Nowadays smartphones are used anywhere and at any time, day or night, by adolescents. Smartphone use, especially at night, is a risk factor for sleep disturbance and depression in adolescents. The purpose of this study was to analyse the correlation between smartphone use at night, sleep disturbance and depression symptoms in adolescents. This cross-sectional study analysed the data from 714 students in Surabaya, who were selected by using a simple random sampling technique. The independent variable was smartphone usage at night while the dependent variable was sleep disturbance and depressive symptoms. The data was collected using three questionnaires: the smartphone usage at night questionnaire, the Insomnia Severity Index questionnaire and the Kutcher Adolescent Depression Scale questionnaire. The data was then analysed using Spearman’s rho analysis (α < 0.05). The results indicated that there was a relationship between the use of smartphones at night and sleep disturbance in adolescents with a positive correlation (r = 0.374), and that there was a relationship between the use of smartphones at night and depression symptoms in adolescents with a positive correlation (r = 0.360). This study highlights that the excessive use of smartphones during the night may play a significant role in sleep problems and depressive symptoms among teenagers. Adolescents with sleep disturbance and depressive symptoms should be carefully monitored for signs of smartphone addiction. Nurses should improve health education for adolescents to inform them about the positive use of smartphones to prevent sleep disturbance and to minimise depressive symptoms.
Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Declaration of Conflict of Interest: None declared.
Author Contributions: The study was conducted, analysed, and interpreted by the authors independently. Authors’ contributions were as followed: RKD, FE, and EM carried out the design of the study, collected the data and performed analysis. RKD, FE, and JG drafted manuscript. All authors have reviewed and approved the manuscript prior to submission.
Ethics: The Ethics Committee on Health Research at the Faculty of Nursing at Airlangga University provides a research-appropriateness test. The approval of ethical appropriateness test was given under 544-KEPK on 25th October 2017. In order to maintain the anonymity of participants, researchers provided survey links to students through WhatsApp. Responses were collected through Google Forms without revealing student identity. The opening page contains the explanation of the research objectives and states that survey participation is voluntary, and approval is indicated if the survey is completed and returned.
 Lim CH, Kim EJ, Kim JH, Lee JS, Lee Y, Park SH. The correlation of depression with Internet use and body image in Korean adolescents. Korean J Pediatr. 2017;60(1):17–23. Search in Google Scholar
 Boumosleh JM, Jaalouk D. Depression, anxiety, and smartphone addiction in university students – a cross sectional study. PLoS One. 2017;12(8):e0182239. Search in Google Scholar
 Lemola S, Perkinson-Gloor N, Brand S, Dewald-Kaufmann JF, Grob A. Adolescents’ electronic media use at night, sleep disturbance, and depressive symptoms in the smartphone age. J Youth Adolesc. 2015;44(2):405–18. Search in Google Scholar
 Sahin S, Ozdemir K, Unsal A, Temiz N. Evaluation of mobile phone addiction level and sleep quality in university students. Pak J Med Sci. 2013;29(4):913–8. Search in Google Scholar
 Nose Y, Fujinaga R, Suzuki M, Hayashi I, Moritani T, Kotani K, et al. Association of evening smartphone use with cardiac autonomic nervous activity after awakening in adolescents living in high school dormitories. Childs Nerv Syst. 2017;33(4):653–8. Search in Google Scholar
 Tao S, Wu X, Zhang Y, Zhang S, Tong S, Tao F. Effects of sleep quality on the association between problematic mobile phone use and mental health symptoms in Chinese college students. Int J Environ Res Public Health. 2017;14(2):185. Search in Google Scholar
 American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Association Publishing; 2016. Search in Google Scholar
 Septania RC. Lebih dari Separuh “Generasi Z” Kecanduan Ponsel: Kompas.com; 2018. Available from: https://tekno.kompas.com/read/2018/02/24/15094817/lebih-dari-separuh-generasi-z-kecanduan-ponsel. Search in Google Scholar
 Schweizer A, Berchtold A, Barrense-Dias Y, Akre C, Suris J-C. Adolescents with a smartphone sleep less than their peers. Eur J Pediatr. 2017;176(1):131–6. Search in Google Scholar
 Berliana SM, Utami ED, Efendi F, Kurniati A. Premarital sex initiation and time interval to first marriage among Indonesians. Bull Indones Econ Stud. 2018;54(2):215–32. Search in Google Scholar
 Elhai JD, Tiamiyu MF, Weeks JW, Levine JC, Picard KJ, Hall BJ. Depression and emotion regulation predict objective smartphone use measured over one week. Pers Individ Dif. 2017;113:21–8. Search in Google Scholar
 World Health Organization. Adolescence: a period needing special attention – recognizing-adolescence [Internet]; 2018 [cited 2018 Jun 12]. Available from: http://apps.who.int/adolescent/second-decade/section2/page1/recognizing-adolescence.html. Search in Google Scholar
 Swanenghyun G, Astuti SS, Ghofir A. The validity and reliability of Insomnia Severity Index of Indonesian Version in Street Adolescents in Yogyakarta. Universitas Gadjah Mada; 2015. Search in Google Scholar
 Quintão S, David S, Gusmão R, Kutcher S. Contribution to the validation of the Kutcher Adolescent Depression Scale (KADS-6) in a Portuguese population. Psicol Refl Crít. 2015;28(2):313–21. Search in Google Scholar
 Thapar A, Collishaw S, Pine DS, Thapar AK. Depression in adolescence. Lancet. 2012;379(9820):1056–67. Search in Google Scholar
 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. Search in Google Scholar
 Liu X, Buysse DJ, Gentzler AL, Kiss E, Mayer L, Kapornai K, et al. Insomnia and hypersomnia associated with depressive phenomenology and comorbidity in childhood depression. Sleep. 2007;30(1):83–90. Search in Google Scholar
©2018 Walter de Gruyter GmbH, Berlin/Boston