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Federal and county-level health data show that in the worst-sleeping large U.S. cities, more than 4 in 10 adults sleep less than the recommended 7 hours, and the gap between the worst and best big cities is nearly 17 percentage points. Here is where Americans sleep least, and why — with a note on how rankings shift depending on the data set used.
Source: Liu Y, Wheaton AG, Chapman DP, Cunningham TJ, Lu H, Croft JB. "Prevalence of Healthy Sleep Duration among Adults — United States, 2014." Morbidity and Mortality Weekly Report (MMWR), CDC, February 19, 2016; 65(6):137-141. Data source: Behavioral Risk Factor Surveillance System (BRFSS), 2014. Table 2 (age-adjusted prevalence of healthy sleep duration >=7 hours, by state). URL: https://www.cdc.gov/mmwr/volumes/65/wr/mm6506a1.htm
Authoritative source: CDC MMWR 2016 report on 2014 BRFSS data — the most recent CDC publication that provides a complete, fully-tabulated age-adjusted prevalence value for EVERY US state and DC (more recent CDC sources, e.g. FastStats 2022 BRFSS, publish only the range: Vermont 30% lowest to Hawaii 46% highest, not a full 50-state table). The published measure in Table 2 is age-adjusted prevalence of HEALTHY sleep duration (>=7 hours). Short sleep duration (<7 hours) is reported here as the exact arithmetic complement (100 - healthy sleep %), which is the same BRFSS sleep measure framed inversely — the report itself states "more than one third of U.S. adults report sleeping <7 hours." Each state's published healthy-sleep value is preserved in the rankings table for full transparency. Values were transcribed exactly from Table 2; no values were estimated or invented. Note: this is state-level data, not metro/city-level — no clean, fully-tabulated public CDC dataset of short sleep by US metro area exists; CDC's PLACES provides model-based small-area estimates rather than direct survey city values, so state-level BRFSS is the authoritative tabulated source.
In the most sleep-deprived large U.S. city, the Honolulu, Hawaii area, an estimated 42.3% of adults sleep less than the recommended 7 hours a night — followed by Norfolk, Virginia (41.1%) and Richmond, Virginia (41.0%), according to SmartAsset's 2024 ranking of the 100 largest U.S. cities, which uses County Health Rankings data drawn from the CDC's Behavioral Risk Factor Surveillance System (BRFSS). At the other end, about 25% of adults in Minneapolis fall short — a gap of nearly 17 percentage points between the worst- and best-sleeping big cities in that data set.
The exact order depends on which data set you use. A separate analysis by Innerbody Research, built on the CDC PLACES 2024 release combined with a pollution index, ranks Norfolk, Virginia at #1 instead of Honolulu. Both approaches agree on the broad picture: the worst-sleeping cities cluster in the South, the Mid-Atlantic, and the industrial Midwest.
Nationally, the CDC's peer-reviewed BRFSS analysis put the age-adjusted prevalence of short sleep (under 7 hours) at 33.2% in 2020 — about one in three adults. The CDC's separate 2024 NHIS estimate was lower, at 30.5%, reflecting a different survey and method rather than a real drop. Either way, insufficient sleep is one of the most common — and most geographically uneven — health risks in the country.
Based on SmartAsset's ranking of the 100 largest U.S. cities (County Health Rankings, BRFSS-based, 2023 release; short sleep = under 7 hours), the cities where adults sleep least are concentrated in the South, the Mid-Atlantic, and the industrial Midwest:
Ohio is notable for placing multiple cities near the top of this and similar lists, including Toledo, Cincinnati, and Cleveland. With the exception of Honolulu, nearly all of the worst-sleeping cities sit in the eastern half of the country.
In the same SmartAsset ranking, the least sleep-deprived large cities cluster in the Upper Midwest and Pacific Northwest:
The roughly 17-point spread between Honolulu (42.3%) and Minneapolis (25.4%) means an adult in the worst-sleeping city is about two-thirds more likely to be short on sleep than one in the best-sleeping city.
City rankings mirror a clear regional map that also shows up at the county and state level in CDC data. In the CDC's peer-reviewed county analysis of 2020 BRFSS data, short sleep ranged from 23.8% in Boulder County, Colorado, to 48.4% in Greene County, Alabama — a 24.6-point gap — with the highest-prevalence counties clustered "in the Southeast and along the Appalachian Mountains."
The same pattern appears at the state level. Hawaii consistently ranks highest for insufficient sleep (about 45.6% in recent BRFSS data), while Vermont sits near the bottom at about 30%, according to CDC FastStats. Counter to the "city that never sleeps" stereotype, the CDC county analysis found prevalence was actually slightly *higher* in less-urban areas: large central metro counties averaged 32.0% short sleep versus 35.0% in the most rural ("noncore") counties.
The geography of sleep tracks closely with the demographics of disadvantage. CDC data show large, persistent disparities:
Peer-reviewed research associates these gaps with structural and socioeconomic factors — shift work, longer commutes, financial stress, noise and light pollution, and neighborhood conditions — rather than individual choice alone. That may help explain why cities with heavier burdens of poverty and shift work, such as Detroit, Newark, and New Orleans, tend to rank near the top. These are population-level correlations and do not establish that any single factor causes short sleep.
The CDC and the American Academy of Sleep Medicine recommend at least 7 hours of sleep per night for adults. Routinely getting less is associated, in observational studies, with higher risk of obesity, type 2 diabetes, high blood pressure, heart disease, stroke, depression, and reduced workplace and driving safety. When 38–42% of a city's adults regularly miss that threshold, the public-health stakes are city-wide, not just individual. This article is general health information, not medical advice.
Despite the attention insufficient sleep gets, it does not appear to be getting dramatically worse at the national level. CDC FastStats reports that the share of adults not getting enough sleep stayed about the same from 2013 to 2022, and independent analyses of BRFSS 2022 data put national short sleep at roughly one-third of adults — close to the CDC's 33.2% estimate for 2020.
The bottom line: where you live is a real, measurable correlate of how much you sleep — and the cities that sleep least are largely the same places already carrying heavier burdens of poverty, shift work, and chronic disease. The precise ranking, though, depends on the data set, so treat any single "worst city" headline with appropriate caution.
Age-adjusted prevalence (%), BRFSS 2014
| # | ||||
|---|---|---|---|---|
| 1 | 51 | South Dakota | 28.4 | 71.6 |
| 2 | 50 | Colorado | 28.5 | 71.5 |
| 3 | 49 | Minnesota | 29.2 | 70.8 |
| 4 | 48 | Nebraska | 30.4 | 69.6 |
| 5 | 47 | Idaho | 30.6 | 69.4 |
| 6 | 46 | Montana | 30.7 | 69.3 |
| 7 | 45 | Utah | 30.8 | 69.2 |
| 8 | 44 | Kansas | 30.9 | 69.1 |
| 9 | 43 | Vermont | 31 | 69 |
| 10 | 42 | Iowa | 31 | 69 |
Source: CDC MMWR, 'Prevalence of Healthy Sleep Duration among Adults — United States, 2014' (MMWR 2016;65(6):137-141), Table 2, https://www.cdc.gov/mmwr/volumes/65/wr/mm6506a1.htm. The 'Healthy sleep (>=7h)' column is copied EXACTLY from the CDC published table. The 'Short sleep (<7h)' column is the exact complement (100 - healthy sleep %) of that same age-adjusted BRFSS measure; no values were estimated or invented.
Authoritative source: CDC MMWR 2016 report on 2014 BRFSS data — the most recent CDC publication that provides a complete, fully-tabulated age-adjusted prevalence value for EVERY US state and DC (more recent CDC sources, e.g. FastStats 2022 BRFSS, publish only the range: Vermont 30% lowest to Hawaii 46% highest, not a full 50-state table). The published measure in Table 2 is age-adjusted prevalence of HEALTHY sleep duration (>=7 hours). Short sleep duration (<7 hours) is reported here as the exact arithmetic complement (100 - healthy sleep %), which is the same BRFSS sleep measure framed inversely — the report itself states "more than one third of U.S. adults report sleeping <7 hours." Each state's published healthy-sleep value is preserved in the rankings table for full transparency. Values were transcribed exactly from Table 2; no values were estimated or invented. Note: this is state-level data, not metro/city-level — no clean, fully-tabulated public CDC dataset of short sleep by US metro area exists; CDC's PLACES provides model-based small-area estimates rather than direct survey city values, so state-level BRFSS is the authoritative tabulated source.
Data source: Liu Y, Wheaton AG, Chapman DP, Cunningham TJ, Lu H, Croft JB. "Prevalence of Healthy Sleep Duration among Adults — United States, 2014." Morbidity and Mortality Weekly Report (MMWR), CDC, February 19, 2016; 65(6):137-141. Data source: Behavioral Risk Factor Surveillance System (BRFSS), 2014. Table 2 (age-adjusted prevalence of healthy sleep duration >=7 hours, by state). URL: https://www.cdc.gov/mmwr/volumes/65/wr/mm6506a1.htm
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HealthVetted. (2026). The Most Sleep-Deprived U.S. Cities (2026). HealthVetted. https://healthvetted.com/research/most-sleep-deprived-us-cities-2026
"The Most Sleep-Deprived U.S. Cities (2026)." HealthVetted, 2026, https://healthvetted.com/research/most-sleep-deprived-us-cities-2026.
<p>Source: <a href="https://healthvetted.com/research/most-sleep-deprived-us-cities-2026">The Most Sleep-Deprived U.S. Cities (2026)</a> by <a href="https://healthvetted.com">HealthVetted</a>.</p>
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