Clinical Summary
Clinical Summary: Prevalence of Bedtime Procrastination in University Students and Reexamination of the Bedtime Procrastination Scale
University students commonly present with poor sleep, but delayed bedtime without an external barrier is an underrecognized contributor that can worsen daytime functioning and mental health. In this Indian university sample, poor sleep was common and bedtime procrastination was frequent enough to merit direct assessment rather than assuming insomnia is driven by medical or psychiatric illness.
Design
an exploratory, cross-sectional survey
N
560 students
Population
all male and female students who were pursuing their studies in graduate and postgraduate courses at the university
Duration
from November 2021 to December 2021
Key Findings
- Two-fifths of the sample (n = 230, 41.1%) reported affirmatively to the question “Do you suffer from poor sleep?” and 113 students (20.2%) scored 36–45 on the BPS, the study-defined range for bedtime procrastination.
- Students who reported poor sleep (n = 230) had higher mean (SD) BPS total scores than those who did not (n = 330): 31.7 (6.9) versus 27.3 (7.5) (t = 7.08, df = 558, P < .001).
- Students who reported external, environmental, or other factors that interfered with sleep (n = 222) had higher mean (SD) BPS total scores than those who did not (n = 338): 31.0 (7.5) versus 27.9 (7.3) (t = 4.84, df = 558, P < .001).
- Higher BPS total scores correlated with fewer hours of sleep (r = −0.17), more daytime tiredness during the week (r = 0.26), and more days with too little sleep (r = 0.36); all P values were < .001.
- Factor analysis of the 9-item BPS yielded a 2-factor solution: factor 1 explained 29.3% of the variance, factor 2 explained 20.0%, and together the 2 factors explained 49.3% of the variance in the response to the BPS.
Clinical Bottom Line
Bedtime procrastination was common in these university students and tracked with worse sleep, especially in students already reporting poor sleep or external barriers to sleep. Clinically, a complaint of poor sleep in students should prompt direct questions about delayed bedtime behavior, not just insomnia symptoms or psychiatric comorbidity.
Practice Implications
- Ask students with poor sleep whether they are going to bed later than intended, because 41.1% reported poor sleep and those students had higher BPS scores of 31.7 (6.9) versus 27.3 (7.5).
- Do not limit screening by sex or academic stage: BPS scores did not differ between males and females (29.0 [7.5] vs 29.2 [7.6], P = .74) or between students less than halfway through coursework and final-year students (28.6 [7.5] vs 29.9 [7.0], P = .12).
- When sleep problems are attributed to environment or routine, consider bedtime procrastination as part of the formulation, because students reporting external, environmental, or other factors interfering with sleep had higher BPS scores of 31.0 (7.5) versus 27.9 (7.3).
- Use caution when interpreting the Bedtime Procrastination Scale in Indian students, because the questionnaire showed a 2-factor structure with only 49.3% of variance explained, and the split followed forward-scored versus reverse-scored items.
