Prevalence of daytime sleepiness and internet addiction among college going students in Bangalore

INTRODUCTION

The proliferation of smartphones and internet access in recent years has brought about dramatic changes in the lifestyle of young adults, especially college students. While these technologies offer academic and social benefits, their excessive use has raised concerns regarding behavioral addiction and its consequences. Internet and smartphone addiction are emerging as behavioral disorders marked by compulsive use, neglect of daily responsibilities, and withdrawal symptoms upon deprivation. These behaviors can severely impact mental health, leading to disturbances in sleep, cognition, and emotional regulation among students, thereby affecting their academic performance and overall quality of life.^1,2

One of the most frequently observed outcomes associated with excessive smartphone and internet use is poor sleep quality, often manifesting as excessive daytime sleepiness (EDS). EDS is characterized by an increased tendency to fall asleep during the day, interfering with academic, professional, and personal functioning. The prevalence of EDS among young adults has been reported to range between 20% and 30%, particularly in populations exposed to high academic stress and poor sleep hygiene, such as medical and college students.^3,4 Sleep deprivation, which is often the root cause of EDS, may be exacerbated by the compulsive late-night use of smartphones and internet browsing.⁵

Several studies have demonstrated a significant relationship between internet/smartphone addiction and poor sleep patterns among students. Medical and professional college students often experience chronic stress, academic pressure, and irregular sleep schedules, all of which are compounded by the high screen time associated with internet use. These factors are independently and synergistically linked to the onset of EDS and poor sleep quality.^3,5 Furthermore, studies have suggested that psychological factors like anxiety and depression may both contribute to and result from internet addiction and sleep disturbances.^2,3

Despite the increasing recognition of this public health issue, there is a dearth of region-specific data, especially among the general college-going population in Indian urban settings. Most Indian studies have focused on medical students or adolescents, leaving a gap in understanding the broader impact of internet usage on sleep health in urban student populations. This study aims to address this gap by determining the prevalence of EDS and internet addiction among college students in Bangalore and by exploring the association between these variables.

Aim and objectives

Aim and objectives were to determine the prevalence of daytime sleepiness among college-going students in Bangalore, to assess the prevalence of internet addiction in the same population and to evaluate the association between internet addiction and daytime sleepiness.

Need for the study

In today’s digital era, internet use is deeply integrated into academic, social, and personal lives of young adults, especially college students. While online engagement supports learning and connectivity, excessive use can disrupt healthy sleep patterns and contribute to daytime sleepiness. Poor sleep not only affects concentration and academic performance, but also impacts emotional wellbeing and daytime functioning. Despite rapid growth in smartphone and internet penetration among Indian youth, limited research has explored how this behavioral shift translates into sleep-related problems within the general student population in urban settings like Bangalore. Most existing studies focus on specific groups such as medical students or adolescents, leaving a gap in understanding the dual burden of internet overuse and daytime sleepiness among a broader college cohort. Investigating these associations is crucial for designing targeted interventions and promoting holistic wellbeing among students who are navigating both academic demands and digital lifestyles.

METHODS

This cross-sectional survey was carried out among 280 medical college students in Rajarajeswari medical college and Hospital Bangalore, Karnataka the survey was performed from September to November 2024. After explaining the study, informed consent will be taken from the study participants. Participants will be selected by purposive sampling technique. The sample size was determined to be 280 using the formula n= Z²pq/d², where Z=At 95% CI, value is 1.96; p=proportion from reference study that is 0.24; q=(1-p)=1-0.24= 0.76; d=precision level (0.05).³ We obtained a sample size of 280. Each student will be interviewed by a pre-tested semi-structured questionnaire to collect information on socio-demographic variables, the ESS to assess daytime sleepiness,⁷ and Young’s IAT to evaluate internet usage patterns.⁸

Study tool

ESS

Daytime sleepiness, which interferes with daily activities, is termed EDS and it is measured by the ESS, a self-administered questionnaire with eight questions. Respondents are asked to rate, on a 4-point Likert scale (0-3), their usual chances of dozing of, or falling asleep while engaged in eight different activities. The ESS score (the sum of 8 item scores) can range from 0 to 24. The higher the ESS score, the higher that person’s average “daytime sleepiness.”

Young’s IAT

It is a 20-item self-report scale developed by Young to assess internet addiction. The criteria include loss of control, neglecting everyday life, relationships and alternative recreation activities, behavioral and cognitive salience, negative consequences, escapism/mood modification, and deception. It is a Likert scale ranging from 1 to 5. The minimum score that can be obtained is 20, whereas the maximum is 100 points.¹²

Statistical analysis

The data was compiled in Microsoft excel worksheet and analyzed using SPSS (Statistical package for social sciences) software version 20.0. The descriptive statistics-All qualitative variables was presented as frequency and percentages. All quantitative variables were presented as mean and standard deviation. Chi-square tests of significance was applied to analyses the association between eating disorders and demographic variables. p values of less than 0.05 was considered statistically significant.¹⁴

RESULTS

In this study, prevalence of daytime sleepiness and internet addiction were assessed among 280 college going students in Bangalore, Karnataka. Among them, 180 (64.3%) were female and 100 (35.7%) were male.

Daytime sleepiness (ESS)

Based on the ESS: 10 students (3.5%) were found to have pathological daytime sleepiness (ESS score >16), indicating a high level of EDS, 149 students (53.2%) had mild to moderate daytime sleepiness, while 121 students (43.2%) had scores within the normal range, indicating minimal or no daytime sleepiness.

This suggests that more than half the participants experienced some degree of daytime drowsiness, which could potentially affect their academic performance and daily activities.

Internet addiction (Young’s IAT)

Internet usage patterns as per Young’s IAT revealed: 47 students (16.7%) had moderate internet addiction, 69 students (24.6%) had mild addiction, while 164 students (58.6%) were considered to have normal or minimal internet use.

The data demonstrates that approximately 41.3% of students exhibited problematic or addictive internet usage behavior, highlighting a considerable burden in this population.

Association between internet addiction and daytime sleepiness

A statistically significant association was found between levels of internet addiction and daytime sleepiness. The chi-square test yielded a value of 25.8 with a p<0.05, indicating that higher levels of internet addiction were significantly associated with increased levels of daytime sleepiness.

This suggests that students with higher internet use were more likely to experience EDS, which may be due to disrupted sleep cycles and poor sleep hygiene associated with late-night internet use.

*p<0.05-significant association

DISCUSSION

In the present study, 3.5% of participants exhibited pathological daytime sleepiness, while 53.2% had mild to moderate levels. These results align with findings from Sathe et al who reported that 27.4% of medical undergraduates experienced EDS, and nearly 44.4% had poor sleep quality, highlighting vulnerability of students to disrupted sleep patterns and their consequences.³

Similar trends were observed in the study conducted by Basu et al where approximately 24.91% of the medical undergraduates were found to have EDS as assessed by the Epworth daytime sleepiness scale (EDSS).⁴ Moreover, 63.48% of participants reported poor sleep quality based on the Pittsburgh sleep quality index (PSQI). The study identified significant associations between EDS and multiple lifestyle and demographic factors including age, semester of study, place of residence, lack of regular physical activity, and excessive use of mobile/laptop devices, all of which contributed to sleep disruption. The authors emphasized that academic pressure, high workload, and erratic sleep habits common among medical students were key contributors to both EDS and poor sleep quality, underscoring the need for institutional strategies to promote sleep hygiene and student well-being.

The prevalence of moderate and mild internet addiction in our study (16.7% and 24.6%, respectively) reflects increasing reliance on digital platforms for both academic and non-academic purposes. This is comparable to the study by Karki et al where 36.8% of undergraduate medical students in Nepal were found to be addicted to smartphones, with significant self-reported overuse and behavioral signs of addiction.¹ Demirci et al also observed that increased smartphone use was positively correlated with poor sleep quality, depression, and anxiety in university students, reinforcing the adverse psychological impacts of digital overdependence.²

Importantly, our study found a significant association between internet addiction and daytime sleepiness (χ²=25.8, p<0.05). This is consistent with findings from multiple studies, including Sathe et al and Kadian et al which emphasize the negative influence of excessive internet and smartphone use on both subjective sleep quality and alertness during daytime activities.^3,5 These findings point toward a vicious cycle: excessive internet use leads to late-night screen time and reduced sleep duration, which in turn causes EDS, affecting concentration and academic performance.

No significant gender differences were observed in our study with respect to either internet addiction or daytime sleepiness. This contrasts slightly with the study by Karki et al where male students exhibited a higher addiction score.¹ However, the gender-neutral findings in our context may reflect a convergence in digital behavior patterns among college students of both sexes in urban India, where internet access and usage habits are becoming increasingly uniform.

Our results also align with Pagel’s review, which described EDS as a common consequence of poor sleep hygiene, with potential impacts on academic and occupational functioning (6). Given the cognitive demands placed on students, persistent EDS can interfere with memory, focus, and productivity. Hence, identifying its link with modifiable behaviors like internet use is critical for early intervention.

Limitations

Study was conducted in medical college students so findings may not be generalizable beyond the study setting.

CONCLUSION

This study highlights a significant prevalence of both daytime sleepiness and internet addiction among college students in Bangalore. More than half of the participants reported varying degrees of daytime sleepiness, and over 40% exhibited mild to moderate internet addiction. The statistically significant association between internet addiction and daytime sleepiness suggests that excessive internet use may be a contributing factor to sleep disturbances and impaired daytime functioning in this population.

These findings underscore the urgent need for awareness programs and preventive strategies aimed at promoting responsible internet use, better sleep hygiene, and stress management among college students. Interventions at the institutional level such as digital wellness education, counseling services, and sleep health promotion can play a vital role in mitigating the dual burden of internet addiction and its impact on students' academic performance and mental health.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

REFERENCES

1. 1. Karki S, Singh JP, Paudel G, Khatiwada S, Timilsina S. How addicted are newly admitted undergraduate medical students to smartphones? a cross-sectional study from Chitwan medical college, Nepal. BMC Psychiatry. 2020;20:95.
2. 2. Demirci K, Akgönül M, Akpinar A. Relationship of smartphone use severity with sleep quality, depression, and anxiety in university students. J Behav Addict. 2015;4(2):85-92.
3. 3. Sathe HS, Saraf AS, Talapalliwar M, Patil V, Kumar V, Karia S. Excessive daytime sleepiness and sleep quality in medical students and their association with smartphone and internet addiction: A cross-sectional study. Ann Indian Psychiatry. 2021;5(2):139-43.
4. 4. Basu M, Saha SK, Majumder S, Chatterjee S, Misra R. A study on sleeping pattern among undergraduate medical students of a tertiary care teaching hospital of Kolkata. Int J Med Public Health. 2019;9(4):118-24.
5. 5. Kadian A, Mittal R, Gupta MC. Mobile phone use and its effect on quality of sleep in medical undergraduate students at a tertiary care hospital. Open J Psychiatry Allied Sci. 2019;10(2):129-35.
6. 6. Pagel JF. Excessive daytime sleepiness. Am Fam Physician. 2009;79(5):391-6.
7. 7. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193-213.
8. 8. Young K. Internet Addiction Test (IAT). Wood Dale, IL: Stoelting. 2016.
9. 9. Goyal N, Gupta S. Sleep quality among medical students in Moradabad, Uttar Pradesh, India. Int J Community Med Public Health. 2019;7:274.
10. 10. Nagori N, Vasava K, Vala A, Ratnani IJ. Association of sleep quality and internet addiction among the medical students. Int J Res Med Sci. 2019;7:2703-7.
11. 11. Kumar VA, Chandrasekaran V, Brahadeeswari H. Prevalence of smartphone addiction and its effects on sleep quality: A cross-sectional study among medical students. Ind Psychiatry J. 2019;28:82-5.
12. 12. Johns M. About the ESS-Epworth Sleepiness Scale. Available at: https://epworthsleepinessscale.com/about-the-ess/. Accessed on 11 January 2026.
13. 13. Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, et al. Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003;60:184-9.
14. 14. Goel N, Malhotra V, Tripathi Y. Sleep habits among first year medical students. J Evolution Med Dent Sci. 2016;5(38):2276-8.