Relationships of excessive internet use with depression, anxiety, and sleep quality among high school students in northern Vietnam

Purpose: To examine the associations of excessive internet use with depression, anxiety, and sleep quality among high school students in northern Vietnam, a country experiencing rapid economic growth. Design and methods: A cross-sectional study was conducted in a high school in northern Vietnam from July to Sep-tember 2019. Symptoms of depression and anxiety were respectively assessed using the Center for Epidemiolog-ical Studies Depression Scale and the Vietnamese Anxiety Scale. Sleep quality was measured using the Pittsburgh Sleep Quality Index. Internet use and demographic characteristics were obtained using structured question-naires. A multiple logistic regression was performed. Results: In total, 678 participants with an average age of 16.1 (standard deviation 0.9) years were included. Nearly one-third of the adolescents (30.7%) exhibited excessive internet use (> 4 h/day), 19.6% experienced depressive symptoms, 14.5% presented anxiety symptoms, and 58.8% reported poor sleep quality. Compared to non-excessive internet users, excessive internet users (> 4 h/day) experienced significantly higher levels of depres-sive symptoms (p = .001), anxiety (p = .008), and poorer sleep quality (p < .001). Students who were female and with fair/poor self-rated health experienced higher depression, anxiety, and poor sleep quality (p < .05). After adjusting for demographic and health-related factors, students with excessive internet use were 58% more likely to experience poor sleep quality (odds ratio, 1.58, 95% confidence interval [1.06, 2.35]). Conclusions: Excessive internet use in Vietnamese high school students was significantly associated with poor sleep quality, but not with depression or anxiety. (c) 2021 Elsevier Inc. All rights reserved.