Effect of Smartphone Use on Sleep in Undergraduate Medical Students: A Cross-Sectional Study

Ashish Goel; Arsalan Moinuddin; Rajesh Tiwari; Yashendra Sethi; Mohammed K Suhail; Aditi Mohan; Nirja Kaka; Parth Sarthi; Ravi Dutt; Sheikh F Ahmad; Sabry M Attia; Talha Bin Emran; Hitesh Chopra; Nigel H Greig

doi:10.3390/healthcare11212891

Effect of Smartphone Use on Sleep in Undergraduate Medical Students: A Cross-Sectional Study

Healthcare (Basel). 2023 Nov 2;11(21):2891. doi: 10.3390/healthcare11212891.

Authors

Ashish Goel¹, Arsalan Moinuddin², Rajesh Tiwari³, Yashendra Sethi^{4

5}, Mohammed K Suhail⁶, Aditi Mohan⁷, Nirja Kaka^{5

8}, Parth Sarthi⁹, Ravi Dutt¹, Sheikh F Ahmad¹⁰, Sabry M Attia¹⁰, Talha Bin Emran^{11

12}, Hitesh Chopra¹³, Nigel H Greig¹⁴

Affiliations

¹ Graphic Era Institute of Medical Sciences, Dehradun 248008, Uttarakhand, India.
² School of Sport and Exercise, University of Gloucestershire, Gloucester GL50 2RH, UK.
³ Gautam Buddha Chikitsa Mahavidyalaya, Dehradun 248007, Uttarakhand, India.
⁴ Government Doon Medical College, Dehradun 248001, Uttarakhand, India.
⁵ PearResearch, Dehradun 248001, Uttarakhand, India.
⁶ Moray House, University of Edinburgh, Edinburgh EH8 8AQ, UK.
⁷ Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar 246174, Uttarakhand, India.
⁸ GMERS Medical College, Himmatnagar 382012, Gujarat, India.
⁹ Rajkiya Medical College, Jalaun 395001, Uttar Pradesh, India.
¹⁰ Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia.
¹¹ Department of Pathology and Laboratory Medicine, Warren Alpert Medical School & Legorreta Cancer Center, Brown University, Providence, RI 02912, USA.
¹² Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh.
¹³ Department of Biosciences, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai 602105, Tamil Nadu, India.
¹⁴ Drug Design & Development Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA.

Abstract

Smartphone use, particularly at night, has been shown to provoke various circadian sleep-wake rhythm disorders such as insomnia and excessive daytime tiredness. This relationship has been mainly scrutinized among patient groups with higher rates of smartphone usage, particularly adolescents and children. However, it remains obscure how smartphone usage impacts sleep parameters in adults, especially undergraduate college students. This study sought to (1) investigate the association between smartphone use (actual screen time) and four sleep parameters: Pittsburgh sleep quality score (PSQI), self-reported screen time, bedtime, and rise time; (2) compare the seven PSQI components between good and poor sleep quality subjects. In total, 264 undergraduate medical students (aged 17 to 25 years) were recruited from the Government Doon Medical College, Dehradun, India. All participants completed a sleep questionnaire, which was electronically shared via a WhatsApp invitation link. Hierarchical and multinomial regression analyses were performed in relation to (1) and (2). The average PSQI score was 5.03 ± 0.86, with approximately one in two respondents (48.3%) having a poor sleep index. Smartphone use significantly predicted respondents' PSQI score (β = 0.142, p = 0.040, R² = 0.027), perceived screen time (β = 0.113, p = 0.043, R² = 343), bedtime (β = 0.106, p = 0.042, R² = 045), and rise time (β = 0.174, p = 0.015, R² = 0.028). When comparing poor-quality sleep (PSQI ≥ 5) to good-quality sleep (PSQI < 5), with good-quality sleep as the reference, except sleep efficiency and sleep medications (p > 0.05), five PSQI components declined significantly: subjective sleep quality (β = -0.096, p < 0.001); sleep latency (β = -0.034, p < 0.001); sleep duration (β = -0.038, p < 0.001); sleep disturbances (β = 1.234, p < 0.001); and sleep dysfunction (β = -0.077, p < 0.001). Consequently, public health policymakers should take this evidence into account when developing guidelines around smartphone use-i.e., the when, where, and how much smartphone use-to promote improved sleep behaviour and reduce the rate of sleep-wake rhythm disorders.

Keywords: medical students; mobile phone; sleep; sleep disturbances.

Grants and funding

This research was funded by King Saud University, Riyadh, Saudi Arabia, Project Number (RSPD2023R748).