Temporal association between objectively measured smartphone usage, sleep quality and physical activity among Chinese adolescents and young adults.
Abstract
We studied the association between objectively measured smartphone usage and objectively measured sleep quality and physical activity for seven consecutive days among Hong Kong adolescents and young adults aged 11-25 years (n = 357, 67% female). We installed an app that tracked the subjects' smartphone usage and had them wear an ActiGraph GT3X accelerometer on their wrist to measure their sleep quality and physical activity level. Smartphone usage data were successfully obtained from 187 participants (52.4%). The participants on average spent 2 h 46 min per day on their smartphone. Multilevel regression showed that 1 min of daytime smartphone usage was associated with 0.07 min decrease in total sleeping time that night (p = .043, 95% confidence interval [CI]: -0.14, -0.003). Broken down for different usage purposes, 1 min of daytime social network usage and games and comics was associated with a 0.28 (p = .02, 95% CI: -0.52, -0.04) min and 0.18 min (p = .01, 95% CI: -0.32, -0.04) decrease in total sleeping time that night, respectively. One minute of daytime smartphone usage was associated with an increase of 4.55 steps in the number of steps (p = .001, 95% CI: 1.77, 7.34) on the next day. To conclude, time spent on a smartphone in the daytime was associated with total sleeping time that night and number of steps the next day, but was not associated with sleep efficiency, wake after sleep onset and moderate-to-vigorous-intensity activity (MVPA) among Hong Kong adolescents and young adults.
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Most research examined screen use over the whole day rather than that more immediate to bedtime, which is probably more detrimental to sleep.
“Most research examined screen use over the whole day rather than that more immediate to bedtime, which is probably more detrimental to sleep.14,15,16”
From Screen Use at Bedtime and Sleep Duration and Quality Among Youths (2024) · cites this paper as [15]
Cites
The Smartphone addiction scale: development and validation of a short version for adolescents
Kwon, M., Kim, D.-J., Cho, H., & Yang, S. (2013) · PLoS ONE · doi:10.1371/journal.pone.0083558 · Cited by 2,177 · see citing works
Demirci, K., Akgönül, M., & Akpinar, A. (2015) · Journal of Behavioral Addictions · doi:10.1556/2006.4.2015.010 · Cited by 1,529 · cited 1× · see citing works
“We believe that the effects of smartphone usage and sleep outcomes are still controversial (some other studies found a null association; Demirci et al., 2015) and warrant further investigations, especially through employing well-designed controlled trials.”
BackgroundActivity-Based Sleep-Wake Identification: An Empirical Test of Methodological Issues
Sadeh, A., Sharkey, M., & Carskadon, M. A. (1994) · Sleep · doi:10.1093/sleep/17.3.201 · Cited by 1,487 · see citing works
Arguments for rejecting the sequential Bonferroni in ecological studies
Moran, M. D. (2003) · Oikos · doi:10.1034/j.1600-0706.2003.12010.x · Cited by 1,484 · see citing works
Woods, H. C., & Scott, H. (2016) · Journal of Adolescence · doi:10.1016/j.adolescence.2016.05.008 · Cited by 1,302 · see citing works
Kushida, C. A., Chang, A., Patil, C. G., Guilleminault, C., Carrillo, O., & Dement, W. C. (2001) · Sleep Medicine · doi:10.1016/s1389-9457(00)00098-8 · Cited by 997 · see citing works
Lemola, S., Perkinson-Gloor, N., Brand, S., Dewald-Kaufmann, J. F., & Grob, A. (2015) · Journal of Youth and Adolescence · doi:10.1007/s10964-014-0176-x · Cited by 940 · see citing works
Falaki, H., Mahajan, R., Kandula, S., Lymberopoulos, D., Govindan, R., & Estrin, D. L. (2010) · International Conference on Mobile Systems, Applications, and Services · doi:10.1145/1814433.1814453 · Cited by 844 · see citing works
Carter, B., Rees, P., Hale, L., Bhattacharjee, D., & Paradkar, M. S. (2016) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2016.2341 · Cited by 718 · see citing works
Sleep and use of electronic devices in adolescence: results from a large population-based study
Hysing, M., Pallesen, S., Stormark, K. M., Jakobsen, R., Lundervold, A. J., & Sivertsen, B. (2015) · BMJ Open · doi:10.1136/bmjopen-2014-006748 · Cited by 678 · see citing works
Böhmer, M., Hecht, B., Schöning, J., Krüger, A., & Bauer, G. (2011) · Proceedings of the 13th International Conference on Human Computer Interaction with Mobile Devices and Services · doi:10.1145/2037373.2037383 · Cited by 604 · see citing works
Who uses mobile phone health apps and does use matter? A secondary data analytics approach
Carroll, J. K., Moorhead, A., Bond, R., LeBlanc, W. G., Petrella, R. J., & Fiscella, K. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.5604 · Cited by 540 · see citing works
Bedtime mobile phone use and sleep in adults
Exelmans, L., & den Bulck, J. V. (2015) · Social Science & Medicine · doi:10.1016/j.socscimed.2015.11.037 · Cited by 488 · see citing works
Wood, B., Rea, M. S., Plitnick, B., & Figueiro, M. G. (2013) · Applied Ergonomics · doi:10.1016/j.apergo.2012.07.008 · Cited by 428 · cited 1× · see citing works
“Compared to other devices with electronic screens, such as televisions and video game consoles, smartphones are more commonly used in bed as they are portable and are usually placed very close to the user (Twenge et al., 2019; Wood et al., 2013).”
BackgroundUsing smartphones and health apps to change and manage health behaviors: a population-based survey
Ernsting, C., Dombrowski, S. U., Oedekoven, M., O´Sullivan, J. L., Kanzler, M., Kuhlmey, A., & Gellert, P. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.6838 · Cited by 400 · see citing works
Mining large-scale smartphone data for personality studies
Chittaranjan, G. T., Blom, J., & Gática-Pérez, D. (2011) · Personal and Ubiquitous Computing · doi:10.1007/s00779-011-0490-1 · Cited by 378 · see citing works
Lepp, A., Barkley, J. E., Sanders, G. J., Rebold, M. J., & Gates, P. (2013) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-10-79 · Cited by 378 · see citing works
Dworak, M., Schierl, T., Bruns, T., & Strüder, H. K. (2007) · PEDIATRICS · doi:10.1542/peds.2007-0476 · Cited by 376 · see citing works
Kenney, E. L., & Gortmaker, S. L. (2016) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2016.11.015 · Cited by 301 · see citing works
Punamäki, R., Wallenius, M., Nygård, C., Saarni, L. A., & Rimpelä, A. (2006) · Journal of Adolescence · doi:10.1016/j.adolescence.2006.07.004 · Cited by 300 · see citing works
Howe, K. B., Suharlim, C., Ueda, P., Howe, D., Kawachi, I. I., & Rimm, E. B. (2016) · BMJ · doi:10.1136/bmj.i6270 · Cited by 212 · see citing works
Measuring smartphone usage and task switching with log tracking and self-reports
Deng, T., Kanthawala, S., Meng, J., Peng, W., Kononova, A., Hao, Q., Zhang, Q., & David, P. (2019) · Mobile Media & Communication · doi:10.1177/2050157918761491 · Cited by 201 · see citing works
Tri, T. M., Blom, J., & Gática-Pérez, D. (2011) · International Conference on Multimodal Interfaces · doi:10.1145/2070481.2070550 · Cited by 200 · see citing works
Lee, U., Lee, J., Ko, M., Lee, C., Kim, Y., Yang, S., Yatani, K., Gweon, G., Chung, K., & Song, J. (2014) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/2556288.2557366 · Cited by 196 · see citing works
Self-citationAdolescent Internet Addiction in Hong Kong: Prevalence, Change, and Correlates
Shek, D. T. L., & Yu, L. (2015) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/j.jpag.2015.10.005 · Cited by 180 · see citing works
Night-time screen-based media device use and adolescents' sleep and health-related quality of life.
Mireku, M., Barker, M. M., Mutz, J., Dumontheil, I., Thomas, M. S. C., Roosli, M., Elliott, P., & Toledano, M. (2019) · Environment International · doi:10.1016/j.envint.2018.11.069 · Cited by 174 · see citing works
Twenge, J. M., Hisler, G. C., & Krizan, Z. (2019) · Sleep Medicine · doi:10.1016/j.sleep.2018.11.009 · Cited by 162 · see citing works
Toon, E., Davey, M. J., Hollis, S. L., Nixon, G. M., Horne, R. S. C., & Biggs, S. N. (2016) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.5580 · Cited by 142 · see citing works
Wang, P.-Y., Chen, K.-L., Yang, S.-Y., & Lin, P.-H. (2019) · PLOS ONE · doi:10.1371/journal.pone.0214769 · Cited by 118 · see citing works
Impact of Media Use on Adolescent Sleep Efficiency
Fobian, A. D., Avis, K. T., & Schwebel, D. C. (2015) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000239 · Cited by 117 · see citing works
The association of sleep and late-night cell phone use among adolescents
Amra, B., Shahsavari, A., Moghadam, R. S., Mirheli, O., Khaniabadi, B. M., Bazukar, M., Yadollahi‐Farsani, A., & Kelishadi, R. (2017) · Jornal de Pediatria · doi:10.1016/j.jped.2016.12.004 · Cited by 117 · see citing works
Telecommunication devices use, screen time and sleep in adolescents
Cabré-Riera, A., Torrent, M., Donaire-Gonzalez, D., Vrijheid, M., Cardis, E., & Guxens, M. (2019) · Environmental Research · doi:10.1016/j.envres.2018.10.036 · Cited by 115 · see citing works
Self-luminous devices and melatonin suppression in adolescents
Figueiro, M. G., & Overington, D. W. U. (2015) · Lighting Research & Technology · doi:10.1177/1477153515584979 · Cited by 110 · see citing works
Digital Screen Time and Pediatric Sleep: Evidence from a Preregistered Cohort Study
Przybylski, A. K. (2019) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2018.09.054 · Cited by 102 · see citing works
Heindl, E. (2014) · Cited by 96 · see citing works
Influence of Pokémon Go on physical activity levels of university players: a cross-sectional study
Wong, F. Y. (2017) · International Journal of Health Geographics · doi:10.1186/s12942-017-0080-1 · Cited by 88 · see citing works
The impact of wearable motion sensing technology on physical activity in older adults
Cooper, C., Gross, A., Brinkman, C., Pope, R., Allen, K., Hastings, S., Bogen, B. E., & Goode, A. P. (2018) · Experimental Gerontology · doi:10.1016/j.exger.2018.08.002 · Cited by 82 · see citing works
John, D., Morton, A. L., ARGUELLO, D. J., Lyden, K. A., & Bassett, D. R. (2018) · Sensors · doi:10.3390/s18041206 · Cited by 74 · see citing works
Falaki, H., Mahajan, R., & Estrin, D. L. (2011) · doi:10.1145/1999916.1999923 · Cited by 73 · see citing works
Characterizing and modeling user activity on smartphones
Shye, A., Scholbrock, B., Memik, G., et al. (2010) · ACM SIGMETRICS International Conference on Measurement and Modeling of Computer Systems (SIGMETRICS) · doi:10.1145/1811039.1811094 · Cited by 71 · see citing works
The Effects of the Removal of Electronic Devices for 48 Hours on Sleep in Elite Judo Athletes
Dunican, I. C., Martin, D. T., Halson, S. L., Reale, R., DAWSON, B. T., Caldwell, J. A., Jones, M. J., & Eastwood, P. R. (2017) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000001697 · Cited by 71 · see citing works
Diversity and End User Context in Smartphone Usage Sessions
Soikkeli, T., Karikoski, J., & Hämmäinen, H. (2011) · International Conference on Next Generation Mobile Applications, Services and Technologies (NGMAST) · doi:10.1109/ngmast.2011.12 · Cited by 63 · see citing works
Lee, P. H., & Suen, L. K. P. (2017) · Sleep And Breathing · doi:10.1007/s11325-016-1406-0 · Cited by 60 · see citing works
Self-citationLee, P. H., & Tse, A. C. Y. (2018) · Gait & Posture · doi:10.1016/j.gaitpost.2018.11.023 · Cited by 55 · see citing works
Self-citationValidation of a Novel, Objective Measure of Occupational Sitting
Ryde, G. C., Gilson, N. D., Suppini, A., & Brown, W. J. (2012) · Journal of Occupational Health · doi:10.1539/joh.12-0091-br · Cited by 43 · see citing works
Interactive vs passive screen time and nighttime sleep duration among school-aged children
Yland, J. J., Guan, S., Emanuele, E., & Hale, L. E. (2015) · Sleep Health · doi:10.1016/j.sleh.2015.06.007 · Cited by 42 · see citing works
Association between insomnia and social network site use in Indonesian adolescents
Nursalam, N., Octavia, M., Tristiana, R. D., & Efendi, F. (2018) · Nursing Forum · doi:10.1111/nuf.12308 · Cited by 42 · see citing works
Characterizing and modeling user activity on smartphones
Shye, A., Scholbrock, B., Memik, G., et al. (2010) · ACM SIGMETRICS Performance Evaluation Review · doi:10.1145/1811099.1811094 · Cited by 37 · see citing works
Pfitzner, R., Gorzelniak, L., Heinrich, J., Berg, A. V., Klümper, C., Bauer, C. P., Koletzko, S., Berdel, D., Horsch, A., Schulz, H., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0065192 · Cited by 34 · see citing works
Emerging Adults’ Text Message Use and Sleep Characteristics: A Multimethod, Naturalistic Study
Murdock, K. K., Horissian, M., & Crichlow-Ball, C. (2016) · Behavioral Sleep Medicine · doi:10.1080/15402002.2015.1120203 · Cited by 31 · see citing works
Awareness of wearing an accelerometer does not affect physical activity in youth
Vanhelst, J., Béghin, L., Drumez, É., et al. (2017) · BMC Medical Research Methodology · doi:10.1186/s12874-017-0378-5 · Cited by 30 · see citing works
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Screen Use at Bedtime and Sleep Duration and Quality Among Youths
Brosnan, B., Haszard, J. J., Meredith-Jones, K. A., Wickham, S.-R., Galland, B. C., & Taylor, R. W. (2024) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2024.2914 · Cited by 69 · see citing works
Tkaczyk, M., Lacko, D., Elavsky, S., Tancoš, M., & Smahel, D. (2023) · Computers in Human Behavior · doi:10.1016/j.chb.2023.107946 · Cited by 24 · see citing works
- Authors
- Lee, P. H., Tse, A. C. Y., Wu, C. S. T., Mak, Y. W., & Lee, U.
- Affiliations
- Hong Kong Polytechnic University (HK)
- Education University of Hong Kong (HK)
- Korea Advanced Institute of Science and Technology (KR)
- Corresponding author
- Lee, Paul H.
- Venue
- Journal of Sleep Research
- Publisher
- Wiley
- Published
- 2020-10-13
- Volume
- 30
- Issue
- 4
- Pages
- e13213-e13213
- ISSN
- 0962-1105 (ISSN-L)
- 1365-2869
- OpenAlex
- W3091868590
- Cited by
- 49
- References
- 52
- Citations by year
- 2026: 11 · 2025: 7 · 2024: 14 · 2023: 15 · 2022: 1 · 2021: 1
- FWCI
- 5.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Sleep Research (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- PolyU Institutional Research Archive (Hong Kong Polytechnic University) (submittedVersion)
- Funders
- Research Grants Council, University Grants Committee (PolyU 251056/16M)
- Topics
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- smartphone use, sleep quality, physical activity, adolescents, young adults, sleep duration, social media use, screen time, step count, sleep efficiency, wake after sleep onset, moderate-to-vigorous physical activity, Hong Kong
- MeSH terms
- Smartphone, Adolescent, Adult, Child, China, Female, Humans, Male, Sleep, Exercise, Young Adult
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