Mediating Effect of Sleep Quality on the Relationship Between Electronic Screen Media Use and Academic Performance Among College Students

Abstract

Objective

We aimed to examine the effects of sleep quality on the association between pre-bedtime electronic screen media use for entertainment and academic performance among college students. We hypothesized that sleep quality mediates the association between pre-bedtime electronic screen media entertainment use and academic performance among college students.

Methods

This was a cross-sectional survey with 1385 participants (age 19.99 ± 1.4 years [range, 17–24 years] and 36.82% males) conducted at Shantou University. The levels of academic performance were based on self-reported academic class ranking from average grades of their last final major examinations. Poor sleep quality was defined as a total score of the Pittsburgh Sleep Quality Index >7. The pre-bedtime prolonged electronic screen media use for entertainment (PESM-E) was defined as the use of electronic screen media for entertainment longer than 60 minutes/night after 10:00 p.m. during the past 6 months.

Results

College students with pre-bedtime PESM-E were 1.28-fold more likely to have a poor academic performance than those who used electronic screen media less than 60 minutes (95% confidence interval [CI]: 1.04–1.57, P=0.020). Furthermore, pre-bedtime PESM-E was significantly associated with poor sleep quality (adjusted odds ratio [AOR]=1.87, 95% CI: 1.27–2.74, P=0.001) after controlling for confounders. Mediation model showed that poor sleep quality accounted for 53.08% of the effect of pre-bedtime PESM-E on lower levels of academic performance (Sobel Z=2.04, P=0.041).

Conclusion

Pre-bedtime PESM-E is associated with poor academic performance in college students, and this association is mediated by poor sleep quality. Our findings highlight the importance of limiting the use of electronic screen media before bedtime in college students.

Keywords:

• poor sleep quality
• sleep
• academic performance
• electronic screen use
• college students

Abbreviations

ANOVA, analysis of variance; AOR, adjusted odds ratio; BMI, body mass index; BAI, Beck Anxiety Inventory; BDI, Beck Depression Inventory; ChiCTR, Chinese Clinical Trial Registry; CI, confidence interval; ESS, Epworth Sleepiness Scale; MEQ, Morningness-Eveningness Questionnaire; PESM, prolonged electronic screen media use; PESM-E, prolonged electronic screen media use for entertainment; PSQI, Pittsburgh Sleep Quality Index; STCSSC, Shantou College Students Sleep Cohort; SUMHC, Shantou University Mental Health Center; VIF, variance inflation factor.

Data Sharing Statement

Data and protocols are available upon reasonable request. Data and protocols are available on request from the corresponding author.

Acknowledgments

The authors thank Prof. Stanley Lin, a native English-speaking scientist who proof-read this manuscript before submission. The work was performed at the Shantou University Mental Health Center.

Disclosure

All authors report no bioMedical financial interests or other potential conflicts of interest for this work.

Additional information

Funding

This study was supported by the Guangdong University Students Innovation and Entrepreneurship Training Program (201910560138 and 202010560040), National Natural Science Foundation of China (No. 81970087) and Guangdong Province Science and Technology Special Fund Project (200115165870512).