Results of the study revealed that Jordanian adolescents have IA ranging from severe 6.1% to moderate levels 51.9%. This finding came to validate the findings by Al-Shdayfat et al., (2016), and Khalil et al., (2022) from Jordan and Egypt respectively. These findings are higher than other worldwide prevalence(Stevens et al., 2021; Chiu et al., 2018;Dalamaria et al., 2021; Ying et al., 2021; Wartberg et al., 2020 ; Mohamed & Bernouss, 2020; & Ozturk & Ayaz-Alkaya, 2021a). The higher level of IA in this study might be related to the high accessibility of the internet in Jordan, according to Telecommunications Regulatory Commission in Jordan 2021 there are 38.9 million Internet users (Telecommunications Regulatory Commission-Jordan Annual Report, 2019), in addition to the wide accessibility during COVID-19 where education institutions implemented online learning which may have increased engagement with the internet in schools.
Regarding sleep quality among adolescents in this study, the total points of the global sleep quality indicate poor sleep quality. All seven component were assessed and showed moderate to high mean result, especially sleep latency, sleep disturbance, and daytime dysfunction. In addition, this study results showed (31.8%) have a good sleep quality and (68.2%) have a poor sleep quality. These results similar to many other studies (Pirdehghan et al., 2021; Adelantado-Renau, Beltran-Valls et al., 2019; Koças et al., 2018; and Durkee et al., 2016). These results are reasonable due to use of the electronic devices among IA adolescents causes sleep damage by keeping late bedtimes, limiting the sleep hours, and sleep quality disturbances.
There is a significant positive relationship between age and IA, older adolescents have more IA, similar to previous studies in China (Xin et al., 2018). Such results are congruent with adolescents tend curiosity to discover their own identity and perspective on life, Adolescents are also especially attracted to technological methods of communication, which offer interaction with others while also providing anonymity, also there is an increased risk of emotional crises, often accompanied by mood changes, which adolescents attempt to combat through withdrawal and adolescent in this age they have gained more independence and their free time and social activities are less controlled by their parents ( Karacic & Oreskovic, 2017)
This study suggests no gender differences in IA. These findings are compatible with a study of Japanese students (Kawabe et al., 2019) and incompatible with studies reported that IA was higher among males in China and Saudi Arabia (Xin et al., 2018; Alhantoushi & Alabdullateef, 2014). While two different studies in Turkey showed that IA more frequent in girls (Karaer & Akdemir, 2019; Çelebioğlu, Aytekin Özdemir, et al., 2020b). The lack of support for gender differences in this study can be explained by gender equity in Jordan: girls and boys are given same educational (UNICEF, 2020). However, the internet addition sometimes is not related only to the time spent on internet but also to the interest and interaction on internet which was supported by previous studies to be more among male adolescents (Alhantoushi & Alabdullateef, 2014; Xin et al., 2018). This interest and interaction on internet are recommended to be addressed in future research since it was not assessed in this study.
The findings also indicate that there is a positive relationship between IA and poor academic performance, this finding is similar to studies suggested that adolescents with higher academic performance were less likely to have IA (Chung et al., 2019; Chi et al., 2020; Tan et al., 2016). However, a contrast result was found in China (Xin et al., 2018). The relationship between poor academic achievement and IA can be explained by the fact that accessibility to internet in Jordan is not controlled by both education authorities or at home, which gives the adolescent the freedom to access whatever they want and chat with peers all the time leaving no time for study (Al-Shdayfat et al., 2016). In addition, students with poor academic performance may find the internet as an escape from some psychological pressures of the adolescent period such as stress, anxieties, and self-esteem issues (Kumar & Mondal, 2018).
There was no association found between IA and family income, which is incompatible with the findings by prior studies (X. S. Wu et al., 2016; Ozturk & Ayaz-Alkaya, 2021; Dong et al., 2019). One explains why there are no difference in Jordan, such as cost of internet is not expensive, adolescents can access from many sources even from there friend and some are free areas like malls (Al-Shdayfat et al., 2016).
This study showed a difference in IA between adolescents in private and public schools, specifically adolescents in public tend to be more likely to suffer from IA, which is consistent with previous research findings(Cruz et al., 2018) and contrast with(Afacan & Ozbek, 2019). This can be explained that adolescent’s from public schools scored higher IA can be explained by the fact that control from schools in private is more, more discipline, longer school times, and longer commutes and homework, which may limit their times accessibility to internet, also the access time of online platform in public schools open 24 hours while in private just in limit time and the students should commitment to this time.
The study revealed a positive association between IA and sleep quality in adolescents; adolescents with poor sleep quality have more IA. These findings are in line with previous studies Tan et al. (2016); (Lin et al., 2019a); (Tereshchenko et al., 2021) and (Tokiya et al., 2020a). However, its contras study found a negative correlation between problematic internet use and adolescent sleep (Kokka et al., 2021). Our findings revealed that except sleep efficiency, the total IA score was significantly associated with the total PSQI score as well as the sub-scores on its six items (subjective sleep quality, sleep latency, sleep duration, sleep disturbance, use of sleep medication and daytime dysfunction. This may explain the subjective sleep quality is a person's sleep attitude, the poor sleep attitude, as manifested by excessive Internet use, has a negative impact on a person's subjective perception of sleep quality. A positive relationship between internet addiction and short sleep duration. The results of the present study also implicated that internet addiction is linked to sleep disturbance with a positive relationship, this finding is supported by previous study (Tokiya et al., 2020b); (Kitazawa et al., 2018). This may explain that sleep disturbance indicates physical impairment thus, the finding may suggest that Internet use has a negative impact on physical health.
In terms of the relationship between internet addiction and use of sleep medication, the current study findings suggested a positive relationship, which is supported by other research (Lin et al., 2019); (Cheung & Wong, 2011), this may be because; internet addiction can cause emotional problems such as anxiety, and this problem can lead to the adolescent's intake of medication which may help them to cope with their emotions. This study results demonstrated a positive relationship between internet addiction and daytime dysfunction, which is consistent with Cheung & Wong (2011), Lin et al. (2019b), also there was a positive correlation between intent addiction pattern of the adolescents and daytime dysfunction. The finding implies that adolescents who suffer from internet addiction have undesirable consequences on daily activities which explain by the time spent in use the internet may disturb normal daily activity. Finally, the current study's findings revealed no link between internet addiction and sleep efficiency, the same observation was made in the study of Lin et al (2019), and in contrast to two previous studies (Cheung & Wong, 2011); (Çelebioğlu, Özdemir, et al., 2020).
Implications and Recommendations
Study has implications for education, public awareness, and parents. It is necessary to raise awareness among parents and teachers about poor sleep quality because of increased internet use. Parents and schools may be at the center of interventions aimed at reducing internet addiction and improving sleep quality, it’s a necessary develop prevention program to increase students' awareness about IA. Parents should also monitor their children’s online activities and limit internet use .Providing psychological support could decrease the stress and enhance using of positive coping strategies among school students establish counselling sessions and mental health clinics for monitoring IA among high-risk school students. Periodic screening for monitoring IA symptoms among students could be effective. professional family-based education and training programs should be directed to all parents about improper Internet usage. As well as developing guidelines regarding what should be the appropriate age for exposure to the internet, at what age a personal device for internet use should be provided to children, and permissible hours of internet use. The study recommends that further research should focus on longitudinal research to address the interdependence and underlying mechanisms that link internet addiction and poor sleep quality and examine other variables which may predict internet addiction such as self-esteem, role identity and social beliefs.
Limitations and Strengths
This study also had several limitations including the use of cross-sectional design limited the researcher’s ability to identify the temporal relationship between sleep quality and internet addiction. Also, the findings of this study are based on self-reported behaviour by participants and reflect their views and perspectives, there could be a mismatch between self-reported and actual behaviour. The subjects recruited only from the Amman area, so one should be cautious in generalizing our findings to Jordanian adolescent. Ad finally, the study was conducted during Covid-19 pandemic which resulted in more use of education platforms and accessibility to internet which may contributed to internet addiction. But the strengths of this study were the large sample size which was sufficient to ensure statistical power. Also, to investigate the relationship between sleep disturbance and IA, we used PSQI and IAT, which have been frequently used as standard indices in several epidemiological surveys. On the other hand, this study has strengths including, the sample size which was large and sufficient to ensure statistical power. And to investigate the relationship between sleep disturbance and IA, the researcher used PSQI and IAT, which have been frequently used as standard indices in several epidemiological surveys.