In June 2020, a Sri Lankan teenager approached me with a "Thank you" card. I told her off, saying that helping her was just my job as a doctor and a fellow human. She had just recovered completely from a 2-months long COVID infection. Her mother awaited me behind the secondary control gate of the facility, and I recognized the concerning look in her eyes.
The girl worked as a cashier in a supermarket with long shifts. Her mother sought for a solution to a very abundantly common problem we see today. "She doesn't sleep at night. Can you please suggest me something, doctor?" the mother asked pointing at her daughter.
Albeit my job was limited to attending to COVID patients, I always live by the motto of not letting any patient case leave my table without having all or most of their concerns attended to.
After a short interview with the teenager, there was only one likely diagnosis:
"Revenge Bedtime Procrastination"
The adverse health effects of prioritizing leisure activities instead of sleep at night has been apparent and very well known. Yet, we have noticed a steep increase in this trend over the last few years. Especially, in the employed circles with high working hours.
This newly found phenomenon is still to be understood, analysed and studied further. However, it is being highly recognized by health sectors, especially psychology. Over time the repetition of this phenomenon can cause terrible health risks from depression to a heart attack.
I wouldn't be surprised to see RBP getting and ICD index number and getting documented as a chapter in the internal medicine books of the future.
It seems to me as if the phenomenon is something to do with the "reward system" our bodies have designed for us. And the innate desire to be "free".
Most of the people who show signs of RBP are usually among the same lifestyle. Long work hours, short breaks, young and borderline demotivated. Much of their time is dedicated to either working long hours (also possible for students studying long hours), getting small amount of off-days and leaves, usually detest the activity they are involved in, and drained out of motivation.
They tend to spend their "free time", which is usually at night, to regain some "control" in their life. This is important. Since, they are, in some ways at least, shackled to the activity and have no way out, they tend to subconsciously feel trapped. To retaliate to the boundaries they are limited to, they incline towards spending the remainder of time they have left in a day in activities instead of sleep.
This form of "retaliation" isn't healthy. However, it is a form of keeping sane and staying connected to their "human" side without completely being suffocated into becoming a robot with no choice and emotions, crunching numbers and living in the same routine with no sight of an end to the cycle.
The concerning part is that the activities of the revenge bedtime procrastination also are limited to harmful behaviours. Staring into a brightly lit phone, pc or tv, sometimes drugs and/or alcohol and sleep deprivation. All of which write a tale of bad endings.
Just as much satisfaction is found from retaliating and finding freedom in the late night activities, disconnecting from the usual cycle and shackles, these activities also become addicting. Tiny shots of dopamine, the "feel-good" hormone, keep igniting a new cycle of RBP every night.
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