How long have I been out?

A: Are we there?
B: Almost.
A: How long have I been out?
B: About an hour.
A: You should have woken me.
B: I like watching you sleep.

Question: What does “out” mean in the sentence? Does it mean “sleep”?

Thank you!!!

Yes, in this context it means sleepiing. More generally “being out” can refer to any state of unconsciousness.

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Is it okay to use “sleeping” instead?
Such as, “how long have I slept?” or “how long have I been sleeping?”

Yes, both are fine. “How long did I sleep?” would also be a very natural and common way to phrase the question upon waking.

“How long have I been sleeping?” could mean, grammatically, that you are still sleeping. Of course, you couldn’t ask a question like that if you were still sleeping. But in the middle of a long speech you could pause and ask, “How long have I been talking?” You may be done talking, or you may continue to speak. But in either case it indicates ongoing action in the past up to the present. Nevertheless, it would be very common to wake and say, “How long have I been sleeping?”

On the other hand, though you could say, “How long have I slept?” without anyone thinking it unusual, I don’t think that would be a common way to phrase the question. “I have slept” indicates the past, perhaps the distant past, and perhaps not continuous. For example, “I have slept in many hotels.” That is in the past, unconnected to the present (unlike your example situation), and perhaps not at one time but at intervals over a long time.

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Thank you very much for the explanation, khardy.
It’s very helpful!!!