Annals of Indian Psychiatry

: 2022  |  Volume : 6  |  Issue : 1  |  Page : 95--98

A cross-sectional study on internet addiction disorder and its association with sleep quality in young adults

Nikhilesh Andhi, Aamer Nawaz Syed, Ayesha Saffura 
 Department of Pharmacy Practice, Samskruti Group of Institutions, Jawaharlal Nehru Technological University, Hyderabad, Telangana, India

Correspondence Address:
Dr. Nikhilesh Andhi
Department of Clinical Pharmacy Practice, Samskruti college of Pharmacy, Kondapur, Ghatkesar Medchal District, Telangana-501301


Background: India is estimated to have 650 million Internet users in the country by 2023, with such explosive numbers internet addiction is emerging to be a major concern within the nation, particularly among youngsters. Aim:To study internet addiction disorder and its association with sleep quality in young adults. Methods And Materials: A cross-sectional study was conducted enrolling a total of 310 participants. Internet addiction and sleep quality were assessed in these participants using Young's Internet Addiction Scale and Pittsburgh Sleep Quality Index, respectively. Result: Out of 310 participants, a total of 140 (45.1%) study participants were found to have an Internet addiction. Consequently,268 (87%) participants showed poor sleep quality. A further outcome of the study implicated Internet addiction influenced job performance (60%), individual's productivity (70.9%), and symptoms such as difficulty in breathing, long pauses between breaths, loud snoring, legs twitching, or jerking, and episodes of disorientation or confusion while asleep. Conclusion: The study results suggest a significant association between sleep quality and Internet addiction and that poor sleep quality is mediated by internet addiction and potentially keeping individuals at risk of developing obstructive sleep apnoea, insomnia, restless legs syndrome, periodic limb movement disorder, depression, anxiety, etc., which upon worsening might lead to the wide variety of cardiovascular diseases, neurological, and psychiatric disorders.

How to cite this article:
Andhi N, Syed AN, Saffura A. A cross-sectional study on internet addiction disorder and its association with sleep quality in young adults.Ann Indian Psychiatry 2022;6:95-98

How to cite this URL:
Andhi N, Syed AN, Saffura A. A cross-sectional study on internet addiction disorder and its association with sleep quality in young adults. Ann Indian Psychiatry [serial online] 2022 [cited 2023 Mar 25 ];6:95-98
Available from:

Full Text


The Internet has become an indispensable tool in people's routine providing aid to connect globally, swiftly becoming an influential tool of communication, exchange of information, and foundation of entertainment. At present, India is ranked as the second-largest online market in the world after China, having over 560 million Internet users. Numerous factors for instance socioeconomic and gender, when taken into account, indicate the majority of Internet users aged between 20 and 29 years.[1]

In 1996, Young initiated the first research work on Internet addiction.[2] Internet addiction disorder is recognized by the American Psychological Association. However, there is still an ongoing debate on listing IAD in the Diagnostic and Statistical Manual of Mental Disorders.[3] Internet addiction is characterized by overuse or uncontrolled preoccupations, cravings for computer use, and Internet access that led to impairment of function or distress.[4] Youngsters are potentially at high risk of developing Internet addiction.[5] Significant proportions of students have Internet addiction which impacts academic performance and consequences of which are on society as a whole.[6]

The spike in the number of Internet addiction among young individuals has directed alarms to address the question. It is crucial for India with the youngest population in the world to take effective measures to ward off and manage Internet addiction.[7]

Problematic Internet addiction is associated with abundant adverse effects on one's life involving occupational, psychological, social life also correlated with social anxiety and social phobia[8],[9],[10] Reduction in the immune system due to inadequate sleep, lack of physical activity eye, and back strain is also encountered.[11]

Studies are uncovering various disadvantages of the Internet one of which includes association with sleep quality. Good quality of sleep is vital for both brain function and for the physical health of the body irrespective of age.[12] The guidelines suggest that healthy adults require 7–9 h of sleep per night while infants and teenagers require more sleep for healthy growth and development.[13] An increased risk for inflammatory-mediated diseases, cardiovascular disease, diabetes, metabolic syndrome, and depression are the consequences of insufficient sleep.[14] Sleep deprivation not only impairs decision-making but also damages temporal memory.[15] Moreover, using portable media devices at bedtime can aggravate poor quality of sleep and daytime sleepiness.[16] The combined effects of rumination and procrastination as important mediators for the relation between Internet addiction and poor sleep quality.[17]


A cross-sectional study was conducted in young Indian adults aged between 18 and 30 years for a period of 1 month. A total of 310 participants were enrolled in the study.

Inclusion criteria

Individuals >18 years of age irrespective of genderIndividuals willing to give consentHistory of using Internet from the past 1 year or more.

Exclusion criteria

Individuals >30 years of age irrespective of genderIndividuals not using the InternetIndividuals are not willing to give consent.

Informed consent was obtained from the study participants, and they were asked to answer a predesigned and pretested anonymous questionnaire. Young's Internet Addiction Scale was used to assess the level of addiction. Based on the responses and scores, participants are classified as mild, moderate, and severe based on the level of addiction. The sleep quality of the study participants was assessed by using Pittsburgh's sleep quality index also known as the PSQI scale which is used to distinguish the poor and good sleep by measuring the factors such as sleep latency, sleep duration, sleep quality, sleep efficiency, sleep disturbances, and daytime dysfunctions over the last month.

Descriptive statistical analysis was performed using the SPSS software version 22 (IBM Corporation, United States of America).

A t-test was performed and the P value was found to be P = 0.0001 which is considered to be extremely statistically significant with a confidence interval of 95%.

 Results and Discussion

Our study consisted of 310 young adults <30 years of age, of which 230 (74.2%) are females, 77 (24.8%) males, and 3 (1%) others [Graph 1]. A total of 140 study participants were found to have an Internet addiction.

Based on Young's Internet Addiction Scale, 4 (3%) participants were identified as severely addicted, whereas 41 (29%) participants showed a moderate level of addiction and 95 (68%) participants showed a mild level of addiction, as shown in [Graph 2].[INLINE:1][INLINE:2]

[Graph 3] shows the influence of Internet addiction on the quality of life of the participants which suggests the extent of addiction. According to the above graph 227 (73.2%), participants choose to spend time online over going out with others, 249 (80.2%) of participants fear that life without the Internet would be boring empty, and joyless and 296 (95.4%) of participants accept that they tend to stay online longer than intended which depicts the dependence and addiction toward the Internet.[INLINE:3]

[Graph 4] shows that 256 (82.5%) study participants complain of loss of sleep being online. 220 (70.9%) and 186 (60%) of study participants complain of suffering grades, productivity, and job performance, respectively.[INLINE:4]

Based on Pittsburgh's sleep quality index, 268 (87%) participants were found to have poor sleep quality [Graph 5].[INLINE:5] A significant number of participants were found experiencing symptoms such as loud snoring, long pauses between breaths, episodes of legs twitching and jerking, episodes of disorientation or confusion, and difficulty in breathing while sleeping.[INLINE:6]

The study demonstrated 45 (14.5%) participants experience long pauses between breaths and loud snoring while sleeping. Similarly, 119 (38.3%) participants experience the episodes of legs twitching or jerking while sleeping. Consequently, 99 (31.9%) participants experience episodes of disorientation or confusion during sleep. Similarly, 41 (13.2%) participants experience difficulty in breathing while sleeping, as shown in [Graph 6].[INLINE:7]

Further, this study observed that 45 participants experienced two or more symptoms while sleeping and have a significant amount of Internet addiction.

Participants with severe Internet addiction 4 (100%) and moderate addiction 41 (100%) exhibited poor sleep quality. Eighty-seven (91.5%) out of 95 participants with mild Internet addiction exhibited poor sleep quality which indicates a close association of Internet addiction with sleep quality.

As a result, the prevalence of Internet addiction disorder was found to be 45.16%, whereas the prevalence of poor sleep quality was found to be 86.45%.


Our findings suggest that there is a strong association between Internet addiction and sleep quality [Graph 7]. The symptoms experienced by the study participants while sleeping are suggestive of participants being at a greater risk of obstructive sleep apnea, insomnia, restless legs syndrome, periodic limb movement disorder, depression, anxiety, etc., which on worsening might lead to a wide variety of cardiovascular diseases, neurological, and psychiatric disorders.


We would like to thank Dr. Surya Teja Paka, Counsellor, Department of Psychiatry, Jaya Krishna Psychiatric Care Center for his support.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


1Internet Usage in India - Statistics and Facts,Statista. Available from: https://. [Last accessed on 2021 Aug 13].
2Brand M.Theoretical Models of the Development and Maintenance of Internet Addiction.In:Montag C;Reuter M.(eds) Internet Addiction.Studies in Neuroscience,Psychology and Behavioral Economics.Springer,Cham.
3Internet Addiction Disorder, Available from: https://. [Last accessed on 2021 Aug 13].
4Shaw M, Black DW. Internet addiction: Definition, assessment, epidemiology and clinical management. CNS Drugs 2008;22:353-65.
5Tomczyk Ł, Solecki R. Problematic internet use and protective factors related to family and free time activities among young people. Educ Sci Theory Pract 2019;19:1-13.
6Anand N, Thomas C, Jain PA, Bhat A, Thomas C, Prathyusha PV, et al. Internet use behaviors, internet addiction and psychological distress among medical college students: A multi centre study from South India. Asian J Psychiatr 2018;37:71-7.
7Maheshwari SK, Preksha S. Internet addiction: A growing concern in India. Indian J Psychiatr Nurs 2018;15:61.
8Weinstein A, Lejoyeux M. Internet addiction or excessive internet use. Am J Drug Alcohol Abuse 2010;36:277-83.
9Murali V, George S. Lost online: An overview of internet addiction. Adv Psychiatr Treat 2007;13:24-30.
10Jaiswal A, Manchanda S, Gautam V, Goel AD, Aneja J, Raghav PR. Burden of internet addiction, social anxiety and social phobia among University students, India. J Family Med Prim Care 2020;9:3607-12.
11Noah B, Gale ,Thomsan ( Firm).Are Social Networking Sites Harmful? Farmington Hills,Mich: Greenhaven Press,A part of Gale,Cengage learning,(2015).
12Sleep Deprivation and Deficiency,NHLBI, NIH. Available from: https://. [Last accessed on 2021 Aug 13].
13Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al. National sleep foundation's sleep time duration recommendations: Methodology and results summary. Sleep Health 2015;1:40-3.
14Okun ML. Biological consequences of disturbed sleep: Important mediators of health? Jpn Psychol Res 2011;53:163-76.
15Harrison Y, Horne JA. The impact of sleep deprivation on decision making: A review. J Exp Psychol Appl 2000;6:236-49.
16Carter B, Rees P, Hale L, Bhattacharjee D, Paradkar MS. Association between portable screen-based media device access or use and sleep outcomes: A systematic review and meta-analysis. JAMA Pediatr 2016;170:1202-8.
17You Z, Mei W, Ye N, Zhang L, Andrasik F. Mediating effects of rumination and bedtime procrastination on the relationship between Internet addiction and poor sleep quality. J Behav Addict 2020;9:1002-10.