ASSOCIATION BETWEEN SMARTPHONE ADDICTION AND SLEEP DISTURBANCES AMONG UNIVERSITY STUDENTS: A CROSS-SECTIONAL STUDY
Main Article Content
Keywords
Smartphone addiction, sleep disturbances, university students, PSQI, SAS-SV, digital health, Pakistan.
Abstract
Smartphone addiction has become a rising behavioral concern, especially among university students who are extensively engaged with digital platforms for academic and social activities. Excessive smartphone use has been increasingly associated with poor sleep quality, a key determinant of cognitive performance and overall health
References
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2. Matar Boumosleh J, Jaalouk D. Depression, anxiety, and smartphone addiction in university students- A cross sectional study. PLOS ONE. 2017;12(8):e0182239.doi: 10.1371/journal.pone.0182239
3. Hasan H, Shihab KA, Mohammad Z, Jahan H, Coussa A, Faris ME. Associations of smartphone addiction, chronotype, sleep quality, and risk of eating disorders among university students: A cross-sectional study from Sharjah/United Arab Emirates. Heliyon. 2023;9(1).doi: 10.1016/j.heliyon.2023.e12882
4. Chen B, Liu F, Ding S, Ying X, Wang L, Wen Y. Gender differences in factors associated with smartphone addiction: a cross-sectional study among medical college students. BMC Psychiatry. 2017;17(1):341.doi: 10.1186/s12888-017-1503-z
5. Sohn SY, Krasnoff L, Rees P, Kalk NJ, Carter B. The Association Between Smartphone Addiction and Sleep: A UK Cross-Sectional Study of Young Adults. Frontiers in Psychiatry. 2021;Volume 12 - 2021.doi: 10.3389/fpsyt.2021.629407
6. Zeyrek I, Tabara MF, Çakan M. Exploring the Relationship of Smartphone Addiction on Attention Deficit, Hyperactivity Symptoms, and Sleep Quality Among University Students: A Cross-Sectional Study. Brain and Behavior. 2024;14(11):e70137.doi: https://doi.org/10.1002/brb3.70137
7. Uzunçakmak T, Ayaz-Alkaya S, Akca A. Prevalence and predisposing factors of smartphone addiction, sleep quality and daytime sleepiness of nursing students: A cross-sectional design. Nurse Education in Practice. 2022;65:103478.doi: https://doi.org/10.1016/j.nepr.2022.103478
8. Alhassan AA, Alqadhib EM, Taha NW, Alahmari RA, Salam M, Almutairi AF. The relationship between addiction to smartphone usage and depression among adults: a cross sectional study. BMC Psychiatry. 2018;18(1):148.doi: 10.1186/s12888-018-1745-4
9. Al Battashi N, Al Omari O, Sawalha M, Al Maktoumi S, Alsuleitini A, Al Qadire M. The Relationship Between Smartphone Use, Insomnia, Stress, and Anxiety Among University Students: A Cross-Sectional Study. Clinical Nursing Research. 2020;30(6):734-40.doi: 10.1177/1054773820983161
10.Zhang J, Yuan G, Guo H, Zhang X, Zhang K, Lu X, et al. Longitudinal association between problematic smartphone use and sleep disorder among Chinese college students during the COVID-19 pandemic. Addictive Behaviors. 2023;144:107715.doi: https://doi.org/10.1016/j.addbeh.2023.107715
11.Kim E, Lee K. Relationship between Smartphone Addiction and Sleep Satisfaction: A Cross-Sectional Study on Korean Adolescents. Healthcare [Internet]. 2022; 10(7).doi: 10.3390/healthcare10071326
12.Qanash S, Al-Husayni F, Falata H, Halawani O, Jahra E, Murshed B, et al. Effect of Electronic Device Addiction on Sleep Quality and Academic Performance Among Health Care Students: Cross-sectional Study. JMIR Med Educ. 2021;7(4):e25662.doi: 10.2196/25662
13.Liu H, Zhou Z, Zhu E, Huang L, Zhang M. Smartphone addiction and its associated factors among freshmen medical students in China: a cross-sectional study. BMC Psychiatry. 2022;22(1):308.doi: 10.1186/s12888-022-03957-5
14.Alageel AA, Alyahya RA, A. Bahatheq Y, Alzunaydi NA, Alghamdi RA, Alrahili NM, et al. Smartphone addiction and associated factors among postgraduate students in an Arabic sample: a cross-sectional study. BMC Psychiatry. 2021;21(1):302.doi: 10.1186/s12888-021-03285-0
15.Tokiya M, Itani O, Otsuka Y, Kaneita Y. Relationship between internet addiction and sleep disturbance in high school students: a cross-sectional study. BMC Pediatrics. 2020;20(1):379.doi: 10.1186/s12887-020-02275-7
16.Nikolic A, Bukurov B, Kocic I, Vukovic M, Ladjevic N, Vrhovac M, et al. Smartphone addiction, sleep quality, depression, anxiety, and stress among medical students. Frontiers in Public Health. 2023;Volume 11 - 2023.doi: 10.3389/fpubh.2023.1252371
17. Abuhamdah SMA, Naser AY. Smart phone addiction and its mental health risks among university students in Jordan: a cross-sectional study. BMC Psychiatry. 2023;23(1):812.doi: 10.1186/s12888-023-05322-6
18. Shahid R, Akram M, Ayub M, Nadeem M, Fatima E, Haroon AM, et al. Prevalence and Correlates of Psychiatric Symptoms Among Medical Students in Punjab: A Comprehensive Cross-Sectional Study: Mental Health Insights: Psychiatric Symptoms Among Punjab Medical Students. DEVELOPMENTAL MEDICO-LIFE-SCIENCES. 2024;1(3):13-9.doi: 10.69750/dmls.01.03.029
19.Aziz B, Khan A, Jamil MF, Khalid M, Waheed F, Sohaib Z, et al. Empathy Levels in Medical Students as they Advance through their Years of Education: Empathy in Medical Training: A Comparative Study. DEVELOPMENTAL MEDICO-LIFE-SCIENCES. 2024;1(3):20-6.doi: 10.69750/dmls.01.03.035
20.Fayaz MS, Ullah A, Anam A, Aziz H, Zahid A. Assessment of Burnout, Academic Stress, and Coping Mechanisms Among Undergraduate Medical Students in Public and Private Sector Medical Colleges: Sector-Based Comparison of Medical Student Well-being. DEVELOPMENTAL MEDICO-LIFE-SCIENCES. 2025;2(4):30-8.doi: 10.69750/dmls.02.04.0120
21.Gao WJ, Hu Y, Ji JL, Liu XQ. Relationship between depression, smartphone addiction, and sleep among Chinese engineering students during the COVID-19 pandemic. World J Psychiatry. 2023;13(6):361-75.doi: 10.5498/wjp.v13.i6.361
22.Leow MQH, Chiang J, Chua TJX, Wang S, Tan NC. The relationship between smartphone addiction and sleep among medical students: A systematic review and meta-analysis. PLOS ONE. 2023;18(9):e0290724.doi: 10.1371/journal.pone.0290724
23.Alzhrani AM, Aboalshamat KT, Badawoud AM, Abdouh IM, Badri HM, Quronfulah BS, et al. The association between smartphone use and sleep quality, psychological distress, and loneliness among health care students and workers in Saudi Arabia. PLOS ONE. 2023;18(1):e0280681.doi: 10.1371/journal.pone.0280681
24.Kang Y, Liu S, Yang L, Xu B, Lin L, Xie L, et al. Testing the Bidirectional Associations of Mobile Phone Addiction Behaviors With Mental Distress, Sleep Disturbances, and Sleep Patterns: A One-Year Prospective Study Among Chinese College Students. Frontiers in Psychiatry. 2020;Volume 11 - 2020.doi: 10.3389/fpsyt.2020.00634
25.Zou Y, Xia N, Zou Y, Chen Z, Wen Y. Smartphone addiction may be associated with adolescent hypertension: a cross-sectional study among junior school students in China. BMC Pediatrics. 2019;19(1):310.doi: 10.1186/s12887-019-1699-9
26.Kil N, Kim J, McDaniel JT, Kim J, Kensinger K. Examining associations between smartphone use, smartphone addiction, and mental health outcomes: A cross-sectional study of college students. Health Promot Perspect. 2021;11(1):36-44.doi: 10.34172/hpp.2021.06
27.Tahir MJ, Malik NI, Ullah I, Khan HR, Perveen S, Ramalho R, et al. Internet addiction and sleep quality among medical students during the COVID-19 pandemic: A multinational cross-sectional survey. PLOS ONE. 2021;16(11):e0259594.doi: 10.1371/journal.pone.0259594
28.Ozcan B, Acimis NM. Sleep Quality in Pamukkale University Students and its relationship with smartphone addiction. Pak J Med Sci. 2021;37(1):206-11.doi: 10.12669/pjms.37.1.3130
29.Liu H, Zhou Z, Huang L, Zhu E, Yu L, Zhang M. Prevalence of smartphone addiction and its effects on subhealth and insomnia: a cross-sectional study among medical students. BMC Psychiatry. 2022;22(1):305.doi: 10.1186/s12888-022-03956-6
30.Dhamija S, Shailaja B, Chaudhari B, Chaudhury S, Saldanha D. Prevalence of smartphone addiction and its relation with sleep disturbance and low self- esteem among medical college students. Industrial Psychiatry Journal. 2021;30(Suppl 1).doi: 10.4103/0972-6748.328813
31.Maurya C, Muhammad T, Maurya P, Dhillon P. The association of smartphone screen time with sleep problems among adolescents and young adults: cross-sectional findings from India. BMC Public Health. 2022;22(1):1686.doi: 10.1186/s12889-022-14076-x
32.Kumar S, Rajasegaran R, Prabhakaran S, Mani T. Extent of Smartphone Addiction and its Association with Physical Activity Level, Anthropometric Indices, and Quality of Sleep in Young Adults: A Cross-Sectional Study. Indian Journal of Community Medicine. 2024;49(1):199-202.doi: 10.4103/ijcm.ijcm_706_22
33.Wang P-Y, Chen K-L, Yang S-Y, Lin P-H. Relationship of sleep quality, smartphone dependence, and health-related behaviors in female junior college students. PLOS ONE. 2019;14(4):e0214769.doi: 10.1371/journal.pone.0214769
34.Sirajudeen MS, Alzhrani M, Alanazi A, Alqahtani M, Waly M, Manzar MD, et al. Prevalence of Upper Limb Musculoskeletal Disorders and Their Association with Smartphone Addiction and Smartphone Usage among University Students in the Kingdom of Saudi Arabia during the COVID-19Pandemic—A Cross-Sectional Study. Healthcare [Internet]. 2022; 10(12).doi: 10.3390/healthcare10122373
35.Kaya F, Bostanci Daştan N, Durar E. Smart phone usage, sleep quality and depression in university students. International Journal of Social Psychiatry. 2020;67(5):407-14.doi: 10.1177/0020764020960207
2. Matar Boumosleh J, Jaalouk D. Depression, anxiety, and smartphone addiction in university students- A cross sectional study. PLOS ONE. 2017;12(8):e0182239.doi: 10.1371/journal.pone.0182239
3. Hasan H, Shihab KA, Mohammad Z, Jahan H, Coussa A, Faris ME. Associations of smartphone addiction, chronotype, sleep quality, and risk of eating disorders among university students: A cross-sectional study from Sharjah/United Arab Emirates. Heliyon. 2023;9(1).doi: 10.1016/j.heliyon.2023.e12882
4. Chen B, Liu F, Ding S, Ying X, Wang L, Wen Y. Gender differences in factors associated with smartphone addiction: a cross-sectional study among medical college students. BMC Psychiatry. 2017;17(1):341.doi: 10.1186/s12888-017-1503-z
5. Sohn SY, Krasnoff L, Rees P, Kalk NJ, Carter B. The Association Between Smartphone Addiction and Sleep: A UK Cross-Sectional Study of Young Adults. Frontiers in Psychiatry. 2021;Volume 12 - 2021.doi: 10.3389/fpsyt.2021.629407
6. Zeyrek I, Tabara MF, Çakan M. Exploring the Relationship of Smartphone Addiction on Attention Deficit, Hyperactivity Symptoms, and Sleep Quality Among University Students: A Cross-Sectional Study. Brain and Behavior. 2024;14(11):e70137.doi: https://doi.org/10.1002/brb3.70137
7. Uzunçakmak T, Ayaz-Alkaya S, Akca A. Prevalence and predisposing factors of smartphone addiction, sleep quality and daytime sleepiness of nursing students: A cross-sectional design. Nurse Education in Practice. 2022;65:103478.doi: https://doi.org/10.1016/j.nepr.2022.103478
8. Alhassan AA, Alqadhib EM, Taha NW, Alahmari RA, Salam M, Almutairi AF. The relationship between addiction to smartphone usage and depression among adults: a cross sectional study. BMC Psychiatry. 2018;18(1):148.doi: 10.1186/s12888-018-1745-4
9. Al Battashi N, Al Omari O, Sawalha M, Al Maktoumi S, Alsuleitini A, Al Qadire M. The Relationship Between Smartphone Use, Insomnia, Stress, and Anxiety Among University Students: A Cross-Sectional Study. Clinical Nursing Research. 2020;30(6):734-40.doi: 10.1177/1054773820983161
10.Zhang J, Yuan G, Guo H, Zhang X, Zhang K, Lu X, et al. Longitudinal association between problematic smartphone use and sleep disorder among Chinese college students during the COVID-19 pandemic. Addictive Behaviors. 2023;144:107715.doi: https://doi.org/10.1016/j.addbeh.2023.107715
11.Kim E, Lee K. Relationship between Smartphone Addiction and Sleep Satisfaction: A Cross-Sectional Study on Korean Adolescents. Healthcare [Internet]. 2022; 10(7).doi: 10.3390/healthcare10071326
12.Qanash S, Al-Husayni F, Falata H, Halawani O, Jahra E, Murshed B, et al. Effect of Electronic Device Addiction on Sleep Quality and Academic Performance Among Health Care Students: Cross-sectional Study. JMIR Med Educ. 2021;7(4):e25662.doi: 10.2196/25662
13.Liu H, Zhou Z, Zhu E, Huang L, Zhang M. Smartphone addiction and its associated factors among freshmen medical students in China: a cross-sectional study. BMC Psychiatry. 2022;22(1):308.doi: 10.1186/s12888-022-03957-5
14.Alageel AA, Alyahya RA, A. Bahatheq Y, Alzunaydi NA, Alghamdi RA, Alrahili NM, et al. Smartphone addiction and associated factors among postgraduate students in an Arabic sample: a cross-sectional study. BMC Psychiatry. 2021;21(1):302.doi: 10.1186/s12888-021-03285-0
15.Tokiya M, Itani O, Otsuka Y, Kaneita Y. Relationship between internet addiction and sleep disturbance in high school students: a cross-sectional study. BMC Pediatrics. 2020;20(1):379.doi: 10.1186/s12887-020-02275-7
16.Nikolic A, Bukurov B, Kocic I, Vukovic M, Ladjevic N, Vrhovac M, et al. Smartphone addiction, sleep quality, depression, anxiety, and stress among medical students. Frontiers in Public Health. 2023;Volume 11 - 2023.doi: 10.3389/fpubh.2023.1252371
17. Abuhamdah SMA, Naser AY. Smart phone addiction and its mental health risks among university students in Jordan: a cross-sectional study. BMC Psychiatry. 2023;23(1):812.doi: 10.1186/s12888-023-05322-6
18. Shahid R, Akram M, Ayub M, Nadeem M, Fatima E, Haroon AM, et al. Prevalence and Correlates of Psychiatric Symptoms Among Medical Students in Punjab: A Comprehensive Cross-Sectional Study: Mental Health Insights: Psychiatric Symptoms Among Punjab Medical Students. DEVELOPMENTAL MEDICO-LIFE-SCIENCES. 2024;1(3):13-9.doi: 10.69750/dmls.01.03.029
19.Aziz B, Khan A, Jamil MF, Khalid M, Waheed F, Sohaib Z, et al. Empathy Levels in Medical Students as they Advance through their Years of Education: Empathy in Medical Training: A Comparative Study. DEVELOPMENTAL MEDICO-LIFE-SCIENCES. 2024;1(3):20-6.doi: 10.69750/dmls.01.03.035
20.Fayaz MS, Ullah A, Anam A, Aziz H, Zahid A. Assessment of Burnout, Academic Stress, and Coping Mechanisms Among Undergraduate Medical Students in Public and Private Sector Medical Colleges: Sector-Based Comparison of Medical Student Well-being. DEVELOPMENTAL MEDICO-LIFE-SCIENCES. 2025;2(4):30-8.doi: 10.69750/dmls.02.04.0120
21.Gao WJ, Hu Y, Ji JL, Liu XQ. Relationship between depression, smartphone addiction, and sleep among Chinese engineering students during the COVID-19 pandemic. World J Psychiatry. 2023;13(6):361-75.doi: 10.5498/wjp.v13.i6.361
22.Leow MQH, Chiang J, Chua TJX, Wang S, Tan NC. The relationship between smartphone addiction and sleep among medical students: A systematic review and meta-analysis. PLOS ONE. 2023;18(9):e0290724.doi: 10.1371/journal.pone.0290724
23.Alzhrani AM, Aboalshamat KT, Badawoud AM, Abdouh IM, Badri HM, Quronfulah BS, et al. The association between smartphone use and sleep quality, psychological distress, and loneliness among health care students and workers in Saudi Arabia. PLOS ONE. 2023;18(1):e0280681.doi: 10.1371/journal.pone.0280681
24.Kang Y, Liu S, Yang L, Xu B, Lin L, Xie L, et al. Testing the Bidirectional Associations of Mobile Phone Addiction Behaviors With Mental Distress, Sleep Disturbances, and Sleep Patterns: A One-Year Prospective Study Among Chinese College Students. Frontiers in Psychiatry. 2020;Volume 11 - 2020.doi: 10.3389/fpsyt.2020.00634
25.Zou Y, Xia N, Zou Y, Chen Z, Wen Y. Smartphone addiction may be associated with adolescent hypertension: a cross-sectional study among junior school students in China. BMC Pediatrics. 2019;19(1):310.doi: 10.1186/s12887-019-1699-9
26.Kil N, Kim J, McDaniel JT, Kim J, Kensinger K. Examining associations between smartphone use, smartphone addiction, and mental health outcomes: A cross-sectional study of college students. Health Promot Perspect. 2021;11(1):36-44.doi: 10.34172/hpp.2021.06
27.Tahir MJ, Malik NI, Ullah I, Khan HR, Perveen S, Ramalho R, et al. Internet addiction and sleep quality among medical students during the COVID-19 pandemic: A multinational cross-sectional survey. PLOS ONE. 2021;16(11):e0259594.doi: 10.1371/journal.pone.0259594
28.Ozcan B, Acimis NM. Sleep Quality in Pamukkale University Students and its relationship with smartphone addiction. Pak J Med Sci. 2021;37(1):206-11.doi: 10.12669/pjms.37.1.3130
29.Liu H, Zhou Z, Huang L, Zhu E, Yu L, Zhang M. Prevalence of smartphone addiction and its effects on subhealth and insomnia: a cross-sectional study among medical students. BMC Psychiatry. 2022;22(1):305.doi: 10.1186/s12888-022-03956-6
30.Dhamija S, Shailaja B, Chaudhari B, Chaudhury S, Saldanha D. Prevalence of smartphone addiction and its relation with sleep disturbance and low self- esteem among medical college students. Industrial Psychiatry Journal. 2021;30(Suppl 1).doi: 10.4103/0972-6748.328813
31.Maurya C, Muhammad T, Maurya P, Dhillon P. The association of smartphone screen time with sleep problems among adolescents and young adults: cross-sectional findings from India. BMC Public Health. 2022;22(1):1686.doi: 10.1186/s12889-022-14076-x
32.Kumar S, Rajasegaran R, Prabhakaran S, Mani T. Extent of Smartphone Addiction and its Association with Physical Activity Level, Anthropometric Indices, and Quality of Sleep in Young Adults: A Cross-Sectional Study. Indian Journal of Community Medicine. 2024;49(1):199-202.doi: 10.4103/ijcm.ijcm_706_22
33.Wang P-Y, Chen K-L, Yang S-Y, Lin P-H. Relationship of sleep quality, smartphone dependence, and health-related behaviors in female junior college students. PLOS ONE. 2019;14(4):e0214769.doi: 10.1371/journal.pone.0214769
34.Sirajudeen MS, Alzhrani M, Alanazi A, Alqahtani M, Waly M, Manzar MD, et al. Prevalence of Upper Limb Musculoskeletal Disorders and Their Association with Smartphone Addiction and Smartphone Usage among University Students in the Kingdom of Saudi Arabia during the COVID-19Pandemic—A Cross-Sectional Study. Healthcare [Internet]. 2022; 10(12).doi: 10.3390/healthcare10122373
35.Kaya F, Bostanci Daştan N, Durar E. Smart phone usage, sleep quality and depression in university students. International Journal of Social Psychiatry. 2020;67(5):407-14.doi: 10.1177/0020764020960207
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Jul 18, 2025
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How to Cite
AYSHA RASHID, Syed Muhammad Omer, Nasir Ali, Aliza Raheel, Ahmed Waheed, Nassir Nazir, Razia Batool, Naz Batool, Amira Shafaqat, & Awais Raza. (2025). ASSOCIATION BETWEEN SMARTPHONE ADDICTION AND SLEEP DISTURBANCES AMONG UNIVERSITY STUDENTS: A CROSS-SECTIONAL STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 32(6), 801-811. https://doi.org/10.53555/7mcbry35
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Author Biographies
AYSHA RASHID
Department of Psychiatry, Fatima Jinnah Medical University / Sir Ganga Ram Hospital, Lahore, Pakistan
Syed Muhammad Omer
Department of Psychiatry, Fatima Jinnah Medical University, Lahore, Pakistan
Nasir Ali
Department of Psychiatry, Sir Ganga Ram Hospital, Lahore, Pakistan
Aliza Raheel
Resident Psychiatrist, Rahbar Medical and Dental College, Lahore, Pakistan
Ahmed Waheed
Department of Psychiatry, Services Institute of Medical Sciences (SIMS) / Services Hospital, Lahore, Pakistan
Nassir Nazir
Registrar, Intellectual Property Tribunal, Lahore, Pakistan
Razia Batool
Lecturer / Lab Incharge, Sahara Medical College, Narowal, Pakistan
Naz Batool
Head, Department of Psychology, The Sahara College, Narowal, Pakistan
Amira Shafaqat
Lecturer, BBA Department, The Sahara College, Narowal, Pakistan
Awais Raza
Superior University, Lahore, Pakistan
How to Cite
AYSHA RASHID, Syed Muhammad Omer, Nasir Ali, Aliza Raheel, Ahmed Waheed, Nassir Nazir, Razia Batool, Naz Batool, Amira Shafaqat, & Awais Raza. (2025). ASSOCIATION BETWEEN SMARTPHONE ADDICTION AND SLEEP DISTURBANCES AMONG UNIVERSITY STUDENTS: A CROSS-SECTIONAL STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 32(6), 801-811. https://doi.org/10.53555/7mcbry35