Bedtime Procrastination in Healthy Adolescents and Adults: a Systematic Review and Meta-Analysis

Abstract Background Bedtime Procrastination (BP) is defined as failing to go to bed at the intended time, while no external circumstances prevent a person from doing so. BP seems to cause sleep insufficiency (<6 hours, affecting up to a ⅓ of Europeans), decrease sleep quality and disrupt circadian rhythms. A review of studies assessing BP prevalence and its correlation with sleep outcomes could provide a more unified understanding of its burden on the population and better aimed interventions. Methods We conducted a systematic review following the PRISMA guidelines. Studies were searched in PubMed, Scopus, PsycINFO. Observational studies published from 2014 to March 2025 were included if they measured BP or its correlation with sleep outcomes (sleep quality, sleep duration, daytime fatigue), self-control, and chronotype in healthy individuals over 12 years old. Every record was screened in blind by two different researchers. Results In our preliminary findings 1772 records were screened, 35 were included. 22 employed a cross-sectional study design, 32 used the BP Scale, 33 studies were conducted on students; 15 reported correlation between BP and sleep quality, 12 sleep duration, 6 daytime fatigue, 15 self-control, 7 chronotype. 6 records assessed the point prevalence of high/low BP, finding a prevalence of high BP ranging from 16% to 50,9%, though using different cut-offs. Conclusions Our results are aligned with the known correlations between BP and worse sleep outcomes. The current research on BP lacks a standardized approach to evaluate the prevalence in the general population. The adoption of an established cut-off score would allow more comparable data and a better distinction of high, low and non-procrastinators. Research on the working population remains limited. Other measures should also be considered, like the recently recognized while-in-bed procrastination and the use of smartphones and social media, to give a better understanding of sleep procrastination as a whole. Key messages • BP is a growing Public Health concern, due to its association with reduced productivity and poorer sleep health and consequent problems on physical health, including increased cardiovascular risk. • There is a need for a better standardized approach to assess BP, to give a broader understanding of the issue in its multiple components.