| Summary: | 碩士 === 國立臺灣大學 === 健康政策與管理研究所 === 102 === Background: Smartphones have gained widespread popularity as they allow users to access the Internet while providing the functions of regular cell phones. Prior research among college students has also found excessive use of the Internet and cell phones to be associated with sleep problems. However, little is known about the effects of smartphone use on sleep quality. Hence, this study aimed to examine the relationship between problematic smartphone use, including smartphone use before sleep, and sleep quality.
Methods: A total of 974 smartphone-using college students in northern Taiwan were recruited in this cross-sectional study during March of 2014 (response rate=81.0%). Problematic Smartphone Use Scale (PSUS), which is modified from Chen Internet Addiction Scale (CIAS), Pittsburgh Sleep Quality Index (PSQI), and Patient Health Questionnaire (PHQ-9) were used in this survey. Exploratory factor analysis was also performed to evaluate the psychometric properties of PSUS. Finally, multivariate logistic regression was employed to assess the associations between problematic smartphone use and sleep quality.
Results: This study identified 47.9% of college students as poor sleepers. Depressive tendency (AOR=3.85, 95% CI=2.63-5.65) and the following variables related to smartphone use were found significantly associated with poor sleep quality: higher PSUS scores (AOR=1.02, 95% CI=1.01-1.03) and smartphone use before sleep (1-3 days/week: AOR=2.19, 95% CI=1.33-3.60; 4-7days/week: AOR=1.82, 95% CI=1.05-3.16), after controlling for background characteristics. In addition, smartphone use before sleep 1-3 days/week had a significant interaction effect with depressive tendency (AOR=0.31, 95% CI=0.16-0.60) on sleep quality. Alternatively, when problematic smartphone use was assessed by its four behavioral manifestations, instead of PSUS scores, “interpersonal and health problems” and “time management problems” were also found to interact significantly with depressive tendency.
Conclusions: Elevated problematic smartphone use may increase the risk of having poor sleep quality among college students. Notably, smartphone use before sleep 1-3 days/week significantly affected sleep quality even among students without depressive tendency. These findings suggest that tailored interventions are urgently needed to ameliorate the impact of problematic smartphone use.
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