Screen, Sleep, and Strain: Digital Eye Strain and Its Associations with Sleep, Ergonomics, Academic Performance, and Mental Health among Undergraduate Students
S. V. Kannappan, Shankar ChokkalingamAbstract
Background:
Digital device use among undergraduates is increasing and has led to concerns about digital eye strain (DES), sleep disturbances, poor use of digital devices, poor concentration, and stress. This study evaluated the burden of DES, its relationships to sleep quality, ergonomics and academic performance, and mental health among undergraduate students.
Methods:
This was a cross-sectional questionnaire based study conducted in the tertiary care teaching medical college and hospital, Chengalpattu district, Tamil Nadu, India, from January to June, 2026 on 420 undergraduate students of medical college. Those students who used digital devices for 1 hour or more per day and were ≥18 years old were included. Students with major ocular disease, recent eye surgery, or any systemic disorders which might affect sleep or eye health were excluded. Simple random sampling with computer-generated random numbers was used to select the participants. A self-administered questionnaire with a structured format was used, which included items from the Computer Vision Syndrome Questionnaire and a Pittsburgh Sleep Quality Index to evaluate screen use, digital eye strain symptoms, sleep quality and academic/mental health. Using the study-specific composite score, risk categories were determined. Pearson correlation was used to assess associations between DES symptom scores and other domains.
Results:
The mean age was 19.85 ± 1.44 years, and 72.1% were female. Daily screen exposure was 2–6 hours in 73.6% and >6 hours in 18.1%. Further, 77.6% reported difficulty focusing after prolonged use of a screen. In total, 76.0% and 2.6% were classified as moderate and high risk, respectively, using the study-defined composite score. The results demonstrated positive correlations for DES symptom scores with sleep quality score (
Conclusion:
Undergraduate students frequently exhibited signs and symptoms of DES and related behaviour and functional impairments. Higher DES symptom scores were positively correlated with sleep quality, academic, mental-health, and ergonomic-practices scores. There are opportunities to reduce this burden through promotion of healthy screen use and digital ergonomics.