Sleep and Biological Rhythms

, Volume 17, Issue 2, pp 233–241 | Cite as

Sleep patterns, mobile phone use and psychological symptoms among adolescents in coastal developed city of China: an exploratory cross-sectional study

  • Xi Mei
  • Zhenyu Hu
  • Dongsheng Zhou
  • Qi Zhou
  • Xingxing Li
  • Xiaojia Wang
  • Pan JingEmail author
Original Article


To better understand the interplay between mobile phone use, sleep pattern, and psychological symptoms, this study examined changes in adolescents’ mobile phone use and sleep associated with mobile phone demand. Also examined was whether sleep duration mediated relationship between mobile phone use and psychological symptoms among adolescents in coastal developed areas of China. A cross-sectional study which includes 3020 students was performed. Students completed general situation questionnaire, Pittsburgh sleep quality index scale, insomnia severity index, Epworth sleepiness scale, Beck depression inventory, self-rating anxiety scale, and mobile phone use questionnaire. Regarding the most time-consuming function, gender differences emerged, with more boys using game function, whereas girls reported higher use of surfing the Internet and music players. Regarding mobile phone use before sleep, for those who often used mobile phone before sleep, sleep duration was significantly shorter and sleep onset latency was significantly longer than those who either sometimes or never used the function except study (P < 0.05). Regression models revealed that mobile phone use before sleep was related to higher levels of depressive symptoms (β = 0.89, P < 0.001) and anxiety symptoms (β = 1.22, P < 0.001). There was a significant mediation effect of the relationship between mobile phone use before sleep and psychological symptoms by sleep duration. Frequent mobile phone use before sleep was associated with significant adverse effects on multiple sleep parameters and psychological symptoms. Sleep duration may be a potential underlying mechanism behind the association between mobile phone use and health symptoms.


Adolescent students Mobile phone use Sleep patterns Psychological symptoms Statistical analysis 



This research was supported by Ningbo social development science and technology research project (Grant No. 2014C50055).

Compliance with ethical standards

Conflict of interest

None declared.


  1. 1.
    Rideout VJ, Foehr UG, Roberts DF. Generation M2: media in the lives of 8- to 18-years-olds. A Kaiser Foundation Study. Available online: Accessed on 01 Mar 2014.
  2. 2.
    Synovate. Young Asians Survey: Media Fact Sheet—Hong Kong. Available online: Accessed on 01 Mar 2014.
  3. 3.
    Lian L, You X, Huang J, Yang R. Who overuses smartphones? Roles of virtues and parenting style in smartphone addiction among Chinese college students. Comput Hum Behav. 2016;65:92–9.CrossRefGoogle Scholar
  4. 4.
    Yen CF, Tang TC, Yen JY, Lin HC, Huang CF, Liu SC, et al. Symptoms of problematic cellular phone use, functional impairment and its association with depression among adolescents in southern taiwan. J Adolesc. 2009;32(4):863–73.CrossRefGoogle Scholar
  5. 5.
    Munezawa T, Kaneita Y, Osaki Y, Kanda H, Minowa M, Suzuki K, et al. The association between use of mobile phones after lights out and sleep disturbances among Japanese adolescents: a nationwide cross-sectional survey. Sleep. 2011;34:1013–20.CrossRefGoogle Scholar
  6. 6.
    Liu Q-Q, Zhou Z-K, Yang X-J, Kong F-C, Niu G-F, Cui-Ying F. Mobile phone addiction and sleep quality among Chinese adolescents: a moderated mediation model. Comput Hum Behav.
  7. 7.
    Cappuccio FP, Taggart FM, Kandala NB, Currie A, Peile E, Stranges S, et al. Metaanalysis of short sleep duration and obesity in children and adults. Sleep. 2008;31:619–26.CrossRefGoogle Scholar
  8. 8.
    Lemola S, Perkinson-Gloor N, Brand S, Dewald-Kaufmann JF, Grob A. Adolescents’ electronic media use at night, sleep disturbance, and depressive symptoms in the smartphone age. J Youth Adolesc.
  9. 9.
    Ortega FB, Chillón P, Ruiz JR, Delgado M, Albers U, Álvarez-Granda JL, Marcos A, Moreno LA, Castillo MJ. Sleep patterns in Spanish adolescents: associations with TV watching and leisure-time physical activity. Eur J Appl Physiol. 2010;110:563–73.CrossRefGoogle Scholar
  10. 10.
    Shochat T, Flint-Bretler O, Tzischinsky O. Sleep patterns, electronic media exposure and daytime sleep-related behaviours among Israeli adolescents. Acta Paediatr. 2010;99:1396–400.CrossRefGoogle Scholar
  11. 11.
    Buysse DJ, Reynolds CF, Monk TH, et al. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213.CrossRefGoogle Scholar
  12. 12.
    Liu XC, Tang MQ, Hu L, et al. Reliability and validity of Pittsburgh sleep quality index. Chin J Psychiatry. 1996;29:103–7.Google Scholar
  13. 13.
    Morin CM. Insomnia: psychological assessment and management. New York: Guilford Press; 1993.Google Scholar
  14. 14.
    Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540–5.CrossRefGoogle Scholar
  15. 15.
    Beck AT, Steer RA, Brown GK Beck depression inventory-II. The Fourteenth Mental Measurements Yearbook 2001.Google Scholar
  16. 16.
    Zung WWK. A rating instrument for anxiety disorders. Psychosomatics. 1971;12:371–9.CrossRefGoogle Scholar
  17. 17.
    Baron RM, Kenny DA. The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51:1173–82.CrossRefGoogle Scholar
  18. 18.
    Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40:879–91.CrossRefGoogle Scholar
  19. 19.
    Cain N, Gradisar M. Electronic media use and sleep in school-aged children and adolescents: a review. Sleep Med. 2010;11(8):735–42.CrossRefGoogle Scholar
  20. 20.
    Hale L, Guan S. Screen time and sleep among school-aged children and adolescents: a systematic literature review. Sleep Med Rev. 2015;21:50–8.CrossRefGoogle Scholar
  21. 21.
    Chang AM, Aeschbach D, Duffy JF, Czeisler CA. Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. Proc Natl Acad Sci USA. 2015;112(4):1232–7.CrossRefGoogle Scholar
  22. 22.
    U.S. Department of Health and Human Services. Your guide to healthy sleep. Available online: Accessed on 01 March 2014.
  23. 23.
    Primack BA, Swanier B, Georgiopoulos AM, Land SR, Fine MJ. Association between media use in adolescence and depression in young adulthood: a longitudinal study. Arch Gen Psychiatry. 2009;66:181–8.CrossRefGoogle Scholar
  24. 24.
    Kessler RC, Avenevoli S, Ries Merikangas K. Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiat. 2001;49:1002–14.CrossRefGoogle Scholar
  25. 25.
    Punamaki RL, Wallenius M, Nygard CH, Saarni L, Rimpela A. Use of information and communication technology (ICT) and perceived health in adolescence: the role of sleeping habits and waking-time tiredness. J Adolesc. 2007;30:569–85.CrossRefGoogle Scholar
  26. 26.
    Van den Bulck J. Adolescent use of mobile phones for calling and for sending text messages after lights out: results from a prospective cohort study with a one-year follow-up. Sleep. 2007;30:1220–3.CrossRefGoogle Scholar
  27. 27.
    Kawada T, Kataoka T, Tsuji F, Nakade M, Krejci M, Noji T, Takeuchi H, Harada T. The relationship between a night usage mobile phone and sleep habit and the circadian typology of Japanese students aged 18–30 yrs. Psychology. 2017;8:892–902.CrossRefGoogle Scholar
  28. 28.
    Alexandru G, Michikazu S, Shimako H, Xiaoli C, Hitomi K, Takashi Y, et al. Epidemiological aspects of self-reported sleep onset latency in Japanese junior high school children. J Sleep Res. 2006;15:266–75.CrossRefGoogle Scholar
  29. 29.
    Eggermont S, Van den Bulck J. Nodding off or switching off? The use of popular media as a sleep aid in secondary-school children. J Paediatr Child Health. 2006;42:428–33.CrossRefGoogle Scholar
  30. 30.
    Lai HL, Good M. Music improves sleep quality in older adults. J Adv Nurs. 2005;49:234–44.CrossRefGoogle Scholar
  31. 31.
    Choi K, Son H, Park M, Han J, Kim K, Lee B, et al. Internet overuse and excessive daytime sleepiness in adolescents. Psychiatry Clin Neurosci. 2009;63:455–62.CrossRefGoogle Scholar
  32. 32.
    Kundi M, Mild K, Hardell L, Mattsson MO. Mobile telephones and cancer—a review of epidemiological evidence. J Toxicol Environ Health B Crit Rev. 2004;7:351–84.CrossRefGoogle Scholar
  33. 33.
    Agostini A, Carskadon MA, Dorrian J, Coussens S, Short MA. An experimental study of adolescent sleep restriction during a simulated school week: changes in phase, sleep staging, performance and sleepiness. J Sleep Res. 2016;26(2):227–35.CrossRefGoogle Scholar

Copyright information

© Japanese Society of Sleep Research 2019

Authors and Affiliations

  • Xi Mei
    • 1
    • 2
  • Zhenyu Hu
    • 1
    • 2
  • Dongsheng Zhou
    • 1
    • 2
  • Qi Zhou
    • 1
    • 2
  • Xingxing Li
    • 1
    • 2
  • Xiaojia Wang
    • 1
  • Pan Jing
    • 1
    Email author
  1. 1.Ningbo Kangning HospitalNingboChina
  2. 2.Ningbo Key Laboratory of Sleep MedicineNingboChina

Personalised recommendations