University students and excessive screen time: links to sleep disturbance and acute health issues

Background: University students often spend a significant amount of time on screens due to academic demands, entertainment and social interactions. However, excessive screen time may negatively affect sleep quality and contribute to deterioration in health. This study aimed to determine the association between sleep disturbance and acute health effects associated with prolonged screen time among students at a higher education institution. Methods: A cross-sectional study was conducted among undergraduate students at a public university in Kuantan, Pahang. A self-administered questionnaire was distributed to eligible participants who owned personal screen-based devices and had sufficient English proficiency to understand the questionnaire. Students who were on study leave and had been diagnosed with insomnia and pre-existing eye disorders that are known not to be caused by excessive screen usage were excluded. Screen device addiction was measured using the Manolis/Roberts Cell-Phone Addiction Scale (MRCPAS), while sleep behaviour was assessed using the Pittsburgh Sleep Quality Index (PSQI). Results: With 155 participants, the findings indicate that the majority preferred using smartphones primarily for educational and entertainment purposes, with an average daily screen time of 7.32 hours. The mean addiction score to the screen device was 12.81 out of 20, indicating a high level of screen device dependency. Despite this, the majority (97.4%) reported good sleep quality. Participants reported several acute health effects due to prolonged screen time, including eye strain, musculoskeletal discomfort (e.g. back pain, neck pain), headaches, and a decline in physical fitness. Chi-square analysis revealed significant associations between sleep disturbance and dry eyes (p=0.022), blurred vision (p=0.023), burning eyes sensation (p=0.048), double vision (p=0.014), difficulty focusing for near vision (p=0.012), feeling that eyesight is worsening (p=0.029), and back pain (p=0.028). Conclusion: Our findings indicate that sleep disturbance had significant associations with several acute health effects caused by prolonged screen time. The results obtained in this study may not accurately reflect the general university student population, as the sample size was limited; however, they may serve as a helpful starting point for larger epidemiological studies.