Association between screen time and sleep quality among university students in Lahore, Pakistan: a cross-sectional study

Abstract Background The growing dependence on digital devices has raised increasing concerns about sleep health, especially among young adults. The current study aimed to assess the association between screen time and sleep quality among university students in Lahore, Pakistan. Secondary objectives encompassed examining gender differences, body mass index (BMI), and common health issues associated with the prolonged screen time. Methods A cross-sectional study was conducted among 618 university students from June to November 2025. Data were collected on demographics, screen time (Stay Free app), and sleep quality (Pittsburgh Sleep Quality Index; PSQI). Data were analyzed using SPSS, with p < 0.05 considered statistically significant. Results Among the 618 participants, the mean age was 23.56 ± 4.83 years, and most were undergraduates (83.2%). The mean daily screen time was 8.23 ± 1.81 h. A significant association was found between screen time categories (low [< 6 h/day], moderate [6–8 h/day], high [> 8 h/day]) and poor sleep quality (Fisher’s exact test, p < 0.001). The mean modified PSQI score was 13.59 ± 4.39, with 93.7% indicating poor sleep. The mean sleep duration was 4.95 ± 1.01 h. A significant dose-response relationship was observed, where compared with high screen time (> 8 h/day), low screen time (< 6 h/day) was associated with lower odds of poor sleep (adjusted odds ratio [AOR] = 0.006, p < 0.001), while moderate screen time (6–8 h/day) was also associated with lower odds (AOR = 0.197, p = 0.039). Sleep duration (AOR = 42.540, p < 0.001) and obesity (AOR = 12.097, p = 0.010) were significant independent predictors of poor sleep quality. Sleep duration correlated positively with subjective poorer sleep quality (ρ = 0.527, p < 0.001). Gender differences in screen time were significant, with females less likely to have high screen time compared with males (χ² = 30.551, df = 2, p < 0.001). The most common health issues linked to prolonged screen time were headache (71.7%), fatigue (62.6%), dry eyes (49.0%) and eye strain (37.9%). Conclusion Prolonged screen time was significantly associated with poor sleep quality and several negative health outcomes among university students. These findings underscore the need for interventions promoting healthy digital habits, improved sleep education, and lifestyle improvements.