Social media addiction and its association with sleep quality and anxiety: A school-based cross-sectional study from Nepal.

Background Excessive use of social media is linked with poor sleep quality and negative mental health outcomes. However, studies assessing the interplay of these three components among school children are exceedingly rare. This study aims to assess the levels of social media addiction, poor sleep quality, and anxiety among higher secondary school children, identify associated factors, and explore the correlations among these components. Methods This study was conducted among 418 higher secondary school students. Multivariable logistic regression at a significance level of 0.05 was employed to determine factors associated with social media addiction, poor sleep quality, and anxiety. Additionally, a correlation test was used to examine the associations between social media addiction, poor sleep quality, and anxiety. Results The prevalence rates of social media addiction, poor sleep quality, and anxiety were 33.5%, 64.4%, and 59.6%, respectively. Female students (aOR: 2.6; 95% CI: 1.6–4.1) and students from private schools (aOR: 3.7; 95% CI: 2.0-6.8) had greater odds of being addicted to social media. Students from the Brahmin/Chhetri ethnic group (aOR: 0.5; 95% CI: 0.3–0.9) had lower odds of experiencing poor sleep quality than the other groups did. Female students (aOR: 2.4; 95% CI: 1.6–3.6) were more likely to experience anxiety. Additionally, sleep quality and anxiety were weakly positively correlated with social media addiction. Conclusion Excessive social media use is associated with poor sleep quality and increased anxiety among Nepalese higher secondary students. Interventions such as face-to-face counseling, digital detox programs, and tailored approaches for high-risk groups are essential to address these issues and enhance their overall well-being. Clinical trial number: Not applicable