Bedtime procrastination mediates the relation between anxiety and sleep problems

J Clin Psychol. 2023 Mar;79(3):803-817. doi: 10.1002/jclp.23440. Epub 2022 Sep 28.


The prevalence of sleep problems is high in primary care patients and in anxious individuals. This study assessed whether total sleep time and bedtime procrastination mediated the association between anxiety and sleep problems. We predicted higher anxiety would be negatively associated with total sleep time and positively associated with bedtime procrastination and sleep problems, and these variables would statistically mediate the association between anxiety and sleep problems. Participants were 308 adult primary care patients, predominantly female (non-Hispanic White = 158, Latinx = 111, mean age = 33.30), who initiated behavioral health services at an integrated primary care clinic. Patients completed a questionnaire regarding psychological health and sleep behaviors. Using structural equation modeling, we found higher anxiety related to higher sleep problems, partially mediated by bedtime procrastination but not total sleep time. This study highlights related factors like anxiety and prebedtime behaviors that may be effective treatment targets for sleep challenges.

Keywords: anxiety; bedtime procrastination; primary care; sleep; sleep quantity.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Anxiety Disorders
  • Female
  • Humans
  • Male
  • Procrastination*
  • Sleep
  • Sleep Wake Disorders* / epidemiology
  • Sleep Wake Disorders* / psychology