Study Objectives. Studies have found that depictions of unhealthy behaviors (e.g., illicit substance use, violence) are common in popular music lyrics; however, we are unaware of any studies that have specifically analyzed the content of music lyrics for unhealthy sleep-related behaviors. We sought to determine whether behaviors known to perpetuate insomnia symptoms are commonly depicted in the lyrics of popular music. Methods. We searched three online lyrics sites for lyrics with the word “insomnia” in the title and performed content analysis of each of the lyrics. Lyrics were analyzed for the presence/absence of the following perpetuating factors: extending sleep opportunity, using counter fatigue measures, self-medicating, and engaging in rituals or anti-stimulus control behaviors. Results. We analyzed 83 music lyrics. 47% described one or more perpetuating factor. 30% described individual(s) engaging in rituals or antistimulus control strategies, 24% described self-medicating, 7% described engaging in counter fatigue measures, and 2% described extending sleep opportunity (e.g., napping during daytime). Conclusion. Maladaptive strategies known to perpetuate insomnia symptoms are common in popular music. Our results suggest that listeners of these sleep-related songs are frequently exposed to lyrics that depict maladaptive coping mechanisms. Additional studies are needed to examine the direct effects of exposing individuals to music lyrics with this content. 1. Introduction Insomnia is a prevalent condition among adolescents and adults, with an estimated prevalence of 22.1% when using DSM-IV-TR criteria [1]. Insomnia frequently presents in the context of comorbid conditions, ranging from substance use disorders to medical or psychiatric disorders, or even other sleep disorders such as obstructive sleep apnea. Less commonly, insomnia may be seen as a primary disorder, with the sleep complaint existing outside of other discernible medical or psychiatric cause [2]. In Spielman’s 3-P model of insomnia, predisposing (biological and psychological inputs), precipitating (acute stressors), and perpetuating factors (behaviors such as napping that maintain or exacerbate sleep difficulties) contribute to individual sleep disturbance to varying degrees [3]. In particular, perpetuating factors can be seen as modifiable behaviors that may serve as intervention points in insomnia treatment and public health awareness campaigns [4–6]. As described by Perlis et al., the four major types of perpetuating factors include (1) extending sleep opportunity (e.g., napping),
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