Relationship between Smartphone Screen Time, Physical Activity, and Self-Reported Fatigue among Medical Students

Abstract

Background: Smartphone use has become an integral part of medical education and daily communication; however, prolonged screen exposure may contribute to sedentary behavior, disturbed sleep, and increased fatigue. Medical students are especially vulnerable due to their hectic schedules, heavy reliance on digital learning platforms and limited access to physical exercise. This study was conducted to find the relationship between the use of smartphones, physical activity and fatigue of medical students.

Methods: A cross-sectional analytical study was conducted among 82 undergraduate medical students at Islamabad Medical and Dental College, Islamabad, Pakistan from April 2025 to September 2025. The information was obtained by a structured questionnaire that collected data on demographic characteristics, daily smartphone screen time, physical activity, sleep duration, sedentary behaviour, and fatigue. Smartphone screen time was classified as 0-<3 hours, 3-5 hours, 5-7 hours and >7 hours daily. Physical activity was categorized as low, moderate, or high, and fatigue was measured by a self-report fatigue scale. IBM SPSS Statistics version 25.0 was used for the analysis of the data. One-way ANOVA, chi-square test, pearson correlation and multiple linear regression were used as indicated. A p value of < 0.05 was regarded statistically significant.

Results: The mean age of participants was 21.8 ± 1.7 years, and 44 (53.7%) were female. Mean daily smartphone screen time was 5.4 ± 2.0 hours, while the mean fatigue score was 21.7 ± 7.0. Fatigue increased progressively across higher screen-time categories, from 15.8 ± 4.9 among students using smartphones for <3 hours/day to 27.0 ± 6.1 among those reporting >7 hours/day (p < 0.001). Students with low physical activity had significantly higher fatigue scores than those with moderate or high physical activity (p < 0.001). Smartphone screen time showed a positive correlation with fatigue (r = 0.51, p < 0.001), whereas weekly physical activity (r = −0.39, p < 0.001) and sleep duration (r = −0.34, p = 0.002) were inversely associated with fatigue. On multivariable analysis, greater smartphone screen time remained independently associated with higher fatigue, whereas greater physical activity was associated with lower fatigue.

Conclusion: Higher smartphone screen time was significantly associated with greater self-reported fatigue among medical students, while higher levels of physical activity were associated with lower fatigue. Promoting balanced smartphone use, regular physical activity, and adequate sleep may help reduce fatigue and improve student well-being.