SLEEP, Vol. 32, No. 6, 2009
CURRENT ESTIMATES INDICATE THAT 20%1 TO 40%2 OF
THE ADULT US POPULATION SLEEP LESS ON WEEK-
DAY NIGHTS THAN THE 7 TO 8 HOURS THOUGHT TO
be needed by the majority of people to maintain behavioral
alertness and avoid sleepiness-related risks of errors and acci-
dents.3,4 The percentage of short sleepers may be even higher
than self-report surveys suggest, because physiological sleep
duration has been found to be as much as an hour or more below
habitual sleep duration as reported in population studies.5,6 The
issue of how much sleep people are obtaining nightly and what
factors influence the habitual duration of sleep are important
because reduced sleep duration has frequently been associated
with a higher prevalence of obesity,7 morbidity, and mortality,8,9
although it is unclear whether these relationships are causal.
This report focuses on lifestyle factors associated with short-
er sleep times, in an effort to identify waking activities under
discretionary control that may be a source for increasing sleep
time in those who need to do so.
Reduced sleep time in industrialized societies is primarily
related to lifestyle. In a recent analysis of time use in the US,
we found that work time was the primary activity that had a re-
ciprocal relationship to sleep time.10 It suggests that Americans
perceive sleep as a flexible commodity that can be exchanged
for waking activities considered more essential or of greater
value. If this is the case, reducing work time and its economic
benefits in order to increase sleep time may not be feasible for
most of the population. This prompted us to ask whether wak-
ing activities under discretionary control and adjacent to the
sleep period may be a better source for increasing sleep time.
The American Time Use Survey (ATUS) is a federally admin-
istered, continuous telephone survey sponsored by the Bureau
of Labor Statistics and conducted by the U.S. Census Bureau.11
ATUS covers all residents living in the 105 million households
in the United States ≥ 15 years of age, with the exception of ac-
tive military personnel and people residing in institutions such
as nursing homes and prisons. People are interviewed once for
15-20 minutes about how they spent their time between 04:00
on the previous day and 04:00 on the interview day. ATUS was
first conducted in 2003. Final annual response rates were 51.2%
(2003), 53.1% (2004), 49.5% (2005), and 55.1% (2006).
For the present analysis, ATUS databases for the years 2003,
2004, 2005, and 2006 were merged. Only weekday interviews
referring to the period Monday 04:00 until Friday 04:00, exclud-
ing holidays or days preceding a holiday, were included in the
analysis, reducing the original sample size of 60,674 to 23,791.
Responses are codified using the ATUS activity classification
system, a 3-tiered system, with 17 major (first-tier) categories,
each having 2 additional levels (tiers) of detail (see ATUS Activ-
ity Lexicon at http://www.bls.gov/tus/ or the appendix of Basner
et al.10). Categories 01.01.01 (“sleeping”), 01.01.02 (“sleepless-
ness”), and 01.01.99 (“sleeping not elsewhere classified”) were
combined as “time in bed” for the analyses, because people usual-
ly either tried to sleep or actually slept. ATUS “activity files” list,
for each respondent, type and duration of all activities performed
SlEEp anD TElEviSiOn
Dubious Bargain: Trading Sleep for Leno and Letterman
Mathias Basner, MD, MS, MSc1,2; David F. Dinges, PhD1
1Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA;
2German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany
Study Objectives: Sleeping less than 7 hours daily impairs alertness
and is associated with increased obesity, morbidity, and mortality; yet
up to 40% of US adults do so. Population data indicate work time is the
primary activity reciprocally related to sleep time in the United States.
Reducing work time and its economic benefits to increase sleep time
may not be feasible for most of the population. We sought to identify
waking activities under discretionary control and adjacent to the sleep
period that would be a more feasible source for increasing sleep time.
Design/participants: American Time Use Survey data from 21,475
respondents aged ≥ 15 years were pooled for the years 2003–2006 to
explore activities in 2-hour periods prior to going to bed and past getting
up on weekdays.
Results: Long workers (≥ 8 hours) terminated bed time an average of
0.68 h earlier than short workers (< 8 hours, P < 0.0001) and 1.31 h
earlier than respondents not working on the interview day (P < 0.001),
but time of going to bed did not differ among groups (22:37 vs. 22:42
vs. 22:37, respectively, P = 0.385). Watching television was the primary
activity people engaged in before going to bed, accounting for 55.6
min (46.3%) of the 2-h pre-bed period. In the morning, travel time and
work time increased steadily toward the end of the post-awakening 2-h
period, accounting for 14.8% and 12.3%, respectively.
Conclusions: Watching television may be an important social Zeitge-
ber for the time of going to bed. Watching less television in the eve-
ning and postponing work start time in the morning appear to be the
candidate behavioral changes for achieving additional sleep. While the
timing of work may not be flexible, giving up some TV viewing in the
evening should be possible to reduce chronic sleep debt and promote
adequate sleep in those who need it.
Keywords: Sleep, Television, Work, Zeitgeber, Mortality, Alertness
Citation: Basner M; Dinges DF. Dubious bargain: trading sleep for
Leno and Letterman. SLEEP 2009;32(6):747-752.
Submitted for publication December, 2008
Submitted in final revised form March, 2009
Accepted for publication March, 2009
Address correspondence to: Mathias Basner, MD, MS, MSc, Division of
Sleep and Chronobiology, Department of Psychiatry, University of Penn-
sylvania School of Medicine, 1013 Blockley Hall, 423 Guardian Drive,
Philadelphia, PA 19104-6021; Tel: (215) 573-9665; Fax: (215) 573-6410;
Sleep, Work, and Television—Basner and Dinges
SLEEP, Vol. 32, No. 6, 2009
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turn off the television and go to bed earlier, or record their fa-
vorite shows and watch them earlier in the evening.
Finally, we note that advancing television viewing in the
evening may not benefit night owls. Social jetlag is very pro-
nounced in late phase chronotypes, as these individuals may
have to get up early due to social demands without being able to
advance their circadian controlled sleep onset.17 Hence, in late
chronotypes watching less TV in the evening may not result in
increased sleep time.
In conclusion, time use surveys of Americans over 14 years
of age suggest that the discretionary time use trade that would
most likely increase sleep time in long workers is an exchange
of evening television time for an earlier bedtime. This could be
accomplished while still working the longer hours many Amer-
icans find necessary.
This research was supported by NIH NR-04281, by Nation-
al Space Biomedical Research Institute through NASA NCC
9-58, and by Institute for Experimental Psychiatry Research
This was not an industry supported study. Dr. Dinges has re-
ceived research support from Cephalon and Merck; has partici-
pated in speaking engagements for Cephalon; and has consulted
for Arena Pharmaceuticals, Cephalon, GlaxoSmithKline, John-
son & Johnson, Merck, Neurogen, Mars, and Sanofi-Aventis.
Dr. Basner has indicated no financial conflicts of interest.
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Sleep, Work, and Television—Basner and Dinges