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Title: Temporal association between objectively measured smartphone usage, sleep quality and physical activity among Chinese adolescents and young adults
Authors: Lee, PH 
Tse, ACY
Wu, CST 
Mak, YW 
Lee, U
Issue Date: Aug-2021
Source: Journal of sleep research, Aug. 2021, v. 30, no. 4, e13213
Abstract: We studied the association between objectively measured smartphone usage and objectively measured sleep quality and physical activity for seven consecutive days among Hong Kong adolescents and young adults aged 11–25 years (n = 357, 67% female). We installed an app that tracked the subjects’ smartphone usage and had them wear an ActiGraph GT3X accelerometer on their wrist to measure their sleep quality and physical activity level. Smartphone usage data were successfully obtained from 187 participants (52.4%). The participants on average spent 2 h 46 min per day on their smartphone. Multilevel regression showed that 1 min of daytime smartphone usage was associated with 0.07 min decrease in total sleeping time that night (p = .043, 95% confidence interval [CI]: −0.14, −0.003). Broken down for different usage purposes, 1 min of daytime social network usage and games and comics was associated with a 0.28 (p = .02, 95% CI: −0.52, −0.04) min and 0.18 min (p = .01, 95% CI: −0.32, −0.04) decrease in total sleeping time that night, respectively. One minute of daytime smartphone usage was associated with an increase of 4.55 steps in the number of steps (p = .001, 95% CI: 1.77, 7.34) on the next day. To conclude, time spent on a smartphone in the daytime was associated with total sleeping time that night and number of steps the next day, but was not associated with sleep efficiency, wake after sleep onset and moderate-to-vigorous-intensity activity (MVPA) among Hong Kong adolescents and young adults.
Keywords: Exercise
Gaming
Screen
Smart device
Smartphone monitoring
Youth
Publisher: John Wiley & Sons
Journal: Journal of sleep research 
ISSN: 0962-1105
DOI: 10.1111/jsr.13213
Rights: © 2020 European Sleep Research Society
This is the accepted version of the following article: Lee, PH, Tse, ACY, Wu, CST, Mak, YW, Lee, U. Temporal association between objectively measured smartphone usage, sleep quality and physical activity among Chinese adolescents and young adults. J Sleep Res. 2021; 30:e13213, which has been published in final form at https://doi.org/10.1111/jsr.13213. This article may be used for non-commercial purposes in accordance with the Wiley Self-Archiving Policy [http://olabout.wiley.com/WileyCDA/Section/id-820227.html].
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