Sleep Quality as a Mediator of Internet Gaming Disorder and Executive Dysfunction in Adolescents: Cross-Sectional Questionnaire Study.

IF 5.8 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Journal of Medical Internet Research Pub Date : 2025-07-09 DOI:10.2196/68571

Michoel L Moshel, Wayne Warburton, Rainer Thomasius, Kerstin Paschke

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引用次数: 0

Abstract

Background: Internet gaming disorder (IGD) has been associated with impairments in executive functioning, particularly inattention and impulsivity. Sleep quality has separately been linked to both gaming behavior and cognitive performance, yet its role as a mediating factor in this relationship is underexplored.

Objective: This study aimed to determine whether sleep quality mediates the relationship between IGD symptoms and executive dysfunction in adolescents, specifically focusing on the domains of inattention and hyperactivity or impulsivity. A reverse mediation model was also tested to explore the bidirectional nature of these relationships.

Methods: A representative sample of 1000 adolescents (539/1000, 53.9% males), aged between 12 and 17 years (mean 14.52, SD 1.64), completed validated self-report measures of IGD symptoms, executive dysfunction, and sleep quality. Structural equation modeling was used to test direct and indirect effects with age and gender included as covariates.

Results: Of the sample, 2.4% (24/1000) met criteria for IGD (875/1000, 87.5% males), and 22.6% (226/1000) met criteria for chronic sleep reduction. Among those with IGD, 54.2% (542/1000) also experienced chronic sleep reduction. In model A (IGD → Sleep → Executive Dysfunction), IGD symptoms were associated with poorer sleep quality (a=0.32, 95% CI 0.19-0.44), which in turn were associated with greater executive dysfunction (b=0.05, 95% CI 0.01-0.10). The indirect effect was significant (a×b=0.02, 95% CI 0.01-0.04), and sleep quality was a partial mediator. In the reverse model (model B), executive dysfunction was associated with poorer sleep quality (a=0.15, 95% CI 0.06-0.25), which subsequently was associated with higher IGD symptoms (b=0.11, 95% CI 0.07-0.16); indirect effect a×b=0.02, 95% CI 0.01-0.04. Simple slope analysis showed that IGD symptoms were associated only with executive dysfunction at average or poor levels of sleep quality. At higher levels of sleep quality, this relationship was no longer significant.

Conclusions: The results of this study suggest that sleep quality may be an important intermediary mechanism by which IGD might contribute to executive dysfunction and provide a basis for the development and implementation of strategies that target sleep issues in IGD. Prospective longitudinal research is needed to examine the directionality of the relationships between IGD, sleep quality, and executive dysfunction longitudinally.

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睡眠质量在青少年网络游戏障碍和执行功能障碍中的中介作用：横断面问卷研究。

背景：网络游戏障碍（IGD）与执行功能障碍有关，特别是注意力不集中和冲动。睡眠质量分别与游戏行为和认知表现有关，但其作为中介因素在这一关系中的作用尚未得到充分探索。目的：本研究旨在确定睡眠质量是否介导青少年IGD症状与执行功能障碍之间的关系，特别是关注注意力不集中、多动或冲动等领域。我们还测试了一个反向中介模型，以探索这些关系的双向性质。方法：1000名青少年（539/1000,53.9%男性）的代表性样本，年龄在12至17岁之间（平均14.52，标准差1.64），完成IGD症状、执行功能障碍和睡眠质量的有效自我报告测量。以年龄和性别为协变量，采用结构方程模型检验直接效应和间接效应。结果：在样本中，2.4%（24/1000）符合IGD标准（875/1000，男性87.5%），22.6%（226/1000）符合慢性睡眠减少标准。在IGD患者中，54.2%（542/1000）也经历了慢性睡眠减少。在模型A （IGD→睡眠→执行功能障碍）中，IGD症状与较差的睡眠质量相关（A =0.32, 95% CI 0.19-0.44），而较差的睡眠质量又与较严重的执行功能障碍相关（b=0.05, 95% CI 0.01-0.10）。间接效应显著（a×b=0.02, 95% CI 0.01-0.04），睡眠质量是部分中介。在相反的模型（模型B）中，执行功能障碍与较差的睡眠质量相关（a=0.15, 95% CI 0.06-0.25），随后与较高的IGD症状相关（B =0.11, 95% CI 0.07-0.16）；间接效应a×b=0.02, 95% CI 0.01-0.04。简单斜率分析显示，IGD症状仅与睡眠质量一般或较差水平的执行功能障碍相关。在较高的睡眠质量水平下，这种关系不再显著。结论：本研究结果表明，睡眠质量可能是IGD导致执行功能障碍的重要中介机制，并为制定和实施针对IGD睡眠问题的策略提供了基础。需要前瞻性的纵向研究来检验IGD、睡眠质量和执行功能障碍之间的纵向关系的方向性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Medical Internet Research 医学-卫生保健

CiteScore

14.40

自引率

5.40%

发文量

654

审稿时长

1 months

期刊介绍： The Journal of Medical Internet Research (JMIR) is a highly respected publication in the field of health informatics and health services. With a founding date in 1999, JMIR has been a pioneer in the field for over two decades. As a leader in the industry, the journal focuses on digital health, data science, health informatics, and emerging technologies for health, medicine, and biomedical research. It is recognized as a top publication in these disciplines, ranking in the first quartile (Q1) by Impact Factor. Notably, JMIR holds the prestigious position of being ranked #1 on Google Scholar within the "Medical Informatics" discipline.