Association between internet addiction and sleep quality among students: a cross-sectional study in Bangladesh

  • Syeda Mushrefa Jahan
  • Shazzat Rahat Hossain
  • Urme Binta Sayeed
  • Abrar Wahab
  • Taifur Rahman
  • Ahmed HossainEmail author
Original Article


Internet addiction has been a major behavioral disorder over the past decade. There remains a paucity of research to find the relationship between internet addictions and sleep quality in low- and middle-income countries such as Bangladesh. The aim of this study is to find the association between internet addiction and sleep quality among the medical college students. We conducted an analytical cross-sectional study in two medical colleges with 390 students in Dhaka, from December 2017 to May 2018. Pittsburg Sleep Quality Index was used to determine the quality of sleep and Orman’s Internet Addiction Test was used to classify the severity of internet addiction. It appears that the prevalence of poor sleep quality is 69.5% among the students and 68.4% of the students are having moderate to severe internet addiction. The results of multivariate logistic regression model indicated that the students with moderate and severe internet addiction are 75% and 95% less likely to have good sleep quality, respectively (OR = 0.25, CI 0.141–0.407; OR = 0.05, CI 0.013–0.118; reference: no internet addiction). Besides, the students who live with family during the class (OR = 1.74, CI 1.02–3.11), with smoking habit (OR = 0.236, CI 0.093–0.551, reference: non-smoker), not brushing teeth before sleep (OR = 1.705, CI 0.932–3.189), and housewife mother (OR = 0.576, CI 0.313–1.056; reference: working mother) are significantly associated with the good sleep quality among the medical college students. This study indicates that a significant proportion of students are having a poor sleep quality; there exists a positive correlation between internet addiction and poor sleep quality among the students. Thus, a necessity for developing interventions and education strategies to reduce internet addiction to improve the sleep quality in students is indispensable.


Internet addiction Sleep quality Pittsburg sleep quality index Orman’s internet addiction test Cross-sectional study Bangladesh 



Dhaka Community Medical College


City Dental College


Odds ratio


Confidence interval


Standard deviation



Authors would like to acknowledge the participants for providing us the information to conduct the study. We would also like to thank the anonymous reviewer and the editor for insightful comments that improved the presentation and clarity of our manuscript.

Author contributions

SMJ and SRH participated in study conception, design and coordination, data interpretation and drafted the manuscript. UBS, TR and AW reviewed the manuscript and helped to draft the manuscript. AH contributed in study conception, design, performed statistical analysis and helped to draft the manuscript. All authors approved of the final manuscript.


Not applicable.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

Ethical approval for the study protocol was obtained from the North South University Review Committee and the two medical colleges.

Informed consent

A written informed consent was obtained from all the study participants.

Availability of data

Click here for the data file


  1. 1.
    Shaw M, Black DW. Internet addiction. CNS Drugs. 2008;22:353–65.CrossRefGoogle Scholar
  2. 2.
    Reed P, Vile R, Osborne LA, Romano M, Truzoli R. Problematic internet usage and immune function. PLoS One. 2015;10:e0134538.CrossRefGoogle Scholar
  3. 3.
    Widyanto L, Griffiths M. ‘Internet addiction’: a critical review. Int J Ment Health Addict. 2006;4:31–51.CrossRefGoogle Scholar
  4. 4.
    Mak K-K, Lai C-M, Watanabe H, Kim D-I, Bahar N, Ramos M, Young KS, Ho RCM, Aum N-R, Cheng C. Epidemiology of internet behaviors and addiction among adolescents in six Asian countries. Cyberpsychol Behav Soc Netw. 2014;17:720–728.CrossRefGoogle Scholar
  5. 5.
    Hasmujaj E. Internet addiction and loneliness among students of University of Shkodra. Eur Sci J. 2016;12:1–12.Google Scholar
  6. 6.
    Tan Y, Chen Y, Lu Y, Li L. Exploring Associations between problematic internet use, depressive symptoms and sleep disturbance among southern Chinese adolescents. Int J Environ Res Public Health. 2016. Scholar
  7. 7.
    Ekinci Ö, Çelik T, Savaş N, Toros F. Association between internet use and sleep problems in adolescents. Neuropsychiatry (London). 2014;51:122–8.Google Scholar
  8. 8.
    Luntamo T, Sourander A, Rihko M, Aromaa M, Helenius H, Koskelainen M, McGrath PJ. Psychosocial determinants of headache, abdominal pain, and sleep problems in a community sample of Finnish adolescents. Eur Child Adolesc Psychiatry. 2012;21:301–13.CrossRefGoogle Scholar
  9. 9.
    Kim SY, Kim M-S, Park B, Kim J-H, Choi HG. Lack of sleep is associated with internet use for leisure. PLoS ONE. 2018;13(1):e0191713. Scholar
  10. 10.
    Vladan S. Problematic internet use: a distinct disorder, a manifestation of an underlying psychopathology, or a troublesome behaviour? World Psychiatry. 2010;9(2):92–3.CrossRefGoogle Scholar
  11. 11.
    Chen YL, Gau SSF. Sleep problems and internet addiction among children and adolescents: a longitudinal study. J Sleep Res. 2016;25:458–65.CrossRefGoogle Scholar
  12. 12.
    Lam LT. Internet gaming addiction, problematic use of the internet, and sleep problems: a systematic review. Curr Psychiatry Rep. 2014;16:444.CrossRefGoogle Scholar
  13. 13.
    Ko C-H, Liu T-L, Wang P-W, Chen C-S, Yen C-F, Yen J-Y. The exacerbation of depression, hostility, and social anxiety in the course of Internet addiction among adolescents: a prospective study. Compr Psychiatry. 2014;55:1377–84.CrossRefGoogle Scholar
  14. 14.
    Abolghasem P, Eftekhari M, Rezania S, Jafarisani M. Studying the relationship between quality of sleep and addiction to internet among students. Nov J Med Biol Sci. 2016. Scholar
  15. 15.
    Islam MA, Hossin MZ. Prevalence and risk factors of problematic internet use and the associated psychological distress among graduate students of Bangladesh. Asian J Gambl Issues Public Heal. 2016;6:11.CrossRefGoogle Scholar
  16. 16.
    Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiat Res. 1989;28:193–213.CrossRefGoogle Scholar
  17. 17.
    Schlarb AA, Friedrich A, Claßen M. Sleep problems in university students—an intervention. Neuropsychiatr Dis Treat. 2017;13:1989–2001.CrossRefGoogle Scholar
  18. 18.
    Al-Gamal E, Alzayyat A, Ahmad MM. Prevalence of internet addiction and its association with psychological distress and coping strategies among university students in Jordan. Perspect Psychiatr Care. 2016;52:49–61.CrossRefGoogle Scholar
  19. 19.
    Ataee M, Ahmadi Jouybari T, Emdadi SH, Hatamzadeh N, Mahboubi M, Aghaei A. Prevalence of internet addiction and its associated factors in hamadan University of medical college students. Life Sci J. 2014;11:214–7.Google Scholar
  20. 20.
    Canan F, Yildirim O, Sinani G, Ozturk O, Ustunel TY, Ataoglu A. Internet addiction and sleep disturbance symptoms among Turkish high school students. Sleep Biol Rhythms. 2013;11:210–3.CrossRefGoogle Scholar
  21. 21.
    Tsitsika A, Janikian M, Schoenmakers TM, Tzavela EC, Ólafsson K, Wójcik S, Macarie GF, Tzavara C, Richardson C. Internet addictive behavior in adolescence: a cross-sectional study in Seven European Countries. Cyberpsychol Behav Soc Netw. 2014;17:528–535.CrossRefGoogle Scholar
  22. 22.
    Choi K, Son H, Park M, Han J, Kim K, Lee B, Gwak H. Internet overuse and excessive daytime sleepiness in adolescents. Psychiatry Clin Neurosci. 2009;63:455–62.CrossRefGoogle Scholar
  23. 23.
    Ak S, Koruklu N, Yılmaz Y. A study on Turkish adolescent’s Internet use: possible predictors of Internet addiction. Cyberpsychol Behav Soc Netw. 2013;16:205–9.CrossRefGoogle Scholar
  24. 24.
    Alaettin U, Mustafa T, Didem A, Emine A, Serhat AM, Burcu IA, Koyuncu T, Necati B. Internet addiction and sleeping quality among college students in West Turkey. Res J Educ Sci. 2016;4(7):1–8.Google Scholar
  25. 25.
    Beutel ME, Brähler E, Glaesmer H, Kuss DJ, Wölfling K, Müller KW. Regular and problematic leisure-time internet use in the community: results from a German population-based survey. Cyberpsychol Behav Soc Netw. 2011;14:291–296.CrossRefGoogle Scholar
  26. 26.
    Liu JT, Lee IH, Wang CH, Chen KC, Lee CI, Yang YK. Cigarette smoking might impair memory and sleep quality. J Formos Med Assoc. 2013;112:287–90.CrossRefGoogle Scholar
  27. 27.
    Morioka H, Itani O, Osaki Y, Higuchi S, Jike M, Kaneita Y, Kanda H, Nakagome S, Ohida T. Association between smoking and problematic internet use among japanese adolescents: large-scale nationwide epidemiological study. Cyber Psychol Behav Soc Netw. 2016;19:557–61.CrossRefGoogle Scholar
  28. 28.
    Brook JS, Zhang C, Rubenstone E, Brook DW. Insomnia in adults: the impact of earlier cigarette smoking from adolescence to adulthood. J Addict Med. 2015;9:40–5.CrossRefGoogle Scholar
  29. 29.
    Park S. Associations of physical activity with sleep satisfaction, perceived stress, and problematic Internet use in Korean adolescents. BMC Public Health. 2014;14:1143.CrossRefGoogle Scholar

Copyright information

© Japanese Society of Sleep Research 2019

Authors and Affiliations

  • Syeda Mushrefa Jahan
    • 1
  • Shazzat Rahat Hossain
    • 1
  • Urme Binta Sayeed
    • 1
  • Abrar Wahab
    • 1
  • Taifur Rahman
    • 2
  • Ahmed Hossain
    • 1
    • 2
    Email author
  1. 1.Department of Public HealthNorth South UniversityDhakaBangladesh
  2. 2.Health Management BD FoundationDhakaBangladesh

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