Relationship of Problematic Smartphone Use, Sleep Quality, and Daytime Fatigue Among Quarantined Medical Students During the COVID-19 Pandemic

Chi Zhang; Ping Zeng; Joshua Tan; Siwei Sun; Minghao Zhao; Ju Cui; Guifang Zhang; Jinzhong Jia; Deping Liu

doi:10.3389/fpsyt.2021.755059

Relationship of Problematic Smartphone Use, Sleep Quality, and Daytime Fatigue Among Quarantined Medical Students During the COVID-19 Pandemic

Front Psychiatry. 2021 Nov 10:12:755059. doi: 10.3389/fpsyt.2021.755059. eCollection 2021.

Authors

Chi Zhang¹, Ping Zeng¹, Joshua Tan², Siwei Sun³, Minghao Zhao², Ju Cui¹, Guifang Zhang¹, Jinzhong Jia⁴, Deping Liu⁵

Affiliations

¹ The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China.
² School of Basic Medicine, Peking University Health Science Center, Beijing, China.
³ Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders, Beijing, China.
⁴ Graduate School Health Science Center of Peking University, Secretariat Office of National Steering Committee for Medical Professional Degree Education, Beijing, China.
⁵ Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, Beijing, China.

Abstract

Background: The COVID-19 pandemic brought about great transformation to medical education mode. Although mobile communication devices played a crucial role in online learning among quarantined university students, the potential smartphone addition problems, negative health behaviors, and psychological symptoms need considerable attention. This study examined the relationship of problematic smartphone use (PSU), sleep quality, and daytime fatigue among medical students. Methods: A web-based survey was conducted in six polyclinic hospitals in Beijing between February and May 2020. 1016 participants (26.01 ± 2.46 years, 65.16% female) completed self-report measurements including Short Version Smartphone Addiction Scale (SAS-SV), Athens Insomnia Scale (AIS), and Subjective Fatigue Scale (FS). Spearman correlation coefficients and multiple regression models were used to analyze the association among PSU, sleep quality, and daytime fatigue. We used structural equation modeling to test the mediating effect of sleep quality between PSU and daytime fatigue. Results: 49.70% of the participants had PSU. Significant positive correlations were found among SAS-SV, AIS, and FS scores (r = 0.35-0.61, P _S < 0.001). Subjects with PSU were more likely to report sleep disturbance (β = 1.07, P < 0.001, OR = 2.91, 95%CI = 2.17-3.91), physical fatigue (β = 1.16, P < 0.001, OR = 3.18, 95%CI = 2.45-4.15), and mental fatigue (β = 0.88, P < 0.001, OR = 2.42, 95%CI = 1.86-3.14). The indirect effect of PSU on physical fatigue and mental fatigue mediated by sleep quality accounted for 50.03 and 45.43% of the total effect, respectively. Conclusions: PSU was significantly associated with sleep disturbance and fatigue among medical students during the COVID-19 pandemic. Sleep quality mediated the relationship between PSU and daytime fatigue. Our results provide valuable information for maintaining medical students' health status and constructing online education structures.

Keywords: COVID-19; fatigue; mediating effect; problematic smartphone use; sleep quality.