Smart phones – The impact of screen time on quality sleep

Have you ever checked your phone just before going to sleep or in the middle of the night? If so, could it be having an impact on your health?

As part of our presentation on modern day addictions at last year's LUCID conference, we conducted some research to assess answers to these questions. The data collected from over 230 respondents looked at mobile device usage and opportunities or threats this presents for the future.

Our survey on phone usage was consistent with the average population, as documented by Ofcom in 'A Decade of Digital Dependency' (2018).  It was comforting to see that two thirds of respondents put their phone on "Do Not Disturb" at night but alarmingly over half check their phone if they wake up in the small hours.

The compulsion to look is strong as 4% looked at their phones before 4am and 11.5% between the hours of 4am and 6am. Additionally, 80% reported tiredness related to screen time.  Science tells us that it only takes a second or two of blue screen light to suppress melatonin, the hormone that makes you feel sleepy. 

Another barrier to sleep appears to be online streaming services, corroborated by Netflix CEO, Reed Hastings. He claims that neither Amazon nor You Tube are their biggest rival, but in fact their biggest challenge remains competing against sleep.

What is the impact of excessive use?

In terms of family impact, 44% of respondents regularly discuss reducing phone use with family, friends or colleagues indicating there is a desire to alter behaviour and a perception that some effects may be negative. Overall, 43% have tried to cut down, citing reasons such as tiredness, digital detox, family impact and sleep issues and more.

We have already mentioned the effect on sleep quality, but perhaps we need to be more aware of the larger impact poor sleeping habits have on our health. Like the need for air and sustenance, our bodies need sleep. Indeed, sleep deprivation has a significant impact on morbidity, mortality and productivity. We take an in-depth look at this in "Is sleep the new blood pressure?" – the second of "The Big Six series on Lifestyle Risk Factors"

Interestingly, the survey also highlighted the prevalence for risk taking behaviour, when 42% of respondents admitted to using their phone whilst driving, which if combined with reduced productivity could well be an area for concern.

Whilst you can check call phone records or use witness testimony, it is almost impossible to prove that someone was over tired due to excessive use of their phone at night, which could become a factor when looking at disability claimants suffering from fatigue symptoms. 

Is our phone a pathway to addiction?

80% of the respondents connected being tired to screen time and more than 15% admitted a strong compulsion to checking their phone between 2 am and 6 am. People continue these behaviours, even when it's widely recognised they impact sleep, productivity and overall health. So, should we be more worried? Perhaps, if you consider that currently there is little in the way of underwriting or claims data to help us understand the impact of behavioural addictions on disability claims.

This phenomena actually has a name – "nomophobia" which is short for "no-mobile-phone" phobia — or the fear of being without a mobile device, or beyond mobile phone contact.  Recongising this phobia – which manifests in early hours screen time - could be the first step to understand and manage the overall risk. It is interesting to see the insertion of this condition in the evolution of the diagnostic criteria for addictions, shown in the table below:

The future

There is a clear link between late night screen time and poor-quality sleep. As the way we categorise addiction changes, from the historical view of an underlying personality defect to now focussing on craving and compulsion control, and then combining this with the near total penetration of smartphones, the risks to one’s mental and physical health cannot be underestimated. Smartphone use may bring numerous social benefits including an ability not to be tied to an office or desktop screen, which has never been more important over the last 3 – 4 months. But if use develops into a more divisive form of addiction, are we ready to spot it and find measures to rehabilitate our claimants?

We must ensure that we do not underestimate the impact from overuse and the opportunity costs involved. To quote Dr Debbie Smith at LUCID "if we're not asking disability claimants about their phone health, then we should be". A holistic claims approach is what we pride ourselves on, and to miss this vital health-check is to miss a trick.