JMIR Publications

ABSTRACT

Background:

Many individuals use audiobooks at bedtime to unwind and facilitate sleep, yet little is known about how this practice relates to sleep health. Understanding these patterns may inform behavioral strategies to support sleep.

Objective:

To examine associations between bedtime audiobook listening, perceived sleep benefits, and sleep onset insomnia in a large adult cohort.

Methods:

A cross-sectional survey was conducted among 1,136 Swedish adults (53% aged ≥50 years; 90% female). Participants reported bedtime audiobook listening frequency, motives, preferred genres, and sleep characteristics. Sleep-related variables included habitual sleep onset latency (<30 vs. ≥30 minutes), frequency of difficulty initiating sleep, and duration of sleep difficulties. Sleep onset insomnia status (Absent, Subthreshold, Clinical) was derived using symptom-based criteria: clinical insomnia was difficulty falling asleep ≥3 times/week for ≥3 months; subthreshold insomnia was either (a) difficulty 1–2 times/week for ≥3 months or (b) ≥3 times/week for <3 months. Logistic regression examined associations between audiobook use, perceived sleep benefits, and insomnia status, reporting adjusted odds ratios (aOR) with 95% confidence intervals (CI).

Results:

Among 1,136 adults, 53% listened to audiobooks daily at bedtime. Daily listeners were more likely to report that audiobooks helped them fall asleep (aOR = 7.45, 95% CI 4.57–12.14, p < .001) and improved overall sleep (aOR = 2.87, 95% CI 2.04–4.04, p < .001), whereas clinical insomnia was associated with lower perceived benefit for falling asleep (aOR = 0.51, 95% CI 0.32–0.81, p = .005). Participants with insomnia were more likely to use audiobooks to reduce worry or racing thoughts, while daily listeners favored fiction and consistent bedtime selections.

Conclusions:

Bedtime audiobook use is common and often perceived as beneficial for sleep. Among individuals without insomnia, audiobooks may serve as stable sleep cues, whereas for those with sleep onset insomnia they appear to function primarily as a cognitive regulation strategy, helping manage worry or racing thoughts. Clinical Trial: The study was not preregistered, as it was an observational survey reporting anonymous, deidentified data.