Association between Digital Burnout and Sleep Quality among King Faisal University Students

Association between Digital Burnout and Sleep Quality among King Faisal University Students | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Association between Digital Burnout and Sleep Quality among King Faisal University Students Majd Almuslim, Ghadeer Alghafli, Israa Alghafli, Sara Alyousef, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6105207/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: As a public health issue, both burnout syndrome and sleep problems affect students' academic performance and their well-being. Overuse of digital devices can cause digital burnout (DBO) to university students. This study aimed to explore digital device usage, sleep quality, DBO levels, and their association with sleep quality (SQ) among King Faisal University (KFU) students for the academic year 2022-2023. Methods: This cross-sectional study targeted undergraduate students of both genders at KFU across all academic levels and specialties. An online self-administered questionnaire was created using Google Forms and distributed via e-mail to KFU students between May and July 2023. Data were analyzed using SPSS software with statistical tests applied, and a p -value of 0.05 was considered the significance threshold. Results: In total, 744 KFU students participated in the study. Data analysis revealed moderate DBO levels and average SQ, 427(57.4%) and 526 (70.8%) respectively, with no significant differences based on age, gender, college, and marital status. Additionally, a statistically significant association was found between higher DBO levels and poorer SQ among the participants (Pearson’s correlation test, r = 0.548, p = 0.000). Conclusions: Our study confirmed the association between DBO and SQ among KFU students. These findings underline the importance of university initiatives that promote stress-reducing activities and adaptive behaviors as resilience measures to support students' mental health, academic performance, and well-being. Digital Burnout Sleep Quality University students Academic-performance Mental health Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Background Burnout syndrome is one of the most common occupational phenomena in the modern world. It is a state of emotional exhaustion that leads to physical, cognitive, and psychological health problems due to prolonged and excessive demands. The issue to be addressed is the rising percentage of students worldwide experiencing school burnout, which has become a significant concern. For example, Asian students are particularly prone to school burnout, which is partly attributed to the cultural orientation towards academic achievement as the hallmark of life and the confirmation of social status [1]. Despite the attention that has been paid to the studies on burnout and sleep issues, research specifically examining the association between digital burnout (DBO) and sleep quality (SQ) among university students remains limited, particularly in the Middle Eastern region. This study is important to address this gap and contribute to the literature by offering new insights into the student's lives in Saudi Arabia, where digital learning is growing rapidly. Freudenberger first introduced the concept of burnout in 1974, describing it as a sense of failure and lethargy or stress resulting from overwhelming demands on energy, personal resources, or spiritual strength [2-3]. Since then, more than 140 definitions have been suggested; until the twenty-first century, burnout was defined as severe stress that evolved from initial idealism and enthusiasm to eventual apathy, along with psychosomatic and social abnormalities. This goes beyond regular fatigue and makes it difficult to manage stress and accomplish daily tasks [4]. Common symptoms include exhaustion, increased susceptibility to illness, irritability, frustration, sleep disturbances, weight fluctuations, cynical outlook, and depressive tendencies [5]. Today, universities face the challenge of educating students to become versatile experts in their respective fields capable of efficiently searching for reliable information and utilizing digital technologies [6]. Meanwhile, in this increasingly demanding knowledge-based society, higher education students experience higher levels of stress, sleep disruption, and a rise in mental health issues compared to previous generations, with certain groups of students experiencing higher levels of stress than others. For instance, the COVID-19 pandemic could further exacerbate their stress response [7-8]. As a result, this can lead to study-related DBO that negatively impact student's well-being, and academic achievement [5]. Adolescents are particularly vulnerable to the harmful effects of poor SQ, one of the most pressing health concerns in this age group [8]. Studies have indicated that 31% and 65% of university students report poor SQ [9]. Contributing risk factors include stress, academic responsibilities, and heavy use of smartphones, social media, and the Internet [10]. Another serious issue is the link between poor sleep quality and reduced academic performance [11], increased risk of insomnia, hypertension [12], cognitive decline, diminished quality of life (QoL), poorer mental health, and suicidal thoughts [13]. Our primary hypothesis is that there is a significant association between DBO and poor SQ among King Faisal University (KFU) students. The secondary hypotheses include: Students with higher DBO levels will have lower academic performance. Increased digital device usage, particularly before bedtime, is directly correlated with decreased SQ. Female students are more likely to experience burnout and sleep problems than male students. Students from certain specialties like health sciences may exhibit greater DBO levels due to higher academic demands. This study is based on two main conceptual frameworks: Firstly, Cognitive Load Theory; Sweller, 1988 [14], which states that excessive digital pressure can cause DBO and suboptimal cognitive performance including poor SQ. The other theory is the Job-Demands Resources (JD-R) Model [15], which is relevant to the academic context, where high levels of academic digital load increase the probability of DBO and negatively impact health through poor SQ. The goal of our study was to assess the association between DBO and SQ among KFU students during the academic year 2022-2023, by linking the research design to the hypotheses to ensure a structured, evidence-based approach to effectively test the proposed association. However, the objectives of the study were: To evaluate the digital device usage and factors associated with it. To explore sleep quality and factors associated with it. To examine the digital burnout levels and factors associated with it. By integrating these theories, we believe that the results of our study would offer a complete understanding of how DBO influences SQ among our study population, ultimately guiding potential interventions and policy changes that focus on preventing DBO and enhancing student’s well-being. Methods 2.1 Ethical Consideration This study was approved by the Institutional Review Board (IRB) of KFU (Ref. No. KFU-REC-2023-MAY-ETHICS837). Informed consent was obtained from all participants once they completed the survey. The study posed minimal risk to participants, as it involved self-reported questionnaire responses without invasive procedures. To ensure all data were anonymized and securely stored to maintain confidentiality. This approach ensured ethical integrity, participant safety, and reliable data collection within KFU academic setting. 2.2 Participant (Subject) Characteristics The targeted population included all available and accessible undergraduate students at KFU from various specialties. 2.2.1 Inclusion criteria Medical fields (e.g. Clinical Pharmacy, Medicine, Veterinary Medicine, Applied Medical Sciences, and Dental). Non-medical fields (e.g. Business Administration, Arts, Law, Islamic Law, Sciences, Agricultural and Food Sciences, Engineering, Computer Sciences and Information Technology, Education). Across all academic levels and genders during the 2022-2023 academic year. 2.2.2 Exclusion criteria Graduates, post-graduates, and faculty members. 2.3 Sampling Procedures Participants for this study were recruited using “convenience sampling techniques”, targeting students at KFU, who were readily available and willing to participate. This non-probability sampling method was chosen due to its accessibility and feasibility in reaching a large number of students within a short time frame. To ensure controlled sampling and minimize potential bias, a group of 15 volunteer students managed the data collection process. These volunteers were trained to facilitate the survey distribution, provide clarification when needed, and encourage participation while maintaining neutrality in the responses. This approach helped enhance response rates while ensuring that the study reached a diverse and representative sample of students across different academic disciplines at KFU. 2.3.1 Sample Size Calculation The sample size was calculated using “Calculator.net” [16], using a Confidence level of 95%, Margin of error of 5%, Population proportion of 50%, and Population size of 50000 as of the last KFU website updates. The calculated sample size was 382, however, the achieved sample was more as indicated in the results. 2.4 Research Design A pre-structured, self-administered online questionnaire was created using Google Forms, with an average completion time of seven minutes. The study questionnaire consisted of four parts: Participants Demographics: Defining students’ personal and academic data such as age, gender, college, marital status, and nationality. Internet and social media use pattern: This study examined the behavior, digital device skills, and stress related to the digital environment among the study population. Sleep Quality Scale (SQS): sleep quality [17]. The scale includes 28 items across six domains: 1. daytime symptoms, 2. Restoration after sleep, 3. problems initiating sleep, 4.-maintaining sleep, 5. Difficulty walking, and 6. sleep satisfaction. Using a four-point, Likert- scale, respondents indicate how frequently they exhibit certain sleep behaviors (0 = “rarely,” 1 = “sometimes,” 2 = “often,” and 3 = “almost always”). The scores for items belonging to domains 2 and 6 (restoration after sleep and sleep satisfaction) were reversed before being tallied. The mean SQ scores were categorized into (poor, average, and good), and the total scores ranged from 0 to 84, with higher scores denoting poorer SQ. Digital Burnout Scale (DBS): is used to detect burnout due to the overuse of digital technologies in daily life [18]. The scale is a 3-dimensional, 24-item, 5-point Likert scale. The DBS dimensions are as follows: 1. Digital Aging, 2. Digital Deprivation, 3. Emotional Exhaustion. DBO mean scores were categorized as (low, moderate, or high), with scores ranging from 0 to 120 with higher scores indicating higher DBO levels. 2.4.1 Quality Assurance For the two scales (SQS and DBS), a bilingual expert and reverse translation tool were employed to evaluate the language validity of the statements translated from English to Arabic. Cronbach’s alpha was used to assess the validity and reliability of the questions and scale items. The resulting coefficient of 0.92 indicated strong validity in both languages and confirmed the adequacy of the questionnaire for collecting valid data. 2.4.2 Study Measures The study included four measures: 1. Internet and social media use pattern 2. Sleep quality scale (SQS) and factors associated with it among the study population 3. Digital burnout scores (DBS) and factors associated with it among the study population 4. Association between DBO and SQ among the study population 2.5 Statistics and Data Analysis Data were analyzed using the Statistical Package for Social Sciences SPSS Statistics (version 26.0, 2019, Armonk, NY, IBM Corp). Descriptive analyses of the categorical data were performed by calculating frequencies and percentages. Cross-tabulation was employed to identify factors associated with DBO and SQ, utilizing the statistical "Pearson Chi-Square" (X²) test for all frequency distributions, and the "Exact probability" test for small frequency distribution parameters. Statistical "Simple logistic regression" test was performed to assess the correlation or association between DBO and SQ using the odds ratio (OR) ± 95% confidence interval. All statistical tests were two-tailed, with an alpha level of 0.05, and results were considered significant if p ≤ 0.05. Results 3.1 Demographic distribution of the study population A total of 744 KFU students were recruited, who voluntarily participated after being informed about the study’s objectives and procedures. This number represents double the initially calculated sample size, it was about 15% of the original KFU population at the study year. The analysis showed that the youngest participants were 17 years old and the oldest were 26 years old, with the majority 480 (64.5%) falling within the 17-21 age range. Most participants were female 530 (71.2%), and 214 (28.8%) were male. Most participants 647 (87%) were single and nearly all 731 (98.3%) were Saudi students (Table 1). Specifically, 464 participants (62.4%) were from non-medical colleges and 280 (37.6%) were from medical colleges (Figure 1 and Table 1). Table 1. Demographic distribution of the study population (N=744) Personal data n (%) Age in years 17-21 480 (64.5%) 22-26 264 (35.5%) Gender Male 214 (28.8%) Female 530 (71.2%) College Non-medical 464 (62.4%) Medical 280 (37.6%) Marital status Single 647 (87.0%) Married 85 (11.4%) Divorced / widow 12 (1.6%) Nationality Saudi 731 (98.3%) 3.2 Internet and social media use pattern The analysis showed that the majority of participants used the Internet and social media (excluding classes) for 4-6 hours daily, with 305 (41%) and 323 (43.5%) reporting this usage, respectively. (Figure 2) 3.3 Sleep quality scale (SQS) and factors associated with it among the study population The majority of KFU participants 526 (70.8%) reported average sleep quality (SQ), while 169 (22.7%) experienced poor SQ and only 49 (6.5%) reported good SQ (Figure 3). The mean score for the overall Sleep Quality Scale (SQS) was 46.1 ± 13.1 SD (SQS range from 0 to 84). Further data analysis using a comparative descriptive approach revealed that 44 (39.3%) of KFU students who used the internet for 1-3 hours daily reported poor SQ compared to 38 (17.7%) of those who used it for 7-10 hours ( p = 0.001). Similarly, 16 (30.2%) of the students who spent > 10 hours on social media experienced poor SQ, while 60 (18.5%) of those who used social media for 4-6 hours reported poor SQ ( p = 0.048). Additionally, 81 (38.9%) of participants who felt “stress in the digital environment” experienced poor SQ; in contrast to 88 (16.4%) of those who believed they did not feel stress in the digital environment but still reported poor SQ ( p = 0.001) (Table 2). Table 2. Sleeping quality and factors associated with it among participating KFU students Sleeping Quality (SQ) Good Average Poor Factors Affecting SQ n % n % n % p -Value Age in years 17-21 27 5.6% 342 71.3% 111 23.1% 0.457 22-26 21 8.0% 185 70.1% 58 22.0% Gender Male 10 4.7% 153 71.5% 51 23.8% 0.437 Female 38 7.2% 374 70.6% 118 22.3% College Non-medical 32 6.9% 325 70.0% 107 23.1% 0.759 Medical 16 5.7% 202 72.1% 62 22.1% Marital status Single 41 6.3% 463 71.6% 143 22.1% .414^ Married 5 5.9% 58 68.2% 22 25.9% Divorced / widow 2 16.7% 6 50.0% 4 33.3% Internet Usage Time (Excluding Classes) per day? 1-3 hours 6 5.4% 62 55.4% 44 39.3% .001* 4-6 hours 23 7.5% 218 71.5% 64 21.0% 7-10 hours 11 5.1% 166 77.2% 38 17.7% > 10 hours 8 7.1% 81 72.3% 23 20.5% Social media uses hour/ day 1-3 hours 14 6.1% 151 65.7% 65 28.3% .048* 4-6 hours 25 7.7% 239 73.8% 60 18.5% 7-10 hours 6 4.4% 103 75.2% 28 20.4% > 10 hours 3 5.7% 34 64.2% 16 30.2% Do you see yourself as too virtual or digital? Yes 27 5.9% 317 69.1% 115 25.1% 0.134 No 21 7.4% 210 73.7% 54 18.9% Level of ability to use digital devices? Satisfactory 24 6.2% 264 68.2% 99 25.6% .214^ Intermediate 24 7.1% 251 73.8% 65 19.1% Poor 0 0.0% 12 70.6% 5 29.4% Feel stress in the digital environment Yes 7 3.4% 120 57.7% 81 38.9% .001* No 41 7.6% 407 75.9% 88 16.4% P : Pearson X 2 test ^ : Exact probability test * p ≤ 0.05 (significant) 3.4 Digital burnout scores (DBS) and factors associated with it among the study population In general, 158 (21.2%) exhibited high DBO levels and 159 (21.4%) displayed low DBO levels. However, more than half of the participants had moderate DBO levels of 427 (57.4%) (Figure 4). Additional analysis revealed that the highest DBS was associated with "Digital Deprivation", with a mean score of 16.9 ± 5.0 SD. “Digital Aging followed this" with a mean score of 36.4 ± 11.0 SD. The lowest score was for "Emotional Exhaustion," with a mean score of 17.5 ± 6.3 SD. In total, the overall DBO mean score was 70.8 ± 22.3 SD (DBS range from 0 to 120). Concerning factors that may be associated with DBO among the study population, through a comparative descriptive approach, the analysis revealed two extremes: the highest levels of DBO 39 (34.8%) were found in participants who used the internet for 1-3 hours daily, whereas the lowest DBO 16 (14.3%) was observed in those who used it for >10 h ( p =0.001). Conversely, the highest DBO was identified in 18 (34%) of participants who engaged in social media for >10 hours daily, compared to the lowest DBO of 19 (13.9%) in those who used social media for 7–10 hours daily ( p =0.001). Similar to the sleep-quality survey items, 89 (42.8%) of participants, who reported feeling stressed in the digital environment, experienced high DBO levels. Although only 69 (12.9%) of those who indicated they did not “feel stress in the digital environment” still reported high DBO levels. ( p = 0.001), respectively (Table 3). Table 3. Factors associated with digital burnout among participating KFU students Overall digital burnout (DBO) level Low Moderate High Factors Affecting DBO n % n % n % p -Value Age in years 17-21 105 21.9% 268 55.8% 107 22.3% 0.486 22-26 54 20.5% 159 60.2% 51 19.3% Gender Male 48 22.4% 117 54.7% 49 22.9% 0.627 Female 111 20.9% 310 58.5% 109 20.6% College Non-medical 91 19.6% 271 58.4% 102 22.0% 0.312 Medical 68 24.3% 156 55.7% 56 20.0% Marital status Single 139 21.5% 373 57.7% 135 20.9% .188^ Married 18 21.2% 50 58.8% 17 20.0% Divorced / widow 2 16.7% 4 33.3% 6 50.0% Internet Usage Time (Excluding Classes) per day? 1-3 hours 28 25.0% 45 40.2% 39 34.8% .001* 4-6 hours 82 26.9% 182 59.7% 41 13.4% 7-10 hours 33 15.3% 139 64.7% 43 20.0% > 10 hours 16 14.3% 61 54.5% 35 31.3% Social media uses hour/ day 1-3 hours 62 27.0% 115 50.0% 53 23.0% .001* 4-6 hours 70 21.6% 205 63.3% 49 15.1% 7-10 hours 19 13.9% 80 58.4% 38 27.7% > 10 hours 8 15.1% 27 50.9% 18 34.0% Do you see yourself as too virtual or digital? Yes 75 16.3% 262 57.1% 122 26.6% .059 No 84 29.5% 165 57.9% 36 12.6% Level of ability to use digital devices? Satisfactory 82 21.2% 209 54.0% 96 24.8% .075^ Intermediate 75 22.1% 208 61.2% 57 16.8% Poor 2 11.8% 10 58.8% 5 29.4% Feel stress in the digital environment Yes 17 8.2% 102 49.0% 89 42.8% .001* No 142 26.5% 325 60.6% 69 12.9% P : Pearson X 2 test ^ : Exact probability test * p ≤ 0.05 (significant) 3.5 Association between digital burnout and sleep quality among the study population Data analysis showed that more than half of the participants 410 (55.1%) with high DBO levels reported poor SQ ( p = 0.001). Moreover, students with high DBO levels were nearly 11 times more likely to have poor SQ than those with low DBO levels (odds ratio [OR] =10.9; 95% CI: 5.9-20.1). Furthermore, the analysis revealed a significant positive correlation between DBO and SQ scores (Pearson’s r=0.548, p =.001) (Figure 4). Discussion The Internet is one of the most significant advancements in education, offering access to extensive knowledge through interactive sessions, webinars, and online courses. However, universities face challenges in training students to become adaptable experts, capable of effectively using digital tools to navigate and filter large amounts of information from reliable and relevant sources [6]. Stress has become a major concern for college students in today’s demanding knowledge-based environment, contributing to an increase in mental health issues. This stress can ultimately lead to study-related burnout, which adversely affects students' overall well-being over time [7,19]. Our study showed that the majority 305-323 (41–43.5%) of KFU participants used the Internet and social media for up to six hours daily, indicating satisfactory proficiency with digital devices. Interestingly, active social media use was found to be negatively correlated with feelings of stress and anxiety in the digital environment. Similar rates have been reported among university students in several studies worldwide [20-21]. The calculated DBO score among our study population demonstrated a mean score of 36.4 ± SD 11.0 for “Digital Aging,” 16.9 ± SD 5.0 for “Digital Deprivation,” and 17.5 ± SD 6.3 for “Emotional Exhaustion.” Durmuş et al. (2022) reported similar findings with 37.6 ± SD 10.0, 15.7 ± SD 5.9, and 19.5 ± SD 5.6, respectively [22]. Despite the high utilization rate, our study revealed that the majority of participants 427 (57.4%) were in the moderate DBO zone, and only 158 (21.2%) were in the high DBO zone (Figure 4). A recent Indian study revealed that 62-65% of undergraduate nursing students had high levels of academic burnout, emotional exhaustion, and disengagement [23]. Indeed, the data analysis indicated that feeling stressed in the digital environment had a statistically significant association with higher DBO levels 89 (42.8%, p =0.001) (Table 3). Göldağ et al. (2022) study concluded that undergraduate students have higher DBO levels than graduate students do, and perceived stress increases in tandem with their increased internet/social media usage time, which matches our study findings [24]. In terms of sleep quality, our study found that approximately 169 (22.7%) of KFU students experienced poor SQ, while the majority 526 (70.8%) had an average SQ (Figure 3). A study conducted by Khayat et al. (2018) from King Abdulaziz University-Jeddah, reported comparable findings but found that approximately half of the students reported poor sleep quality, with a minority (5.7%) taking sleep medications at least once or twice a week [25]. Several factors may explain why DBO and SQ levels in our study population are lower than those reported in the literature. These differences likely result from a combination of KFU’s digital academic workload, cultural variations in technology use, and differing levels of student adaptation to digital learning. Additionally, institutional infrastructure and support resources may play a role. Methodological differences in other studies, such as variations in survey instruments, cut-off points, or a focus on high-stressed academic environments (e.g., medical and engineering students), could also contribute. Furthermore, the timing of data collection whether during exam periods or less demanding academic phases may have influenced the results. Considering the influence of DBO on SQ, our current study showed a statistically significant association between poor SQ and high DBO levels (r=0.548, p =0.000; Figure 4), this is equivalent to Wang et al. (2020) study conducted in China [26]. Similarly, a study by Naderi et al. (2021) study done in Tehran showed that the relationship between students’ academic burnout and sleep quality patterns was significantly positive [27]. Additionally, as the relationship between DBO and SQ is bidirectional, our current study showed that KFU students with high DBO levels were approximately 11 times more likely to have poor SQ than those with low DBO levels (OR=10.9; 95% CI: 5.9-20.1), which is higher than what is reported in the literature. For instance, Amaral et al. (2021) found that excessive daytime sleepiness (mostly due to internet addiction) significantly increased the chances of high emotional exhaustion (OR adj: 5.7; p <0.001) and high depersonalization (OR: 4.259; p <0.001) [28]. Overall, these findings highlight the importance of developing strategies to ensure enjoyable activities that promote physical and mental well-being. Brubaker et al. (2020) revealed that a two-week protocol involving the use of a sunrise alarm clock combined with the removal of electronic devices was effective in improving SQ and reducing DBO and perceived stress levels [29]. Evidence-based effective time management in academic, personal, and professional lives should be adopted [30]. A proposed “refresh activation” intervention program by Brenda et al involved active meditation that integrates movement, conscious breathing, focused attention, and music. This technique proved to serve as a coping strategy and had a positive impact on reducing academic burnout among university students targeted in this study [31-32]. In Saudi Arabia, it is recommended that study programs identify curriculum aspects that contribute to student overload and establish institutional policies and support services to enhance student well-being. Future research should dig deeper into these aspects. Novelty within our research arises from its distinct study population which includes KFU students by gender and academic specialty across every academic year leading up to their pre-internship period, though previous investigations mainly studied medical or nursing students. Our research presents additional insights in addition to the discovered outcomes, because KFU students demonstrated intermediate Internet and social media usage, with lower DBO and average SQ levels when compared to peer groups in literature studies. The probability of inferior SQ with rising DBO levels showed nearly 11-fold higher ratios compared to past research studies' results. The theoretical and practical implications of our study provide vital insights into how DBO affects SQ among KFU students. Our study data might provide practical support to develop these concepts for digital learning platforms along with burnout and cognitive strain theoretical frameworks. At the same time, clinically, poor sleep quality creates negative health effects by damaging cognitive function while weakening the immune system and escalating mental health issues like anxiety and depression. The study’s findings guide early identification and prevention strategies, recommending evidence-based interventions for universities, policymakers, and educators to mitigate DBO impacts. Additionally, health services, counselling centres, and sleep clinics can utilize these insights to support affected students. However, the significance of these results does not preclude the emergence of new challenges and questions. The study's findings highlight correlations but do not establish causation, in addition, certain variables are influenced by context and culture. Other potential confounding factors, such as mental health, physical activity, non-academic screen time, and dietary behaviour, may also impact sleep and burnout. One key limitation and principal weakness of this study is that it was conducted at one institution, King Faisal University in one country, Saudi Arabia, which raises questions about the generalizability of the findings to other universities, regions, and cultural contexts. Furthermore, the three-month data collection period, which was restricted by exam schedules and graduation requirements, may not have allowed for the full exploration of the experiences of students from different academic environments, educational systems or socio-economic contexts. Given the cross-sectional design, it is impossible to make causal inferences about burnout and its determinants. Convenience sampling combined with voluntary participation may lead to selection bias because the responses were from students who had access to and participated in the survey via email. To overcome these limitations, future work should involve a wider range of institutions across different countries and cultures, data collection over a longer period, and the use of longitudinal or experimental research designs to establish cause-and-effect relationships and increase the external validity of the findings. Conclusion Our study was concluded by revealing the fact that although KFU students have a moderate level of internet and social media usage, the rate of high DBO levels and poor SQ compared to other peer groups reported in the literature was lower. Specifically, the likelihood of a lower SQ being related to higher DBO was nearly 11 times higher than the ratios reported in previous studies, as well as a significant correlation between DBO and SQ among the participants. This shows the need for preventive and coping strategies to raise the awareness of the university stakeholders and its management. It is therefore important to put in place effective mental health interventions, social support and supervision to improve on the mental health of students and in turn their academic achievement. Abbreviations DBO: Digital Burnout DBS: Digital Burnout Scale IRB: Institutional Review Board KFU: King Faisal University QoL: Quality of Life SQ: Sleep Quality SQS: Sleep Quality Scale Declarations Ethics approval and consent to participate This study was approved by the Institutional Review Board (IRB) of KFU (Ref. No. KFU-REC-2023-MAY-ETHICS837). Informed consent was obtained from all participants. Consent for publication NA. Availability of data and material The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request. Competing interests All authors declare no potential financial and non-financial competing interests to disclose. Funding No funding was required for this study. Authors' contributions MM conceptualized the project idea, constructed the methodology, analyzed the collected data, and supervised the project. GG, IG, SY, GD, and BS distributed the survey and collected data. OM conceptualized the project idea, constructed the methodology, and supervised the project. HAS analyzed and interpreted the data and was a major contributor to writing the manuscript. All authors read and approved the final manuscript. Acknowledgments The authors would like to thank all KFU students from different specialties who helped in the collection of the required sample during the planned study period, as well as all students who participated in the survey. References Khammissa RAG, Nemutandani S, Feller G, Lemmer J, Feller L (2022) Burnout phenomenon: neurophysiological factors, clinical features, and aspects of management. 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Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB (2001) The Job Demands-Resources Model of Burnout. Journal of Applied Psychology 86(3): 499–512. doi:10.1037/0021-9010.86.3.499 Calculator.net (2024) Sample Size Calculator. Calculator.net. Available via https://www.calculator.net/sample-size-calculator.html. Accessed 1 Jan 2025. Shahid A, Wilkinson K, Marcu S, Shapiro CM (2011) Sleep quality scale (SQS). STOP, THAT and One Hundred Other Sleep Scales. In Springer e-Books 85: 345–350. doi:10.1007/978-1-4419-9893-4_85 ERTEN P, ÖZDEMİR O (2020) The digital burnout scale. İnönü Üniversitesi Eğitim Fakültesi Dergisi 21(2): 668–683. doi:10.17679/inuefd.597890 Barbayannis G, Bandari M, Zheng X, Baquerizo H, Pecor KW, Ming X (2022) Academic Stress and Mental Well-Being in College Students: Correlations, Affected Groups, and COVID-19. 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Research and Development in Medical Education 10(1): 16. doi:10.34172/rdme.2021.016 Amaral KV, Galdino MJQ, Martins JT (2021) Burnout, daytime sleepiness and sleep quality among technical-level Nursing students. Revista Latino-Americana de Enfermagem 29. doi: 10.1590/1518-8345.5180.3487 Brubaker JR, Swan A, Beverly EA (2020) A brief intervention to reduce burnout and improve sleep quality in medical students. BMC Medical Education 20(1). doi:10.1186/s12909-020-02263-6 Zayed AM (2024) Digital Resilience, Digital Stress, and Social Support as Predictors of Academic Well-Being among University Students. Journal of Education and Training Studies 12(3): 60. doi:10.11114/jets.v12i3.6894 Alyami A, Abdulwahed A, Azhar A, Binsaddik A, Bafaraj SM (2021) Impact of Time-Management on the Student’s Academic Performance: A Cross-Sectional Study. Creative Education 12(3): 471–485. doi:10.4236/ce.2021.123033 Banda J, D’Amico R, Flores Á (2023) Intervention program to reduce academic burnout in university Mexican students. IntechOpen e-Books doi:10.5772/intechopen.1002623 Additional Declarations No competing interests reported. Supplementary Files ProofReading.pdf Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6105207","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":423348867,"identity":"1396aaf3-30d1-482a-b996-052fa83aea4a","order_by":0,"name":"Majd Almuslim","email":"","orcid":"","institution":"King Faisal University","correspondingAuthor":false,"prefix":"","firstName":"Majd","middleName":"","lastName":"Almuslim","suffix":""},{"id":423348868,"identity":"f6502d18-0303-4441-b648-2d9a18c0747e","order_by":1,"name":"Ghadeer Alghafli","email":"","orcid":"","institution":"King Faisal 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12:38:11","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-6105207/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6105207/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":78146751,"identity":"3cb06ee8-544e-40db-9f07-0f0bdfd97d23","added_by":"auto","created_at":"2025-03-10 11:03:41","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":173553,"visible":true,"origin":"","legend":"\u003cp\u003eColleges to which the participating KFU students belong.\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-6105207/v1/44badbbf146319449a18c8ef.png"},{"id":78146798,"identity":"53153442-7ddb-4c95-aa76-3ea800020943","added_by":"auto","created_at":"2025-03-10 11:03:46","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":108634,"visible":true,"origin":"","legend":"\u003cp\u003eInternet and Social Media Usage Time per day (Excluding Classes) among participating KFU students.\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-6105207/v1/1df9173a8b905db4ab653278.png"},{"id":78146796,"identity":"3153d5b2-f039-45d4-afab-940617d5d5fd","added_by":"auto","created_at":"2025-03-10 11:03:44","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":74039,"visible":true,"origin":"","legend":"\u003cp\u003eSleeping quality (SQ) levels among participating KFU students\u003c/p\u003e","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-6105207/v1/f477a6d2335d7ee434df9fa2.png"},{"id":78146754,"identity":"e5bcfebf-d607-4016-921f-30c6f451b00f","added_by":"auto","created_at":"2025-03-10 11:03:41","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":73944,"visible":true,"origin":"","legend":"\u003cp\u003eDigital burnout (DBO) levels among participating KFU students.\u003c/p\u003e","description":"","filename":"Figure4.png","url":"https://assets-eu.researchsquare.com/files/rs-6105207/v1/f6ef243a3d185540c808c878.png"},{"id":78147573,"identity":"89a8b880-1dde-487b-9ef5-8065ddd36487","added_by":"auto","created_at":"2025-03-10 11:11:44","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":145315,"visible":true,"origin":"","legend":"\u003cp\u003eAssociation between Digital Burnout and Sleeping Quality among participating KFU students.\u003c/p\u003e","description":"","filename":"Figure5.png","url":"https://assets-eu.researchsquare.com/files/rs-6105207/v1/1e8e320e18594d8ecb353144.png"},{"id":78149354,"identity":"2d9ce8fb-5bba-472b-8c57-9104c2832427","added_by":"auto","created_at":"2025-03-10 11:35:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1647630,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6105207/v1/b4004166-323c-4f7f-96e6-e678493e62be.pdf"},{"id":78147556,"identity":"cc1008c9-426d-484b-86ee-91c3adb477cc","added_by":"auto","created_at":"2025-03-10 11:11:41","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":201802,"visible":true,"origin":"","legend":"","description":"","filename":"ProofReading.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6105207/v1/4d7bdf9f87209b0463743191.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Association between Digital Burnout and Sleep Quality among King Faisal University Students","fulltext":[{"header":"Background","content":"\u003cp\u003eBurnout syndrome is one of the most common occupational phenomena in the modern world. It is a state of emotional exhaustion that leads to physical, cognitive, and psychological health problems due to prolonged and excessive demands. The issue to be addressed is the rising percentage of students worldwide experiencing school burnout, which has become a significant concern. For example, Asian students are particularly prone to school burnout, which is partly attributed to the cultural orientation towards academic achievement as the hallmark of life and the confirmation of social status [1]. Despite the attention that has been paid to the studies on burnout and sleep issues, research specifically examining the association between digital burnout (DBO) and sleep quality (SQ) among university students remains limited, particularly in the Middle Eastern region. This study is important to address this gap and contribute to the literature by offering new insights into the student\u0026apos;s lives in Saudi Arabia, where digital learning is growing rapidly.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFreudenberger first introduced the concept of burnout in 1974, describing it as a sense of failure and lethargy or stress resulting from overwhelming demands on energy, personal resources, or spiritual strength [2-3]. Since then, more than 140 definitions have been suggested; until the twenty-first century, burnout was defined as severe stress that evolved from initial idealism and enthusiasm to eventual apathy, along with psychosomatic and social abnormalities. This goes beyond regular fatigue and makes it difficult to manage stress and accomplish daily tasks [4]. Common symptoms include exhaustion, increased susceptibility to illness, irritability, frustration, sleep disturbances, weight fluctuations, cynical outlook, and depressive tendencies [5].\u003c/p\u003e\n\u003cp\u003eToday, universities face the challenge of educating students to become versatile experts in their respective fields capable of efficiently searching for reliable information and utilizing digital technologies [6]. Meanwhile, in this increasingly demanding knowledge-based society, higher education students experience higher levels of stress, sleep disruption, and a rise in mental health issues compared to previous generations, with certain groups of students experiencing higher levels of stress than others. For instance, the COVID-19 pandemic could further exacerbate their stress response [7-8].\u003c/p\u003e\n\u003cp\u003eAs a result, this can lead to study-related DBO that negatively impact student\u0026apos;s well-being, and academic achievement [5]. Adolescents are particularly vulnerable to the harmful effects of poor SQ, one of the most pressing health concerns in this age group [8]. Studies have indicated that 31% and 65% of university students report poor SQ [9]. Contributing risk factors include stress, academic responsibilities, and heavy use of smartphones, social media, and the Internet [10]. Another serious issue is the link between poor sleep quality and reduced academic performance [11], increased risk of insomnia, hypertension [12], cognitive decline, diminished quality of life (QoL), poorer mental health, and suicidal thoughts [13].\u003c/p\u003e\n\n\u003cp\u003eOur primary hypothesis is that there is a significant association between DBO and poor SQ among King Faisal University (KFU) students. The secondary hypotheses include:\u0026nbsp;\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eStudents with higher DBO levels will have lower academic performance.\u003c/li\u003e\n \u003cli\u003eIncreased digital device usage, particularly before bedtime, is directly correlated with decreased SQ.\u003c/li\u003e\n \u003cli\u003eFemale students are more likely to experience burnout and sleep problems than male students.\u003c/li\u003e\n \u003cli\u003eStudents from certain specialties like health sciences may exhibit greater DBO levels due to higher academic demands.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThis study is based on two main conceptual frameworks: Firstly, Cognitive Load Theory; Sweller, 1988 [14], which states that excessive digital pressure can cause DBO and suboptimal cognitive performance including poor SQ. The other theory is the Job-Demands Resources (JD-R) Model [15], which is relevant to the academic context, where high levels of academic digital load increase the probability of DBO and negatively impact health through poor SQ.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe goal of our study was to assess the association between DBO and SQ among KFU students during the academic year 2022-2023, by linking the research design to the hypotheses to ensure a structured, evidence-based approach to effectively test the proposed association. However, the objectives of the study were:\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eTo evaluate the digital device usage and factors associated with it.\u003c/li\u003e\n \u003cli\u003eTo explore sleep quality and factors associated with it.\u003c/li\u003e\n \u003cli\u003eTo examine the digital burnout levels and factors associated with it.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eBy integrating these theories, we believe that the results of our study\u0026nbsp;would offer a complete understanding of how DBO influences SQ among our study population, ultimately guiding potential interventions and policy changes that focus on preventing DBO and enhancing student\u0026rsquo;s well-being.\u003c/p\u003e\n"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003e2.1 Ethical Consideration\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Institutional Review Board (IRB) of KFU (Ref. No. KFU-REC-2023-MAY-ETHICS837). Informed consent was obtained from all participants once they completed the survey. The study posed minimal risk to participants, as it involved self-reported questionnaire responses without invasive procedures. To ensure all data were anonymized and securely stored to maintain confidentiality. This approach ensured ethical integrity, participant safety, and reliable data collection within KFU academic setting.\u003c/p\u003e\n\n\u003cp\u003e\u003cem\u003e2.2 Participant (Subject) Characteristics\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe targeted population included all available and accessible undergraduate students at KFU from various specialties.\u003c/p\u003e\n\n\u003cp\u003e2.2.1 Inclusion criteria\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n\u003cli\u003eMedical fields (e.g. Clinical Pharmacy, Medicine, Veterinary Medicine, Applied Medical Sciences, and Dental).\u003c/li\u003e\n\u003cli\u003eNon-medical fields (e.g. Business Administration, Arts, Law, Islamic Law, Sciences, Agricultural and Food Sciences, Engineering, Computer Sciences and Information Technology, Education).\u003c/li\u003e\n\u003cli\u003eAcross all academic levels and genders during the 2022-2023 academic year.\u003c/li\u003e\n\u003c/ul\u003e\n\n\u003cp\u003e2.2.2 Exclusion criteria\u003c/p\u003e\n\u003cp\u003eGraduates, post-graduates, and faculty members.\u003c/p\u003e\n\n\u003cp\u003e\u003cem\u003e2.3 Sampling Procedures\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants for this study were recruited using \u0026ldquo;convenience sampling techniques\u0026rdquo;, targeting students at KFU, who were readily available and willing to participate. This non-probability sampling method was chosen due to its accessibility and feasibility in reaching a large number of students within a short time frame. To ensure controlled sampling and minimize potential bias, a group of 15 volunteer students managed the data collection process. These volunteers were trained to facilitate the survey distribution, provide clarification when needed, and encourage participation while maintaining neutrality in the responses. This approach helped enhance response rates while ensuring that the study reached a diverse and representative sample of students across different academic disciplines at KFU.\u003c/p\u003e\n\n\u003cp\u003e2.3.1 Sample Size Calculation\u003c/p\u003e\n\u003cp\u003eThe sample size was calculated using \u0026ldquo;Calculator.net\u0026rdquo; [16], using a Confidence level of 95%, Margin of error of 5%, Population proportion of 50%, and Population size of 50000 as of the last KFU website updates. The calculated sample size was 382, however, the achieved sample was more as indicated in the results. \u003c/p\u003e\n\n\u003cp\u003e\u003cem\u003e2.4 Research Design\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA pre-structured, self-administered online questionnaire was created using Google Forms, with an average completion time of seven minutes. The study questionnaire consisted of four parts: \u003c/p\u003e\n\u003col class=\"decimal_type\"\u003e\n\u003cli\u003eParticipants Demographics: Defining students\u0026rsquo; personal and academic data such as age, gender, college, marital status, and nationality. \u003c/li\u003e\n\u003cli\u003eInternet and social media use pattern: This study examined the behavior, digital device skills, and stress related to the digital environment among the study population. \u003c/li\u003e\n\u003cli\u003eSleep Quality Scale (SQS): sleep quality [17]. The scale includes 28 items across six domains: 1. daytime symptoms, 2. Restoration after sleep, 3. problems initiating sleep, 4.-maintaining sleep, 5. Difficulty walking, and 6. sleep satisfaction. Using a four-point, Likert- scale, respondents indicate how frequently they exhibit certain sleep behaviors (0 = \u0026ldquo;rarely,\u0026rdquo; 1 = \u0026ldquo;sometimes,\u0026rdquo; 2 = \u0026ldquo;often,\u0026rdquo; and 3 = \u0026ldquo;almost always\u0026rdquo;). The scores for items belonging to domains 2 and 6 (restoration after sleep and sleep satisfaction) were reversed before being tallied. The mean SQ scores were categorized into (poor, average, and good), and the total scores ranged from 0 to 84, with higher scores denoting poorer SQ. \u003c/li\u003e\n\u003cli\u003eDigital Burnout Scale (DBS): is used to detect burnout due to the overuse of digital technologies in daily life [18]. The scale is a 3-dimensional, 24-item, 5-point Likert scale. The DBS dimensions are as follows: 1. Digital Aging, 2. Digital Deprivation, 3. Emotional Exhaustion. DBO mean scores were categorized as (low, moderate, or high), with scores ranging from 0 to 120 with higher scores indicating higher DBO levels.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e2.4.1 Quality Assurance\u003c/p\u003e\n\u003cp\u003eFor the two scales (SQS and DBS), a bilingual expert and reverse translation tool were employed to evaluate the language validity of the statements translated from English to Arabic. Cronbach\u0026rsquo;s alpha was used to assess the validity and reliability of the questions and scale items. The resulting coefficient of 0.92 indicated strong validity in both languages and confirmed the adequacy of the questionnaire for collecting valid data.\u003c/p\u003e\n\n\u003cp\u003e2.4.2 Study Measures\u003c/p\u003e\n\u003cp\u003eThe study included four measures:\u003c/p\u003e\n\u003cp\u003e1. Internet and social media use pattern\u003c/p\u003e\n\u003cp\u003e2. Sleep quality scale (SQS) and factors associated with it among the study population\u003c/p\u003e\n\u003cp\u003e3. Digital burnout scores (DBS) and factors associated with it among the study population\u003c/p\u003e\n\u003cp\u003e4. Association between DBO and SQ among the study population\u003c/p\u003e\n\n\u003cp\u003e\u003cem\u003e2.5 Statistics and Data Analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eData were analyzed using the Statistical Package for Social Sciences SPSS Statistics (version 26.0, 2019, Armonk, NY, IBM Corp). Descriptive analyses of the categorical data were performed by calculating frequencies and percentages. Cross-tabulation was employed to identify factors associated with DBO and SQ, utilizing the statistical \u0026quot;Pearson Chi-Square\u0026quot; (X\u0026sup2;) test for all frequency distributions, and the \u0026quot;Exact probability\u0026quot; test for small frequency distribution parameters. Statistical \u0026quot;Simple logistic regression\u0026quot; test was performed to assess the correlation or association between DBO and SQ using the odds ratio (OR) \u0026plusmn; 95% confidence interval. All statistical tests were two-tailed, with an alpha level of 0.05, and results were considered significant if \u003cem\u003ep\u003c/em\u003e \u0026le; 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cem\u003e3.1 Demographic distribution of the study population\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA total of 744 KFU students were recruited, who voluntarily participated after being informed about the study\u0026rsquo;s objectives and procedures. This number represents double the initially calculated sample size, it was about 15% of the original KFU population at the study year. The analysis showed that the youngest participants were 17 years old and the oldest were 26 years old, with the majority 480 (64.5%) falling within the 17-21 age range. Most participants were female 530 (71.2%), and 214 (28.8%) were male. Most participants 647 (87%) were single and nearly all 731 (98.3%) were Saudi students (Table 1). Specifically, 464 participants (62.4%) were from non-medical colleges and 280 (37.6%) were from medical colleges (Figure 1 and Table 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e Demographic distribution of the study population (N=744)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"311\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 174px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePersonal data\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 90px;\"\u003e\n \u003cp\u003e(%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge in years\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 174px;\"\u003e\n \u003cp\u003e17-21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp\u003e480\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 90px;\"\u003e\n \u003cp\u003e(64.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 174px;\"\u003e\n \u003cp\u003e22-26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp\u003e264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 90px;\"\u003e\n \u003cp\u003e(35.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 174px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp\u003e214\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 90px;\"\u003e\n \u003cp\u003e(28.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 174px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp\u003e530\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 90px;\"\u003e\n \u003cp\u003e(71.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCollege\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 174px;\"\u003e\n \u003cp\u003eNon-medical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp\u003e464\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 90px;\"\u003e\n \u003cp\u003e(62.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 174px;\"\u003e\n \u003cp\u003eMedical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp\u003e280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 90px;\"\u003e\n \u003cp\u003e(37.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 174px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp\u003e647\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 90px;\"\u003e\n \u003cp\u003e(87.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 174px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 90px;\"\u003e\n \u003cp\u003e(11.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 174px;\"\u003e\n \u003cp\u003eDivorced / widow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 90px;\"\u003e\n \u003cp\u003e(1.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"bottom\" style=\"width: 311px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNationality\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 174px;\"\u003e\n \u003cp\u003eSaudi\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp\u003e731\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 90px;\"\u003e\n \u003cp\u003e(98.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\u003cem\u003e\u003c/em\u003e\n\u003cp\u003e\u003cem\u003e3.2 Internet and social media use pattern\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe analysis showed that the majority of participants used the Internet and social media (excluding classes) for 4-6 hours daily, with 305 (41%) and 323 (43.5%) reporting this usage, respectively. (Figure 2)\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.3 Sleep quality scale (SQS) and factors associated with it among the study population\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe majority of KFU participants 526 (70.8%) reported average sleep quality (SQ), while 169 (22.7%) experienced poor SQ and only 49 (6.5%) reported good SQ (Figure 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe mean score for the overall Sleep Quality Scale (SQS) was 46.1 \u0026plusmn; 13.1 SD (SQS range from 0 to 84). Further data analysis using a comparative descriptive approach revealed that 44 (39.3%) of KFU students who used the internet for 1-3 hours daily reported poor SQ compared to 38 (17.7%) of those who used it for 7-10 hours (\u003cem\u003ep\u003c/em\u003e = 0.001). Similarly, 16 (30.2%) of the students who spent \u0026gt; 10 hours on social media experienced poor SQ, while 60 (18.5%) of those who used social media for 4-6 hours reported poor SQ (\u003cem\u003ep\u003c/em\u003e = 0.048). Additionally, 81 (38.9%) of participants who felt \u0026ldquo;stress in the digital environment\u0026rdquo; experienced poor SQ; in contrast to 88 (16.4%) of those who believed they did not feel stress in the digital environment but still reported poor SQ (\u003cem\u003ep\u003c/em\u003e = 0.001) (Table 2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e Sleeping quality and factors associated with it among participating KFU students\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"630\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 235px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"6\" style=\"width: 314px;\"\u003e\n \u003cp\u003eSleeping Quality (SQ)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 81px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 99px;\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 106px;\"\u003e\n \u003cp\u003eAverage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 109px;\"\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eFactors Affecting SQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026nbsp;%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e-Value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 630px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge in years\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003e17-21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e5.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e342\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e71.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e23.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.457\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003e22-26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e8.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e70.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e22.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 630px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e4.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e71.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e23.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.437\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e7.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e374\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e70.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e22.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 630px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCollege\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eNon-medical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e6.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e325\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e70.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e23.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.759\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eMedical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e5.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e72.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e22.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 630px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e6.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e463\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e71.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e22.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 81px;\"\u003e\n \u003cp\u003e.414^\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e5.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e68.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e25.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eDivorced / widow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e16.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e50.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e33.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 630px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInternet Usage Time (Excluding Classes) per day?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003e1-3 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e5.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e55.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e39.3%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003e4-6 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e7.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e218\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e71.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e21.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003e7-10 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e5.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e77.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e17.7%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003e\u0026gt; 10 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e7.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e72.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e20.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 630px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial media uses hour/ day\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003e1-3 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e6.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e65.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e28.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.048*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003e4-6 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e7.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e239\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e73.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e18.5%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003e7-10 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e4.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e75.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e20.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003e\u0026gt; 10 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e5.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e64.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e30.2%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 630px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you see yourself as too virtual or digital?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e5.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e69.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e25.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 81px;\"\u003e\n \u003cp\u003e0.134\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e7.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e210\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e73.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e18.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 630px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of ability to use digital devices?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eSatisfactory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e6.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e68.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e25.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 81px;\"\u003e\n \u003cp\u003e.214^\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eIntermediate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e7.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e251\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e73.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e19.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e70.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e29.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 630px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFeel stress in the digital environment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e3.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e57.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e38.9%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 235px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 36px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e7.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e407\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e75.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 44px;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e16.4%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e: Pearson X\u003csup\u003e2\u003c/sup\u003e test \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u003cstrong\u003e^\u003c/strong\u003e: Exact probability test \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;* \u003cem\u003ep\u003c/em\u003e \u0026le; 0.05 (significant)\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.4 Digital burnout scores (DBS) and factors associated with it among the study population\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn general, 158 (21.2%) exhibited high DBO levels and 159 (21.4%) displayed low DBO levels. However, more than half of the participants had moderate DBO levels of 427 (57.4%) (Figure 4). Additional analysis revealed that the highest DBS was associated with \u0026quot;Digital Deprivation\u0026quot;, with a mean score of 16.9 \u0026plusmn; 5.0 SD. \u0026ldquo;Digital Aging followed this\u0026quot; with a mean score of 36.4 \u0026plusmn; 11.0 SD. The lowest score was for \u0026quot;Emotional Exhaustion,\u0026quot; with a mean score of 17.5 \u0026plusmn; 6.3 SD. In total, the overall DBO mean score was 70.8 \u0026plusmn; 22.3 SD (DBS range from 0 to 120).\u003c/p\u003e\n\u003cp\u003eConcerning factors that may be associated with DBO among the study population, through a comparative descriptive approach, the analysis revealed two extremes: the highest levels of DBO 39 (34.8%) were found in participants who used the internet for 1-3 hours daily, whereas the lowest DBO 16 (14.3%) was observed in those who used it for \u0026gt;10 h (\u003cem\u003ep\u003c/em\u003e =0.001). Conversely, the highest DBO was identified in 18 (34%) of participants who engaged in social media for \u0026gt;10 hours daily, compared to the lowest DBO of 19 (13.9%) in those who used social media for 7\u0026ndash;10 hours daily (\u003cem\u003ep\u003c/em\u003e =0.001). Similar to the sleep-quality survey items, 89 (42.8%) of participants, who reported feeling stressed in the digital environment, experienced high DBO levels. Although only 69 (12.9%) of those who indicated they did not \u0026ldquo;feel stress in the digital environment\u0026rdquo; still reported high DBO levels. (\u003cem\u003ep\u003c/em\u003e = 0.001), respectively (Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u003c/strong\u003e Factors associated with digital burnout among participating KFU students\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"626\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 180px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"6\" style=\"width: 373px;\"\u003e\n \u003cp\u003eOverall digital burnout (DBO) level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 74px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 111px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 137px;\"\u003e\n \u003cp\u003eModerate\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 125px;\"\u003e\n \u003cp\u003eHigh\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eFactors Affecting DBO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e-Value\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 626px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge in years\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003e17-21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e21.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e268\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e55.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e22.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.486\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003e22-26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e20.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e60.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e19.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 626px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e22.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e54.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e22.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.627\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e20.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e58.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e20.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 626px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCollege\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003eNon-medical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e19.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e58.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e22.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0.312\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003eMedical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e24.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e55.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e20.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 626px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e21.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e373\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e57.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e20.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 74px;\"\u003e\n \u003cp\u003e.188^\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e21.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e58.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e20.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003eDivorced / widow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e16.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e33.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e50.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 626px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInternet Usage Time (Excluding Classes) per day?\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003e1-3 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e25.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e40.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e34.8%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003e4-6 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e26.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e59.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e13.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003e7-10 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e15.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e64.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e20.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026gt; 10 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e14.3%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e54.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e31.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 626px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial media uses hour/ day\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003e1-3 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e27.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e50.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e23.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003e4-6 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e21.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e63.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e15.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003e7-10 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e13.9%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e58.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e27.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026gt; 10 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e15.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e50.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e34.0%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 626px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you see yourself as too virtual or digital?\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e16.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e262\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e57.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e26.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 74px;\"\u003e\n \u003cp\u003e.059\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e29.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e57.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e12.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 626px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel of ability to use digital devices?\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003eSatisfactory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e21.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e54.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e24.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 74px;\"\u003e\n \u003cp\u003e.075^\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003eIntermediate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e22.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e208\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e61.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e16.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e11.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e58.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e29.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" style=\"width: 626px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFeel stress in the digital environment\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003eYes\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e8.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e49.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e42.8%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 180px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e26.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\n \u003cp\u003e325\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 56px;\"\u003e\n \u003cp\u003e60.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e12.9%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e: Pearson X\u003csup\u003e2\u003c/sup\u003e test \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u003cstrong\u003e^\u003c/strong\u003e: Exact probability test \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;* \u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026le; 0.05 (significant)\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3.5 Association between digital burnout and sleep quality among the study population\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eData analysis showed that more than half of the participants 410 (55.1%) with high DBO levels reported poor SQ (\u003cem\u003ep\u003c/em\u003e = 0.001). Moreover, students with high DBO levels were nearly 11 times more likely to have poor SQ than those with low DBO levels (odds ratio [OR] =10.9; 95% CI: 5.9-20.1). Furthermore, the analysis revealed a significant positive correlation between DBO and SQ scores (Pearson\u0026rsquo;s r=0.548,\u0026nbsp;\u003cem\u003ep\u003c/em\u003e =.001) (Figure 4).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe Internet is one of the most significant advancements in education, offering access to extensive knowledge through interactive sessions, webinars, and online courses. However, universities face challenges in training students to become adaptable experts, capable of effectively using digital tools to navigate and filter large amounts of information from reliable and relevant sources [6]. Stress has become a major concern for college students in today\u0026rsquo;s demanding knowledge-based environment, contributing to an increase in mental health issues. This stress can ultimately lead to study-related burnout, which adversely affects students\u0026apos; overall well-being over time [7,19].\u003c/p\u003e\n\u003cp\u003eOur study showed that the majority 305-323 (41\u0026ndash;43.5%) of KFU participants used the Internet and social media for up to six hours daily, indicating satisfactory proficiency with digital devices. Interestingly, active social media use was found to be negatively correlated with feelings of stress and anxiety in the digital environment. Similar rates have been reported among university students in several studies worldwide [20-21]. \u0026nbsp;The calculated DBO score among our study population demonstrated a mean score of 36.4 \u0026plusmn; SD 11.0 for \u0026ldquo;Digital Aging,\u0026rdquo; 16.9 \u0026plusmn; SD 5.0 for \u0026ldquo;Digital Deprivation,\u0026rdquo; and 17.5 \u0026plusmn; SD 6.3 for \u0026ldquo;Emotional Exhaustion.\u0026rdquo; Durmuş et al. (2022) reported similar findings with 37.6 \u0026plusmn; SD 10.0, 15.7 \u0026plusmn; SD 5.9, and 19.5 \u0026plusmn; SD 5.6, respectively [22]. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDespite the high utilization rate, our study revealed that the majority of participants 427 (57.4%) were in the moderate DBO zone, and only 158 (21.2%) were in the high DBO zone (Figure 4). A recent Indian study revealed that 62-65% of undergraduate nursing students had high levels of academic burnout, emotional exhaustion, and disengagement [23]. \u0026nbsp;Indeed, the data analysis indicated that feeling stressed in the digital environment had a statistically significant association with higher DBO levels 89 (42.8%,\u0026nbsp;\u003cem\u003ep\u003c/em\u003e =0.001) (Table 3). G\u0026ouml;ldağ et al. (2022) study concluded that undergraduate students have higher DBO levels than graduate students do, and perceived stress increases in tandem with their increased internet/social media usage time, which matches our study findings [24]. In terms of sleep quality, our study found that approximately 169 (22.7%) of KFU students experienced poor SQ, while the majority 526 (70.8%) had an average SQ (Figure 3). A study conducted by Khayat et al. (2018) from King Abdulaziz University-Jeddah, reported comparable findings but found that approximately half of the students reported poor sleep quality, with a minority (5.7%) taking sleep medications at least once or twice a week [25].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSeveral factors may explain why DBO and SQ levels in our study population are lower than those reported in the literature. These differences likely result from a combination of KFU\u0026rsquo;s digital academic workload, cultural variations in technology use, and differing levels of student adaptation to digital learning. Additionally, institutional infrastructure and support resources may play a role. Methodological differences in other studies, such as variations in survey instruments, cut-off points, or a focus on high-stressed academic environments (e.g., medical and engineering students), could also contribute. Furthermore, the timing of data collection whether during exam periods or less demanding academic phases may have influenced the results.\u003c/p\u003e\n\u003cp\u003eConsidering the influence of DBO on SQ, our current study showed a statistically significant association between poor SQ and high DBO levels (r=0.548,\u0026nbsp;\u003cem\u003ep\u003c/em\u003e =0.000; Figure 4), this is equivalent to Wang et al. (2020) study conducted in China [26]. Similarly, a study by Naderi et al. (2021) study done in Tehran showed that the relationship between students\u0026rsquo; academic burnout and sleep quality patterns was significantly positive [27]. \u0026nbsp;Additionally, as the relationship between DBO and SQ is bidirectional, our current study showed that KFU students with high DBO levels were approximately 11 times more likely to have poor SQ than those with low DBO levels (OR=10.9; 95% CI: 5.9-20.1), which is higher than what is reported in the literature. For instance, Amaral et al. (2021) found that excessive daytime sleepiness (mostly due to internet addiction) significantly increased the chances of high emotional exhaustion (OR adj: 5.7;\u0026nbsp;\u003cem\u003ep\u003c/em\u003e \u0026lt;0.001) and high depersonalization (OR: 4.259;\u0026nbsp;\u003cem\u003ep\u003c/em\u003e \u0026lt;0.001) [28].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOverall, these findings highlight the importance of developing strategies to ensure enjoyable activities that promote physical and mental well-being. Brubaker et al. (2020) revealed that a two-week protocol involving the use of a sunrise alarm clock combined with the removal of electronic devices was effective in improving SQ and reducing DBO and perceived stress levels [29]. Evidence-based effective time management in academic, personal, and professional lives should be adopted [30]. A proposed \u0026ldquo;refresh activation\u0026rdquo; intervention program by Brenda et al involved active meditation that integrates movement, conscious breathing, focused attention, and music. This technique proved to serve as a coping strategy and had a positive impact on reducing academic burnout among university students targeted in this study [31-32]. In Saudi Arabia, it is recommended that study programs identify curriculum aspects that contribute to student overload and establish institutional policies and support services to enhance student well-being. Future research should dig deeper into these aspects.\u003c/p\u003e\n\u003cp\u003eNovelty within our research arises from its distinct study population which includes KFU students by gender and academic specialty across every academic year leading up to their pre-internship period, though previous investigations mainly studied medical or nursing students. Our research presents additional insights in addition to the discovered outcomes, because KFU students demonstrated intermediate Internet and social media usage, with lower DBO and average SQ levels when compared to peer groups in literature studies. The probability of inferior SQ with rising DBO levels showed nearly 11-fold higher ratios compared to past research studies\u0026apos; results.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe theoretical and practical implications of our study provide vital insights into how DBO affects SQ among KFU students. Our study data might provide practical support to develop these concepts for digital learning platforms along with burnout and cognitive strain theoretical frameworks. At the same time, clinically, poor sleep quality creates negative health effects by damaging cognitive function while weakening the immune system and escalating mental health issues like anxiety and depression. The study\u0026rsquo;s findings guide early identification and prevention strategies, recommending evidence-based interventions for universities, policymakers, and educators to mitigate DBO impacts. Additionally, health services, counselling centres, and sleep clinics can utilize these insights to support affected students. However, the significance of these results does not preclude the emergence of new challenges and questions. The study\u0026apos;s findings highlight correlations but do not establish causation, in addition, certain variables are influenced by context and culture. Other potential confounding factors, such as mental health, physical activity, non-academic screen time, and dietary behaviour, may also impact sleep and burnout.\u003c/p\u003e\n\u003cp\u003eOne key limitation and principal weakness of this study is that it was conducted at one institution, King Faisal University in one country, Saudi Arabia, which raises questions about the generalizability of the findings to other universities, regions, and cultural contexts. Furthermore, the three-month data collection period, which was restricted by exam schedules and graduation requirements, may not have allowed for the full exploration of the experiences of students from different academic environments, educational systems or socio-economic contexts. Given the cross-sectional design, it is impossible to make causal inferences about burnout and its determinants. Convenience sampling combined with voluntary participation may lead to selection bias because the responses were from students who had access to and participated in the survey via email. To overcome these limitations, future work should involve a wider range of institutions across different countries and cultures, data collection over a longer period, and the use of longitudinal or experimental research designs to establish cause-and-effect relationships and increase the external validity of the findings.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOur study was concluded by revealing the fact that although KFU students have a moderate level of internet and social media usage, the rate of high DBO levels and poor SQ compared to other peer groups reported in the literature was lower. Specifically, the likelihood of a lower SQ being related to higher DBO was nearly 11 times higher than the ratios reported in previous studies, as well as a significant correlation between DBO and SQ among the participants. This shows the need for preventive and coping strategies to raise the awareness of the university stakeholders and its management. It is therefore important to put in place effective mental health interventions, social support and supervision to improve on the mental health of students and in turn their academic achievement.\u003c/p\u003e\n"},{"header":"Abbreviations","content":"\u003cp\u003eDBO: Digital Burnout\u003c/p\u003e\n\u003cp\u003eDBS: Digital Burnout Scale\u003c/p\u003e\n\u003cp\u003eIRB: Institutional Review Board\u003c/p\u003e\n\u003cp\u003eKFU: King Faisal University\u003c/p\u003e\n\u003cp\u003eQoL: Quality of Life\u003c/p\u003e\n\u003cp\u003eSQ: Sleep Quality\u003c/p\u003e\n\u003cp\u003eSQS: Sleep Quality Scale\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Institutional Review Board (IRB) of KFU (Ref. No. KFU-REC-2023-MAY-ETHICS837). Informed consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNA.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors declare no potential financial and non-financial competing interests to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was required for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMM conceptualized the project idea, constructed the methodology, analyzed the collected data, and supervised the project. GG, IG, SY, GD, and BS distributed the survey and collected data. OM conceptualized the project idea, constructed the methodology, and supervised the project. HAS analyzed and interpreted the data and was a major contributor to writing the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank all KFU students from different specialties who helped in the collection of the required sample during the planned study period, as well as all students who participated in the survey.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKhammissa RAG, Nemutandani S, Feller G, Lemmer J, Feller L (2022) Burnout phenomenon: neurophysiological factors, clinical features, and aspects of management. Journal of International Medical Research 50(9): 030006052211064. doi:10.1177/03000605221106428\u003c/li\u003e\n\u003cli\u003eHillert A, Albrecht A, Voderholzer U (2020) The Burnout Phenomenon: A R\u0026eacute;sum\u0026eacute; After More Than 15,000 Scientific Publications. Frontiers in Psychiatry 11. doi:10.3389/fpsyt.2020.519237\u003c/li\u003e\n\u003cli\u003eEd\u0026uacute;-Valsania S, Lagu\u0026iacute;a A, Moriano JA (2022) Burnout: A Review of Theory and Measurement. International Journal of Environmental Research and Public Health 19(3): 1780. doi:10.3390/ijerph19031780\u003c/li\u003e\n\u003cli\u003eTavella G, Hadzi-Pavlovic D, Parker G (2021) Burnout: Redefining its key symptoms. Psychiatry Research 302(1): 114023. doi:10.1016/j.psychres.2021.114023\u003c/li\u003e\n\u003cli\u003eCarmona-Halty M, Mena-Chamorro P, Sep\u0026uacute;lveda-P\u0026aacute;ez G, Ferrer-Urbina R (2022) School Burnout Inventory: Factorial Validity, Reliability, and Measurement Invariance in a Chilean Sample of High School Students. Frontiers in Psychology 12. doi:10.3389/fpsyg.2021.774703\u003c/li\u003e\n\u003cli\u003eAsikainen H, Salmela-Aro K, Parpala A, Katajavuori, N (2019) Learning profiles and their relation to study-related burnout and academic achievement among university students. Learning and Individual Differences 78: 101781. doi:10.1016/j.lindif.2019.101781\u003c/li\u003e\n\u003cli\u003eLiu Y, Chen J, Chen K, Liu F, Wang W (2023) The associations between academic stress and depression among college students: A moderated chain mediation model of negative affect, sleep quality, and social support. Acta Psychologica 239: 104014. doi:10.1016/j.actpsy.2023.104014\u003c/li\u003e\n\u003cli\u003eCellini N, Menghini L, Mercurio M, Vanzetti V, Bergamo D, Sarlo M (2020) Sleep quality and quantity in Italian University students: an actigraphic study. Chronobiology International 37(11): 1538\u0026ndash;1551. doi:10.1080/07420528.2020.1773494\u003c/li\u003e\n\u003cli\u003eLi Y, Bai W, Zhu B, Duan R, Yu X, Xu W, Wang M, Hua W, Yu W, Li W, Kou C (2020) Prevalence and correlates of poor sleep quality among college students: a cross-sectional survey. Health and Quality of Life Outcomes 18(1). doi:10.1186/s12955-020-01465-2\u003c/li\u003e\n\u003cli\u003eNavarro-Mart\u0026iacute;nez R, Chover-Sierra E, Colomer-P\u0026eacute;rez N, Vlachou E, Andriuseviciene V, Cauli O (2020) Sleep quality and its association with substance abuse among university students. Clinical Neurology and Neurosurgery 188: 105591. doi:10.1016/j.clineuro.2019.105591\u003c/li\u003e\n\u003cli\u003eSuardiaz Muro M, Morante Ruiz M, Ortega Moreno M, Ruiz MA, Mart\u0026iacute;n Plasencia P, Vela Bueno A (2020) Sleep and academic performance in university students: a systematic review. Revista de Neurolog\u0026iacute;a, 71(02): 43. doi:10.33588/rn.7102.2020015\u003c/li\u003e\n\u003cli\u003eYang Z, Heizhati M, Wang L, Li M, Pan F, Wang Z, Abudureyimu R, Hong J, Yao L, Yang W, Liu S, Li N (2021) Subjective Poor Sleep Quality is Associated with Higher Blood Pressure and Prevalent Hypertension in General Population Independent of Sleep Disordered Breathing. Nature and Science of Sleep 13: 1759\u0026ndash;1770. doi:10.2147/nss.s329024\u003c/li\u003e\n\u003cli\u003e\u0026Ccedil;elik N, Ceylan B, \u0026Uuml;nsal A, \u0026Ccedil;ağan \u0026Ouml; (2018) Depression in health college students: relationship factors and sleep quality. Psychology, Health \u0026amp; Medicine 24(5): 625\u0026ndash;630. doi:10.1080/13548506.2018.1546881\u003c/li\u003e\n\u003cli\u003eTheories I (2014) Cognitive load theory - Information Systems Theories. Is.theorizeit.org. Available via https://is.theorizeit.org/wiki/Cognitive_load_theory#:~:text=Cognitive%20load%20theory%20was%20\u003cbr\u003emost%20extensively%20developed%20by,working%20memory%20and%20a%20virtually%20\u003cbr\u003e0unlimited%20long-term%20memory. Accessed 30 Dec 2024.\u003c/li\u003e\n\u003cli\u003eDemerouti E, Bakker AB, Nachreiner F, Schaufeli WB (2001) The Job Demands-Resources Model of Burnout. Journal of Applied Psychology 86(3): 499\u0026ndash;512. doi:10.1037/0021-9010.86.3.499\u003c/li\u003e\n\u003cli\u003eCalculator.net (2024) Sample Size Calculator. Calculator.net. Available via https://www.calculator.net/sample-size-calculator.html. Accessed 1 Jan 2025.\u003c/li\u003e\n\u003cli\u003eShahid A, Wilkinson K, Marcu S, Shapiro CM (2011) Sleep quality scale (SQS). STOP, THAT and One Hundred Other Sleep Scales. In Springer e-Books 85: 345\u0026ndash;350. doi:10.1007/978-1-4419-9893-4_85\u003c/li\u003e\n\u003cli\u003eERTEN P, \u0026Ouml;ZDEMİR O (2020) The digital burnout scale. İn\u0026ouml;n\u0026uuml; \u0026Uuml;niversitesi Eğitim Fak\u0026uuml;ltesi Dergisi 21(2): 668\u0026ndash;683. doi:10.17679/inuefd.597890\u003c/li\u003e\n\u003cli\u003eBarbayannis G, Bandari M, Zheng X, Baquerizo H, Pecor KW, Ming X (2022) Academic Stress and Mental Well-Being in College Students: Correlations, Affected Groups, and COVID-19. Frontiers in Psychology 13(886344). doi:10.3389/fpsyg.2022.886344\u003c/li\u003e\n\u003cli\u003eOlateju JA (2019) Utilization of the internet by undergraduate students of the University of Ibadan, Nigeria. International Journal of Science and Technology Education Research 10(3): 30\u0026ndash;36. doi:10.5897/ijster2018.0441\u003c/li\u003e\n\u003cli\u003eLai F, Wang L, Zhang J, Shan S, Chen J, Tian L (2023) Relationship between Social Media Use and Social Anxiety in College Students: Mediation Effect of Communication Capacity. International Journal of Environmental Research and Public Health 20(4): 3657. doi:10.3390/ijerph20043657\u003c/li\u003e\n\u003cli\u003eDurmuş S\u0026Ccedil;, G\u0026uuml;lnar E, \u0026Ouml;zveren H (2022) Determining digital burnout in nursing students: A descriptive research study. Nurse Education Today 111: 105300. doi:10.1016/j.nedt.2022.105300\u003c/li\u003e\n\u003cli\u003eSheilini M, Prakash P, Nayak S (2023) Academic burnout among undergraduate nursing students: A quantitative survey approach. Journal of Education and Health Promotion 12(1): 141. doi: 10.4103/jehp.jehp_1120_22\u003c/li\u003e\n\u003cli\u003eG\u0026Ouml;LDAĞ B (2021) An Investigation of the Relationship between University Students\u0026rsquo; Digital Burnout Levels and Perceived Stress Levels. Journal of Learning and Teaching in Digital Age 7(1): 90\u0026ndash;98. doi:10.53850/joltida.958039\u003c/li\u003e\n\u003cli\u003eKhayat MA, Qari M, Almutairi BS, Shuaib BH, Rambo MZ, Alrogi MJ, Alkhattabi SZ, Alqarni DA (2018) Sleep Quality and Internet Addiction Level among University Students. The Egyptian Journal of Hospital Medicine 73(7): 7042\u0026ndash;7047. doi: 10.12816/ejhm.2018.17224\u003c/li\u003e\n\u003cli\u003eWang Y, Xiao H, Zhang X, Wang L (2020) The Role of Active Coping in the Relationship Between Learning Burnout and Sleep Quality Among College Students in China. Frontiers in Psychology 11. doi:10.3389/fpsyg.2020.00647\u003c/li\u003e\n\u003cli\u003eNaderi H, Dehghan H, Dehrouyeh S, Tajik E (2021) Academic burnout among undergraduate nursing students: Predicting the role of sleep quality and healthy lifestyle. Research and Development in Medical Education 10(1): 16. doi:10.34172/rdme.2021.016\u003c/li\u003e\n\u003cli\u003eAmaral KV, Galdino MJQ, Martins JT (2021) Burnout, daytime sleepiness and sleep quality among technical-level Nursing students. Revista Latino-Americana de Enfermagem 29. doi: 10.1590/1518-8345.5180.3487\u003c/li\u003e\n\u003cli\u003eBrubaker JR, Swan A, Beverly EA (2020) A brief intervention to reduce burnout and improve sleep quality in medical students. BMC Medical Education 20(1). doi:10.1186/s12909-020-02263-6\u003c/li\u003e\n\u003cli\u003eZayed AM (2024) Digital Resilience, Digital Stress, and Social Support as Predictors of Academic Well-Being among University Students. Journal of Education and Training Studies 12(3): 60. doi:10.11114/jets.v12i3.6894\u003c/li\u003e\n\u003cli\u003eAlyami A, Abdulwahed A, Azhar A, Binsaddik A, Bafaraj SM (2021) Impact of Time-Management on the Student\u0026rsquo;s Academic Performance: A Cross-Sectional Study. Creative Education 12(3): 471\u0026ndash;485. doi:10.4236/ce.2021.123033\u003c/li\u003e\n\u003cli\u003eBanda J, D\u0026rsquo;Amico R, Flores \u0026Aacute; (2023) Intervention program to reduce academic burnout in university Mexican students. IntechOpen e-Books doi:10.5772/intechopen.1002623\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Digital Burnout, Sleep Quality, University students, Academic-performance, Mental health","lastPublishedDoi":"10.21203/rs.3.rs-6105207/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6105207/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e As a public health issue, both burnout syndrome and sleep problems affect students' academic performance and their well-being. Overuse of digital devices can cause digital burnout (DBO) to university students. This study aimed to explore digital device usage, sleep quality, DBO levels, and their association with sleep quality (SQ) among King Faisal University (KFU) students for the academic year 2022-2023.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e This cross-sectional study targeted undergraduate students of both genders at KFU across all academic levels and specialties. An online self-administered questionnaire was created using Google Forms and distributed via e-mail to KFU students between May and July 2023. Data were analyzed using SPSS software with statistical tests applied, and a\u003cem\u003e p\u003c/em\u003e-value of 0.05 was considered the significance threshold.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e In total, 744 KFU students participated in the study. Data analysis revealed moderate DBO levels and average SQ, 427(57.4%) and 526 (70.8%) respectively, with no significant differences based on age, gender, college, and marital status. Additionally, a statistically significant association was found between higher DBO levels and poorer SQ among the participants (Pearson’s correlation test, r = 0.548, \u003cem\u003ep\u003c/em\u003e= 0.000).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e Our study confirmed the association between DBO and SQ among KFU students. These findings underline the importance of university initiatives that promote stress-reducing activities and adaptive behaviors as resilience measures to support students' mental health, academic performance, and well-being.\u003c/p\u003e","manuscriptTitle":"Association between Digital Burnout and Sleep Quality among King Faisal University Students","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-03-10 11:03:36","doi":"10.21203/rs.3.rs-6105207/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"90f16e74-9391-4e61-9eb3-53b721f76e91","owner":[],"postedDate":"March 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-06-05T12:53:26+00:00","versionOfRecord":[],"versionCreatedAt":"2025-03-10 11:03:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6105207","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6105207","identity":"rs-6105207","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}