counties with more short sleepers had lower average life expectancy. One summary of the work puts it bluntly in its “In A Nutshell” section, noting that Sleeping fewer than seven hours per night is linked to shorter life expectancy across all 3,000 plus U.S. counties and flags this as a priority for local public health interventions.
Public health agencies have long drawn a similar line. For the purpose of modeling, the CDC defined sufficient sleep as at least seven hours a night, aligning with broader medical guidance that adults need seven to nine hours for optimal health. In the new county level work, that same cutoff became a crucial dividing line, with insufficient sleep, defined as less than seven hours, associated with decreased life expectancy in the communities studied. One report on the project notes that For the purpose of their models, CDC researchers treated seven hours as the minimum for “sufficient” sleep and then tracked how falling short of that mark correlated with mortality.
Why sleep now rivals smoking as a mortality risk
Perhaps the most jarring finding from the county data is where sleep ranks among other threats to longevity. When researchers stacked insufficient sleep against a roster of familiar risks, including smoking, physical inactivity, and loneliness, they found that short sleep was one of the top predictors of early death. In one account of the study, a sleep disorder specialist explains that the researchers compared average life expectancy in each county with a range of behavioral and social factors and found that Sleep ranked second only to smoking as a predictor of life expectancy, ahead of inactivity and loneliness.
That ranking is not a rhetorical flourish, it reflects the strength of the statistical association between sleep duration and mortality once other factors are controlled. A nationwide analysis of county data, described under the title Insufficient Sleep Strongly Predicts Shorter Life Expectancy, reports that getting fewer than seven hours of sleep per night was one of the strongest behavioral predictors of reduced life expectancy, with only smoking showing a stronger association. In other words, at the population level, chronic short sleep is now sitting near the top of the same risk ladder that public health campaigns have spent decades climbing to warn people about cigarettes.
The scale of the dataset, 3,143 counties and years of tracking
Part of what gives this research its weight is sheer scale. Instead of focusing on a handful of cities or a single health system, the investigators drew on data from 3,143 U.S. counties, covering the period from 2019 through 2025. That breadth allowed them to see how sleep and life expectancy moved together across urban and rural areas, coastal and inland regions, and communities with very different economic profiles. One widely shared summary framed it starkly, stating that “Sleep deprivation is the new smoking” and highlighting that new data across 3,143 US counties from 2019 to 2025 ranks getting less than seven hours of sleep as a leading predictor of early death.
The methods behind that conclusion were not casual. Researchers used Centers for Disease Control and Prevention survey data on sleep duration and paired it with county level mortality and life expectancy figures, then ran a detailed analysis to see which behaviors best predicted differences in lifespan. A description of the work notes that using the 2019 to 2025 Centers for Disease Control and Prevention data, the team conducted an analysis that ranked insufficient sleep alongside smoking, inactivity, and loneliness, with only smoking displaying a stronger association with reduced life expectancy. That combination of a large sample and rigorous modeling is what lets them speak confidently about patterns that hold across the country, not just in isolated pockets.
A pattern that held steady through COVID and across incomes
One obvious question is whether the link between sleep and life expectancy is just a byproduct of the COVID era, when stress, illness, and economic disruption reshaped daily life. The county level data suggest it is not. Analysts report that the relationship between short sleep and shorter life expectancy held steady year after year, including during the height of COVID, rather than spiking only in the most chaotic months. In one summary of the work, researchers note that the link held steady year after year, including during COVID, suggesting that the association is robust to major societal shocks.
Income is another potential confounder, since poorer counties often face a tangle of health challenges that can shorten lives. Yet the new research indicates that the sleep life expectancy connection appears regardless of income level. Counties with higher rates of insufficient sleep tended to have lower life expectancy whether they were affluent suburbs or struggling rural areas. A detailed report on the county by county findings notes that the pattern continued over the study period and that insufficient sleep remained one of the top five predictors of premature death even after adjusting for economic factors, a point underscored in coverage that describes how this pattern continued over the years and was significant enough to draw attention from the National Institute for Occupational Safety and Health, as reflected in a summary of how this pattern persisted.
Where insufficient sleep ranks among top predictors of early death
When researchers lined up the usual suspects that cut lives short, insufficient sleep did not lurk in the background, it landed squarely near the top. The county level models consistently identified short sleep as one of the top five predictors of premature death, alongside smoking and a handful of other behavioral and social risks. One account of the study notes that a similar trend across the country placed insufficient sleep among the top 5 predictors of premature death, a finding that emerged as analysts compared counties with different sleep profiles and mortality rates, as described in coverage of how Dec county level data revealed this ranking.
That ranking is echoed in more technical descriptions of the work. In the Insufficient Sleep Strongly Predicts Shorter Life Expectancy project, researchers report that insufficient sleep showed a stronger association with reduced life expectancy than inactivity and loneliness, with only smoking surpassing it. The study’s summary explains that the nationwide analysis placed insufficient sleep near the top of the risk hierarchy, reinforcing the idea that sleep is not a secondary concern but a central pillar of longevity. For public health planners, that means sleep now belongs in the same strategic conversations as tobacco control and physical activity, not as an afterthought but as a core target.
Why researchers say sleep may matter more than diet or exercise
For years, the standard wellness script has emphasized diet and exercise as the twin engines of a long life, with sleep often treated as a supporting character. The new county level findings are prompting some experts to flip that script. One synthesis of the research on sleep and longevity notes that these findings really highlight the importance of sleep among all other behaviors that we commonly think of as essential, including what we eat and how much we move. In that discussion, a researcher argues that the data suggest sleep may be more important for longevity than diet, exercise, or even social ties, a point underscored in a report that frames Dec findings as a wake up call for how we prioritize health behaviors.
That does not mean diet and exercise suddenly do not matter, but it does suggest that without adequate sleep, their benefits may be blunted. Researchers point to several plausible pathways, including the way chronic short sleep disrupts hormones that regulate appetite, blood sugar, and blood pressure, and how it can fuel inflammation that damages blood vessels and organs over time. The county level results, which show that communities with widespread insufficient sleep have shorter life expectancy even when other behaviors are accounted for, give population level backing to those biological theories. In effect, the data argue that sleep is a foundational behavior, one that supports or undermines the impact of everything else we do for our health.
How the county findings translate into everyday risk
For individuals, the idea that insufficient sleep is a top predictor of early death can feel abstract until it is grounded in daily routines. The county level research suggests that if you live in a community where short sleep is the norm, you are more likely to be surrounded by people juggling multiple jobs, long commutes, or irregular shifts that cut into rest. Over time, that collective sleep debt shows up in higher rates of chronic disease and lower life expectancy in the local statistics. One detailed report on the project notes that insufficient sleep was consistently associated with decreased life expectancy across counties, reinforcing the idea that chronic short nights are not just a personal inconvenience but a community wide health burden, a point captured in the description of how CDC modeling linked sleep duration to mortality.
From a risk perspective, the comparison to smoking is instructive. Just as lighting up a single cigarette does not guarantee lung cancer but raises the odds over years of exposure, a few nights of short sleep are unlikely to shave years off a life on their own. The danger lies in patterns that persist for months and years, especially in environments that normalize late nights and early mornings without recovery. The county data, which average sleep and life expectancy across entire populations, capture the cumulative effect of those patterns. They show that where short sleep is widespread, early death is more common, even after accounting for other factors. That is the level of risk that public health officials are now weighing as they consider how to respond.
Why local public health officials are paying attention
One of the most practical implications of the county level research is that it gives local health departments a new, concrete lever to pull. Instead of treating sleep as a private matter, officials can now see it as a measurable community metric that predicts how long residents will live. Analysts who worked on the county by county models argue that the strength and consistency of the sleep life expectancy link make it a promising target for local public health action, a point highlighted in coverage that notes the link held steady year after year and flagged insufficient sleep as a priority for local public health interventions.
Translating that insight into policy will not be simple, but the county data offer some starting points. Communities can use their own sleep and life expectancy profiles to identify neighborhoods where short sleep is most common, then target interventions such as workplace scheduling reforms, noise and light pollution controls, or public campaigns that encourage consistent bedtimes. The fact that the pattern holds across income levels suggests that even relatively affluent counties have room to improve, particularly in sectors like tech and finance where long hours are often celebrated. As more local leaders absorb the message that insufficient sleep is one of the top predictors of premature death, I expect to see sleep move from the wellness pages into city council agendas and state health plans.
Reframing sleep as critical infrastructure for a longer life
Taken together, the county level findings amount to a reframing of sleep from a personal preference to a form of health infrastructure that communities either support or erode. The data show that when large numbers of people in a county routinely get less than seven hours of sleep, life expectancy falls, and that this pattern persists across 3,143 counties, through the turbulence of COVID, and across income brackets. A large county by county Sleep Advantages analysis underscores that sleep is one of the factors most predictive of mortality, not a side note to more familiar risks.
For individuals, that reframing can be both unsettling and empowering. It is unsettling because it suggests that years of burning the candle at both ends may carry a cost that is visible in county mortality tables, not just in morning grogginess. It is empowering because, unlike some structural determinants of health, sleep is at least partly within personal and local control. As more evidence accumulates, including the sweeping Dec analysis of sleep habits and longevity across the country, the case for treating sleep as a central pillar of public health grows stronger. The new county level study does not just link poor sleep to shorter life expectancy, it challenges every community to decide how much it is willing to sacrifice in the name of staying awake.
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