Moderated mediation model of the association between problematic smartphone use and dry eye disease within Moroccan adolescents

This study scrutinizes the mediating role of sleep disturbance in the relationship between problematic smartphone use and dry eye disease and examines the moderating role of physical activity. A total of 2202 high school students from twelve regions of Morocco completed the Smartphone Addiction Scale-Short Version (SAS-SV), the Insomnia Severity Index (ISI), and the Dry Eye Questionnaire-5 (DEQ-5). Participants were also asked to rate the number of days per week during which they performed physical activity for at least 60 min. Our findings indicated that 50% of participants were problematic smartphone users, 39.3% suffered from dry eye disease and 38.3% suffered from sleep problems. The results suggested that sleep disorder mediated partially the relationship between problematic smartphone use and dry eye disease. Physical activity (at least 180 min per week) influenced the relationship between problematic smartphone use and dry eye disease. Specifically, it moderated both the direct link between smartphone use and dry eye, and the indirect link mediated by sleep disorders. This moderating effect was significant (index = - 0.0218, 95% CI [- 0.0260, - 0.0173]). These results offer valuable insights for preventing and managing sleep disturbances and dry eye disease linked to problematic smartphone use.