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.
The most sleep-deprived U.S. cities
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:
- Honolulu, HI — 42.3%
- Norfolk, VA — 41.1%
- Richmond, VA — 41.0%
- New Orleans, LA — 39.4%
- Detroit, MI — 38.9%
- Kansas City, MO — 38.8%
- Huntsville, AL — 38.7%
- Toledo, OH — 38.5%
- Philadelphia, PA — 38.4%
- Newark, NJ — 38.4%
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.
Where Americans sleep best
In the same SmartAsset ranking, the least sleep-deprived large cities cluster in the Upper Midwest and Pacific Northwest:
- Minneapolis, MN — 25.4%
- Madison, WI — 25.8%
- Portland, OR — 26.5%
- Seattle, WA — 27.4%
- Denver, CO — 27.5%
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.
A regional, not random, pattern
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.
Sleep deprivation is unequally distributed
The geography of sleep tracks closely with the demographics of disadvantage. CDC data show large, persistent disparities:
- Native Hawaiian and Pacific Islander adults report the highest short sleep of any major group — about 46.5% (age-adjusted, BRFSS 2020).
- Black (non-Hispanic) adults report the next highest — 43.6% (age-adjusted, BRFSS 2020) and 40.2% in the 2024 NHIS.
- White, Hispanic, and Asian adults report markedly lower rates — for example, in the 2024 NHIS, White non-Hispanic adults were at 28.9%, Hispanic adults at 29.0%, and Asian non-Hispanic adults at 27.9%.
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.
Why this matters
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.
How to read these numbers
- These are survey- and model-based estimates, not headcounts. Each city figure carries a margin of error, so cities within a point or two of each other are effectively tied, and rankings can shift between data sets.
- "Short sleep" measures quantity, not quality. An adult who is in bed 7 hours but wakes repeatedly is not counted as sleep-deprived here. The 2024 NHIS separately found 15.4% of adults have trouble falling asleep and 18.1% have trouble staying asleep most days or every day.
- Don't compare across surveys. BRFSS-based rates (around one-third of adults) run a few points higher than the NHIS 2024 estimate (30.5%) because of different questions and methods, not because one is "right."
- City labels actually reflect county data. The city percentages here are mapped from county-level County Health Rankings figures, so they describe the surrounding county, which can differ from the city limits or the broader metro area most people picture.
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.
Sources
- Centers for Disease Control and Prevention (CDC), PLACES Project — Health Risk Behaviors measure definitions (short sleep duration). www.cdc.gov/places/measure-definitions/health-risk-behaviors.html
- CDC, Preventing Chronic Disease — "Prevalence and Geographic Patterns of Self-Reported Short Sleep Duration Among US Adults, 2020." www.cdc.gov/pcd/issues/2023/22_0400.htm
- CDC, National Center for Health Statistics — "Short Sleep Duration and Sleep Difficulties Among Adults: United States, 2024" (Data Brief 559, NHIS). www.cdc.gov/nchs/products/databriefs/db559.htm
- CDC FastStats — "Sleep in Adults." www.cdc.gov/sleep/data-research/facts-stats/adults-sleep-facts-and-stats.html
- County Health Rankings & Roadmaps — "Insufficient Sleep" (BRFSS-based measure). www.countyhealthrankings.org/health-data/community-conditions/health-infrastructure/health-promotion-and-harm-reduction/insufficient-sleep
- SmartAsset — "Americans Sleep Least in These U.S. Cities (2024 Study)." smartasset.com/data-studies/insufficient-sleep-2024
- Innerbody Research — "The Most (and Least) Sleep-Deprived US Cities." www.innerbody.com/most-sleep-deprived-cities