Behavioral profiles and temporal patterns of problematic smartphone use: associations with sleep hygiene and physical activity in adolescents

Abstract

Background: Problematic smartphone use (PSU) is a heterogeneous behavior, yet little is known about how dominant-use profiles relate to sleep hygiene, physical activity, and temporal usage patterns in adolescents.

Objective: To categorize adolescents with PSU into predefined dominant-use profiles and examine their associations with sleep hygiene, physical activity, and temporal smartphone-use patterns.

Methods: A total of 220 Tunisian middle school students (aged 14–16 years) screening positive for PSU according to validated Smartphone Addiction Scale–Short Version cutoffs underwent one month of objective monitoring via iOS/Android tracking tools. Following data validation, 180 participants were categorized into four profiles: social media (n = 52), gaming (n = 50), streaming (n = 40), and fitness (n = 38). Associations with sleep hygiene (Sleep Hygiene Index [SHI]) and physical activity (Physical Activity Questionnaire for Adolescents [PAQ-A]) were examined.

Results: Distinct behavioral profiles were associated with differences in health outcomes. Gaming and streaming profiles exhibited the highest total and late-night screen time, lowest physical activity, and poorest sleep hygiene (all p < 0.001), whereas the fitness profile demonstrated the most favorable pattern. Late-night screen time was associated with additional variance in SHI scores after adjustment for profile membership and demographics (standardized β = 0.42, p < 0.001).

Conclusion: Adolescent PSU manifests in distinct behavioral profiles with varying health-related associations. Nocturnal gaming and streaming are associated with poorer outcomes, potentially informing prevention efforts prioritizing usage patterns and timing over aggregate screen time. Consequently, digital well-being interventions may need to be profile-specific and time-sensitive.