Smartphone addiction negatively affects sleep quality both directly and indirectly through increased perceived stress and reduced engagement in a health-promoting lifestyle, with perceived stress accounting for 47.51% and health-promoting lifestyle accounting for 14.83% of the total effect.
Sleep disorder prevalence among college students was 51.9% in this sample.
Smartphone addiction was significantly and positively correlated with poor sleep quality.
Smartphone addiction had a significant direct effect on sleep quality even after accounting for mediators.
Perceived stress partially mediated the relationship between smartphone addiction and sleep quality, accounting for 47.51% of the total effect.
Health-promoting lifestyle partially mediated the relationship between smartphone addiction and sleep quality, accounting for 14.83% of the total effect.
Perceived stress and health-promoting lifestyle served as parallel mediators in the smartphone addiction–sleep quality relationship.
This research suggests that among college students, heavy smartphone use is linked to poorer sleep quality through two distinct pathways. In a survey of over 2,300 medical university students in China, more than half reported sleep disorders. Students who scored higher on smartphone addiction tended to sleep worse, but the study found this relationship was not just a direct one — it was also partly explained by the fact that smartphone-addicted students experienced more perceived stress and were less likely to engage in healthy behaviors like exercise and proper nutrition. The study found that increased perceived stress was the more influential of the two indirect pathways, explaining about 47.5% of the link between smartphone addiction and poor sleep, while a less healthy lifestyle explained about 14.8%. Smartphone addiction still had a direct negative effect on sleep quality even after accounting for these two factors. Together, these findings suggest that smartphones may harm sleep both by keeping people directly awake or disrupting sleep patterns, and by creating a cycle of stress and unhealthy habits that further erode sleep. This research suggests that addressing sleep problems in college students may require a multi-pronged approach. Simply limiting smartphone use may help, but interventions that also target stress management skills and encourage health-promoting behaviors — such as physical activity, balanced diet, and relaxation techniques — could be particularly effective. The findings highlight that the harms of smartphone overuse extend beyond screen time itself, rippling through students' mental and physical wellbeing in ways that ultimately affect sleep.
Xie Y, Pei Q, Chen Y, Xiao L, Yin D. (2026). The influence of smartphone addiction on sleep quality among college students: The parallel mediating roles of perceived stress and health-promoting lifestyle.. PloS one. https://doi.org/10.1371/journal.pone.0340852