Longitudinal association between problematic smartphone use and sleep disorder among Chinese college students during the COVID-19 pandemic

Zhang, Jianghui; Yuan, Guojing; Guo, Haiyun; Zhang, Xueqing; Zhang, Kexin; Lu, Xiaoyan; Yang, Huayu; Zhu, Zhihui; Jin, Guifang; Shi, Haiyan; Du, Jun; Hao, Jiahu; Sun, Ying; Su, Puyu; Yang, Linsheng; Zhang, Zhihua

doi:10.1016/j.addbeh.2023.107715

Cited by 8 publications

(6 citation statements)

References 59 publications

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“…Fifth, the timing of our study amid the COVID-19 pandemic, characterized by increased reliance on electronic devices, especially among adolescents engaged in online learning, may have influenced the prevalence of PSU. This context could complicate the interpretation of associations with ACEs . However, it is noteworthy that our survey was conducted within schools where offline teaching had resumed, mitigating some of the confounding effects.…”

Section: Discussionmentioning

confidence: 99%

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Childhood Adversity and Adolescent Smartphone Use Across Sexual Orientation and Gender Expression

Zheng,

Jiang,

Peng

et al. 2024

JAMA Netw Open

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ImportanceNonheterosexual and gender-nonconforming (GNC) individuals tend to report adverse childhood experiences (ACEs) more frequently compared with heterosexual and gender-conforming individuals, and individuals who have experienced ACEs, identify as nonheterosexual, or exhibit moderate to high levels of GNC are more prone to engaging in problematic smartphone use (PSU). However, there is limited school-based data among adolescents regarding this matter.ObjectivesTo explore the associations between ACEs and PSU among adolescents across different sexual orientation and gender expression groups.Design, setting, and participantsUsing data from the 2021 School-Based Chinese Adolescents Health Survey, this cross-sectional study includes participants from 288 public high schools across 8 provinces in China. Statistical analysis was performed from October 2023 to February 2024.ExposuresData on ACEs, sexual orientations, and gender expressions (high, moderate, and low GNC) were collected.Main outcomes and measuresPSU was assessed using the 10-item Smartphone Addiction Scale-Short Version (SAS-SV). Weighted linear, logistic, or Poisson regression models were used.ResultsAmong the 85 064 adolescents included (mean [SD] age, 14.92 [1.77] years), 42 632 (50.1%) were female, 70 157 (83.2%) identified as Han Chinese, and 14 208 (16.8) identified as other ethnicities (Miao, Hui, Yi, Dai, and other ethnic groups). The prevalence of PSU among participants was 35.4%. Weighted Poisson regression models indicated that the interaction between GNC and ACE was significant (adjusted prevalence ratio [APR], 0.98; 95% CI, 0.97-0.99). Further stratified analysis demonstrated homosexual adolescents who experienced 4 or more ACEs showed a significantly increased prevalence of PSU (APR, 1.79; 95% CI, 1.64-1.96). Similarly, a markedly higher prevalence of PSU was observed among bisexual individuals with 4 or more ACEs (APR, 1.60; 95% CI, 1.41-1.80). Regarding gender expression categories, a significantly higher prevalence of PSU was noted among high GNC adolescents with 4 or more ACEs (APR, 1.78; 95% CI, 1.60-1.98) compared with low GNC adolescents without ACEs. Furthermore, experiencing any 3 ACE categories (abuse, neglect, and household dysfunction) was associated with an increased prevalence of PSU across different sexual orientation and gender expression subgroups.Conclusions and relevanceIn this cross-sectional study, the amalgamation of elevated ACE scores with nonheterosexual orientations or GNC identities was significantly associated with increased PSU prevalence. These findings underscore that preventing ACEs may be beneficial in mitigating PSU among adolescents, particularly for nonheterosexual adolescents and those with high levels of GNC.

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Section: Discussionmentioning

confidence: 99%

“…This context could complicate the interpretation of associations with ACEs. 45 , 46 However, it is noteworthy that our survey was conducted within schools where offline teaching had resumed, mitigating some of the confounding effects.…”

Section: Discussionmentioning

confidence: 99%

Childhood Adversity and Adolescent Smartphone Use Across Sexual Orientation and Gender Expression

Zheng,

Jiang,

Peng

et al. 2024

JAMA Netw Open

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“…Regular moderate exercise is an effective strategy to mitigate stress and anxiety, with physical activity fostering positive mental states. This, in turn, supports mental health, alleviates anxiety, and promotes sound sleep ( 53 ). Earlier studies reveal that students experiencing higher stress, fatigue, and sleepiness shortly after the onset of the COVID-19 pandemic reported elevated anxiety and depression levels, alongside compromised sleep quality, in response to public health emergencies.…”

Section: Discussionmentioning

confidence: 99%

Mental well-being and sleep quality among vocational college students in Sichuan, China during standardized COVID-19 management measures

Gao,

Wang,

Liu

et al. 2024

Front. Public Health

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PurposeThis research investigated the impact of the COVID-19 pandemic on the mental well-being and sleep quality of students in higher vocational colleges in Sichuan, China, identifying key factors influencing their psychological health during this period.MethodsBetween January and February 2022, a comprehensive survey was conducted among students from several higher vocational colleges in Sichuan, utilizing a randomized selection approach to involve 3,300 participants. Data were collected through direct interviews executed by skilled interviewers.ResultsOut of 3,049 valid responses, a significant number reported experiencing symptoms of poor mental health, anxiety, depression, and insomnia, with prevalence rates of 21.2%, 9.7%, 14.1%, and 81.9%, respectively. Factors contributing positively to mental health and sleep included a higher family economic status, reduced stress from the pandemic, and decreased online activity. Conversely, lack of physical activity post-pandemic, disruptions to education and employment, and deteriorating relationships emerged as negative influencers. Interestingly, a lack of pre-pandemic mental health knowledge acted as a protective factor against insomnia.ConclusionThe ongoing management of COVID-19 has notably influenced the psychological and sleep health of vocational college students, driven by economic, emotional, lifestyle, and educational factors. The findings underscore the necessity for targeted interventions to address these challenges effectively.

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“…Numerous reports have shown that excessive smartphone use can result in sleep disorders (31,32). Encouraging physical activity has been suggested as a counteractive measure to this problem (33). Therefore, it is anticipated that the addictive nature of mobile phones may serve as a positive predictor of sleep disorders.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with sleep disorders among university students in Jiangsu Province: a cross-sectional study

Hu,

Wu,

Wang

et al. 2024

Front. Psychiatry

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ObjectiveThis study aims to establish the precise prevalence of sleep disorders among university students in Jiangsu Province. Utilizing a representative sample of students, we measured their sleep quality based on the Pittsburgh Sleep Quality Index (PSQI). Our objective is to quantitatively assess the magnitude of sleep quality and identify key factors. By detailed analysis of these relationships, our study seeks to provide actionable insights for the development of targeted interventions to enhance sleep quality within this population.MethodsFrom October to November 2022, we conducted a cross-sectional web-based survey in Jiangsu Province, China. Using convenient cluster sampling in each college, a total of 8457 participants were selected. The PSQI was applied to assess sleep quality among university students. Data collected included sociodemographic details, scores from the Mobile Phone Dependence Index (MPAI) and psychological resilience measured by the Connor-Davidson Resilience Scale (CD-RISC).ResultsThe overall prevalence of poor sleep quality among the participants was 39.30%. Binary logistic regression analysis revealed that higher physical activity (OR = 0.921; 95% CI: 0.779-1.090), earlier roommate bedtimes (OR = 0.799; 95% CI: 0.718-0.888), quieter dormitories (OR = 0.732; 95% CI: 0.647-0.828) and higher psychological resilience (OR = 0.982; 95% CI, 0.979-0.984) were protective factors linked to lower risk of poor sleep quality. Conversely, being a female student (OR = 1.238; 95% CI: 1.109-1.382), being a senior (OR = 1.582; 95% CI: 1.344-1.863), single-child status (OR = 1.195; 95% CI: 1.077-1.326), regular smoking (OR = 1.833; 95% CI: 1.181-2.847), regular alcohol consumption (OR = 1.737; 95% CI: 1.065-2.833), high academic stress (OR = 1.326; 95% CI: 1.012-1.736), high employment stress (OR = 1.352; 95% CI: 1.156-1.582), dissatisfaction with dormitory hygiene (OR = 1.140; 95% CI: 1.028-1.265), poor self-rated physical health (OR = 1.969; 95% CI: 1.533-2.529), poor self-rated mental health (OR = 2.924; 95% CI: 2.309-3.702) and higher mobile phone dependency were risk factors associated with an increased likelihood of poor sleep quality.ConclusionThe sleep quality among university students should attract immediate attention. The development of public services and mental health education initiatives is crucial in enhancing the sleep health of this population.

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Longitudinal association between problematic smartphone use and sleep disorder among Chinese college students during the COVID-19 pandemic

Cited by 8 publications

References 59 publications

Childhood Adversity and Adolescent Smartphone Use Across Sexual Orientation and Gender Expression

Childhood Adversity and Adolescent Smartphone Use Across Sexual Orientation and Gender Expression

Mental well-being and sleep quality among vocational college students in Sichuan, China during standardized COVID-19 management measures

Factors associated with sleep disorders among university students in Jiangsu Province: a cross-sectional study

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