Introduction
Sleep is one of the most important functions of the body. Its conservation across all animal species suggests it plays a vital role in sustaining life. According to the World Health Organization (WHO), individuals aged 18 to 64 are recommended to sleep between 7 and 9 hours, although this requirement varies throughout life. Adequate rest helps restore energy levels, eliminate free radicals accumulated during the day, regulate and restore cortical electrical activity, support synaptic homeostasis, regulate metabolic, endocrine, and immune processes, and consolidate memory.1
Sleep comprises two main phases. The first is Non-REM (Non-Rapid Eye Movement) sleep, characterized by slow-wave sleep, which can be either light or deep, and occurs mainly during the first hour after falling asleep, especially following prolonged wakefulness. The second phase is REM (Rapid Eye Movement) sleep, during which heart rate and blood pressure increase, breathing becomes faster, and the eyes move rapidly. In an 8-hour sleep period, individuals typically return to REM stages 4 to 5 times, accumulating approximately 2 hours of vivid dreaming.2 In young and healthy individuals, a complete sleep cycle lasts an average of 90 minutes, resulting in 5 to 6 cycles during an 8-hour night. Each cycle includes stages: Stage I, drowsiness; Stage II, light sleep; Stage III, delta or deep sleep; and Stage IV, rapid eye movement.3–5
As a result of measures implemented during the pandemic and the transition to the “new normal,” many daily activities have shifted to relying on electronic devices such as computers, mobile phones, and tablets. These tools, now essential, have also fostered greater technological dependence. Consequently, terms have emerged to describe behaviors associated with excessive use of these devices. One such term is vamping, which refers to the excessive use of cell phones late into the night.6 Another term, phubbing, describes ignoring others during a conversation to focus on a mobile phone.7 Finally, nomophobia refers to anxiety or distress caused by the lack of access to or excessive use of a mobile phone.8
According to the 2022 National Survey on the Availability and Use of Information Technologies in Households (ENDUTIH), conducted by the National Institute of Statistics and Geography (INEGI), mobile phones are the most used electronic devices, surpassing computers. This shift is attributed to users’ limited economic resources. Moreover, 96.4% of individuals with a university-level education have internet access, and 88.1% own a smartphone.9
In this context, university students are particularly susceptible to the effects of excessive electronic device use, which negatively impacts their sleep quality and, consequently, their motor, cognitive, and physiological performance.10 Additionally, using devices before bedtime can disrupt sleep patterns, as the blue light emitted by screens affects the duration of REM sleep.6
Thus, this study examines the relationship between excessive use of electronic devices, particularly smartphones, and sleep quality among university students.
Methodology
Study Type
This study adopts a mixed-methods approach, combining qualitative and quantitative evaluations of the impact of technology overuse on sleep quality. It is also observational, as no interventions (surgical, pharmacological, etc.) were implemented that could alter or modify the data collected.
Sample Selection
The study included regular students in the fourth, fifth, or sixth semesters of the Clinical Chemistry and Nursing & Obstetrics programs at the Faculty of Health Sciences, Zacatelco Campus, Autonomous University of Tlaxcala. All participants provided informed consent, agreed to participate, and owned a mobile device regardless of its brand or model. The sample comprised more than 60% of students in both degree programs.
Evaluation Instruments
The first instrument used was the “Phubbing Scale,” developed by Karadağ et al.1 and adapted into Spanish by Blanca & Bendayan.11 This scale comprises 16 items with five response options: “never, rarely, sometimes, almost always, and always.” Items 1-5 evaluate how often participants pay attention to their phones, even in the company of others, and whether the phone is the first object they look at upon waking up. Items 6-10 assess mood, time spent using the phone during the day and night, and the distractions caused by phone use. Items 11-16 evaluate how participants feel when they lack Wi-Fi or mobile data. A participant is classified as follows: if “always” is marked more than 10 times, the participant exhibits phubbing; if “always” is marked between 6 and 9 times, the participant shows a disruption in communication; and if “always” is marked fewer than 5 times, the participant demonstrates good social communication with no presence of phubbing.
The second instrument was the “Vamping Scale,” which consisted of 11 items. Items 1-2 identify whether the participant owns a mobile device and which electronic device they use most frequently (smartphone, tablet, or laptop). Items 3-11 assessed the behavioral aspects related to vamping.
Finally, a questionnaire with 10 items was used to evaluate sleep hygiene habits before sleeping. Responses to each item were dichotomous and qualitative.
Application of Evaluation Instruments
The evaluation instruments were administered virtually through a Google Forms questionnaire. The first page displayed the informed consent letter, which participants had to accept to proceed with the evaluation. Initially, the form was tested with six individuals to verify its accessibility and identify any unclear questions for possible revision.
Afterward, approval was sought from the Faculty of Health Sciences administration for implementing the evaluation questionnaires. Once authorized, the program coordinators for each degree were informed about the terms of their collaboration and approved their students’ participation in the evaluations.
Results
The results showed that students of Nursing and Obstetrics have more knowledge about sleep hygiene; however, they exhibited poor sleep hygiene due to their pre-sleep habits, which included consuming coffee, using the bed for tasks other than sleeping, not maintaining regular sleep schedules, using TV or mobile devices, and falling asleep on the sofa or elsewhere. Additionally, the results indicate that despite the greater knowledge of sleep hygiene among students in Nursing and Obstetrics, their sleep quality was lower compared to the Clinical Chemistry students (Table 1).
Moreover, the results also show that a few university students from Clinical Chemistry, Nursing, and Obstetrics sleep satisfactorily despite both groups knowing sleep hygiene (Table 2).
On the other hand, Table 3 reveals that a significant percentage of students from both programs keep their mobile phones within reach at all times, even when in the company of others. Additionally, it is interesting that mobile phone usage ranges from 4 to 6 hours a day for recreational purposes rather than academic ones. Finally, it is worth noting that there were no differences in the results based on gender; both men and women kept their mobile phones within reach, and their usage patterns were similar across genders.
Discussion
The results obtained from the evaluation of technology use and its impact on sleep hygiene and quality in the university community of the Faculty of Health Sciences at the Universidad Autonomy de Tlaxcala revealed that, despite the habits related to the use of electronic devices, students in Clinical Chemistry, Nursing, and Obstetrics reported satisfactory sleep quality. However, in addition to using electronic devices for recreational and academic purposes, poor pre-sleep habits were also observed, which negatively impacted sleep quality.
In this context, Sierra12 mentions that the Pittsburgh Sleep Quality Index is considered poor when high scores are present in seven components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of hypnotic medication, and daytime dysfunction. On the other hand, Puerto9 highlights that the perception of sleep quality can be variable; for example, 62.4% of participants rated their sleep quality as “fair” and 37.6% as “good.” The results also show that the average time students go to bed during school days is 11:38 p.m.; on weekends, they go to bed after midnight. This could explain why approximately 30% of students report poor sleep quality, characterized by excessive latency and low sleep efficiency. However, these findings contradict Ortiz,2 who reported that 72.3% of participants rated their sleep quality as good or very good, while only 27.7% considered it poor.
Our studies also show that, regarding the use of electronic devices, students spend between 4 and 6 hours daily using their phones, primarily for social media. These results align with those of Puerto,9 who reported an average of 5 to 6 hours of daily social media use. Additionally, students tend to check their phones before bed, a habit also described by Rodríguez,13 who stated that students do not get the necessary sleep hours during school days due to the use of mobile phones or academic tasks.
However, the results of this research differ from those reported by Pacheco,6 who emphasized that, in addition to using mobile devices, most adolescents find it essential to have internet access on their devices, which they perceive as an opportunity to access social media, online games, and other content. Weezel and Benavides14 support this information, noting a 60% increase in the population with mobile phone access between 2002 and 2008, with a particular emphasis on the youth population contributing to this increase.
Finally, gender did not significantly influence technology abuse or sleep hygiene. This contrasts with Rodríguez,13 who stated that women use mobile devices more than men, who pointed out that men tend to be more prone to nomophobia. Additionally, Sierra12 mentions that insomnia complaints are more frequent in women. However, this may be related to the sample’s age, as gender differences become more evident with aging.
In conclusion, the results of this research reflect that, although the use of electronic devices is part of the daily routine for students in the Faculty of Health Sciences, its impact on sleep quality varies depending on individual habits. While a significant percentage of students report acceptable sleep quality, poor pre-sleep habits and prolonged use of electronic devices contribute to problems such as excessive latency and low sleep efficiency. Moreover, the time spent on social media and the habit of checking the phone before bed are key factors that influence sleep hygiene, aligning with previous findings in scientific literature. However, the lack of consensus in prior studies about the impact of gender and other underlying factors suggests that further research is needed to consider additional variables such as cultural context, academic demands, and personal stress management strategies.
Therefore, it is essential to promote educational campaigns within the university community to encourage healthy sleep habits that balance technology use and promote better sleep quality, which will improve students’ physical and mental well-being.