Surveillance

Five CDC surveillance systems have monitored or currently monitor sleep related factors, including sleep duration, sleep disorders, and sleep related symptoms among adults, youth, and children. Brief information about each system and the sleep related survey questions used by each system are provided below.

Population:

Noninstitutionalized adults aged 18 years or older in all 50 states, the District of Columbia, US territories.

Method of administration:

Telephone survey (cell phones included since 2011).

Sleep Duration Question

• On average, how many hours of sleep do you get in a 24-hour period?

Inadequate Sleep Optional Module: 2009 (12 states), 2010 (14 states), 2011 (9 states), 2012 (5 states)

Sleep Disorders Optional Module: 2017 (9 states), 2018 (1 state)

Core Question (All States): 2013, 2014, 2016, 2018, 2020

Sleep Disorders Optional Module Questions

• Over the last 2 weeks, how many days have you had trouble falling asleep or staying asleep or sleeping too much?
• Over the last 2 weeks, how many days did you unintentionally fall asleep during the day?
• Have you ever been told that you snore loudly?
• Has anyone ever observed that you stop breathing during your sleep?

Sleep Disorders Optional Module: 2017 (9 states), 2018 (1 state)

Inadequate Sleep Optional Module Questions

• On average, how many hours of sleep do you get in a 24-hour period?
• Do you snore?
• During the past 30 days, for about how many days did you find yourself unintentionally falling asleep during the day?
• During the past 30 days, have you ever nodded off or fallen asleep, even just for a brief moment, while driving?

Inadequate Sleep Optional Module: 2009 (12 states), 2010 (14 states), 2011 (9 states), 2012 (5 states)

Perceived Insufficient Rest or Sleep Question

• During the past 30 days, for about how many days have you felt you did not get enough rest or sleep? (number of days)

Healthy Days/Quality of Life Modules: 1995–2002, 2004–2007

Core Question (All States): 2008–2010

BRFSS Survey Data

BRFSS Questionnaires

Population:

High school and middle school students.

Method of administration:

Self-administered paper and pencil questionnaire completed during class during the spring of odd numbered years.

Sleep Duration Question

• On an average school night, how many hours of sleep do you get?

National High School Questionnaire: Beginning in 2007

Standard High School Questionnaire: Beginning in 2015

Standard Middle School Questionnaire: Beginning in 2015

YRBS Data Files and Documentation

YRBS Questionnaires

Population:

Civilian noninstitutionalized adults aged 18 years or older.

Method of administration:

Personal household interview.

Sleep Duration Question

Since 2004:

• On average, how many hours of sleep do you get in a 24-hour period? (2004-2018, 2020, 2022)

Before 2004:

• On the average, how many hours of sleep do you get in a 24-hour period? (1990)
• How many hours do you usually sleep at night? (1983)
• On the average, how many hours of sleep do you usually get at night? (1977)

Sleep-Related Symptoms Questions

Rotating Core (even years) after 2019 redesign:

• During the past 30 days, how often did you wake up feeling well-rested? (2020, 2022)
• During the past 30 days, how often did you have trouble falling asleep? (2020, 2022)
• During the past 30 days, how often did you take any medication to help you fall asleep or stay asleep? (2020, 2022)
• During the past 30 days, how often did you have trouble staying asleep? (2020, 2022)

Sample Adult Core prior to 2019 redesign:

• In the past week, how many times did you have trouble falling asleep? (2013-2018)
• In the past week, how many times did you have trouble staying asleep? (2013-2018)
• In the past week, how many times did you take medication to help you fall asleep or stay asleep? (2013–2018)
• In the past week, on how many days did you wake up feeling well rested? (2013-2015, 2018)
• During the past 12 months, have you regularly had excessive sleepiness during the day? (2002, 2007, 2012)
• During the past 12 months, have you regularly had insomnia or trouble sleeping? (2002, 2007, 2012)

In PHQ-8 Depression section:

• Over the last two weeks, how often have you been bothered by trouble falling or staying asleep, or sleeping too much? (2019, 2022)

NHIS Questionnaires, Datasets, and Related Documentation

Population:

Children aged 17 years or younger.

Method of administration:

Personal household interview of adult (parent, guardian, caretaker, other adult).

Rotating Core (even years, starting 2020) (for children 2-17 years old)

• In a typical week during the school year, how often does [child name] wake up well-rested? (for children 6-17 years old)
• In a typical week, how often does [child name] wake up well-rested? (for children 2-5 years old)
• In a typical week during the school year, how often does [child name] have difficulty getting out of bed in the morning? (for children 6-17 years old)
• In a typical week, how often does [child name] have difficulty getting out of bed in the morning? (for children 2-5 years old)
• In a typical week during the school year, how often does [child name] complain about being tired during the day? (for children 6-17 years old)
• In a typical week, how often does [child name] complain about being tired during the day? (for children 2-5 years old)
• In a typical week during the school year, how often does [child name] nap or fall asleep during the day, such as in school, watching TV, or riding in a car? (for children 6-17 years old)
• In a typical week, how often does [child name] nap or fall asleep during the day, such as in school, watching TV, or riding in a car? (for children 2-5 years old)
• In a typical week during the school year, on nights [child name] has school the next day, how often does [child name] go to bed at the same time? (for children 6-17 years old)
• In a typical week how often does [child name] go to bed at the same time? (for children 2-5 years old)
• In a typical week during the school year, on school days, how often does [child name] wake up at the same time? (for children 6-17 years old)
• In a typical week how often does [child name] wake up at the same time? (for children 2-5 years old)

Annual Core (annually, starting 2019) for children <2 years old:

• Is it hard to put [child name] to sleep?
• Does [child name] have trouble staying asleep?
• Is it hard for [your family members] to get enough sleep because of [child name]?

Sample Child Core prior to 2019 redesign:

• [Child name] has trouble getting to sleep… not true, sometimes true, or often true, during the past two months (2004–2018)
• During the past 12 months has, [child name] regularly had excessive sleepiness during the day? (2012)
• During the past 12 months has, [child name] regularly had insomnia or trouble sleeping? (2007, 2012)

NHIS Questionnaires, Datasets, and Related Documentation

Population:

Individuals aged 16 years or older were eligible for the Sleep Disorders questionnaire.

Interview Setting and Mode of Administration:

The questions on sleep disorders were administered in the home, using the Computer-Assisted Personal Interviewing (CAPI) system, as part of the survey participant household interview.

Sleep Disorders Questionnaire

2021-2022: Sleep schedule (4 questions)

2019-2020: Sleep schedule, sleep disorder symptoms, and discussion with health professional (8 questions)

2017-2018: Sleep schedule, sleep disorder symptoms, and discussion with health professional (8 questions)

2015-2016: Sleep schedule, sleep disorder symptoms, and discussion with health professional (6 questions)

2013–2014: Sleep schedule and discussion with health professional (3 questions)

2011–2012: Sleep schedule and discussion with health professional (3 questions)

2009–2010: Sleep schedule and discussion with health professional (3 questions)

2007–2008: Sleep schedule, sleep disorder symptoms, discussion with health professional, and sleep-related difficulty with daily activities (23 questions)

2005–2006: Sleep schedule, sleep disorder symptoms, discussion with health professional, and sleep-related difficulty with daily activities (23 questions)

NHANES Questionnaires, Datasets, and Related Documentation

Population:

Participants who were 25 to 74 years old when first examined in NHANES I (1971–1975).

Interview Setting and Mode of Administration:

Personal interviews.

Sleep Questions (1982–1984)

• How often do you have trouble falling asleep?
• How often do you have trouble with waking up during the night?
• How often do you have trouble with waking up too early and not being able to fall asleep again?
• How often do you get so sleepy during the day or evening that you have to take a nap?
• Compared to one year ago, do you have sleep problems much more now, somewhat more now, somewhat less now, much less now or is your sleeping pattern about the same?
• How often do you usually take a sedative or sleeping pill that has been prescribed by a doctor to help you sleep?
• How many hours of sleep do you usually get at night (or when you usually sleep)?

NHANES I – Epidemiologic Followup Study (NHEFS)