Problematic Smartphone Use and Sleep Disturbance in Adolescents and Young Adults: A Systematic Review of Longitudinal and Experimental Evidence
Abstract
Problematic smartphone use (PSU) refers to excessive or poorly regulated smartphone use associated with functional impairment. Adolescents and young adults are vulnerable to both PSU and sleep disturbances; however, existing evidence has been predominantly cross-sectional and limited in determining temporal relationships. This review aimed to synthesize longitudinal and experimental evidence regarding the association between PSU and sleep disturbances among adolescents and young adults. PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials were searched from inception to January 2026. Eligible studies included prospective cohort studies and randomized controlled trials involving adolescents or young adults that assessed PSU or related smartphone behaviors and reported at least one sleep-related outcome or a relevant mental health pathway associated with PSU and sleep disturbances. Nine studies were included, comprising six prospective cohort studies and three randomized controlled trials, with a total of 11,857 participants. The mean age of participants ranged from 12.5 to 22.7 years, and follow-up or intervention durations ranged from 4 weeks to 2 years. Longitudinal evidence showed that nocturnal mobile phone-related awakenings were associated with restless sleep (aOR 5.39, 95% CI: 2.13–13.65) and difficulty falling asleep (aOR 3.44, 95% CI: 1.03–11.54). High screen time was associated with difficulty falling asleep (aOR 2.41, 95% CI: 1.41–4.13). Cross-lagged analyses suggested bidirectional associations between PSU and sleep problems. Experimental studies indicated that mindfulness-based interventions, screen-time reduction, and bedtime phone restriction improved several sleep outcomes. Overall, longitudinal and experimental evidence suggests a bidirectional association between PSU and sleep disturbances among adolescents and young adults.