When poor sleep hurts most: procrastination as a moderator of the association between sleep quality and academic performance in medical students

The demanding nature of medical training elevates the risk of sleep disruption and may compromise academic performance. At the same time, procrastination is a prevalent self-regulatory difficulty among students that has been independently linked to poorer academic outcomes. Although both sleep quality and procrastination are two critical self-regulatory variables that have been linked to performance, their interplay is not well understood. The present cross-sectional study examined whether procrastination moderates the association between sleep quality and academic performance in medical students. An a priori power analysis indicated that a minimum of 119 participants was required. The final sample comprised 125 medical students (M age = 25.6 years, 54% female). Participants completed self-report measures of sleep quality (Pittsburgh Sleep Quality Index; PSQI), procrastination (Behavioral and Emotional Academic Procrastination Scale; BEPS), and academic performance (composite exam grades). Hierarchical regression analyses showed that poorer sleep quality and greater procrastination were each significantly associated with lower academic performance. In addition, the interaction between sleep quality and procrastination was significant, accounting for an additional 2.7% of variance in performance. The simple slope analysis supported the main hypothesis: the negative association between poor sleep and performance was stronger at higher levels of procrastination, whereas the association was weaker among students with lower procrastination. Though the additional variance was modest (Δ R 2  = 0.027), results may inform evidence-based strategies to support student well-being and success.