Sleep and Mood: What 2,956 US Counties Show

Everyone knows a bad night makes a bad day more likely. What is less obvious is how tightly the two move together at the scale of a whole country. We wanted a number, so we went to the largest public dataset that measures both.

The data

The CDC's PLACES project publishes model-based estimates for every US county, built on the Behavioral Risk Factor Surveillance System. Two of its measures line up with what a mood tracker records each morning and evening:

• Short sleep: the share of adults who report sleeping fewer than 7 hours on average.

• Frequent mental distress: the share of adults who report 14 or more days in the past month when their mental health was not good.

We downloaded the 2025 release, which uses 2023 BRFSS data, from the CDC open data portal, kept the age-adjusted estimate of each measure, and matched them by county. That gave 2,956 counties with both numbers. We then computed the correlation, split the counties into five equal groups by their short-sleep rate, and compared the ends of the distribution.

What the counties show

Nationally, PLACES estimates that 36.8% of adults sleep fewer than 7 hours and 16.3% report frequent mental distress. Across counties, the two rise together:

• The correlation between a county's short-sleep rate and its frequent-mental-distress rate is 0.63. In plain terms, about 39% of the county-to-county variation in frequent mental distress lines up with variation in short sleep.

• The fitted line has a slope of 0.31: a county where 10 percentage points more adults sleep short tends to have about 3 points more adults in frequent mental distress.

Sorted into fifths by short sleep, with the average frequent-mental-distress rate for each:

1. Best-sleeping fifth (24.7% to 33.4% sleeping short, average 31.4%): 16.8% in frequent mental distress.

2. Second fifth (average 34.8% short sleep): 17.8%.

3. Middle fifth (average 37.3%): 18.6%.

4. Fourth fifth (average 39.4%): 19.4%.

5. Worst-sleeping fifth (40.5% to 51.0%, average 42.6%): 20.3%.

Every step up in short sleep is a step up in distress, with no reversal anywhere on the ladder. At the extremes the gap is larger. The 100 counties with the least short sleep (average 28.6%) have a frequent-distress rate of 16.1%. The 100 counties with the most short sleep (average 45.9%) sit at 21.3%, roughly a third higher.

One more way to see it: split the counties in half by short sleep. Among the better-sleeping half, 24% of counties are above the median county for frequent mental distress. Among the worse-sleeping half, 72% are.

The best-sleeping county in the set is Boulder, Colorado, where 24.7% of adults sleep short and 15.4% report frequent distress. At the other end, Greene County, Alabama has 51.0% short sleep and 21.5% frequent distress.

What this does and does not mean

This is a county-level comparison, not a study of individuals. Counties with more short sleep also tend to have more shift work, lower incomes, and worse physical health, and those travel with mental distress on their own. The estimates are modeled from survey responses, not a census of every resident. So the number says that sleep and mood are strongly linked across the country. It does not say how much of your own low mood a better night would fix.

That is a question only your own data can answer.

Finding your own number

The county data is a map; your own entries are the territory. The way to find out whether sleep drives your mood is to record both for a couple of weeks, with the sleep note made in the morning before the day has a chance to color it, and the mood note made in the evening.

Then look at the low days as a group and ask what the previous night looked like. If most of them follow a short night, you have found the lever that matters most for you. If they do not, you have ruled out the most common suspect and can look at the next one.

This is why Mood Textapp asks two questions a day rather than one: how you slept, each morning, and how the day was, each evening. The patterns summary puts the two side by side over the last two weeks.

Sleep problems that last for weeks, or low mood that does not lift, are worth a conversation with a doctor. If you are in crisis, call or text 988 for the 988 Suicide & Crisis Lifeline.

Try it by text

Text Hi to (572) 223-3345 to start Mood Textapp. It works on any phone that can text, with no app to install and no account to create. Each morning it asks how you slept, each evening how your day was, and you answer in a few words. Ask for your patterns whenever you want to see how the two line up.

Your first 20 messages are free. After that, one $9.99 a month subscription covers every Textapp. Details are on the Mood Textapp page. Text STOP at any time to end it.