Andersen Thea Otte, Sejling Christoffer, Jensen Andreas Kryger, Drews Henning Johannes, Ritz Beate, Varga Tibor V, Rod Naja Hulvej
Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Sleep. 2023 Dec 11;46(12). doi: 10.1093/sleep/zsad256.
This study investigated the complex relationship between nighttime smartphone use, sleep, and mental health among adult populations in Denmark.
Data from three interconnected samples (aged 16-89 years) from the SmartSleep Study included 5798 individuals with survey and register data; 4239 individuals also provided high-resolution smartphone tracking data. Logistic regression models and causal discovery algorithms, which suggest possible causal pathways consistent with the underlying data structure, were used to infer the relationship between self-reported and tracked nighttime smartphone use, self-reported sleep quality, mental health indicators, and register-based psychotropic medication use.
Frequent self-reported nighttime smartphone use was associated with high perceived stress (OR: 2.24, 95% CI = 1.42 to 3.55) and severe depressive symptoms (OR: 2.96, 95% CI = 2.04 to 4.28). We found no clear associations between tracked nighttime smartphone use and mental health outcomes, except for the cluster that used their smartphones repeatedly during the sleep period, which was associated with severe depressive symptoms (OR = 1.69, 95% CI = 1.24 to 2.31). Poor sleep quality (vs. good sleep quality) was associated with high perceived stress (OR = 5.07, 95% CI = 3.72 to 6.90), severe depressive symptoms (OR = 9.67, 95% CI = 7.09 to 13.19), and psychotropic medication use (OR = 2.13, 95% CI = 1.36 to 3.35). The causal discovery models suggest that nighttime smartphone use affects mental health through both problematic smartphone use and poor sleep quality.
The complex relationship between nighttime smartphone use, sleep, and poor mental health may create a vicious circle over time, and nighttime smartphone use may constitute a potential leverage point for public health interventions aimed at improving sleep and mental health.
本研究调查了丹麦成年人群中夜间使用智能手机、睡眠和心理健康之间的复杂关系。
来自SmartSleep研究的三个相互关联的样本（年龄在16 - 89岁之间）的数据包括5798名有调查和登记数据的个体；4239名个体还提供了高分辨率的智能手机使用跟踪数据。逻辑回归模型和因果发现算法用于推断自我报告的和跟踪的夜间智能手机使用、自我报告的睡眠质量、心理健康指标以及基于登记的精神药物使用之间的关系，这些算法能提出与基础数据结构一致的可能因果路径。
频繁自我报告夜间使用智能手机与高感知压力（比值比：2.24，95%置信区间 = 1.42至3.55）和严重抑郁症状（比值比：2.96，95%置信区间 = 2.04至4.28）相关。我们发现，除了在睡眠期间反复使用智能手机的群体与严重抑郁症状相关（比值比 = 1.69，95%置信区间 = 1.24至2.31）外，跟踪的夜间智能手机使用与心理健康结果之间没有明确关联。睡眠质量差（与良好睡眠质量相比）与高感知压力（比值比 = 5.07，95%置信区间 = 3.72至6.90）、严重抑郁症状（比值比 = 9.67，95%置信区间 = 7.09至13.19）以及精神药物使用（比值比 = 2.13，95%置信区间 = 1.36至3.35）相关。因果发现模型表明，夜间智能手机使用通过有问题的智能手机使用和睡眠质量差来影响心理健康。
夜间智能手机使用、睡眠和心理健康不佳之间的复杂关系可能会随着时间形成恶性循环，夜间智能手机使用可能构成旨在改善睡眠和心理健康的公共卫生干预的潜在切入点。
