Screen Time and its Association with Sleep and Immunity among Undergraduate Medical Students: A Cross- Sectional Study

Abstract

Background and Aim: With advancing technology, screen-based activities have evolved globally, leading to excessive usage and addictions that can disrupt sleep and impair immunity. The Neutrophil-Lymphocyte Ratio (NLR) serves as a biomarker for inflammation and stress, indicating the balance between innate and adaptive immunity. So, we attempted to study the relationship between Screen Time (ST) sleep and NLR among undergraduate students at a central Medical Institute. Methods: A questionnaire-based, cross-sectional study was conducted among undergraduate students for 1 year using the Self-reported HELENA Scale and Android App Tracker for ST, Epworth Sleepiness Scale (ESS) for Sleep quality assessments and immunity status was assessed by NLR estimation. Collected Data was entered in SPSS V.26 and analysed using descriptive statistics. Results: A total of 126 participants responded, out of which 100 (61 females, 39 males) were included after screening. ST >4 hr/day among 80% participants, higher in females (51 F, 29 M); 11% had ST of 2-4hrs/day and 9% had <2hrs/ day. Sleep quality score showed moderate daytime sleepiness in 19% (12F, 7M) while 58% (35F, 23M) had excessive sleepiness, indicating poor sleep in these participants. Normal NLR (0.78-3.58) was seen in 90% participants while the remaining 10% (8F, 2M) had elevated NLR (>3.58). Screen time was positively and significantly associated with ESS and NLR having r-values of 0.110 and 0.965, respectively (p<0.001). Conclusion: We conclude that increased screen time affects the sleep quality adversely, resulting in excessive daytime sleepiness and decreased immunity among participants.