Recent work has highlighted important gaps in insomnia research, seeking to identify contributors to insomnia severity1 and engagement with treatment.2 However, one area that remains overlooked is the role of bedtime procrastination in sleep disturbances and disorders. We propose that bedtime procrastination is a nuanced sleep concern that warrants immediate attention in terms of its relationship with established sleep disturbances such as insomnia, obstructive sleep apnea, and on-call work schedules.
Bedtime procrastination is the volitional delay of sleep in the absence of external factors, where one anticipates being worse off due to the delay.3 More than 50% of the general population report procrastinating their bedtime 2 or more nights per week,4 a behavior associated with shorter sleep duration, lower sleep quality, and increased daytime fatigue.5 Motivations to procrastinate bedtime are broad, including reducing negative emotions, a desire for me-time and entertainment, and may be driven by habit.6,7 The bedtime procrastination literature has recently seen significant growth, more than doubling during the 2020–2021 period.5 However, despite this burgeoning field of research, little attention has been given to the relationship between bedtime procrastination and sleep disturbances or disorders.
Emerging evidence points to a potential link between bedtime procrastination and insomnia. Clinical insomnia symptoms are prevalent in almost 15% of the global population,8,9 with up to 35% of adults experiencing subclinical symptoms.10 Hallmark characteristics of insomnia, such as difficulty initiating sleep and delayed sleep onset, are also described as motivations to procrastinate bedtime when people do not feel sleepy.6,7 Bedtime procrastination has been linked to increased insomnia severity11 and increased sleep effort, which can exacerbate insomnia severity.12 It may be that individuals with higher levels of sleep effort engage in bedtime procrastination as an avoidance or safety behavior to reduce anxiety about not being able to fall asleep.12 Further, as a mediator between emotional regulation and insomnia severity,13 bedtime procrastination may be used as a coping mechanism by those who struggle with emotional regulation, which in turn can worsen insomnia severity. Future research is needed to investigate the specific drivers of bedtime procrastination (eg, negative pre-sleep emotions, anxiety about being unable to fall asleep, self-administered sleep restriction, poor stimulus control) and procrastination behaviors in specific populations, such as those with insomnia, obstructive sleep apnea, and on-call and shift workers. A more nuanced understanding of these drivers, and a determination of whether a subtype of insomnia exists that engages in bedtime procrastination, is essential to improve public sleep health.
Notably, sleep-related anxiety is described as a motivation to procrastinate bedtime,6 with technology use commonly serving as a pre-sleep emotional regulation tool.6,14 Sleep-related anxiety can also occur among individuals with sleep disorders and variable work schedules: sleep-related worry contributes to difficulties with sleep onset in insomnia,15 individuals with obstructive sleep apnea report fear of going to bed due to concerns about adverse events during sleep,16 and pre-sleep anxiety impacts on-call workers, particularly when the chance of missing an alarm is high.17 Individuals in these populations may use bedtime procrastination behaviors to alleviate pre-sleep anxiety, potentially worsening sleep outcomes. Given the prevalence of bedtime procrastination in public health messaging around sleep, understanding its role within the context of other sleep disturbances or disorders is essential.
As the populations who engage in bedtime procrastination are diverse with varied motivations, a one-size-fits-all approach to reducing bedtime procrastination may not be effective. Personalized interventions have shown promise in reducing bedtime procrastination,18 although are yet to be developed for and tested in individuals with insomnia or other sleep disorders. Further, although cognitive behavioral therapy for insomnia is the gold standard treatment for insomnia,19 cognitive behavioral therapy for insomnia has not been effective in reducing bedtime procrastination.20 As bedtime procrastination may co-occur with and exacerbate sleep disturbances or disorders, interventions likely need to be tailored to these populations.
In summary, bedtime procrastination is a prevalent sleep concern that may present differently in individuals with sleep disturbances or disorders. Given the body of observational research on bedtime procrastination is predominantly in university student populations, future research should prioritize populations with sleep disturbances and/or disorders, or those with specific occupational demands. Shifting focus from considering bedtime procrastination a single phenomenon and understanding how and why bedtime procrastination manifests within specific populations and sleep disorders holds promise in improving sleep health outcomes.
DISCLOSURE STATEMENT
All authors have seen and approved this manuscript. V.M.H. is a paid advisor to Samsung Health. H.M., S.A.F., M.J., A.L.R., and G.E.V. have no conflicts of interest to declare.
Citation: Hill VM, Meaklim H, Ferguson SA, Junge M, Rebar AL, Vincent GE. Bedtime procrastination and sleep disturbances: a call for targeted research and interventions to improve sleep health. J Clin Sleep Med. 2025;21(1):219–220.
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