Abstract
BACKGROUND: The widespread use of smart devices, particularly among university students, has raised concerns about their impact on sleep quality. Bedtime usage of smart devices is associated with sleep disruptions and poor sleep quality. OBJECTIVE: This study aimed to explore the behavioral and perceptual factors influencing university students' intention to stop using smart devices at bedtime in Saudi Arabia. METHODS: A cross-sectional survey was conducted in June 2024 and distributed via social media platforms to university students (aged ≥18 years). The questionnaire collected data on demographics, smart device usage habits, perceived negative effects on sleep, and physical sleep disturbances. The Pittsburgh Sleep Quality Index was used to assess sleep quality. Path analysis was performed to evaluate relationships between the outcome variables, intended to stop using smart device usage, and 3 latent variables: sleep quality smartphone usage, sleep quality perceived negative effects, and sleep quality during the past month. Model fit was assessed using chi-square, comparative fit index, and root mean square error of approximation. RESULTS: Of the 774 participants, 90.43% (700/774) reported using their smart devices every night and 72.48% (561/774) believed bedtime device use negatively affected them the next morning. The most frequently reported next-morning symptoms were fatigue or drowsiness (480/774, 62.01%). Common purposes for bedtime device use were staying in touch with friends or family (432/774, 55.81%), entertainment (355/774, 45.86%), and filling up spare time (345/774, 44.57%). Overall, 58.26% (451/774) expressed an intention to stop bedtime device use within the next 3 months. Path analysis demonstrated that frequent nightly use (path coefficient=0.36) and after-lights-off usage (0.49) were positively associated with the intention to stop, whereas spending ≥3 hours on devices (-0.35) and engaging in multiple activities (-0.18) had negative associations. The strongest predictors of the intention to stop were perceived negative effects on next-morning well-being (0.71) and difficulty breathing comfortably during sleep (0.64). Model fit was excellent (comparative fit index=0.845 and root mean square error of approximation=0.039). CONCLUSIONS: Perceived negative effects on sleep quality and physical sleep disturbances are strong predictors of the intention to stop using smart devices at bedtime among university students in Saudi Arabia. Interventions aimed at improving sleep hygiene should focus on raising awareness about the impact of smart device use on well-being and addressing behaviors such as late-night usage and heavy screen time. Public health strategies should target both psychological and physiological aspects of bedtime smart device use to improve sleep quality in this population.