Sleep is a pillar of health: sleeping too little or poorly increases, over time, the risk of cardiovascular disease, obesity and diabetes, and takes a toll on your mood. The prevention check-up helps identify poor sleep, signs of sleep apnea and the habits worth changing, and then refers you to your regular doctor if needed.
Why is sleep a health issue?
Because insufficient or poor-quality sleep is not just a matter of being tired: it affects blood pressure, blood sugar, appetite, mood and alertness. Inserm, the French National Institute of Health and Medical Research, sums up the available data in one sentence: poor sleep increases the risk of cardiovascular disease, obesity, diabetes, cancer and accidents. It is a common problem that we see every day in our consultations, even when it is not always named.
The figures from the 2024 Health Barometer survey by Santé publique France, the French public health agency, show the scale of the issue. Adults aged 18 to 79 report sleeping an average of 7 hours 32 minutes per 24 hours, but 21.5% of them are “short sleepers,” at 6 hours or less a night; men and people aged 40–59 are the most affected. One in three adults complains of insomnia, meaning difficulty falling asleep or waking up during the night, peaking at 43.4% among women aged 70 to 79. Sleep is also socially unequal, poorer among manual workers, clerical and service workers, and people in financial difficulty.
How many hours of sleep do you need at each age?
For adults, Inserm notes that at least 7 hours of sleep a night is generally recommended. Actual needs vary from person to person: some people are naturally short sleepers, others need 9 hours, and needs decrease slightly with age while sleep becomes more fragmented. So the right question is not just “how many hours?” but “do I wake up rested, and can I get through the day without dozing off?”
| Age | Nightly duration guideline | What changes at this age |
|---|---|---|
| Ages 18–25 | 7 to 9 hours | Body clock naturally shifted toward the evening, screens, irregular schedules between weekdays and weekends |
| Ages 26–64 | 7 to 9 hours | Work and family load, coffee to compensate, first signs of snoring, perimenopause in women |
| 65 and older | 7 to 8 hours | Lighter, more fragmented sleep, earlier bedtimes and wake-up times, naps, more frequent use of sleeping pills |
Regularity matters as much as duration: going to bed and getting up at similar times every day stabilizes the body clock. And sleeping a lot without feeling rested is a signal in itself: it is one of the situations that raise the possibility of sleep apnea.
Which warning signs should prompt action?
Poor sleep is worth discussing with a professional when it persists, when it affects your day, or when it comes with snoring and pauses in breathing. Here are the questions we ask in consultations, similar to those in the check-up’s self-assessment questionnaire.
- It takes you more than thirty minutes to fall asleep, or you wake up at night and cannot get back to sleep, several nights a week, for several months. This is the usual definition of chronic insomnia.
- You doze off during the day: in meetings, in front of a screen, at the wheel. Drowsiness while driving is a signal to take very seriously.
- Your partner describes loud snoring and pauses in your breathing, followed by noisy gasping.
- You wake up with headaches or a dry mouth, or you get up several times to urinate.
- You take a sleeping pill regularly, or you are increasing the dose.
- Your mood is changing: irritability, anxiety, loss of motivation. Sleep and mood often deteriorate together, as we explain on our page about mental health in the prevention check-up.
None of these signs is enough to make a diagnosis. Their value is in starting a conversation and then, if needed, an assessment by your regular doctor.
Sleep apnea: how can you spot it?
Obstructive sleep apnea-hypopnea syndrome (OSAHS) is characterized by abnormally frequent interruptions (apneas) or reductions (hypopneas) in breathing during sleep, as defined by French National Health Insurance (Assurance Maladie). It is widely underdiagnosed, because the person who has it is not aware of it: it is often those around them who raise the alarm.
The figures vary depending on how it is measured. In 2014, the French National Authority for Health (HAS) cited about 4% of the French adult population; more recent estimates relayed by French National Health Insurance, based on sleep recordings, are considerably higher and rise sharply with age: 7.9% between 20 and 44, 19.7% between 45 and 64, and 30.5% from age 65. Men are about twice as affected as women, but the gap narrows after menopause.
Factors that contribute to sleep apnea
Excess weight is the leading one: according to French National Health Insurance, more than 60% of people with metabolic syndrome have sleep apnea. Next come age, being male, alcohol and tobacco, which worsen symptoms, and certain anatomical features (nasal obstruction, enlarged tonsils, a receding jaw).
Symptoms to know
The HAS lists six symptoms whose combination suggests the diagnosis: daytime sleepiness, severe snoring every night, a feeling of choking or suffocating during sleep, daytime fatigue, needing to urinate at night (nocturia) and morning headaches. French National Health Insurance adds memory and concentration problems. Short questionnaires exist to estimate the likelihood of sleep apnea before any testing; they point the way, but they do not diagnose.
How is it diagnosed, and what comes next?
The diagnosis relies on a sleep recording prescribed by a doctor — respiratory polygraphy at home or polysomnography in a sleep center — which measures the apnea-hypopnea index. Depending on severity and associated conditions, the HAS recommends continuous positive airway pressure (CPAP) for severe forms, a mandibular advancement device for moderate forms without serious cardiovascular disease, and in all cases lifestyle and dietary measures. The choice is an individual medical decision; the role of the prevention check-up is to bring the question to light and to refer you.
How are sleep, the heart and metabolism linked?
Short or broken sleep is not neutral for the heart or for blood sugar. Inserm reports that sleeping less than 6 hours a night increases the risk of type 2 diabetes by 28%, and lists cardiovascular disease, obesity and diabetes among the documented consequences of poor sleep. The mechanisms are multiple: appetite hormones, the stress system, blood pressure that does not come down at night, inflammation.
Sleep apnea concentrates these effects. French National Health Insurance lists its complications: high blood pressure, coronary artery disease, heart failure, heart rhythm disorders, stroke and diabetes, with an overall increase in cardiovascular mortality.
That is why sleep belongs in any discussion of cardiovascular risk: someone who snores, dozes off during the day and has blood pressure that is hard to control should be checked for sleep apnea. We explain how this risk is estimated on our page about 10-year cardiovascular risk, and why it is central to the prevention check-up at ages 45–50.
How does the prevention check-up address sleep?
Sleep is one of the official topics of Mon bilan prévention, France’s national prevention check-up program, an appointment fully covered (100%) by French National Health Insurance at four key stages of adult life. The self-assessment questionnaire you complete before the appointment includes questions about your sleep; the professional goes over them with you, and together you decide whether it is one of the priorities to include in your Personalized Prevention Plan. We describe the full framework on our reference page about the prevention check-up.
What the check-up picks up changes with age:
- At ages 18–25, it is mainly shifted schedules, late-night screens and sleep debt offset with caffeine, often linked to the stress of studying.
- At 45–50, it is mental load, waking up at night, the first signs of snoring in men and perimenopausal sleep problems in women.
- At ages 60–65 and 70–75, it is fragmented sleep, naps that push the night back, regular use of sleeping pills and the high prevalence of sleep apnea.
The check-up includes no examination: it does not diagnose insomnia or sleep apnea. It lets you name the problem, choose one concrete lever and be referred to your regular doctor when an assessment is needed. You can prepare for this conversation by looking at the prevention check-up questionnaire.
Which habits actually improve sleep?
The recommendations of the HAS and the SFTG (Société de formation thérapeutique du généraliste, a French general practice training society) on insomnia in adults, approved in December 2006, put non-drug measures first: sleep hygiene rules, regulation of the sleep-wake cycle and behavioral therapies. Sleeping pills are reserved for cautious, temporary use, particularly in older adults.
In practice, here are the levers we suggest most often, to be tried one at a time rather than all at once:
- A regular schedule, with a consistent wake-up time seven days a week: this is the most powerful setting for the body clock.
- Light in the morning and physical activity during the day, avoiding intense exercise in the two hours before bedtime.
- Less caffeine after lunch, less alcohol in the evening: alcohol helps you fall asleep but then fragments the second half of the night and worsens snoring.
- Screens off before bed and a cool, dark, quiet bedroom, used only for sleep.
- A short nap, early in the afternoon, if you need one; no long naps that “eat into” the following night.
- A sleep diary for two or three weeks: bedtimes, wake-up times, night wakings, naps, coffee, alcohol. It is the first tool your doctor will ask for.
When should you see someone, and who?
See your regular doctor (médecin traitant) if your sleep problems have lasted more than three months, if you doze off during the day, if someone describes snoring with pauses in your breathing, if you take a sleeping pill regularly, or if your mood is deteriorating along with your nights. Your regular doctor does the initial sorting, looks for a cause (pain, medication, thyroid, anxiety, depression) and refers you if needed.
Depending on the situation, your doctor may refer you to a sleep center, a pulmonologist or an ENT specialist to look for sleep apnea, or to a psychologist for cognitive behavioral therapy for insomnia, possibly through Mon soutien psy, France’s covered psychologist sessions program (see our page on mental health). Two situations should not wait: drowsiness at the wheel, and dark thoughts associated with insomnia.
Key takeaways
- Sleep is a health determinant in its own right: sleeping less than 6 hours is associated with an increased risk of diabetes and cardiovascular disease (Inserm).
- In 2024, one adult in five slept 6 hours or less and one in three complained of insomnia (Santé publique France).
- Snoring with pauses, daytime sleepiness, morning headaches: these signs suggest sleep apnea, which is very common after 45 and underdiagnosed.
- The prevention check-up identifies poor sleep and refers you; it does not replace a sleep study or a consultation.
- Regular schedules, daylight, physical activity, less alcohol and fewer screens in the evening: non-drug measures are the recommended first step.
What Sokrate lets you do
The Sokrate service lets you prepare your prevention check-up online with an adaptive questionnaire covering nine dimensions of health, including sleep. Your answers are summarized in a Personalized Prevention Plan written and signed by a doctor, sent to your regular doctor unless you object, and a coordinating nurse provides follow-up. The check-up remains fully covered (100%) by French National Health Insurance when carried out by an authorized professional. To be notified when the service opens, join the waitlist.