Late Bedtime and Poor Sleep Quality Among University Esports Players: A Cross-Sectional Study.

Background/Objectives: Sleep timing is an important dimension of sleep health, yet its association with sleep quality among university esports players remains unclear. This study examined factors associated with poor sleep quality, emphasizing habitual bedtime. Methods: This cross-sectional study included 164 university esports players with previous competition experience. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariable logistic regression examined factors associated with poor sleep quality, with bedtime modeled continuously. Sensitivity analyses addressed circular clock time, PSQI measurement coupling, and self-reported sleep duration. Results: Poor sleep quality was identified in 50.6% of participants. Self-reported chronic disease (OR = 5.60, 95% CI: 1.72-18.28; p = 0.004) and each one-hour delay in bedtime (OR = 1.33, 95% CI: 1.13-1.57; p < 0.001) were associated with poor sleep quality after multivariable adjustment. Bedtime showed the most favorable numerical model performance indices among the evaluated sleep-timing indicators. The association with later bedtime persisted in circular analyses, after excluding the PSQI habitual sleep-efficiency component (β = 0.327, 95% CI: 0.165-0.490; p < 0.001), and among participants reporting at least 7 h of actual sleep (OR = 1.49, 95% CI: 1.16-1.91; p = 0.002). Conclusions: Poor sleep quality was common among university esports players. Later bedtime was consistently associated with poor sleep quality, including among those reporting at least 7 h of actual sleep. Habitual bedtime may warrant consideration alongside sleep duration when assessing sleep health in this population. Longitudinal studies are needed to establish directionality.