SMART PHONE USE BEFORE SLEEP AND INSOMNIA SYMPTOMS AMONG MEDICAL STUDENTS: A CROSS SECTIONAL STUDY AT AYUB MEDICAL COLLEGE ABBOTTABAD

Abstract

Background Insomnia and poor sleep quality are increasingly reported among medical students, with growing concern regarding the impact of smartphone use before sleep. Excessive nighttime smartphone exposure may disrupt sleep through delayed sleep onset, cognitive arousal, and circadian rhythm disturbance. However, local evidence examining this association among medical students in Pakistan remains limited. Objective To assess the association between smartphone use before sleep and insomnia symptoms among undergraduate medical students at Ayub Medical College, Abbottabad. Methods A cross-sectional study was conducted among MBBS students from all academic years at Ayub Medical College. Data were collected using a structured, self-administered questionnaire that assessed patterns of smartphone use before sleep, including duration, frequency, timing, and purpose of use. Insomnia symptoms were evaluated using the validated Insomnia Severity Index (ISI). Insomnia severity was categorized as no insomnia, subthreshold, moderate, or severe. Data were analyzed using descriptive and inferential statistics, with associations examined between smartphone use variables and insomnia severity. Results A total of 265 medical students participated in the study. According to ISI scores, 31.7% of students had no insomnia, 41.9% had subthreshold insomnia, 21.1% had moderate insomnia, and 5.3% had severe insomnia. Prolonged smartphone use before sleep was significantly associated with higher insomnia severity. Moderate to severe insomnia was observed in 15.2% of students using smartphones for less than 60 minutes, 31.7% of those using smartphones for 60–90 minutes, and 34.6% of those using smartphones for more than 90 minutes before sleep. Non-academic smartphone use accounted for 61.5% of bedtime use. Students sleeping less than six hours per night had higher mean ISI scores and a greater prevalence of moderate to severe insomnia compared to those with longer sleep duration. Conclusion Insomnia symptoms were highly prevalent among medical students, with prolonged smartphone use before sleep showing a strong association with increased insomnia severity. Smartphone use before bedtime represents a modifiable risk factor for sleep disturbance. Targeted interventions promoting healthy smartphone habits and sleep hygiene may help reduce insomnia and improve well-being among medical students.