ArticleFrontiers in public health2026
Associations of smartphone addiction and physical activity with sleep quality and neck/shoulder symptoms in university students: a cross-sectional study.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To examine the associations of smartphone addiction, physical activity, and sedentary time with sleep quality and neck/shoulder symptoms during the previous 7 days in university students, and to assess the potential modifying role of physical activity in outcomes associated with smartphone addiction. Methods: A cross-sectional survey was conducted among 585 students from a single university in Jilin Province, China. Smartphone addiction, physical activity, sedentary time, sleep quality, and neck/shoulder symptoms were assessed using validated questionnaires. Multivariable linear regression and Poisson regression with robust variance were used to examine adjusted associations and interaction terms. Results: Of the participants, 43.8% were classified as having poor sleep, and 46.2% reported at least one neck/shoulder symptoms during the previous 7 days. After adjustment for covariates, higher smartphone addiction and longer sedentary time were both associated with higher PSQI scores, a higher prevalence of poor sleep, and a higher prevalence of neck/shoulder symptoms during the previous 7 days. Meeting physical activity recommendations was associated with lower PSQI scores and a lower prevalence of poor sleep, but showed no independent association with neck/shoulder symptoms. After further adjustment for PSQI, smartphone addiction, sedentary time, and PSQI score were still significantly associated with a higher prevalence of neck/shoulder symptoms. Interaction plots showed descriptively lower predicted PSQI scores and lower predicted probabilities of neck/shoulder symptoms among students who met physical activity recommendations at comparable levels of smartphone addiction; however, the formal interaction terms were not statistically significant. Conclusion: Smartphone addiction and sedentary time were consistently associated with poorer sleep quality and more frequent neck/shoulder symptoms. Physical activity was more consistently associated with sleep outcomes than with neck/shoulder symptoms. These findings support considering smartphone use, sedentary behaviour, physical activity, and sleep management together in campus health promotion research.
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