Association of internet addiction with sleep quality among university students

Muhammad Shaheer; Muhammad Muttahar Khalil; Samira Faiz Bari; Farhan Muhammad Qureshi; Syeda Sehrish Zehra; Jaweria Basharat; Muhammad Owais Baloch

doi:10.18203/2394-6040.ijcmph20262690

Authors

Muhammad Shaheer Karachi Institute of Medical Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Muhammad Muttahar Khalil Karachi Institute of Medical Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Samira Faiz Bari Department of Community Medicine & Public Health, Karachi Institute of Medical Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
Farhan Muhammad Qureshi Department of Community Medicine & Public Health, Karachi Institute of Medical Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
Syeda Sehrish Zehra Department of Community Medicine & Public Health, Karachi Institute of Medical Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
Jaweria Basharat Karachi Institute of Medical Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Muhammad Owais Baloch Department of Community Medicine & Public Health, Karachi Institute of Medical Sciences, National University of Medical Sciences, Rawalpindi, Pakistan

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20262690

Keywords:

Internet addiction, Mental health, Sleep quality, University students, Young’s internet addiction test

Abstract

Background: Initially an educational and entertainment tool, the internet has become additive, impairing time management, circadian rhythm and sleep quality. The objective of the study is to observe the frequency of internet addiction (IA) and poor sleep quality among university students of Karachi, Pakistan and to determine the association of IA with sleep quality.

Methods: The cross-sectional study was conducted from 15th July 2025 to 21st January 2026 among 373 university students of Karachi. Students from public and private sector institutions were recruited through convenience sampling. Internet addiction test and pittsburgh sleep quality index assessed IA and sleep quality. The correlation between IA scores and sleep quality scores was accessed using Spearman's correlation test. Univariate and multivariable logistic regression identified predictors of poor sleep (vs. normal sleep) based on p<0.25 selection criterion. Data were entered and analyzed using SPSS version 25.

Results: Of 373 participants (median age 21 years, 71.3% male), the prevalence of internet addiction was found to be 85.7% while 60.3% of our study participants reported poor sleep quality. A statistically significant, weak positive correlation was found between IA and sleep quality, rs=0.295, p<0.001. Univariate analysis showed female sex (OR=2.18), asthma, other illnesses and IA severity were significantly associated with poor sleep (p<0.05). Multivariable regression identified female sex (AOR=2.29), other illnesses (AOR=2.20) and moderate-to-severe IA (AOR=5.58) as independent predictors of poor sleep.

Conclusions: Internet addiction and poor sleep were highly prevalent, while moderate-to-severe internet addiction was the strongest independent predictor of poor sleep.

References

Ejaz W, Altay S, Ittefaq M. How effective are fact-checks in Pakistan and who engages with them. Inform Comm Soc. 2025;28(14):2439-61.

Khayat MA, Qari MH, Almutairi BS, Shuaib BH, Rambo MZ, Alrogi MJ, et al. Sleep quality and internet addiction level among university students. Egypt J Hosp Med. 2018;73(7):7042-7.

Kuss DJ, Lopez-Fernandez O. Internet addiction and problematic Internet use: A systematic review of clinical research. World J Psychiat. 2016;6(1):143-76.

Kawyannejad R, Mirzaei M, Valinejadi A, Hemmatpour B, Karimpour HA, AminiSaman J, et al. General health of students of medical sciences and its relation to sleep quality, cell phone overuse, social networks and internet addiction. BioPsychoSocial Med. 2019;13:1-7.

Lin PH, Lee YC, Chen KL, Hsieh PL, Yang SY, Lin YL. The relationship between sleep quality and internet addiction among female college students. Front Neurosci. 2019;13:599.

Kocas F, Şaşmaz T. Internet addiction increases poor sleep quality among high school students. Turk J Public Health. 2018;16(3):167-77.

Alimoradi Z, Lin C-Y, Broström A, Bülow PH, Bajalan Z, Griffiths MD, et al. Internet addiction and sleep problems: A systematic review and meta-analysis. Sleep Med Rev. 2019;47:51-61.

Panel CC, Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, et al. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. J Clin Sleep Med. 2015;11(6):591-2.

Garbarino S, Lanteri P, Bragazzi NL, Magnavita N, Scoditti E. Role of sleep deprivation in immune-related disease risk and outcomes. Commun Biol. 2021;4(1):1304.

Crowley R, Alderman E, Javadi AH, Tamminen J. A systematic and meta-analytic review of the impact of sleep restriction on memory formation. Neurosci Biobehav Rev. 2024;10:5929.

Navarro-Martínez R, Chover-Sierra E, Colomer-Pérez N, Vlachou E, Andriuseviciene V, Cauli O. Sleep quality and its association with substance abuse among university students. Clin Neurol Neurosurg. 2020;188:105591.

Zahoor M, Waqar S, Kawish AB, Mashhadi SF, Shahzad A. Sleep quality and its possible predictors among university students of Islamabad, Pakistan. Pak Armed Forces Med J. 2023;73(1):164.

Nichols LA, Nicki R. Development of a psychometrically sound internet addiction scale: a preliminary step. Psychol Addict Behav. 2004;18(4):381.

Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.

Zahra S, Bari SF, Qureshi FM, Mumtaz S, Ali H. Assessment of Internet addiction among university students: A cross-sectional analysis of socio-demographic and behavioral factors. Ann Abbasi Shaheed Hosp Karachi Med Dent Coll. 2026;31(1):85-92.

Ali SM, Hamid Z, Khan MU, Khalid A, Bari SF, Qureshi FM, et al. Shift work sleep disorder and its effects on neurocognitive function in young physicians. Discov Psychol. 2026;3:729.

Liu X, Gui Z, Chen Z-M, Feng Y, Wu X-d, Su Z, et al. Global prevalence of internet addiction among university students: a systematic review and meta-analysis. Curr Opin Psychiatry 2025; 38(3): 182-99.

Nadeem A, Cheema MK, Naseer M, Javed H. Comparison of quality of sleep between medical and non-medical undergraduate Pakistani students. J Pak Med Assoc 2018; 68(10): 1465-70.

Muhammad N, Hussain M, Adnan SM. Screen time and sleep quality among college and university students of Karachi. J Health Biol Sci 2021; 9(1): 1-14.

Theorell-Haglöw J, Ulander M, Brandberg J, Claesson M, Franklin KA, Hedner J, et al. What are the important risk factors for excessive daytime sleepiness in a population-based cohort? J Sleep Res 2025; 34(4): e14449.

Viticchi G, Altamura C, Falsetti L, Buratti L, Salvemini S, Polidoro F, et al. Poor sleep quality in patients affected by migraine: a population study. Neurol Sci 2020; 41(Suppl 2): 495-6.

Aldabayan YS. Mental health and sleep quality among patients with asthma and COPD. Front Med. 2023;10:1181742.

Abbas S, Rafiq A, Yasin K. Internet addiction, psychological distress and sleep deprivation among university students. Pakistan Islamicus. 2023;3(3):558-67.

Schmid S. Impact of evening smartphone use and emotion regulation on sleep and circadian rhythm. Salzburg: University of Salzburg. 2020.

Menon S, Narayanan L, Kahwaji AT. Internet addiction: A research study of college students in India. J Econ Bus. 2018;1(1):100-6.