Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China.
Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China.
Addict Behav. 2023 Sep;144:107715. doi: 10.1016/j.addbeh.2023.107715. Epub 2023 Apr 8.
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.
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.
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.
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.
智能手机使用问题（PSU）和睡眠障碍（SD）是大学生常见的公共卫生问题。虽然之前的横断面研究发现 PSU 和 SD 之间存在关系，但这种关系的因果方向尚不清楚。本研究旨在探讨 COVID-19 大流行期间 PSU 和 SD 的纵向变化，确定它们之间的因果关系，并确定影响这种关联的混杂因素。
研究样本包括 1186 名中国大学生（47.7%为男性），平均年龄为 18.08 岁。参与者在基线和随访调查中完成了智能手机成瘾量表-短版（SAS-SV）和匹兹堡睡眠质量指数（PSQI），两次调查相隔一年。交叉滞后面板模型（CLPM）用于检验 PSU 和 SD 之间的因果关系，按性别和每日体力活动时间长短进行分层。固定效应面板回归用于确认 CLPM 的发现。
CLPM 分析结果表明，总体样本中 PSU 和 SD 之间存在显著的双向关系，这与固定效应模型的结果一致。然而，亚组分析显示，这种双向关联在男性或每天进行超过 1 小时体力活动的人群中消失了。
我们的研究表明，PSU 和 SD 之间存在显著的双向关联，性别和每日体力活动水平存在差异。鼓励体力活动可能是打破 PSU 和 SD 之间双向关联的潜在干预措施，这对旨在减少 PSU 和 SD 负面影响的公共卫生策略具有重要意义。
