Childhood Environmental Unpredictability and Bedtime Procrastination Among Undergraduate Medical Students in South India: A Cross-sectional Study

Objective: To examine the association between retrospectively reported childhood environmental unpredictability and bedtime procrastination among undergraduate medical students in South India.Methods: This single-center cross-sectional online survey included 200 undergraduate medical students. Bedtime procrastination was assessed using the nine-item Bedtime Procrastination Scale (BPS; range, 9–45), and childhood unpredictability using the 38-item Questionnaire of Unpredictability in Childhood (QUIC; range, 0–38). Because the BPS has no validated diagnostic cutoff, scores were analyzed continuously. The primary analysis used Spearman rank correlation with bootstrap confidence intervals (CI), and robust linear regression was used to quantify the association. An additional multivariable model adjusted for age, sex, academic year, residence, and socioeconomic category.Results: The mean age was 18.8 years (standard deviation [SD], 1.1), and 67.0% of participants were women. Mean BPS and QUIC scores were 27.93 (SD, 7.19) and 9.39 (SD, 5.53), respectively. Overall QUIC score was weakly associated with BPS score (Spearman rho=0.242; 95% bootstrap confidence interval, 0.111–0.366; p<0.001). After adjustment for age, sex, academic year, residence, and socioeconomic category, a five-point higher QUIC score was associated with a 1.48-point higher mean BPS score (95% CI, 0.52–2.43; p=0.003). Three parental domains showed small exploratory associations after false-discovery-rate adjustment.Conclusion: Childhood environmental unpredictability showed a small positive association with bedtime procrastination. The cross-sectional, retrospective findings are hypothesis-generating and do not establish causality.