Bedtime Audiobook Listening Motives and Insomnia Status: Survey Study.

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: This study aimed to examine associations between bedtime audiobook listening, perceived sleep benefits, and sleep-onset insomnia symptoms in a large adult sample. Methods: A cross-sectional online survey was conducted among 1136 Swedish adults (aged ≥50 years: n=600, 53%; women: n=1027, 90%). Recruitment took place in Sweden between January and February 2026 through social media, university campus flyers, and book-related media outlets. Respondents reported bedtime audiobook listening frequency, motives, preferred genres, and sleep characteristics. Sleep-related variables included the frequency and duration of difficulty initiating sleep. Sleep-onset insomnia symptom status (absent, subthreshold, and clinical level) was derived using symptom-based criteria. Clinical-level sleep-onset insomnia symptoms were defined as difficulty falling asleep ≥3 times per week for ≥3 months, and subthreshold sleep-onset insomnia symptoms were defined as either difficulty falling asleep 1 to 2 times per week for ≥3 months or ≥3 times per week for <3 months. Modified Poisson regression with robust variance estimation was used to examine associations between audiobook use, perceived sleep benefits, and insomnia symptom status, with adjusted prevalence ratios (aPRs) and 95% CIs reported. Results: Among the self-selected sample of 1136 Swedish adults, 53% (n=601) listened to audiobooks daily at bedtime. Sleep-onset insomnia symptoms were common in this sample (those reporting clinical-level or subthreshold symptoms: n=427, 38%), although these estimates should be interpreted in the context of the recruitment approach and may not reflect population prevalence. Daily listeners had a higher prevalence of reporting that audiobooks helped them fall asleep (aPR 1.32, 95% CI 1.21-1.44) and improved overall sleep (aPR 1.73, 95% CI 1.41-2.12), whereas clinical-level sleep-onset insomnia symptoms were associated with a lower prevalence of reporting perceived benefit for falling asleep (aPR 0.93, 95% CI 0.87-0.98). Daily listeners also had a higher prevalence of reporting difficulty falling asleep without an audiobook (aPR 1.93, 95% CI 1.67-2.22). Participants with sleep-onset insomnia symptoms had a higher prevalence of using audiobooks to reduce worry or racing thoughts (subthreshold symptoms: aPR 1.34, 95% CI 1.16-1.55; clinical-level symptoms: aPR 1.28, 95% CI 1.10-1.49), while daily listeners had a higher prevalence of selecting the same audiobook at bedtime (aPR 1.13, 95% CI 1.00-1.26) and a lower prevalence of preferring nonfiction (aPR 0.61, 95% CI 0.49-0.77). Conclusions: Bedtime audiobooks may be perceived to serve different roles depending on sleep health, with cognitive regulation motives more frequently reported among individuals with sleep-onset insomnia symptoms. Owing to the cross-sectional design, it remains unclear whether audiobook use influences sleep-related experiences or whether individuals with particular sleep characteristics are more likely to adopt audiobooks as a bedtime strategy.