Short Sleep Duration by Occupation Group — 29 States, 2013–2014
Authors: Taylor M. Shockey, Anne G. Wheaton
Journal: MMWR Morbidity and Mortality Weekly Report (2017)

The American Academy of Sleep Medicine and the Sleep Research Society have determined that adults require ≥7 hours of sleep per day to promote optimal health (1).Short sleep duration (<7 hours per day) has been linked to adverse health outcomes including cardiovascular disease, obesity, diabetes, depression, and anxiety, as well as safety issues related to drowsy driving and injuries (1,2).Additional research has found that sleep duration varies by characteristics such as race, education, marital status, obesity, and cigarette smoking (3).Work-related factors such as job stress, work hours, shift work, and physically demanding work have been found to be associated with sleep duration and quality (4-6).All of these work factors vary by industry and occupation of employment, and the prevalence of short sleep duration has been shown to vary by broad industry and occupation category (7).To provide updated and more detailed information about which occupation groups have the highest prevalences of short sleep duration, CDC analyzed data from currently employed adults surveyed for the 2013 and 2014 Behavioral Risk Factor Surveillance System (BRFSS) in 29 states.Among 22 major occupation groups, the highest prevalences of short sleep duration were among workers in the following five groups: Production (42.9%),Healthcare Support (40.1%),Healthcare Practitioners and Technical (40.0%),Food Preparation and Serving-Related (39.8%), and Protective Service (39.2%).The significant differences among occupation groups in the prevalence of short sleep duration suggest that work-related factors should be further evaluated as they might relate to sleep.BRFSS is an annual, random-digit-dialed telephone survey of noninstitutionalized, U.S. civilian residents aged ≥18 years.It is conducted by U.S. states and territories to gather data on health-related risk behaviors, chronic illnesses and conditions, and use of health-related services.*The BRFSS questionnaire is composed of a set of core questions that are asked by all states; in addition, states may choose from optional modules on specific subjects or include state-added questions.Twentynine states † administered the optional industry and occupation module in 2013 or 2014.Response rates for BRFSS are calculated based on American Association of Public Opinion Research guidelines.The median response rate for all states, territories, and the District of Columbia was 46.4% in 2013 and 47.0% in 2014, whereas the response rates for states included in analyses ranged from 31.1% to 59.2% in 2013 and from 33.0% to 57.6% in 2014.§ To determine occupation, BRFSS participants who were employed for wages, self-employed, or out of work for <1 year were asked, "What kind of work do you do?" Participants' responses were recorded as free text and later coded to one of the 574 U.S. Bureau of Census ( 2002) occupation numeric codes ¶ by an auto-coding system or computer-assisted human coders.Because of the difficulty in reporting results for such a large number of occupations, and to protect participants' privacy, the 574 Bureau of Census codes were grouped into 93 two-digit detailed occupation groups used by CDC's National Center for Health Statistics to code occupations for the National Health Interview Survey,** and these detailed groups were collapsed into the 22 two-digit Standard Occupational Classification System major occupation groups created by the Bureau of Labor Statistics.† † Respondents also were asked, "On average, how many hours of sleep do you get in a 24-hour period?"Responses to this question were dichotomized into ≥7 hours of sleep (sufficient sleep) and <7 hours of sleep (short sleep duration).Among the 412,829 BRFSS participants in 2013 and 2014, a total of 207,143 (50.2%) were currently employed for wages, self-employed, or out of work for <1 year and were considered for analyses.After excluding 523 respondents (0.3%) who were on active military duty, 249 (0.1%) who were unpaid or retired workers, and 26,750 (12.9%) with insufficient or missing information necessary for occupational coding, the final sample for analyses totaled 179,621 (86.7% of the currently employed respondents).Prevalence of short sleep duration was calculated by the 22 major and 93 detailed occupation groups and adjusted for the following characteristics: age group (18-34 years, 35-44 years, 45-54 years, 55-64 years, and ≥65 years); sex (male or female); race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, and non-Hispanic