Satisfaction with life in relation to sleep health among a nationally representative sample of U.S. adults

Purpose: To investigate associations between life satisfaction and sleep health among adults in the United States. Methods: We analyzed cross-sectional, nationally-representative data from the 2022 National Health Interview Survey. Life satisfaction was dichotomized as 'very satisfied/satisfied' vs. 'dissatisfied/very dissatisfied.' Sleep duration was defined as 'recommended' vs. 'short' (≥7 vs.<7 hours), frequent insomnia symptoms as difficulty falling/staying asleep: 'yes' [most days/every day to either] vs. 'no' [never/some days for both]), and restorative sleep as feeling well rested in the past 30 days: 'yes' [never/some days] vs. 'no' [most days/every day]. Using survey-weighted Poisson regression with robust variance adjusting for confounders, we estimated prevalence ratios (aPR) and 95% confidence intervals (CI) overall and by age, sex, race, and ethnicity to test for effect modification. Results: Among 25,090 adults (mean age of 48.1±0.17 years; 54% women), 96.0% reported life satisfaction with comparable prevalence across age: 18-30 years [96.3%], 31-49 years [96.6%], and ≥50 years [95.3%]; and among men [95.8%] along with women [96.1%]. Prevalence by race and ethnicity ranged from 93.5% [non-Hispanic (NH)-Multiracial/other] to 98.3% [NH-Asian]. Life satisfaction vs. dissatisfaction was associated with recommended sleep duration (aPR:1.14 [95% CI:1.07-1.21]), restorative sleep (aPR:1.61 [95% CI:1.45 -1.79]), and infrequent insomnia symptoms (aPR:1.25 [95% CI:1.16-1.33]) even after further adjustment. Although life satisfaction varied by age, sex, race, and ethnicity, they did not modify associations between life satisfaction and sleep. Conclusions: Life satisfaction was associated with recommended sleep duration, infrequent insomnia symptoms, and restorative sleep. Pathways underlying the life satisfaction-sleep relationship should be identified to inform interventions.