The relationship between bedtime procrastination and high risk for obstructive sleep apnea syndrome in the youth population

Studies have shown that, beyond demographic and obesity-related factors, certain abnormal sleep behaviors are associated with a high risk of obstructive sleep apnea syndrome (OSAS). This study aimed to investigate whether bedtime procrastination (BtP), an unhealthy sleep behavior, is correlated with an increased risk of OSAS. A total of 1,405 Chinese college students (20 ± 1 years old, 37.1% male) participated in this questionnaire-based cross-sectional study. BtP and OSAS risk and symptoms were evaluated using the Bedtime Procrastination Scale (BPS), the STOP-Bang Questionnaire (SBQ), and the Berlin Questionnaire (BQ). Results showed that BPS scores were significantly positively correlated with OSAS symptom scores on both the SBQ and BQ (all <i>p</i> < 0.05). Students at high risk of OSAS had higher BPS scores than those at low risk. BtP, along with male gender and body mass index (BMI), was an independent predictor of OSAS risk (all <i>p</i> < 0.01). The combination of these three variables discriminated OSAS risk with a sensitivity of 62.86% and specificity of 69.68% (AUC = 0.711) for the SBQ, and a sensitivity of 67.03% and specificity of 82.41% (AUC = 0.778) for the BQ. Self-reported data from college students revealed that BtP was independently correlated with increased OSAS risk and symptom severity. Therefore, habitually going to bed later than intended should be considered a potential behavioral risk factor for OSAS among the young population. Combined with gender and BMI, a BPS cutoff score of 2.67 may serve as a supplementary indicator for OSAS screening.