Accepted for/Published in: JMIR Mental Health
Date Submitted: Jul 14, 2019
Open Peer Review Period: Jul 17, 2019 - Sep 11, 2019
Date Accepted: Apr 20, 2020
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Associations of electronic device use before and after sleep with psychological distress in Chinese adults: a cross-sectional study
ABSTRACT
Background:
Hong Kong has a high penetration rate of computer, smartphone, and tablet use (electronic device [e-device]). Little is known about the effect of the duration of e-device use before and after sleep on psychological symptoms.
Objective:
To investigate the associations of the duration of e-device use before and after sleep with psychological distress.
Methods:
A probability-based landline telephone survey was conducted on 3162 Hong Kong adults (54.6% female, mean age [years]±SD=47.4±18.3) in 2016. Multivariable linear and Poisson regressions were used to calculate adjusted regression-coefficients (aB) and prevalence ratios (aPR) of anxiety and depressive symptoms (measured by Patient Health Questionnaire-4) for the duration from waking to first e-device use (≥61; 31-60; 6-30; ≤5 minutes) and the duration of e-device use before sleeping (≤5; 6-30; 31-60; ≥61 minutes), respectively.
Results:
First e-device use in ≤5 (vs >60) minutes after waking was associated with anxiety symptoms (aB 0.35, 95% CI 0.24-0.46; aPR 1.74, 95% CI 1.34-2.25) and depressive symptoms (aB 0.27, 95% CI 0.18-0.37; aPR 1.84, 95% CI 1.33-2.54). Using e-devices ≥61 (vs ≤5) minutes before sleeping was also associated with anxiety (aB 0.17, 95% CI 0.04-0.31; aPR 1.32, 95% CI 1.01-1.73) and depressive symptoms (aB 0.17, 95% CI 0.05-0.28; aPR 1.47, 95% CI 1.07-2.02). E-device uses both in ≤5 minutes after waking and ≥61 minutes before sleeping were strongly associated with anxiety (aB 0.68, 95% CI 0.47-0.90; aPR 2.64, 95% CI 1.90-3.67) and depressive (aB 0.55, 95% CI 0.36-0.74; aPR 2.56, 95% CI 1.69-3.88) symptoms.
Conclusions:
E-device use immediately (≤5 minutes) after waking and use for a long duration (≥61 minutes) before sleeping were associated with anxiety and depressive symptoms in Chinese adults.
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