Li Lu, Feng Xiuqiong, Luo Shengyu, Lin Li, Xiang Hongyu, Chen Dezhong, Qin Kang, Guo Xun, Chen Weiqing, Guo Vivian Yawei
Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China.
Department of Public Health, Guangzhou Huangpu District Center for Disease Control and Prevention, Guangzhou, 510530, Guangdong, China.
Sleep Med. 2024 May;117:53-59. doi: 10.1016/j.sleep.2024.03.007. Epub 2024 Mar 8.
Internet addiction (IA) has emerged as a recognized risk factor associated with impaired health-related quality of life (HRQOL) in adolescents. However, the role of sleep disturbance in this association remains unclear. This study aimed to investigate the association of IA with HRQOL in Chinese adolescents and to evaluate the potential mediating role of sleep disturbance.
A cross-sectional study was conducted among adolescents attending six randomly selected middle schools in Guangzhou, China. Adolescents self-reported their internet use using the Young Diagnostic Questionnaire. HRQOL and sleep disturbance were assessed by the Pediatric Quality of Life Inventory version 4.0 and the Pittsburgh Sleep Quality Index, respectively. Multivariate linear regression analysis was employed to assess the association between IA and HRQOL. Baron and Kenny's causal steps method was used to examine the possible mediating role of sleep disturbance.
Of the 6473 adolescents included, 23.5% had maladaptive internet use (MIU) and 16.6% had pathological internet use (PIU). Compared to adolescents with adaptive internet use (AIU), those with IA had significantly lower scores across all HRQOL dimensions and summary scales. Mediation analysis revealed that sleep disturbance was a significant mediator. Specifically, sleep disturbance mediated 34.55% of the effects of MIU and 34.06% of the effects of PIU on the HRQOL total scale score , respectively.
IA was associated with poorer HRQOL, indicating the needs of preventing IA in Chinese adolescents. Additionally, our findings underscored the importance of enhancing sleep quality to mitigate the adverse impact of IA on adolescents' well-being.
网络成瘾已成为青少年健康相关生活质量受损的一个公认风险因素。然而，睡眠障碍在这种关联中的作用仍不明确。本研究旨在调查中国青少年网络成瘾与健康相关生活质量的关联，并评估睡眠障碍的潜在中介作用。
在中国广州随机选取的六所中学对青少年进行了一项横断面研究。青少年使用青少年诊断问卷自我报告其互联网使用情况。分别通过儿童生活质量量表第4.0版和匹兹堡睡眠质量指数评估健康相关生活质量和睡眠障碍。采用多元线性回归分析评估网络成瘾与健康相关生活质量之间的关联。使用Baron和Kenny的因果步骤法检验睡眠障碍的可能中介作用。
在纳入的6473名青少年中，23.5%有适应不良的互联网使用（MIU），16.6%有病理性互联网使用（PIU）。与具有适应性互联网使用（AIU）的青少年相比，网络成瘾的青少年在所有健康相关生活质量维度和汇总量表上的得分显著更低。中介分析显示，睡眠障碍是一个显著的中介因素。具体而言，睡眠障碍分别介导了MIU对健康相关生活质量总量表得分影响的34.55%和PIU对健康相关生活质量总量表得分影响的34.06%。
网络成瘾与较差的健康相关生活质量相关，表明在中国青少年中预防网络成瘾的必要性。此外，我们的研究结果强调了提高睡眠质量以减轻网络成瘾对青少年幸福感的不利影响的重要性。
