The Impact of Problematic Smartphone Use on Sleep Quality Among Chinese Young Adults: Investigating Anxiety and Depression as Mediators in a Three-Wave Longitudinal Study

Abstract

Background

Sleep disorders are a significant health issue that urgently needs to be addressed among undergraduate students, and one of the potential underlying problems could be problematic smartphone use (PSU). This study aimed to clarify the relationship between PSU and poor sleep quality by investigating the independent and serial mediating roles of anxiety and depressive symptoms in a population of university students in Tibet, China.

Methods

A total of 2993 Tibetan college students completed three waves of data surveys, with all participants completing questionnaires on PSU, anxiety, depressive symptoms, and sleep quality (Time 1 (T1) -Time 3 (T3)). Bootstrapped mediation analysis was used to explore the mediating role of anxiety and depressive symptoms in the longitudinal relationship between PSU and sleep quality.

Results

Both direct and indirect effects of PSU on poor sleep quality were found. PSU (T1) can had not only a direct negative influence on poor sleep quality (T3) among young adults (direct effect = 0.021, 95% CI = 0.010–0.033) but also an indirect negative impact via three pathways: the independent mediating effect of anxiety symptoms (T2) (indirect effect 1 = 0.003, 95% CI = 0.001–0.006), the independent mediating effect of depressive symptoms (T2) (indirect effect 2 = 0.004, 95% CI = 0.002–0.006), and the serial mediating effects of anxiety (T2) and depressive symptoms (T2) (indirect effect 3 = 0.008, 95% CI=0.005–0.011).

Conclusion

These findings highlight the role of anxiety and depression symptoms as joint mediating factors in the relationship between PSU and sleep disturbances. Interventions focused on improving sleep that incorporate behavioural measures could benefit from treatment approaches targeting mental disorders.

Keywords:

• sleep quality
• problematic smartphone use
• anxiety
• depressive symptoms
• longitudinal study

Ethics Statement

This study received approval from the Ethics Committee of Xizang Minzu University [No. 202329] and complied with the Declaration of Helsinki. The subjects were fully informed of the content and purpose of the survey before participation. All participants provided informed consent before the participation in the present study.

Acknowledgment

The authors would like to express their special thanks for the support and assistance of the participating schools and student administrators, as well as the study participants.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests.

Additional information

Funding

This work was supported by the Scientific Research Plan Projects of Shaanxi Province Education Department (Grant No. 22JK0205), National Natural Science Foundation of China (International Cooperation and Exchange Programme) (Grant No. 81761128030), Natural Science Foundation of Tibet Autonomous Region (Grant No. XZ202201ZR0055G), Tibet Autonomous Region Higher Education Teaching Reform Project (Grant No. JG2023-53), Research Projects of Xizang Minzu University (Grant No. 23MDY08), the Scientific Research Project of Xizang Minzu University (No. 23MDQ03).