Unraveling the Internet Gaming Disorder and ADHD Link in Adolescents: The Role of Depression, Anxiety, and Sleep

Introduction: Internet Gaming Disorder (IGD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are two emerging mental health problem that is found to be associated. This comorbiditiy is shared by features such as impulsivity, inattention, and impaired self-regulation. However, the role of comorbid depression, anxiety, and sleep in this relationship remains underexplored. Methods: We conducted a systematic review in accordance to PRISMA guidelines, searching ScienceDirect, PubMed, and Google Scholar for studies published between 2020-2025. Inclusion and exclusion criteria are checked before manual abstract and full-text screening are performed. Risk of Bias (RoB) are assessed by JBI’s checklist. A total of 17 studies were included. Results: Findings consistently revealed a positive association between IGD-ADHD and depression, anxiety, sleep. Depression and anxiety commonly mediate this relationship, with adolescents using gaming as an escape from emotional distress, which in turn worsened executive dysfunction and emotional regulation. Sleep are also identified as partial mediators, as both ADHD and IGD disrupt circadian rhythm and sleep quality, reinforcing the cycle. Conclusions: The link between ADHD and IGD in adolescents is robust and influenced by depression, anxiety, and sleep. These factors act as mediators and amplifiers in a bidirectional pathway, highlighting the need for integrative prevention and intervention strategies that address both behavioral regulation and emotional well-being.