Progressive Smartphone Restriction Combined with Psychoeducational Guidance and Pre-Sleep Autonomic Regulation Improves Sleep Efficiency and Time-of-Day Cognitive Performance in Physically Active Students with Nomophobia: A Randomized Controlled Trial

TL;DR

A new approach combining smartphone limits, education, and relaxation improves sleep and afternoon thinking in students who fear being without their phones.

Contribution

A progressive smartphone restriction protocol combined with psychoeducation and pre-sleep relaxation is shown to enhance sleep and cognitive outcomes beyond standard restriction.

Findings

Adapted intervention improved sleep efficiency and reduced sleep onset latency more than standard restriction.

The adapted group showed reduced pre-sleep anxiety and stress compared to the standard group.

Afternoon cognitive performance improved in the adapted group but not in the standard group.

Abstract

Aim: This study compared the effects of standard evening smartphone restriction with an adapted intervention combining progressive restriction, psychoeducational guidance, and pre-sleep relaxation on sleep, psychological state, cognitive performance, and physical performance in physically active physical education students with moderate-to-high nomophobia. Methods: Thirty participants (age 21.9 ± 1.2 years; intermediate chronotype) completed a randomized controlled trial consisting of a 7-day baseline period, a 14-day intervention phase, and post-intervention assessments. The standard group (n = 15) implemented a 2-h pre-bedtime smartphone restriction combined with general sleep hygiene guidance. The adapted group (n = 15) followed a progressive restriction protocol (30→60→120 min) supplemented with psychoeducational guidance targeting smartphone-related anxiety and a nightly slow-paced breathing routine. Objective sleep parameters were quantified using wrist-worn actigraphy. Subjective sleep quality, pre-sleep anxiety, and stress were assessed using visual analog scales. Cognitive performance (psychomotor vigilance task and choice reaction time) and physical performance (vertical jumps and agility) were evaluated at both morning and afternoon time points. Results: The adapted intervention produced significantly greater improvements in sleep efficiency (time × group: F(1,28) = 6.84, p = 0.014, ηp2 = 0.20; d = 0.78) and sleep onset latency (F(1,28) = 5.97, p = 0.021, ηp2 = 0.18; d = 0.72) compared with standard restriction. Significant reductions were also observed in pre-sleep anxiety (F(1,28) = 7.12, p = 0.012, ηp2 = 0.20; d = 0.81) and stress (F(1,28) = 6.45, p = 0.017, ηp2 = 0.19; d = 0.74). Cognitive performance showed significant time × group × time-of-day interactions, with improvements during afternoon assessments in psychomotor vigilance (F(1,28) = 7.48, p = 0.011; d = 0.83) and choice reaction time (F(1,28) = 6.89, p = 0.014; d = 0.79) exclusively in the adapted group. Physical performance outcomes remained stable across interventions. Conclusions: Progressive smartphone restriction combined with psychoeducational strategies and pre-sleep relaxation yields clinically meaningful improvements in sleep continuity, psychological arousal, and afternoon cognitive performance, exceeding the benefits achieved through behavioral restriction alone.

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