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American Journal of  Medical 
Science and Innovation (AJMSI) 

Relationship between Social Media Use and Sleep Disturbance among Adults in Afghanistan
Abdul Tawab Khpalwak1*, Mohammad Salim Hamidi2

Volume 3 Issue 1, Year 2024
ISSN: 2836-8509 (Online)

DOI: https://doi.org/10.54536/ajmsi.v3i1.2418
https://journals.e-palli.com/home/index.php/ajmsi

Article Information ABSTRACT

Received: February 04, 2024
Accepted: March 18, 2024
Published: March 22, 2024

This study aimed to investigate the impact of  excessive social media use on sleep and mental 
well-being among adults in Afghanistan. An online survey was conducted across 19 provinces 
in Afghanistan to assess social media usage and its effects on sleep. 407 Afghan adults 
Participated in the survey and were asked about their usage patterns, perceived addiction, and 
impact on their sleep quality and mental well-being. The survey revealed that many Afghan 
adults exhibited excessive social media usage and showed signs of  addiction. ¾ participants 
reported a strong urge to use social media. Social media usage, particularly before bedtime, 
significantly affected sleep patterns and mental well-being. 68% of  participants identified 
social media as a problem. A direct correlation was observed between the duration of  social 
media usage and sleep disturbances, with increased usage leading to poor sleep quality and 
difficulty concentrating on daily activities. This study highlights the need for awareness and 
interventions to address the harmful effects of  excessive social media use on sleep and 
mental well-being. Mental health professionals, policymakers, and health organizations are 
urged to collaborate and develop strategies to promote mental well-being and address the 
issue of  excessive social media usage.

Keywords
Mental Health, Social Media, 
Sleep Disturbance, Afghanistan, 
Social Media Addiction

1 Medical Faculty, Bost University, Afghanistan
2 Jahan University, Kabul, Afghanistan
* Corresponding author’s e-mail: tawabkhpalwak@gmail.com

INTRODUCTION
When well-rested, we can better manage our thoughts, 
feelings, and behaviors, which happens when we sleep 
better at night (Perry Dr. et al., 2013)1. However, in the 
modern world, various factors disrupt the establishment 
of  healthy sleeping patterns, and one such factor, which 
remains relatively unknown, is the excessive use of  social 
media on screens (Garett et al., 2016)2; this phenomenon 
is rapidly growing worldwide, particularly in developing 
countries like Afghanistan, where people have limited 
access to education and are largely unaware of  the 
detrimental effects of  excessive social media usage on 
their overall well-being (Facebook Aware of  Instagram’s 
Harmful Effect on Teenage Girls, Leak Reveals | 
Instagram | The Guardian, n.d.)3. In Afghanistan, adults 
primarily utilize social media for entertainment purposes, 
such as viewing videos, photos, status updates, and 
news, rather than for educational or research purposes 
(Afghanistan - Media Landscapes, n.d.)4
Some individuals cannot read or write, rely solely on 
images to identify others and become dependent on 
social media platforms. Numerous studies have affirmed 
that spending excessive time on social media platforms 
can profoundly impact social relationships, mental well-
being, and various aspects of  daily functioning, including 
sleep disruption, anxiety, depression, feelings of  isolation, 
and decreased focus (Hou et al., 2019; Savci & Aysan, 
2016; Seabrook et al., 2016)5–7.
The prevalence of  “nomophobia,” or the fear of  being 
without a mobile phone, further exacerbates the issue, as 
individuals feel compelled to constantly stay connected 
to social media to remain abreast of  current events and 
developments within their communities, country and the 
world at large, potentially leading to addiction disorders 

(Al-Barashdi et al., 2015; Bhattacharya et al., 2019)8,9. The 
duration of  social media usage directly correlates with its 
negative impact on mental well-being, particularly sleep 
quality; the longer individuals engage with social media 
platforms, the greater the disturbance it poses to their 
sleep and cognitive function (Al-Barashdi et al., 2015; 
Pirdehghan et al., 2021)8,10. Social media usage may 
disrupt sleep in several ways, such as by dislodging sleep, 
promoting physiological activity, or delaying circadian 
rhythms because of  the bright light from devices (Cain & 
Gradisar, 2010; Scott & Woods, 2018)11,12.
Social media has increasingly infiltrated the daily lives of  
many Afghan adults, most unaware of  their dependence 
and addiction, consequently jeopardizing their social 
interactions and personal lives (Afghanistan - Media 
Landscapes, n.d.)4. Therefore, to demonstrate the 
adverse effects of  social media on the quality of  life, it 
is essential to undertake scientific research to investigate 
the relationship between social media usage and sleep 
disorders. This study aimed to ascertain how much 
Afghan adults spend on social media and its potential 
effects on their sleep duration and quality.
Additionally, this research examined the association 
between prolonged and reduced social media usage 
and their respective negative implications for sleep 
quality among adults. The findings of  this study will 
raise awareness of  excessive social media usage and its 
detrimental effects on mental health, sleep patterns, 
and overall well-being. Mental health professionals, 
policymakers, and health organizations can utilize 
these findings to address this issue and promote public 
awareness regarding the addictive nature of  social media 
usage and its negative consequences on individuals’ 
mental health and sleep habits.



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LITERATURE REVIEW
Websites that allow users to create profiles and show 
their relationships with other users are called social media 
platforms (Boyd & Ellison, 2007)13. Social media are 
now integral to our lives and are used for communication, 
news, business, and pleasure (Worley, 2018)14. According 
to a report from the Statista website, there are 4.8 billion 
social media users worldwide, approximately 59.4% 
of  the global population (Social Media: Worldwide 
Penetration Rate 2023 | Statista, n.d.)15. This means that 
six out of  ten people worldwide use social media, which 
keeps growing (Digital 2020: Global Digital Overview - 
DataReportal – Global Digital Insights, n.d.; Social Media 
Statistics & Facts | Statista, n.d.; Kim et al., 2006)16–18. 
Social media platforms serve many purposes, such as 
staying connected, seeking information, and providing 
entertainment. They are crucial in people’s daily lives (Lin 
& Lu, 2011)19. However, excessive use of  social media 
can negatively affect health and well-being by disrupting 
sleep patterns. Sleep is essential to both physical and 
mental health. (Loft & Cameron, 2014)20.
There is much attention on the potential adverse effects of  
screen use and social media on health (Gruber et al., 2012; 
Perry Dr. et al., 2013; Sikder & Rhein-Waal, n.d.)1,21,22. 
Studies have found that spending too much time on 
social media is associated with mental health problems 
such as stress, anxiety, depression, sleep disturbances, 
and low self-esteem (Seabrook et al., 2016)5. Excessive 
use is widespread among young people, but we do not 
know much about how it affects their ability to sleep (van 
den Eijnden et al., 2021)23. Excessive or addictive social 
media usage can be described as a behavioral addiction in 
which individuals become excessively preoccupied with 
social media platforms. This addiction is characterized 
by an irresistible compulsion to frequently access and 
engage with social media, resulting in substantial time and 
energy being dedicated to it, disrupting essential areas of  
life (Social Media Addiction: Recognize the Signs, n.d.)24.
Many studies in developed countries have focused on the 
relationship between social media use and mental health 
problems in various groups of  people (Hou et al., 2019; 
Savci & Aysan, 2016, 2017; Selfhout et al., 2009)6,7,25,26, 
mainly in young individuals (Glazzard & Stones, 2020)27. 
These studies have also shown that excessive social media 
use disrupts sleep patterns and duration, which negatively 
affects performance, mood regulation, communication, 
thinking, comprehension, and overall health (Al et al., 
2023; Fredriksen et al., 2004; Gruber et al., 2012; Wolfson 
& Carskadon, 1998)21,28–30. Most of  these studies found 
a positive link between social media use and mental health 
problems. However, an earlier study conducted in 2002 
found a negative relationship between internet addiction 
and depression, which is not a widely accepted concept 
(Shaw & Gant, 2002)31. In this study, we specifically 
focused on how excessive social media use affects sleep 
disturbances among Afghan people. Sleep is crucial for 
health and well-being (Sikder & Rhein-Waal, n.d.)22 but is 
often overlooked in public health messages and education 

(Gruber et al., 2012; Perry Dr. et al., 2013)1,21.
A study conducted among university students in Khust 
Province, Afghanistan, found that many students were 
addicted to social media, which positively correlated with 
depression. The more addicted they were, the more signs 
and symptoms of  depression they showed (Haand & 
Shuwang, 2020)32. Social media disrupts sleep in three 
ways: displacing sleep time (Cain & Gradisar, 2010; 
Levenson et al., 2017)(Cain & Gradisar, 2010; Levenson 
et al., 2017), delaying sleep, and promoting physiological 
activity (Scott & Woods, 2018)12. Research has also 
shown that social media use reduces sleep quality by 
creating a constant urge to control and influence behavior 
(Pea et al., 2012)34.
A study among young American adults showed that 
participants with higher social media usage had a higher 
risk of  sleep disruption (Levenson et al., 2016)33. An 
Italian study of  junior and senior high school students 
found that female students had higher phone and social 
media engagement. The study also found that using mobile 
devices near bedtime had a positive relationship with sleep 
problems (Almeida et al., 2023; Bruni et al., 2015)35,36. 
Sleep problems are linked to depression, negative social 
relationships, and poor school performance (Alfano et al., 
2009)37.
Additionally, individuals with sleep problems often 
experience symptoms of  anxiety, reduced cognitive 
function, and a weakened immune system (Stickley et al., 
2019)38. Inadequate sleep increases the risk of  chronic 
conditions such as obesity, diabetes, and cardiovascular 
disease. Therefore, addressing and managing sleep 
disturbances is vital to improving overall well-being and 
various aspects of  life (Sleep and Chronic Disease | 
CDC, n.d.)39.

METHODOLOGY
A simple random sampling method is used in this study. A 
self-reported English questionnaire was prepared for data 
collection from different studies. A professional translator 
translated the questionnaire into the local language 
(Pashto). The research study, method, and questionnaire 
were reviewed and approved by the research and ethics 
committee of  the Medical Faculty of  Bost University; 
Reference number: BostEthics-0751, meeting number 4, 
conducted on 26 June 2023.
The questionnaire was adjusted into a Microsoft format 
to be shared online with prospective participants, which 
everyone could access. The questionnaire was shared 
through different social media platforms and groups for 
data collection from 10 July 2023 to 23 July 2023. The 
questionnaire was easy to complete; on average, it took 
9 minutes and 30 seconds for every person to complete 
it. It is important to note that before submitting their 
responses, consent was obtained from each participant, 
and they were duly informed about the purpose of  
the study. The participants were assured that their 
confidentiality would be protected. Those unwilling to 
participate had the right to refuse and were not obligated 



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to participate in the study. No financial or other incentives 
were provided to students to complete the survey.
According to the unknown population sample size 
formula(Gupta et al., 2016)40, the sample size was 
calculated as 385.
Infinite population sample size formula s=z2 * P(1-p)/M2

Where,
S = Sample size
Z = Given Z value = 1.96 (confidence level 95%)
p = population proportion (assumed to be 50%=0.5)
M = margin of  error= 5%
Pop = Population
Infinite population sample size formula
ones = z2 * P(1-p)/M2

s = (1.96)2 * 0.5(1-0.5)/(0.05)2

s = 3.8416 * 0.25/0.00252

s = 384.16
To be more accurate, the sample size was increased to 407 
respondents. The sample size was limited to adults, the 
society’s most active social media group.
The data were analyzed using Microsoft Forms, Microsoft 
Excel, and Microsoft Access.

Data Analysis 
A total of  407 survey respondents from 19 different 
provinces of  Afghanistan completed and submitted 

survey forms. Of  these, 54 were female, 353 were 
male (13% female; 87% male), and most (293 survey 
participants) were aged 18–32. Regarding education level, 
all participants were educated as they completed the 
survey forms; among the 407 survey participants, 357 
(88%) were undergraduate degree students or completed 
undergraduate degree studies.
All the respondents used social media for different 
purposes and durations during the day and night, as the 
statistics are as follows:

Ⅰ) 117 out of  407 (28.7%) used social media for four 
or more hours.

ⅠⅠ) 82 out of  407 (20.1%) users used social media for 
3 hours.

ⅠⅠⅠ) 93 out of  407 (22.8%) participants used social 
media for two hours.

Ⅳ) 88 out of  407 (21.6%) users used social media for 
one hour.

Ⅴ) 27 out of  407 (6.6%) participants used social media 
for 30 minutes or less. 
This suggests that a significant proportion of  the participants 
relied heavily on social media in their daily lives.
After comparing the duration of  social media usage and 
sleep quality, as shown in Table 1, we found that more 
extended social media usage is directly linked to sleep 
disturbance, sleep quality, and nightmares.

Table 1: Social Media Usage Linked to Nightmares and Sleep Quality
Total # 
Participants

Social media 
usage duration

Social media has a negative 
effect on my normal sleep.

Nightmare Sleep Quality
Very 
good

Good Bad Very 
bad

117 4 hours or more 85 56 23 61 29 4
82 3 hours 62 29 14 55 11 2
93 2 hours 71 34 23 62 6 2
88 1 hour 62 21 19 59 9 1
27 30 minutes or less 19 8 9 15 3 0

Figure 1: Sleep quality of  participants considering last month



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Table 2: Social media usage before bed
Using social media before bed
Total 
respondents:

# Respondents Duration Enthusiasm for daily activities
Very often Sometimes Rarely Very rarely

353 out of  407 202 1 hour 15 30 89 68
94 1-2 hours 18 24 31 21
49 Two or > hours 17 11 13 8

If  your sleep is being negatively affected because of  excessive use of  social media, please write down the 
effects:
Respondents’ comments: (Mostly repeated comments are compiled in this chart.)
No restful sleeping and headache.
No or less sleeping, anxiety, and depression.
I was being mentally and physically fatigued and being lazy.
Restlessness and loss of  focus on daily activities
Abnormal sleeping and cannot wake up in the morning quickly.
Eye problems and heavy head. 
I cannot wake up in the morning and have a lazy day with worries regarding sad news which I have seen on social media.
Sleep disturbance and nightmares with no focus.
Loss of  focus and inability to study, which ends with depression.
Stress and engagement with what I see on social media are repeatedly coming to me, which distresses me. 
I am pretty good, with no adverse effects, as I use it for a limited time. 
Can not fall asleep quickly, in reverse in the morning, cannot get up quickly. 
Irregular sleeping cycle
Before sleeping is fine with me, but I cannot fall asleep if  I use social media after midnight. 
Seems always tired.
Can not offer the prayer of  the morning because of  late sleeping
The negative and bad news about the country, especially the videos of  poor people, make me cry and fall asleep late, 
this causes me to be tired and sleepy tomorrow.
Black circles around the eye and miss the morning offer prayer, a sign of  unfortunate.  
No regular sleep and being stressed.
Anxiety with being lazy and dull.

Table 3: Feeling the urge to use social media
Feeling an urge to use social media
Total Respondents: Rarely Some Time Very often
407 (100%) 78 (19%) 174 (43%) 155 (38%)

A question that asked participants to assess their sleep quality 
in the previous month was answered as follows (Figure 1):
As shown in the following Table 2, 87% of  the 

respondents (353 out of  407) admitted using social media 
before bed. However, they also expressed enthusiasm for 
daily activities instead of  using social media before bed.

Of  the 407 or 73% of  participants, 299 mentioned that 
social media negatively affected their normal sleeping 
process and mental health, and they commented on their 
adverse effects below to an open question.
Therefore, to fall asleep early and sleep well, 39 of  407 
participants were taking sleeping tablets once or twice a 
week.

Regarding whether they (respondents) felt an urge to use 
social media more and more, the answer was yes, and the 
statistics were as follows (Table 3):
The study also revealed that those with more thirst or 
desire to use social media use it for long hours than those 
with less desire to use it (Table 4).



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Table 5: Lose of  concentration, ability to work, and communication ability
Frequency of  Loss of  concentration, ability to work, communicate, and perform daily activities
Total Respondents: Not happened Rarely Some Time Very often
407 (100%) 97 (24%) 129 (32%) 115 (28%) 66 (16%)

How do you limit the usage of  social media (the ways)?
Respondents’ comments:
I lifted the unnecessary social media groups, prepared a schedule for my daily routine, and am following it.
Firm intention targeted a goal I am studying for. 
I did sports and paid attention to my mental and physical health after I became addicted to social media. 
Giving time to my beloved family and children helped me reduce my social media usage, and I feel very well. 
I am studying more and getting motivated to return to natural life rather than internet life. 
I am trying to be busy with other activities and remembering how social media affects my health.
Motivated strongly and intended not to use social media. 
NO activation of  internet bundle.
I use my mobile just when needed, and when I feel slightly distressed because of  social media, I switch off  the phone. 
I do busy myself  intentionally with activities related to my job, so my usage of  social media has decreased. 
Activation of  a small package of  internet bundle for most needed activities. 
I do not activate oversized internet packages and watch a movie before falling asleep. Watching movies makes me 
fall asleep in 15 minutes, and I made my habit of  sleeping early and avoiding using social media. 
Priorities my daily routine and study in my free time. 
I watch YouTube to learn and study psychology. 
Deactivation of  social media accounts deactivates new internet bundles for days when the old one ends. 
I limited the use of  smartphones and am using a simple mobile for calling.
I turned off  the notifications and used the NO Disturb mode of  my mobile. 
I am scheduled to use social media for 30 minutes; if  it increases, I get the notification. 
I have solid intentions and try to be busy with my daily routine, job, and work.

Table 4: Urge to use social media
Urge to use social 
media

Number of  
participants

4 hours or 
more

3 hours 2 hours 1 hour 30 minutes or 
less

Very often 155 (38%) 78 31 31 41 5
Sometime 174 (43%) 29 38 39 92 15
Rarely 78 (19%) 10 13 23 48 7

As summarized in Table 5, Participants also reported that 
because of  excessive use of  social media, they lost their 
focus and ability to work, communicate, and perform 
daily routine activities well.
Despite falling asleep late and not sleeping adequately, 
241 of  407 participants declared that they woke up in 
the middle of  the night or early in the morning. More 

than half  of  the participants (276 out of  407) felt that 
excessive use of  social media was a problem for them 
and were trying to limit the frequency and duration of  
social media usage. Of  407, 202 mentioned that they 
successfully limited social media usage using different 
ways. From 202 optional comments, we share 20 of  them 
in this article, which are selected randomly.

In conclusion, the study revealed that more participants 
were using social media for extended periods and 
that excessive usage had a detrimental impact on their 
mental well-being and sleep. It has been shown that the 
more people use social media, the more it impacts their 
sleeping length, sleeping quality, routine tasks, focus, 
concentration, and enthusiasm for daily activities.

In contrast, people who use social media for a shorter 
period have a less unfavorable influence on their sleeping 
mood, mental health, and sleep quality.

RESULT AND DISCUSSION
The study of  407 participants found that longer hours of  
social media usage are directly linked to sleep disturbance, 



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sleep quality, and nightmares. The study also revealed that 
87% of  the respondents used social media before bed, 
and 73% mentioned that social media negatively affected 
their normal sleeping process and mental health.

- 28.7% of  the participants used social media for four 
or more hours, 20.1% for 3 hours, 22.8% for 2 hours, 
21.6% for 1 hour, and 6.6% for 30 minutes or less.

- 276 out of  407 participants felt that excessive use of  
social media was a problem for them and were trying to 
limit the frequency and duration of  social media usage.

- 241 of  407 participants declared that they wake up 
in the middle of  the night or very early in the morning 
despite falling asleep late and not sleeping adequately.
Participants also reported that excessive use of  social 
media caused them to lose focus and ability to work, 
communicate, and perform daily activities well. The study 
showed that more participants were using social media 
for extended periods, and excessive usage of  social media 
had a detrimental impact on their mental well-being and 
sleep.
The findings of  this study are significant for various 
stakeholders, including organizations, policymakers, 
individuals working towards mental health well-being, 
and frequent users of  social media. This study highlights 
the detrimental effects of  excessive social media use on 
sleep patterns and mental health. The positive correlation 
between social media addiction and reduced sleep quality 
indicates that individuals more addicted to social media 
experience lower quality sleep than those who use it for 
shorter durations.
The participant’s comments further support the notion 
that excessive social media use adversely impacts daily life. 
Many participants reported difficulties in falling asleep, 
feeling tired and sleepless, facing challenges in studying 
and performing daily activities, increased anxiety, feelings 
of  depression, frequent headaches, and experiencing 
laziness and fatigue. In addition, participants mentioned 
difficulties in maintaining focus and concentration.
Furthermore, several practical approaches were identified 
when participants were asked to provide strategies to 
limit their social media usage. A common theme among 
the participant responses was a solid intention to limit 
their social media usage. Activation of  mini-internet 
packages, engaging in studying, spending quality time 
with family, focusing on daily activities, participating in 
physical exercise, creating a schedule for daily activities, 
and enforcing strict adherence to their self-imposed 
restrictions were cited as effective strategies.
These findings have practical implications for both 
individuals and society as a whole. By raising awareness 
about the negative impact of  excessive social media use 
on sleep and mental health, this study can help guide 
individuals toward healthier habits. The results also call 
for the attention of  organizations, policymakers, and 
mental health professionals to develop interventions and 
initiatives that address the growing problem of  social 
media addiction. By incorporating these findings into 
public health campaigns and educational programs, we 

can work towards promoting better sleeping habits and 
safeguarding mental health among social media users.

CONCLUSION
In conclusion, this study provides compelling evidence 
that social media significantly negatively impacts Afghan 
adults’ sleep and mental health, resulting in reduced 
duration and quality of  sleep. Moving forward, it is 
recommended that policymakers and organizations take 
proactive measures to increase awareness about the 
detrimental effects of  excessive social media usage on 
health. Additionally, interventions in the form of  sleep 
education should be implemented to assist individuals 
in achieving a balance between online interactions and 
sufficient sleep. Furthermore, future research should be 
conducted into other aspects of  excessive social media use, 
including stress, anxiety, academic performance, addiction 
levels, and self-esteem. By understanding these factors 
more deeply, we can develop comprehensive strategies 
to address the multifaceted challenges of  excessive social 
media usage among adults in Afghanistan. This will 
involve addressing the immediate sleep and mental health 
concerns and tackling broader issues relating to stress, 
addiction, and overall well-being. We can work towards 
creating a healthier digital environment for Afghan adults 
through a targeted approach that combines education, 
awareness, and further research.

Acknowledgments
This research was part of  my project with Unisfere 
Organization (https://unisfere.com/) during my 
fellowship program (University Research Fellowship).

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