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

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

doi:10.1016/j.addbeh.2023.107715

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

Addict Behav. 2023 Sep:144:107715. doi: 10.1016/j.addbeh.2023.107715. Epub 2023 Apr 8.

Authors

Jianghui Zhang¹, Guojing Yuan¹, Haiyun Guo¹, Xueqing Zhang¹, Kexin Zhang¹, Xiaoyan Lu¹, Huayu Yang¹, Zhihui Zhu¹, Guifang Jin¹, Haiyan Shi¹, Jun Du¹, Jiahu Hao², Ying Sun², Puyu Su², Linsheng Yang¹, Zhihua Zhang³

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China.
² Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China.
³ Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China. Electronic address: zhangzh@ahmu.edu.cn.

PMID: 37059002
DOI: 10.1016/j.addbeh.2023.107715

Abstract

Background: Problematic smartphone use (PSU) and sleep disorders (SD) are common public health problems among college students. While previous cross-sectional studies have found a relationship between PSU and SD, the causal direction of this relationship remains unclear. This study aims to examine the longitudinal changes of PSU and SD during the COVID-19 pandemic, determine the causal relationship between them, and identify confounding factors that affect this association.

Methods: The study sample consisted of 1186 Chinese college students (47.7% male) with a mean age of 18.08 years. Participants completed the Smartphone Addiction Scale - Short Version (SAS-SV) and the Pittsburgh Sleep Quality Index (PSQI) at both baseline and follow-up surveys, conducted one year apart. The cross-lagged panel model (CLPM) was used to examine the causal relationship between PSU and SD, stratified by gender and duration of daily physical activity. The fixed effect panel regression was used to confirm the findings of CLPM.

Results: The results of the CLPM analysis showed a significant bidirectional relationship between PSU and SD for the overall sample, which was consistent with the fixed effects model findings. However, subgroup analyses revealed that the bidirectional association disappeared among males or those who engaged in daily physical activity for more than 1 h.

Conclusions: Our study shows a significant bidirectional association between PSU and SD, with variations across gender and daily physical activity levels. Encouraging physical activity may serve as a potential intervention to disrupt the bidirectional association between PSU and SD, which has important implications for public health strategies aimed at reducing the negative consequences of PSU and SD.

Keywords: College students; Cross-lagged panel model; Fixed effects model; Problematic smartphone use; Sleep disorder.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Behavior, Addictive* / epidemiology
COVID-19* / epidemiology
Female
Humans
Male
Pandemics
Sleep Wake Disorders* / epidemiology
Smartphone
Students