Sleep Health Research Abstract

Prevalence, Disturbance, and Daytime Burden of Poor Sleep, and Its Bidirectional Link with Stress: Findings from a Cross-Sectional Survey of 545 Adults

June 2026

Key Findings

1. Insufficient sleep was the norm: 77.4% of respondents averaged fewer than seven hours a night and 47.1% fewer than six, well below recommended levels for adult health.
   
2. Sleep disturbance was frequent and near-universal: 72.5% had trouble sleeping on three or more nights a week, and 85.7% reported at least one ongoing sleep difficulty, most commonly waking through the night (60.2%) and not waking refreshed (53.4%).
   
3. Poor sleep carried a heavy daytime burden, led by low energy (66.6%), impaired concentration and productivity (56.9%), irritability (47.2%), and anxiety (42.6%).
   
4. Sleep and stress were tightly and bidirectionally linked: 75.0% said their sleep quality worsens with stress, 30.8% struggle to sleep specifically because of stress or anxiety, and 42.6% said poor sleep itself causes anxiety, a self-reinforcing cycle further compounded by diet, with 57.4% eating less healthily when sleep is poor.
   
5. Lifestyle-based strategies were rated most effective for sleep: meditation (92.3%) and daytime exercise (89.1%) outperformed supplements (75.1%) and sleep-promoting foods (74.3%), though uptake of the most effective approaches remained modest.

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Background

Sleep is a foundational determinant of physical and mental health, yet insufficient and poor-quality sleep is increasingly common and frequently co-occurs with stress, low mood, and impaired daytime functioning. The relationship between sleep, stress, and diet is recognised as bidirectional and self-reinforcing, but the day-to-day burden of poor sleep and the strategies people use to address it are often under-characterised outside clinical settings. This study aimed to characterise sleep duration and disturbance across a broad adult sample, the specific difficulties and daytime symptoms associated with poor sleep, the interrelationship between sleep and stress, and the sleep aids people use together with their perceived effectiveness. The survey was conducted by DR.VEGAN^®.

Methods

A cross-sectional online survey was administered to 545 adults. Individual-level response data were available for all analyses. The survey captured average nightly sleep duration and the number of nights per week with trouble sleeping; the specific sleep difficulties experienced (multiple responses permitted); the daytime symptoms attributed to poor sleep; the timing of the last meal before bed; beliefs about the influence of diet on sleep and the bidirectional relationship between sleep and stress; and the strategies used to sleep better, each rated for perceived effectiveness. Sleep-duration and disturbance-frequency percentages are reported among respondents who answered those items (n=473 and n=443 respectively); all other percentages are of the full sample. The sample skewed female (86.8%) and toward midlife and older adults, with 75.2% aged 45 or over.

Results

Sleep duration and disturbance

Insufficient sleep was the prevailing pattern. Among the 473 respondents reporting their sleep duration, 77.4% averaged fewer than seven hours per night and 47.1% fewer than six. Disturbance was both frequent and widespread: of the 443 reporting disturbance frequency, 72.5% had trouble sleeping on three or more nights a week and 40.6% on five to seven nights. Across the full sample, 85.7% reported at least one ongoing sleep difficulty. See Figure 1.

Nature of sleep difficulties

The dominant difficulties were those of sleep maintenance rather than sleep onset. Waking up throughout the night was the most common (60.2%), followed by not waking refreshed (53.4%) and waking too early and being unable to return to sleep (45.0%). Stress or anxiety was named as the specific cause of difficulty getting to sleep by 30.8%. See Figure 2.

Daytime burden of poor sleep

The daytime consequences of poor sleep were substantial and dominated by energy and cognitive effects. Low energy was the most commonly reported consequence (66.6%), followed by impaired concentration and productivity (56.9%), irritability (47.2%), and anxiety (42.6%). Memory, headaches, gut health, and susceptibility to illness were also notably affected. See Figure 3.

The sleep–stress–diet cycle and management strategies

Sleep and stress were tightly interlinked in both directions: 75.0% said their sleep quality worsens with stress, while 42.6% said poor sleep itself causes anxiety — a bidirectional loop further reinforced by diet, with 57.4% eating less healthily when their sleep is poor. In managing sleep, lifestyle strategies were rated most effective: meditation (92.3%) and daytime exercise (89.1%) outperformed vitamins and supplements (75.1%) and sleep-promoting foods (74.3%). However, the most effective strategies were not always the most used — meditation was used by only 17.2% despite the highest effectiveness rating. See Figure 4.

Conclusions

This survey of 545 adults reveals a high burden of insufficient and disturbed sleep, with more than three-quarters sleeping under seven hours a night, nearly three-quarters disturbed on three or more nights a week, and a daytime toll dominated by low energy, impaired concentration, and mood disturbance. The difficulties reported were predominantly those of sleep maintenance, waking through the night and unrefreshing sleep, rather than sleep onset, which has implications for the types of intervention most likely to help. Most striking is the tight, bidirectional coupling between sleep and stress: poor sleep worsens with stress and itself generates anxiety, and this loop is compounded by deteriorating diet, pointing clearly to the value of integrated approaches that address sleep, stress, and nutrition together rather than in isolation. Encouragingly, the strategies rated most effective, meditation, daytime exercise, and nutritional support, are accessible and lifestyle-based, yet the most effective were not always the most widely adopted, suggesting an opportunity to better align behaviour with what works. As a self-reported, cross-sectional survey of a predominantly female, midlife sample, these findings describe associations rather than causal relationships; prospective research would be required to establish the direction and mechanism of the observed sleep–stress–diet links.

Keywords: sleep, insomnia, sleep disturbance, sleep maintenance, daytime fatigue, stress, sleep–stress cycle, diet and sleep, lifestyle intervention, cross-sectional survey

Survey date: 2024–2025  |  Sample size: N = 545  |  Population: 87% female; 75% aged 45+  |  Data type: Individual-level responses  

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