Distinct Sleep Patterns Linked to Health Outcomes

Summary: Researchers have identified four distinct sleep patterns linked to long-term health outcomes, revealing the profound impact of sleep habits on chronic health conditions.

Utilizing data from the Midlife in the United States study, the team found that “insomnia sleepers” and “nappers” dominate the population, with insomnia sleepers facing a higher risk of chronic illnesses like cardiovascular disease, diabetes, and depression over a decade. The study emphasizes the challenge in changing sleep habits, underscoring the need for public education on sleep hygiene to improve overall health.

This research highlights the necessity for tailored interventions to promote healthy sleep, considering the significant role of sleep in healthy aging and chronic disease prevention.

Key Facts:

  1. Four sleep patterns identified: Good sleepers, Weekend catch-up sleepers, Insomnia sleepers, and Nappers, with insomnia sleepers and nappers most common and linked to higher chronic health risks.
  2. Over a 10-year period, sleep patterns largely remained consistent, especially among insomnia sleepers and nappers, suggesting entrenched sleep habits.
  3. The study, funded by the National Institute on Aging, indicates the influence of socioeconomic factors on sleep patterns and highlights the importance of societal support for improving sleep health.

Source: Penn State

Poor sleep habits are strongly associated with long-term chronic health conditions, according to decades of research.

To better understand this relationship, a team led by researchers in Penn State’s College of Health and Human Development identified four distinct patterns that characterize how most people sleep. These patterns are also predictive of long-term health, the researchers said.

Soomi Lee, associate professor of human development and family studies at Penn State, led a team in identifying these sleep patterns and their correlation to overall health.

Their results were published in Psychosomatic Medicine.

This shows a person sleeping.
The identification of distinct sleep patterns also suggests that these prevention programs should not be one-size-fits-all and can be targeted based on a variety of factors, including the risk of chronic conditions and socioeconomic vulnerability. Credit: Neuroscience News

Using a national sample of adults from the Midlife in the United States study, the team gathered data on approximately 3,700 participants’ sleep habits and their chronic health conditions across two time points 10 years apart.

The data included self-reported sleep habits, including sleep regularity and duration, perceived sleep satisfaction and daytime alertness, as well as the number and type of chronic conditions.

Researchers used the data to identify four different sleep patterns.

  • Good sleepers, who are characterized by optimal sleep habits across all datapoints.
  • Weekend catch-up sleepers, who are characterized by irregular sleep, specifically short average sleep duration, but longer sleep times on weekends or non-workdays.
  • Insomnia sleepers, who are characterized by sleep problems related to clinical insomnia symptoms, including short sleep duration, high daytime tiredness and a long time to fall asleep.
  • Nappers, who are characterized by mostly good sleep but frequent daytime naps.

Researchers found that more than half of participants were identified as insomnia sleepers or nappers, both of which are suboptimal sleep patterns. Additionally, being an insomnia sleeper over the 10-year period was associated with a significantly higher likelihood of chronic health conditions, including cardiovascular disease, diabetes and depression.

Results also showed that people were unlikely to change their sleep pattern over the course of the 10 years. This was especially true for insomnia sleepers and nappers. The MIDUS study may not represent the entire population, researchers said, as it primarily comprises healthy adults, but — despite this — most participants displayed suboptimal insomnia sleeper or napper sleep patterns.

“These results may suggest that it is very difficult to change our sleep habits because sleep health is embedded into our overall lifestyle. It may also suggest that people still don’t know about the importance of their sleep and about sleep health behaviors,” Lee said.

“We need to make more efforts to educate the public about good sleep health. There are sleep hygiene behaviors that people could do to improve their sleep, such as not using cell phones in bed, exercising regularly and avoiding caffeine in the late afternoon.”

While the sleep patterns were seemingly not age-related, researchers found that older adults and retirees were more likely to be nappers. They also found that those with less education and those facing unemployment were more likely to be insomnia sleepers.

According to Lee, the fact that phase of life and economic conditions can influence longstanding sleep patterns suggests that societal and neighborhood influences — including economic stressors and access to health resources — may have significant effects on individual health and, in this case, sleep habits.

All these findings strongly suggest the need for programs and interventions to promote healthy sleep and sleep habits, the researchers said. The identification of distinct sleep patterns also suggests that these prevention programs should not be one-size-fits-all and can be targeted based on a variety of factors, including the risk of chronic conditions and socioeconomic vulnerability.

“Sleep is an everyday behavior,” Lee said.

“Sleep is also modifiable, So, if we can improve sleep almost every day, what outcomes might we see after several months, or even several years? Better sleeping habits can make many significant differences, from improving social relationships and work performance to promoting long-term healthy behaviors and healthy aging.”

Other researchers from Penn State on the team included Orfeu Buxton, professor of biobehavioral health and associate director of Clinical and Translational Science Institute, and David Almeida, professor of human development and family studies. Additional collaborators included Claire E. Smith, assistant professor of psychology, University of South Florida; Meredith Wallace, associate professor of psychiatry and biostatistics, University of Pittsburgh; Sanjay R. Patel, professor of medicine and epidemiology, University of Pittsburgh; and Ross Andel, professor in the Edson College of Nursing and Health Innovation, Arizona State University.

Funding: The National Institutes of Health’s National Institute on Aging funded this study.

About this sleep and health research news

Author: Sara LaJeunesse
Source: Penn State
Contact: Sara LaJeunesse – Penn State
Image: The image is credited to Neuroscience News

Original Research: Closed access.
10-year Stability of an Insomnia Sleeper Phenotype and Its Association with Chronic Conditions” by Soomi Lee et al. Psychosomatic Medicine


10-year Stability of an Insomnia Sleeper Phenotype and Its Association with Chronic Conditions


To identify distinct sleep health phenotypes in adults, examine transitions in sleep health phenotypes over time and subsequently relate these to the risk of chronic conditions.


A national sample of adults from the Midlife in the United States study (N = 3,683) provided longitudinal data with two timepoints (T1:2004-2006, T2:2013-2017). Participants self-reported on sleep health (regularity, satisfaction, alertness, efficiency, duration) and the number and type of chronic conditions. Covariates included age, sex, race, education, education, partnered status, number of children, work status, smoking, alcohol, and physical activity.


Latent transition analysis identified four sleep health phenotypes across both timepoints: good sleepersinsomnia sleepersweekend catch-up sleepers, and nappers. Between T1 to T2, the majority (77%) maintained their phenotype, with the nappers and insomnia sleepers being the most stable. In fully adjusted models with good sleepers at both timepoints as the reference, being an insomnia sleeper at either timepoint was related to having an increased number of total chronic conditions by 28-81% at T2, adjusting for T1 conditions. 

Insomnia sleepers at both timepoints were at 72-188% higher risk for cardiovascular disease, diabetes, depression, and frailty. Being a napper at any timepoint related to increased risks for diabetes, cancer, and frailty. Being a weekend catch-up sleeper was not associated with chronic conditions. Those with lower education and unemployed were more likely to be insomnia sleepers; older adults and retirees were more likely to be nappers.


Findings indicate heightened risk of chronic conditions involved in suboptimal sleep health phenotypes, mainly insomnia sleepers.

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