OBJECTIVE: The aim of the study was to determine the risk factors for binge-watching (BW) among Polish medical and non-medical students.
METHODS: A STROBE-compliant cross-sectional observational study, was carried out in Poland from July 2022 - March 2023. The web-based survey consisted of a personal questionnaire, a Binge-Watching Behaviour Questionnaire, a Scale of Motivation for Watching TV Series, a shortened version of the Ryff Well-Being Scale, and the De Jong Gierveld Loneliness Scale. Inclusion criteria were being a student and providing informed consent to participate. The study involved 726 respondents (70.5% female) with an average age of 22.41 (SD=3.89), including 308 (44%) medical students.
RESULTS: In the group of Polish medical students, the regression model was well-fitted F(10,287)=30.189; p<0.001, R2=0.496, and the risk factors were escape motivation (β=0.416; p<0.001), psychological well-being (β=-0.165; p=0.003), emotional loneliness (β=0.152; p=0.014), and social loneliness (β=-0.118; p=0.031). Among Polish students of other majors, the regression model was well-fitted F(10,378)=46.188; p<0.001, R2=0.538, and the influence of escape motivation (β=0.456; p<0.001), entertainment motivation (β=0.258; p<0.001), the psychological well-being of students (β=-0.134; p=0.004), and emotional loneliness (β=0.111; p=0.032) was demonstrated.
CONCLUSIONS: Students are in a high-risk group for behavioural addiction known as binge-watching. Emotional loneliness, the desire to escape from everyday life problems, and reduced psychological well-being intensified binge-watching in all the studied groups. Entertainment motivation and social loneliness differentiated the groups of Polish medical and non-medical students in terms of BW risk factors.

Pre-sleep arousal impairs sleep. Therefore, watching suspenseful TV series before sleep is not recommended as they increase arousal. In particular, the consumption of multiple episodes of the same suspenseful TV series in one sitting - termed binge-watching - could lead to large increases in physiological arousal delaying sleep onset. Furthermore, abrupt endings during critical scenes - termed cliffhangers - result in unfinished story lines, which further increase cognitive arousal and could negatively impact sleep architecture and the number of awakenings. However, the effects of binge-watching and cliffhangers on objective sleep parameters are still unknown. Here we tested in a controlled sleep-laboratory setting whether pre-sleep arousal induced by watching 3-4 episodes of a suspenseful TV series has negative effects on sleep in 50 healthy young participants (39 females, mean age = 22.62 ± 2.60 (SD)). Watching a neutral TV series served as a control condition, according to a within-subject design. In one group of participants, the suspenseful TV series ended with a cliffhanger. In the other group, the same TV series ended where no ongoing action was interrupted. Pre-sleep arousal was measured both subjectively with the self-reported level of stress and objectively with the mean heart rate and cortisol level. As expected, suspenseful TV series induced higher cognitive and physiological pre-sleep arousal than neutral control TV series, with highest values for TV series with cliffhangers. In spite of the high pre-sleep arousal, participants fell asleep faster after watching the suspenseful compared with the neutral TV series (F(1,48) = 4.89, p = 0.032, η2 = 0.09). Sleep architecture and the number of awakenings remained unaffected. However, in the first two sleep cycles, heart rate was still higher after watching suspenseful TV series (F(1,48) = 6.76, p = 0.012, η2 = 0.12). And only after cliffhangers, objective sleep quality - measured as the ratio between slow-wave and beta activity during sleep - was lower than in the other conditions (interaction effect, F(1,48) = 5.05, p = 0.029, η2 = 0.10). Our results speak against large impairments of pre-sleep watching of multiple episodes of suspenseful TV series and cliffhangers on sleep quality and architecture. However, unfinished narratives might induce more subtle changes in oscillatory power during sleep, possibly reflecting ongoing cognitive processing during sleep.

Recent advances in technology and the Internet have led to the emergence of a phenomenon known as binge-watching. This qualitative study aims to explore experiences and perceptions of binge-watching behavior. The criteria of behavioral addiction were used to examine the characteristics of binge-watching behavior.
We recruited 25 self-identified binge-watchers in Taiwan and conducted seven focus-group interviews with them in 2019 and 2020. Before their interview, the participants were asked to complete a brief questionnaire to collect information on their sociodemographic characteristics and binge-watching frequency.
The participants defined binge-watching behavior as consecutively watching episodes of shows with continuous content, rather than based on the time spent watching or the number of episodes watched. While they felt it may affect their daily routine, they mentioned almost no impacts on their health. Most participants emphasized the pleasure and social functions of binge-watching. This differs from previous studies, which have suggested an association between binge-watching and negative emotions. Notably, while most participants considered binge-watching to be an addictive behavior, they denied that they themselves were addicted.
Our participants generally reported positive attitudes toward binge-watching. The addictiveness of binge-watching remains controversial. Further studies exploring the possibility of addictive binge-watching and potential mechanisms are warranted.