Association of sleep quality, smartphone addiction, and depressive symptoms among undergraduate medical students in Nepal

Abstract Introduction While research has examined the connections between sleep quality, smartphone addiction, and depressive symptoms in general, no studies focused on undergraduate medical students in Nepal have specifically tested the complex relationship between these factors. Therefore, this study aimed to investigate the interaction between smartphone addiction, sleep quality, and depressive symptoms among undergraduate medical students of Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Methods A cross-sectional study was conducted among 212 undergraduate medical students at Maharajgunj Medical Campus, Tribhuvan University, Nepal. Sleep quality, smartphone addiction, and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index, Smartphone Addiction Scale Short Version, and Patient Health Questionnaire-9. Data were analyzed using IBM SPSS version 26 via the bootstrap model approach. Results Out of the total participants, 67.9% were male. Males showed higher scores in smartphone addiction and depressive symptoms than females (b = 5.3, Bca 95% CI:1.2, 9.1, p < 0.05). The unadjusted model indicated that the presence of smartphone addiction explained 36.5% of the indirect impact of sleep quality on depressive symptoms. However, in the adjusted model, after introducing socio-demographic, behavioral, and educational variables as covariates, this percentage decreased to 33.02%. Conclusion This study highlights the significant role of both smartphone addiction and sleep quality in mediating the indirect effect on depressive symptoms among undergraduate medical students. Smartphone addiction emerged as a key mediator of depressive symptoms, indicating a potentially important factor in mental health. Investigating this relationship further through longitudinal studies will be crucial for developing effective preventative and therapeutic approaches.