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Cover page of the Journal of Health Sciences


 
 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 12  |  Issue : 3  |  Page : 237-241

A cross-sectional study to investigate the association between excessive smartphone use and sleep disturbances among adolescents, studying at KLE Society's Raja Lakhamagouda Science Institute, Belagavi, Karnataka, India, with a view to develop an information booklet


Department of Child Health Nursing, Institute of Nursing Sciences, KLE Academy of Higher Education and Research, Belagavi, Karnataka, India

Date of Web Publication15-Oct-2019

Correspondence Address:
Sabiyah Youssouf
Wachpora, Murran, Pulwama - 192 301, Jammu and Kashmir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kleuhsj.kleuhsj_76_19

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  Abstract 


BACKGROUND: We are in the second decade of the 21st century and technology has enveloped us in such a way that it is the technological gadgets that help us to open our eyes in the morning (i.e., alarm on a smartphone or an alarm clock), and it is the same technological devices that accompany us to our bed and remain there till we close our eyes at the night. The most important and multifunctional gift that the technology has provided us is the “Smartphone,” that has impacted our lives negatively. Smartphone addiction is a new kind of health disorder that is increasing the risk of severe health problems including sleep disturbances among adolescents.
OBJECTIVE OF THE STUDY: The aim of the present study was to find out the association between excessive smartphone use and sleep disturbances among adolescents.
MATERIALS AND METHODS: A cross-sectional study was conducted on 150 adolescents, who were selected by nonprobability purposive sampling technique. Standardized Smartphone Addiction Scale Short-Version and Pittsburgh's Sleep Quality Index were used to assess the smartphone addiction and sleep disturbances among the participants, respectively. The correlation between smartphone addiction and sleep disturbances was found by Karl Pearson's correlation coefficient.
RESULTS: The results of the study showed that majority of the participants (99 [66%]) had high smartphone addiction and minority of them (51 [34%]) had low smartphone addiction. Out of 150 participants, 80 (53.33%) showed high sleep disturbances, whereas 70 (46.67%) showed low sleep disturbances. The study findings showed a significant positive correlation (r = 0.8921) between excessive smartphone use and sleep disturbances among adolescents.
CONCLUSION: The study concluded that excessive smartphone use affects both the sleep quality and sleep quantity of adolescents; moreover increased smartphone addiction leads to increased sleep disturbances among them.

Keywords: Adolescents, sleep disturbances, smartphone, smartphone addiction, smartphone use


How to cite this article:
Youssouf S, Aribenchi SL, Salimath G. A cross-sectional study to investigate the association between excessive smartphone use and sleep disturbances among adolescents, studying at KLE Society's Raja Lakhamagouda Science Institute, Belagavi, Karnataka, India, with a view to develop an information booklet. Indian J Health Sci Biomed Res 2019;12:237-41

How to cite this URL:
Youssouf S, Aribenchi SL, Salimath G. A cross-sectional study to investigate the association between excessive smartphone use and sleep disturbances among adolescents, studying at KLE Society's Raja Lakhamagouda Science Institute, Belagavi, Karnataka, India, with a view to develop an information booklet. Indian J Health Sci Biomed Res [serial online] 2019 [cited 2019 Nov 19];12:237-41. Available from: http://www.ijournalhs.org/text.asp?2019/12/3/237/269206




  Introduction Top


We are in the second decade of the 21st century and technology has enveloped us in such a way that it is the technological gadgets that help us to open our eyes in the morning (i.e., alarm on a smartphone or an alarm clock), and it is the same technological devices that accompany us to our bed and remain there till we close our eyes at the night. The great technological advancements have influenced our lives greatly. The most important and multifunctional gift that the technology has provided us is the smartphone. Smartphone is an electronic device used to call, text, and perform some additional functions such as listening to music, playing different types of games, watching and making videos, and accessing different internet sites. The smartphone has made an important place in each corner of the world; there is hardly a person in the present era who has not used, seen or heard about a smartphone. The modern smartphone has replaced almost everything in our life, it replaced the books, the televisions and radios, the newspapers, the calculators, the playgrounds, and it replaced the chirping birds that woke us up in the morning. Not only this, the smartphone on the one hand shortened the long distance relationships by social networking sites, but on the other hand, decreased the face to face interactions and physical gatherings.

With the increased competition among the network service providers, newer offers, mobile companies, and launching of advanced and updated versions of smartphones, it has become an easy task for our young generation, especially adolescents to afford high standard smartphones at reasonable prices. Adolescents are also competing with each other in getting the most advanced and multifunctional smartphones, increasing the risks of smartphone addiction among them. Smartphone addiction is defined as the compulsive and repetitive use of the smartphone by users leading to psychological or behavioral dependency among them (Margaret Rouse 2018).

We know that adolescent belongs to the stage of life with great energy, creativity, and enthusiasm, if given right support and opportunity, can be the great resources for the present and future of our society, but if left neglected and uncared, can become the source of devastation to Humanity.

Excessive mobile phone use by adolescents is a serious matter of concern that needs to be observed and resolved. Worldwide smartphone addiction is emerging as a compulsive behavior that forces the adolescents to use smartphone repeatedly in a harmful way.[1] This “smartphone addiction/abuse/misuse” among teenagers has now become a global problem and higher authorities need to take remedial measures for this devastating issue at the earliest.[1] When coming to Indian adolescents, they are not an exception here, they are also immensely involved in this behavioral addiction (smartphone addiction), that increases the risk of different psychological emotional and physiological problems psychopathologies including sleep disturbances, and has a negative impact on their social and health aspects.[2]

Normally, the adolescent needs 8.5–10 h of sleep per night “Centre for Disease Control 2012.” It is not only the quantity but also the quality of the sleep that matters the most but, unfortunately, this smartphone over use plays a major role in decreasing the number of quality sleep hours among adolescents. Disturbed sleep patterns at night lead to excessive day time sleepiness, and there are increased risks of injury, falls, accidents, and casualties among people who drive in sleep-deprived conditions, as sleep deprivation causes attention deficit, disorientation, and excessive drowsiness.[3] Apart from the various benefits of cell phone, its excessive use can cause addictive tendencies among adolescents. The radiations emitted by mobile phones are categorized as “a carcinogenic hazard” and “possibly carcinogenic to humans.”[4]

A descriptive study conducted by Fobian et al. in 2016 in America to find how sleep efficiency is related to media use in American-African adolescents, concluded that sleep quality of adolescents is negatively affected by the use of media on longer durations, especially at bedtime and during the night hours.[5]

Amra et al. in his study also concluded that using smartphone in the night hours after going to bed leads to decreased quality and efficiency of sleep.[6]

Keeping all the above evidence in mind and while confronting the situations personally, we found a need to investigate the association between excessive smartphone use and sleep disturbances among adolescents with a view to develop an information booklet and to take appropriate remedial measures to curb this problem at its earliest.


  Materials and Methods Top


We obtained the Ethical Clearance from the Ethical Clearance Committee of KLE Academy of Higher Education and Research and formal permission from the Principal of KLE Society's Raja Lakhamagouda Science Institute, Belagavi, Karnataka, for conducting the main study. The present study was conducted on a sample of 150 PUC students of KLE Society's Raja Lakhamagouda Science Institute of 2018 batch, including 85 females and 65 males, using a nonexperimental descriptive research design. The participants possessing the inclusion criteria characteristics were selected using nonprobability purposive sampling technique. The eligibility/inclusion criteria included the adolescents who: (1) were studying at KLE Society's Raja Lakhamagouda Science Institute, Belagavi, Karnataka, India; (2) participated in the study by their own choice; (3) were owning a smartphone; (4) participated in the process of data collection, and the exclusion criteria included the adolescents who were: (1) sick during the process of collection of data and (2) who had sleep disturbances because of some other reasons (e.g., pain, environmental disturbances, study stress, etc.).

Duration of the study

The time duration for the present study was 1 year from March 2018 to March 2019.

Instruments used

The data were collected from the participants using self-structured pro forma that obtained data about the demographic details (age, gender, and type of residence) of the participants, Smartphone Addiction Scale short-version (SAS-SV) (Min Kwon et al.) that assessed smartphone addiction among the patients, and Pittsburgh Sleep Quality Index (Buysse et al.) that assessed the overall sleep quality of the adolescents, after taking the proper permission from the original authors of these tools.

Smartphone Addiction Scale-short version

It consists of ten items; all weighed equally on a six-point Likert scale. All the six scores are summed up to get a total score. SAS-SV has a cutoff value of 31 in boys and 33 in girls.

Pittsburgh Sleep Quality Index

It consists of 19 self-rated items and 5 items answered by the roommate (if available). All the 19 items are summed up to gain seven component scores, every component ranging from 0 to 3 as the final score. The seven component scores are then added to get a global score ranging from 0 to 21, with 0 indicating no difficulty in any component and 21 indicating severe difficulty in all components.

Pilot study

The researchers took the written permission from the Principal of the Shri Siddharameshwar Pre University College and after that conducted a pilot study at Shri Siddharameshwar Pre University College, Shivabasava Nagar, Belagavi, Karnataka. The pilot study results showed a significant correlation between the excessive smartphone use and sleep disturbances among the adolescents. Hence, the study was found to be feasible, practical, and can be conducted on a larger sample for better generalizations.

The data were analyzed by using Karl Pearson's Correlation Coefficient to find out the correlation between excessive smartphone use and sleep disturbances among adolescents. The software used was Statistical Package for the Social Sciences Version 16.


  Results Top


Major findings of the study were

Findings related to the sociodemographic variables of participants

We found that majority of the adolescents 82 (54.67%) belonged to 18 years of age group, 56 (37.33%) to 17 years age group and 12 (8%) to 19 years age group. Out of 150 participants, 85 (56.67%) were female and 65 (43.33%) were male. Majority (98 ([65.33%]) of the participants were residing in urban area, whereas minority of them (52 [34.69%]) were residing in rural areas [Table 1].
Table 1: Distribution of adolescents by age, gender, and area of residence

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Findings related to the levels of smartphone addiction levels of among adolescents

In the present study, we found that out of 150 participants, majority (99 [66%]) had high smartphone addiction, whereas minority (51 [34%]) of them had low smartphone addiction [Table 2] and [Graph 1].
Table 2: Distribution of adolescents by level of smartphone addiction

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Findings related to the levels of sleep disturbances among adolescents

results showed that out of the 150 participants, 80 (53.33%) were having high sleep disturbances, whereas 70 (46.67%) were having low sleep disturbances [Table 3] and [Graph 2].
Table 3: Distribution of adolescents by level of sleep disturbances

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Findings related to the comparison of demographic characteristics of adolescents with mean smartphone addiction scores:

In the present study, adolescents with 17 years of age recorded a mean smartphone addiction score of 38.79 (standard deviation [SD] =14.92), adolescents with 18 years of age showed a mean smartphone addiction score of 40.56 (SD = 13.25), while the adolescents with 19 years of age recorded a mean smartphone addiction score of 39.77 (SD = 13.94), with F = 0.2872 and P = 0.7508. The result indicates that there was no significant difference in mean smartphone addiction among adolescents with different age groups. Moreover male adolescents recorded a mean smartphone addiction score of 42.46 (SD = 11.96), while female adolescents recorded a mean smartphone addiction score of 37.72 (SD = 15.03), with t = 2.0887 and P = 0.0385. The result shows that there is a significant difference in mean smartphone addiction level among genders. The participants belonging to urban areas recorded a mean smartphone addiction score of 43.66 (SD = 12.72), while participants belonging to rural areas recorded a mean smartphone addiction score of 32.44 (SD = 13.27), with t = −5.0655 and P = 0.0001. The result indicates that there is a significant difference in mean smartphone addiction levels among urban and rural adolescents.

Findings related to the comparison of demographic characteristics of adolescents with mean sleep disturbance scores

In the present study, adolescents with 17 years of age recorded mean sleep disturbances score of 9.93 (SD = 5.86), adolescents with 18 years of age showed a mean sleep disturbances score of 10.66 (SD = 5.01), while the adolescents with 19 years of age recorded a mean sleep disturbances score of 11.25 (SD = 4.94), with F = 0.4638 and P = 0.6298. The result indicated that the adolescents in different age groups showed no significant difference in mean sleep disturbances. Male adolescents recorded a mean sleep disturbance score of 11.45 (SD = 4.70), while female adolescents recorded a mean sleep disturbances score of 9.66 (SD = 5.65), with t = 2.0616 and P = 0.0410. The result indicates that there is a significant difference in mean sleep disturbance levels among genders. Participants belonging to urban areas recorded a mean sleep disturbances score of 12.15 (SD = 4.97), while participants belonging to rural areas recorded a mean sleep disturbances score of 7.19 (SD = 4.38), with t = −6.0516 and P = 0.0001. The result indicated that there is a significant difference in mean sleep disturbance levels among urban and rural adolescents.

Findings related to the correlation between excessive smartphone use and sleep disturbances among adolescents

Our study found that there is a strong significant positive relationship between smartphone addiction and sleep disturbances among adolescents, with r = 0.8921, r2 = 0.7959, P = 0.0001. This insinuated that as the level of smartphone addiction increases among adolescents, the level of sleep disturbances will also increase [Table 4] and [Graph 3].
Table 4: Correlation between smartphone addiction scores and sleep disturbance scores of adolescents

Click here to view




  Discussion Top


In our study, we found that out of 150 participants, majority (99 [66%]) had high smartphone addiction, whereas minority (51 [34%]) of them had low smartphone addiction. Those participants who had high smartphone addiction also had high sleep disturbances and disturbed the quality of sleep. A similar study conducted by Soni et al. showed that out of 587 participants, 33.3% (n = 196) were using smartphone excessively and concluded that adolescents are using smartphones for longer durations, leading to significant disturbances in sleep and behavioral problems.[7] The present study found that there is a strong positive correlation between smartphone addiction and sleep disturbances among adolescents, with r = 0.8921, r2 = 0.7959 and P = 0.0001. This insinuated that as the level of smartphone addiction increases, the level of sleep disturbances also increase. Kurugodiyavar et al. in their study also came to the conclusion that there is an inverse relationship between sleep efficiency and smartphone addiction that means sleep efficiency decreases with increased use of smartphone.[8]


  Conclusion Top


Based on the findings of the study, the following conclusions were drawn:

The sociodemographic variables of adolescents such as gender and area of residence of adolescents are associated with the levels of smartphone addiction, whereas age of the adolescents is not associated with the levels of smartphone addiction. Moreover, area of residence of adolescents is associated with the levels of sleep disturbances, whereas age and gender of the adolescents are not associated with the levels of sleep disturbances. The mean smartphone addiction scores showed that male participants are more addicted to smartphone than females and urban adolescents had more smartphone addiction than rural adolescents. Moreover sleep disturbances were seen more in urban adolescents than rural adolescents, and male adolescents had more sleep disturbances than female adolescents. The participants who had higher smartphone addiction showed higher levels of sleep disturbances, and as the level of smartphone addiction increases among adolescents, the level of sleep disturbances also increases.


  Strengths and Weaknesses of the Study Top


Strengths

The present study focused on smartphone addiction and sleep disturbances among adolescents. Both these problems are considered as research thrust areas and need to be dealt with updated knowledge, positive attitude, and healthy practices based on the current research. Moreover, the present study is a preliminary step for that.

Weaknesses

The present study was conducted on a small sample, and for better results and generalizations, similar studies should be conducted on a larger sample size at different settings.

Acknowledgments

The authors are grateful for the Administration and the PUC Students of the KLE RLS College, Belagavi, for their support and participation.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Davey S, Davey A. Assessment of smartphone addiction in Indian adolescents: A Mixed method study by systematic-review and meta-analysis approach. Int J Prev Med 2014;5:1500-11.  Back to cited text no. 1
    
2.
Smartphone 'Addiction' May Affect Adolescent Development. Medscape; 2019. Available from: https://www.medscape.com/viewarticle/804666. [Last accessed on 2019 Apr 21].  Back to cited text no. 2
    
3.
Nhlbi. Nih. Gov; 2019. Available from: https://www.nhlbi.nih.gov/files/docs/resources/sleep/pslp_wg.pdf. [Last accessed on 2019 Apr 21].  Back to cited text no. 3
    
4.
Mobile Phone Radiation and Health; 2019. Available from: http://en.wikipedia.org/wiki/Mobile_phone_radiation_and_health. [Last cited on 2019 Apr 21].  Back to cited text no. 4
    
5.
Fobian AD, Avis K, Schwebel DC. Impact of media use on adolescent sleep efficiency. J Dev Behav Pediatr 2016;37:9-14.  Back to cited text no. 5
    
6.
Amra B, Shahsavari A, Shayan-Moghadam R, Mirheli O, Moradi-Khaniabadi B, Bazukar M, et al. The association of sleep and late-night cell phone use among adolescents. J Pediatr (Rio J) 2017;93:560-7.  Back to cited text no. 6
    
7.
Soni R, Upadhyay R, Jain M. Prevalence of smart phone addiction, sleep quality and associated behaviour problems in adolescents. Int J Res Med Sci 2017;5:515.  Back to cited text no. 7
    
8.
Kurugodiyavar M, Sushma HR, Godbole M, Nekar M. Impact of smartphone use on quality of sleep among medical students. Int J Community Med Public Health 2017;5:101-9.  Back to cited text no. 8
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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