Over the last two decades, cell phones have become essential in everyday life. However, mobile phone technology is inseparable from exposure to electromagnetic fields, which raised significant health concerns. In particular, active mobile phone users reported headaches, earache, warmth sensations, fatigue, and concentration difficulties (Thomée et al., 2011). Cell phone use can additionally be linked with inadequate night sleep and its negative outcomes. Adolescents and young adults who use mobile phones before bedtime or after lights out may be particularly susceptible to the harmful consequences. Therefore, the significance of this topic is that it can help enhance teenagers’ health, and the purpose of the review is to gather relevant information about the effects of the proposed intervention.
In that regard, the problem lies in listing confirmed adverse health outcomes of night cell phone use and linking them to a potentially helpful intervention of cell phone use restrictions. In this review, “night cell phone use” is defined as using a mobile phone soon before sleep or instead of night sleep. The “negative health outcomes” notion encompasses all confirmed physical and mental conditions potentially caused by night cell phone use. Furthermore, the “population group” is a cohort of individuals affected by night cell phone use. This literature review primarily focuses on the population group of adolescents from 12 to 18 years old. However, evidence from thematically similar studies is considered if effects are consistent across different population groups or if the age difference is insignificant. The following PICO question is considered:
In adolescents from 12 to 18 years old (P), do restrictions in night cell phone use (I), compared with no restrictions of night cell phone use (C), reduce the rate of insomnia (O) in 12 months (T)?
Methods
Eight academic studies have been selected for this literature review. Due to convenience considerations, full bibliographic details of sources are listed in the References section. The search and selection have been conducted via the Google Scholar database. The following inclusion criteria have been applied:
- Theme — all articles are related to subjects of cell phone use outcomes and sleep quality in adolescents and young adults;
- Study type — only primary studies were included in the review scope;
- Date of publishing — only studies published in 2008 or later were included in the final selection;
- Source quality — only peer-reviewed articles from academic journals were included in the review scope;
- Academic relevance — the final selection included studies with 30 or more citations in scholarly sources.
If the studies were identified as systematic reviews and meta-analysis papers or lacked detailed discussions of results, they were excluded.
Regarding evidence strength, the Elsevier level of evidence criteria was applied to evaluate the credibility of papers included in the scope of review (Elsevier Author Services, n.d.). In total, the seven studies reached Level 2 in the evidence hierarchy, while a seminal work by Thomée et al. (2011) reached Level 1 by virtue of being a high-quality longitudinal prospective cohort study.
Keywords: night cell phone use, negative health outcomes, adolescents, sleep quality, sleep deprivation, insomnia.
Results
In summary, the major findings of the studies point to multiple negative health outcomes associated with night cell phone use. First, Thomée et al. (2011) used a questionnaire as a data collection procedure, aiming to determine “associations between psychosocial aspects of mobile phone use and mental health symptoms in a prospective cohort of young adults” (p. 66). Their research’s major finding was the association between high mobile phone use during the 1-year follow-up period and sleep deprivation, stress, and depression. This finding was later confirmed by Lemola et al. (2015). Their study’s objective was to investigate whether the use of smartphones at night was related to symptoms of depression and sleep disturbance in adolescents. Lemola et al. (2015) used questionnaires as their procedure for data collection, assessing respondents’ sleep duration, sleep difficulties, depressive symptoms, and electronic media use before sleep. Their most significant finding was the association between owning a gadget and increased use of electronic media before bedtime. The latter was also related to the signs of depression and sleep disturbance.
Further, Bruni et al. (2015) conducted a questionnaire-based survey of 850 preadolescents and adolescents, aiming to confirm that the late turning off time of mobile phones led to sleep quality deterioration. They found different negative effects of the use and number of gadgets in the bedroom, late turning off time, and other factors on sleep quality. Next, Amra et al. (2017) used the same procedure for data collection, aiming to “assess the relationship of late-night cell phone use with sleep duration and quality in a sample of Iranian adolescents” (p. 560). According to their findings, this connection is confirmed, and physical activity can reduce the effects of using gadgets before sleep. Further, as noticed by Gamble et al. (2014), who conducted a survey to collect data, using computers and cell phones was associated with sleep schedule disruption and wake lag. Overall, their review confirmed the negative health outcomes of night cell phone use, such as insomnia, depression, and fatigue, which was the purpose of their study.
The major strength of the mentioned articles is that they all proved the connection between the use of gadgets and poor health outcomes, supporting previous research. What is more, they all are quite self-critical as they include well-developed limitations. As for the weaknesses, one may notice that the choice of the data collection procedure might have resulted in biased results. In other words, information received through surveys and questionnaire is often overly subjective. Some studies also had small research samples and short follow-up periods.
Discussion
In summary, the studies analyzed in this review confirmed that night cell phone use leads to sleep deprivation, insomnia, and depression in adolescents and young adults. The academic community agrees that using mobile phones or other electronic devices before sleep is harmful to one’s sleep quality and mental health (Adachi-Mejia et al., 2014; Lemola et al., 2015). Noticeably, the negative effects of night cell phone use remained persistent in young adulthood: Thomée et al. (2011) confirmed an increased prevalence of depressive symptoms in young adults aged between 20 and 24.
Further, Alshobaili and AlYousefi (2019) revealed that young adults who spend more than 60 minutes on night cell phone use had a 7.4-times greater risk of disturbed, poor-quality sleep. In addition, the mobile phone use restriction tested by He et al. (2020) produced significant positive outcomes in individuals using cell phones before sleep. However, answering the PICO question requires additional RCTs tailored specifically to the adolescent population. Furthermore, such RCTs must include at least a one-year-long follow-up period to confirm the positive longitudinal effects of night cell phone use restrictions. In that regard, one can consider the lack of adolescent-focused high-quality RCTs a critical weakness in this research area.
Conclusion
So far, the academic community has confirmed various negative health outcomes stemming from night cell phone use. In particular, adolescents and young adults who use mobile phones soon before sleep are at risk of poor sleep quality, insomnia, and depression. However, the lack of high-quality, large-scope RCTs with adolescent participants makes answering the PICO question challenging. The studies point to a hypothetic positive effect of restrictions as an anti-insomnia intervention in adolescents aged between 12 and 18. While the efficacy of such intervention seems plausible, high-quality RCTs in targeted population groups are necessary to answer the PICO question with full confidence.
References
Adachi-Mejia, A. M., Edwards, P. M., Gilbert-Diamond, D., Greenough, G. P., & Olson, A. L. (2014). TXT me I’m only sleeping: Adolescents with mobile phones in their bedroom. Family & Community Health, 37(4), 252-257. Web.
Alshobaili, F. A., & AlYousefi, N. A. (2019). The effect of smartphone usage at bedtime on sleep quality among Saudi non-medical staff at King Saud University Medical City. Journal of Family Medicine and Primary Care, 8(6), 1953-1957. Web.
Amra, B., Shahsavari, A., Shayan-Moghadam, R., Mirheli, O., Moradi-Khaniabadi, B., Bazukar, M., Yadollahi-Farsani, A., & Kelishadi, R. (2017). The association of sleep and late-night cell phone use among adolescents. Jornal de Pediatria, 93, 560-567. Web.
Bruni, O., Sette, S., Fontanesi, L., Baiocco, R., Laghi, F., & Baumgartner, E. (2015). Technology use and sleep quality in preadolescence and adolescence. Journal of Clinical Sleep Medicine, 11(12), 1433-1441. Web.
Elsevier Author Services. (n.d.). Levels of evidence in research. Web.
Gamble, A. L., D’Rozario, A. L., Bartlett, D. J., Williams, S., Bin, Y. S., Grunstein, R. R., & Marshall, N. S. (2014). Adolescent sleep patterns and night-time technology use: Results of the Australian Broadcasting Corporation’s Big Sleep Survey. PloS One, 9(11), e111700. Web.
He, J. W., Tu, Z. H., Xiao, L., Su, T., & Tang, Y. X. (2020). Effect of restricting bedtime mobile phone use on sleep, arousal, mood, and working memory: A randomized pilot trial. PloS One, 15(2), e0228756. Web.
Lemola, S., Perkinson-Gloor, N., Brand, S., Dewald-Kaufmann, J. F., & Grob, A. (2015). Adolescents’ electronic media use at night, sleep disturbance, and depressive symptoms in the smartphone age. Journal of Youth and Adolescence, 44(2), 405-418. Web.
Thomée, S., Härenstam, A., & Hagberg, M. (2011). Mobile phone use and stress, sleep disturbances, and symptoms of depression among young adults – A prospective cohort study. BMC Public Health, 11(1), 66-79. Web.