US adults are losing sleep because they are staying up late to watch television shows or sporting events, playing video games, and reading, new research suggests.
A series of surveys conducted by the American Academy of Sleep Medicine (AASM) showed that, among all 2000 adults surveyed, 88% acknowledged losing sleep because they were staying up late "binge-watching" multiple episodes of a television show or streaming series. This number climbed to 95% in those between 18 and 44 years old.
In addition, half the respondents reported staying up past their bedtime to play video games and almost 60% stayed up late to watch sporting events. The latter was even more common among the men.
Ironically, respondents ranked sleep as one of their most important priorities, second only to family.
"It's encouraging that Americans rank sleep as one of their highest priorities, but choosing to binge on entertainment at night instead of sleeping has serious ramifications," AASM president Kelly A. Carden, MD, sleep physician with Saint Thomas Medical Partners-Sleep Specialists, Nashville, Tennessee, said in a press release.
"Sleep is essential to health, well-being, and safety and chronic insufficient sleep can lead to an increased risk of health problems, mood disorders, and motor vehicle accidents," Carden added.
The findings were published online November 4 on AASM's website.
The proliferation of new streaming platforms has led to concerns about their impact on sleep, Fariha Abbasi-Feinberg, MD, director of sleep medicine at Millennium Physician Group in Fort Myers, Florida, and a member of the board of directors for AASM, told Medscape Medical News.
"There are more digital temptations and we are bombarded by social messages that we need to keep up with these shows, so the question is how watching them affects sleep," she said.
The motivation for the surveys was "to sort through what kinds of distractions they were and their impact" on sleep.
To investigate, AASM commissioned a survey of 2003 US adults aged 18 years or older in September 2019. Participants were asked where sleep ranked in their life priorities, as well as what activities kept them awake past bedtime.
On average, most participants ranked sleep as their second priority.
Entertainment, on the other hand, was ranked as the least important priority for most groups, with the exception of those who were age 65 years or older and those residing in the Midwest region. They ranked entertainment as their fifth priority.
Family was regarded as the most important priority in all age groups, sexes, and geographical regions. On the other hand, men listed work as their third priority, whereas women prioritized nutrition/and diet as third. Older respondents likewise tended to prioritize exercise and nutrition/diet over work.
"What made me laugh a little was that when we asked adults how important sleep was to them, they ranked it as number 2, with family ranked as number 1. But then it turned out that they didn't act on that sense of priority," Abbasi-Feinberg said.
Many participants who stayed up past bedtime felt upset with that behavior, with almost a quarter (24%) reporting feeling "frustrated," followed by 13% who felt "guilty" (margin of error on all percentages, +/− 2 percentage points).
In general, younger people reported the highest level of frustration compared with older individuals.
Generation Z (age 18 - 24 years): 32%
Millennials (age 22 - 38 years): 30%
Generation X (age 39 - 54 years): 24%
Baby Boomers (age 55 - 73): 16%
Silent Generation (age ≥ 75): 10%
Men were more relaxed about staying up past bedtime, while women were more likely to be frustrated (21% vs 14% and 21% vs 27 %, respectively).
"Binge watching," defined as watching multiple episodes of a TV show or streaming video series, was the behavior most implicated in staying up past bedtime; 88% of all respondents reported loss of sleep as a result of this activity.
The group most likely to engage in binge watching was between ages 18 and 44 years, compared with those aged 45 years or older (95% vs 80%, respectively). Close to half (44%) of young adults between ages 18 and 24 years said they "often" stayed up past their bedtime to watch shows.
There were no sex differences in binge-watching patterns.
Video games were another culprit in keeping people up late, with half of respondents reporting loss of sleep by playing video games. Differences in sex and age were found, with men more likely than women and Generation Z more likely than those in other age groups to engage in late-night gaming.
Over half of respondents (58%) reported losing sleep because they stayed up past their bedtime to watch a sporting event, with men more likely than women to engage in this activity (72% vs 45%).
Conversely, women were more likely to stay up late to finish a book (71% vs 61%), and 25- to 44-year-olds were more likely than other age groups to lose sleep because of reading.
"The way we read [books] has changed, because most of us now use electronic readers," Abbasi-Feinberg noted.
Unlike a traditional book with paper pages, e-readers adversely affect the quality of sleep.
Abbasi-Feinberg explained that the negative impact of late-night watching of all electronic devices goes beyond the number of hours of which the user is robbed of sleep.
"We think that the light emitted from these devices can affect melatonin that, under ordinary circumstances, goes up at night — a signal that helps the body to fall asleep," she said. Abbasi-Feinberg added that she advises her patients to stop using electronic devices at least an hour prior to bedtime.
She noted that the AASM recommends approximately 7 hours of sleep per night.
"Sleep helps the brain function, enabling it to form new pathways and retain information in a better way, and we know sleep deficiency can affect the brain and lead to problems during the day, which is why AASM was so concerned about the statistics we found in these surveys," Abbasi-Feinberg said.
Three Pillars of Health
Commenting on the findings for Medscape Medical News, Paul Doghramji, MD, senior faculty practice physician at Collegeville Family Practice and medical director of health services at Ursinus College, Collegeville, Pennsylvania, said that clinicians need to realize they don't know enough about sleep and don't emphasize sleep enough to their patients.
Too little information about sleep "is disseminated in medical school, residency, post-residency, and to practicing clinicians, which is why many clinicians avoid discussing and emphasizing it with their patients," said Doghramji, who is also a member of the board of directors at the National Sleep Foundation.
However, once a clinician is "savvy about the impact of sleep and its effect on patients, clinicians should proactively ask patients about sleep habits at least during annual checkups but also when symptoms suggest it," he added.
Sleep problems can exacerbate issues often associated with other medical or psychiatric conditions, such as fatigue, difficulty concentrating, depression, anxiety, and low energy, he said.
"Clinicians should always inquire about sleep when patients present with these symptoms," said Doghramji.
Abbasi-Feinberg agreed, suggesting that sleep should be considered a "vital sign," and that clinicians should "ask about sleep at every visit."
"We consider sleep to be one of the 'three pillars' of health, along with good nutrition and regular exercise," she concluded.
The survey was funded by the American Academy of Sleep Medicine (AASM). Abbasi-Feinberg reports no relevant financial relationships. Doghramji reports serving on the advisory board for Eisai Pharmaceuticals, Jazz Pharmaceuticals, and Harmony Biosciences.
AASM website. Published November 4, 2019. Survey
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Cite this: Batya Swift Yasgur. Americans Losing Sleep Over Late-Night Binge Watching - Medscape - Nov 13, 2019.