Association of Internet addiction with psychiatric symptom levels and sleep disorders

Internet Addiction Disorder (IAD) is characterized by excessive or compulsive Internet use, negatively affecting daily functioning and mental health.

A sleep disorder refers to conditions disrupting sleep quality, duration, or regularity, causing impaired daytime functioning, increased psychological distress, and potential adverse health outcomes.

Sun, Y., Wang, Z., & Liu, T. (2025). Association of Internet addiction with psychiatric symptom levels and sleep disorders: A systematic review and meta-analysis. Frontiers in Psychology, 16, 1573058. https://doi.org/10.3389/fpsyg.2025.1573058

Key Points

• Phenomenon Explored: Internet addiction disorder (IAD) and its association with psychiatric symptoms (depression, anxiety, stress) and sleep disorders.
• Research Aim: To conduct a systematic review and meta-analysis to quantify the relationship between Internet addiction, psychological problems, and sleep quality.
• Key Findings: Internet addiction was significantly associated with moderate levels of depression (r=0.39), anxiety (r=0.30), and stress (r=0.34), and lower sleep quality (r=0.26).
• Implications: Highlighting these associations emphasizes the importance of addressing Internet addiction to mitigate mental health risks and improve sleep quality, potentially influencing mental health practices and interventions.

Rationale

The systematic review addresses the growing concern of Internet addiction (IA), particularly prevalent among adolescents and young adults.

Prior studies established significant correlations between IA and mental health disorders, including depression, anxiety, and poor sleep quality (Kumar et al., 2018; Lozano-Blasco & Cortes-Pascual, 2020).

Yet, there was no recent comprehensive meta-analysis synthesizing this evidence, particularly in light of increased Internet use due to the COVID-19 pandemic.

Previous reviews have identified significant correlations but did not thoroughly investigate recent data, indicating a clear gap (Alimoradi et al., 2019; Lei et al., 2020).

Method

• PRISMA Guidelines: The review and meta-analysis adhered to PRISMA guidelines and was registered with PROSPERO (CRD42023408958).
• Databases Searched: Web of Science, PubMed, Embase, Cochrane Library from January 2018 to June 2023.
• Search Terms: Internet addiction, psychological distress, depression, anxiety, sleep disturbances.
• Inclusion/Exclusion Criteria: Studies assessing associations between IA and anxiety, depression, stress, or sleep quality, published in English between 2018-2023. Excluded were conference abstracts, poor quality studies, reviews, meta-analyses, guidelines, and studies with incomplete data.
• Number of Studies Included: 48 studies.
• Data Extraction: Conducted independently by two researchers, with disagreements resolved by a third researcher.

Statistical Measures

• Methods Used: Inverse variance method calculated pooled Pearson’s correlation coefficients, odds ratios (ORs), and mean differences. Fisher Z-scores were used to stabilize variance.
• Purpose of Measures: Pearson’s correlations and ORs quantified associations between IA and psychiatric symptoms or sleep disorders. Mean differences assessed the severity differences between IA and non-IA groups.

Results

• Depression: Moderate positive correlation with IA (r=0.39). Significant subgroup effects based on geographic location and measurement tools.
• Anxiety: Moderate correlation (r=0.30); no significant effects based on age or measurement instruments.
• Stress: Moderate correlation (r=0.34), but less robust compared to anxiety and depression.
• Sleep Quality: Weak positive correlation (r=0.26), significant across age groups.

Insight

This study clearly demonstrates that Internet addiction has meaningful relationships with psychiatric symptoms and sleep disorders.

These findings reinforce existing theories like Compensatory Internet Use Theory, which proposes individuals with psychological distress use the Internet excessively as a coping mechanism.

These findings align with and expand upon previous meta-analyses (Alimoradi et al., 2019), particularly highlighting the pandemic’s amplifying effects.

Future research should explore longitudinal relationships and causation pathways.

Clinical Implications

Practitioners and policymakers should prioritize screening and interventions for Internet addiction to prevent or mitigate associated psychiatric and sleep disorders.

Specific recommendations include developing controlled Internet usage guidelines and psychoeducational programs.

Potential implementation challenges include variations in cultural perceptions of Internet use and limited public awareness.

Strengths

This study had several methodological strengths, including:

• Comprehensive and systematic search strategy.
• Adherence to rigorous PRISMA guidelines.
• Broad range of geographical and demographic data.
• Robust statistical analysis methods including sensitivity and subgroup analyses.

Limitations

This study also had several limitations, including:

• Reliance on self-reported data subject to biases.
• High heterogeneity among included studies.
• Lack of longitudinal studies limiting understanding of causation.
• Potential measurement bias due to diverse assessment tools.

Socratic Questions

1. What alternative explanations could account for the relationship between Internet addiction and psychiatric symptoms?
2. How might cultural differences influence the relationship between Internet addiction and mental health symptoms?
3. Could there be reverse causality, where psychiatric symptoms lead to increased Internet use?
4. How would you design a longitudinal study to clarify causation between Internet addiction and sleep disorders?
5. What practical steps could schools implement to help adolescents manage their Internet usage based on these findings?