Advancing a biopsychosocial model of bedtime procrastination

PROJECT SUMMARY
Cardiometabolic diseases are the leading cause of death in the United States. With rates of these diseases
rising, there is an urgent need to identify modifiable risk factors that contribute to cardiometabolic diseases. A
growing literature has shown that circadian disruption, including disturbances in the regularity of circadian activity
and misalignment of sleep to circadian activity, increases cardiometabolic disease risk. However, there is a
critical gap in our understanding of the sleep-related behaviors which lead to circadian disruption and subsequent
disease risk. Bedtime procrastination refers to the tendency to delay bedtime in the absence of external
obligations. Bedtime procrastinators often have late and irregular sleep timing and engage in behaviors that
increase evening light exposure, potentially serving to misalign and destabilize circadian rhythms. Through
circadian disruption and insufficient sleep, bedtime procrastination poses a risk to cardiometabolic health.
However, no research has investigated the role of bedtime procrastination in circadian disruption or
cardiometabolic health. Furthermore, to date, research on the mechanisms underlying bedtime procrastination
has centered on a single construct: self-regulation. However, emerging research suggests that there are two
distinct pathways leading to bedtime procrastination. The first pathway involves delaying bedtime due to
difficulties with disengaging from rewarding pre-sleep activities, and second involves delaying bedtime to avoid
pre-sleep anxiety. As intervention on the reward- and avoidance-driven pathways would require different
strategies, this lack of research represents a significant barrier to future research and treatment. Together, the
primary objective of this project is to advance a biopsychosocial model of bedtime procrastination. To accomplish
this objective, two studies will be conducted. The first study will evaluate the impact of bedtime procrastination
on circadian disruption (Aim 1) and the risk of bedtime procrastination to cardiometabolic health (Aim 2). Aims
1 and 2 will be evaluated in a sample of overweight individuals using innovative multidimensional assessment of
circadian disruption and cardiometabolic health over the course of a year. The second study seeks to elucidate
the roles of anxiety, reward, and self-regulation in the development of daily bedtime procrastination (Aim 3) using
an intensive longitudinal design in a large sample of young adults. This project will advance an integrated model
of bedtime procrastination. Given that nearly 75% of individuals report procrastinating their bedtime at least once
per week, and the extensive impact of this behavior on sleep health, bedtime procrastination likely has a
substantial impact on public health. Accordingly, this project will evaluate the impact of this behavior on circadian
disruption and cardiometabolic health. Furthermore, by elucidating the mechanisms that underly bedtime
procrastination, this project will lay the foundation for future research identifying treatment targets and developing
novel interventions for bedtime procrastination and circadian-sleep disturbances.

Grant Number: 5F31HL176119-02
NIH Institute/Center: NIH
Principal Investigator: Steven Carlson