BEDTIME USE OF HAND HELD DEVICES AMONG

MBBS STUDENTS OF A RURAL MEDICAL COLLEGE IN KERALA

GUIDE
DR.SIJI VS,ASSN.PROFESSOR OF COMMUNITY MEDICINE IN SUTAMS

INVESTIGATORS
Roshan RS

Fathimath Shibila V P

Meenambika B

Yadhukrishna OA
 INTRODUCTION
Sleep is a physiological state of unawareness which is regulated homeostaticaly. Sleep plays an
important role in cognitive and physical functions, cellular toxin removal, disease prevention and
restoration of both mind and body. Proper sleep is important for children and adolescents. Lack of sleep
in adolescents is becoming an important health issue. Many factors can affect sleep hygiene but the role
of mobile use in causing sleep problems in adolescence has gained huge attention in the past few years.

Due to technology revolution , most of the mobile phone users now have smartphone which
enable them to access internet and social networks, watching videos, online chatting and playing games.
This results in exposure to stimulating content, mobile phone overuse and phone addiction thus
contributing to hyper arousal in pre bedtime period and poor sleep quality.

Hand held devices is a piece of computing equipment that can be used in the hand. (1).Going by
this definition of handheld devices and gadgets many appliances can qualify to be called handheld, like a
mobile phone, PDA, mobile PC, handheld game consoles and so on. Their technology is a fast growing
one, which influences various aspects of our life. These devices are reshaping student’s everyday lives in
diverse ways, especially by deliver contents in versatile forms.

ADVANTAGES

• Usage of mobile devices in the learning process.

• It has a great effect on the health care sector, where the need for accurate and fast delivery of
information.(2)

DISADVANTAGES

• Prolonged use of these device prior to bedtime or even after lights out is a common habit
among students(young adults), this may cause various problems. (3)
o Delayed bed time
o Sleep loss
o Irregular sleep wake pattern.
o Psychological disorders.
o Vision problem due to the blue light from display.

Many studies have been conducted worldwide touching different aspect of handheld devices.
RATIONALE
Recent evidences and studies suggests that a most of the individuals in between the age of 21 and 25
use smart phones. (4)
RELAVANCE
Data related to bedtime use of handheld devices among students can be used to analyze students
health.
OBJECTIVE
1. To study the prevalence of bedtime use of handheld devices among MBBS students of SUTAMS.
2. To assess the sleep quality using PITTSBURGH SLEEP QUALITY INDEX.
 REVIEW OF LITERATURE
• An article on A meta-analysis of the effect of media devices on sleep outcomes by JAMA
pediatrics showed that Twenty studies were included and quality assessed, involving 125,198
children, 50.1% were male. There was a strong and consistent association between bedtime
media device use and: inadequate sleep quantity (OR =2.17; 95%CI 1.42-3.32); poor sleep
quality (OR=1.46; 95%CI 1.14-1.88); and excessive daytime sleepiness (OR=2.72; 95%CI 1.32-
5.61). Additionally, children who had access to (but did not use) media devices at night were
more likely to have inadequate: sleep quantity (OR=1.79; 95%CI 1.39-2.31); sleep quality
(OR=1.53; 95%CI 1.11-2.10); and daytime sleepiness (OR=2.27; 95%CI 1.54-3.35). (OR-odds
ratio, CI-confidence intervals).(5)

• A study, which has been conducted by the National Institute of Mental Health and Neuro
Sciences (NIMHANS) revealed that among 2000 people aged between 18 and 40 years, those
who used their mobile phones before going to bed, 72.4% had poor sleep quality. Respondents
were asked to evaluate their sleep based on a seven-day recall period. The study showed that
65.5% of the respondents - more men than women -kept their mobile phone nearby while
sleeping. The survey also found that among the users who slept with their mobile phone by their
bedside, 70% of men and 54% of women reported poor quality of sleep. Among those who do
not keep their mobile phones beside them, only 8.89 -12.38% reported poor sleep.

• In a study done by global pediatric health Parents of 234 children, ages 8 to 17 years, were
surveyed to quantify hours of technology use (computer, video games, cell phone, and
television), hours of sleep, and inattentive behaviors. Using any device at bedtime was
associated with a statically significant increased use of multiple forms of technology at bedtime
and use in the middle of the night, reducing sleep quantity and quality. Little association was
found between technology use and inattention. A statistically significant association was found
between bedtime technology use and elevated body mass index. (6)

• Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society
and the American Physiological society revealed that Evening exposure to light-emitting (LE)
devices can adversely affect circadian timing, sleep, and alertness, even when participants
maintain a fixed 8-hour sleep episode in darkness and the duration of evening LE-device
exposure is limited. (7)
 METHODOLOGY

• Study design: cross sectional study

• Study setting: SUT academy of medical sciences
• Study period: 29/07/22 to 29/07/23
• Study subject: MBBS students of SUTAMS
• Inclusion criteria: Students of SUTAMS who are willing to participate in the study
• Exclusion criteria: Students on medicine, poor sleep quality

• Sample size:

N=500
4∗72.4∗27.6
N=
14.48²

• Sampling method: Universal sampling.

• Data collection method: Questionnaire send through social media platform.
• Data collection tool: Semi-structured questionnaire.
• Data analysis: Data will be entered in in MS excel and analysis will be done using SPSS software.
• Ethical consideration:
• Ethical clearance for the study will be obtained from ethical committee of SUTAMS vencode.
• Consent and confidentiality of subject will be maintained.
 QUESTIONNAIRE

DEMOGRAPHIC DETAILS

Name:

Sex: M/F/Other

Age:

Batch:

GENERAL QUESTIONS

1. Are you using any handheld devices during bedtime: yes\no

-How many devices use at a time :1/2/more - which type
• Smart phone
• Computer(lap)
• I pad, tablet
• Smart watch
• Others

2. How long will you use after went to bed.

• whether used in presence of light/not.

• If using in reading light of not.

DURATION OF USE ________.

3. Where do you kept your gadgets during sleep.

 On the bed
 Near the bed
 On the table

4. In the past month how many days have you been using these devices during sleeping

• once a week
• twice a week
• daily
• others
5. Purpose of use

• Calling
• Social media
• Gaming
• Music and videos
• Surfing
• others

6. During the past month, what time have you usually gone to bed at night.

BED TIME________.

7. During the past month, how long(in minutes) has it usually taken you to fall asleep each night.

NUMBER OF MINUTES ________.

8. During the past month, what time have you usually gotten up in the morning.

GETTING UP TIME ________.

9. During the past month, how many hours of actual sleep did you get at night?(This may be different
than the number of hours you spent in bed)

HOURS OF SLEEP PER NIGHT ________.

10. During the past month, how often have you had trouble sleeping because you

a) Cannot get to sleep within 30 minutes

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

b) Wake up in the middle of the night or early morning

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

c) Have to get up to use the bathroom

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week
d) Cannot breathe comfortably

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

e) Cough or snore loudly

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

f) Feel too cold

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

g) Feel too hot

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

h) Had bad dreams

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

I) Have pain

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week
 j) Other reason(s), please describe
__________________________________________________________________________________
__________________________________________________________________________________
_______________________________________________.

How often during the past month have you had trouble sleeping because of this?

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

11. During the past month, how would you rate your sleep quality overall?

• Very good
• Fairly good
• Fairly bad
• Very bad

12. During the past month, how often have you taken medicine to help you sleep (prescribed or over the
counter)

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

13. During the past month, how often have you had trouble staying awake while driving, eating meals,
or engaged in social activity?

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

14. During the past month, how much of a problem has it been for you to keep up enough enthusiasm
to get things done?

• No problem at all
• Only a very slight problem
• Somewhat of a problem
• A very big problem
15. Do you have a bed partner or room mate?

• No bed partner or room mate

• Partner/room mate in other room
• Partner in same room, but not same bed
• Partner in same bed

If you have a room mate or bed partner, ask him/her how often in the past month you have had

a) Loud snoring

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

b) Long pauses between breaths while asleep

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

c) Legs twitching or jerking while you sleep

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

d)Episodes of disorientation or confusion during sleep

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week

e) Other restlessness while you sleep; please describe

• Not during the past month

• Less than once a month
• Once or twice a week
• Three or more times a week
 BIBLIOGRAPHY
1. Education and Information Technologies 19 (2), 441-450, 2014

2. Australasian Journal of Educational Technology 25(2),2009

3. Journal of Knowledge & Communication Management,2018

4. International Journal of Pharmaceutical Investigation. 2017 Jul-Sep; 7(3): 125–131

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680647/#__ffn_sectitle

5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5380441/

6. https://pubmed.ncbi.nlm.nih.gov/29119131/

7. https://pubmed.ncbi.nlm.nih.gov/29845764/