Excessive internet use plus lack of sleep, exercise linked to teen truancy and school absence

BMJApr 17 2024

Spending too much time online to the point of compulsion and the neglect of other necessary activities, plus not sleeping or exercising enough, are linked to a heightened risk of both truancy and school absence due to illness among teens, finds research published online in the Archives of Disease in Childhood.

Teenage girls seem to be more vulnerable than teenage boys to excessive internet use, but getting the recommended quota of shut eye and exercise and having a trusting relationship with parents all seem to be protective, the findings indicate.

Although differences in how excessive internet use is assessed and categorized can make it difficult to quantify, digital media may be a factor tempting teens to stay home from school, and may also hinder learning through lack of sleep, suggest the researchers.

To try and gauge what impact excessive internet use might have on school attendance and what, if any, mitigating factors there might be, the researchers used data from the School Health Promotion study, a national biennial survey conducted in Finland and managed by the Institute for Health and Welfare.

They focused on 86,270 year 8 and 9 pupils aged 14 to 16. The teens were specifically asked about their relationship with their parents in terms of how often they shared concerns with them (often to fairly rarely), as well as how long they slept every night, and how many days of the week they had been on the move for at least an hour.

Excessive internet use was assessed using a validated (Excessive Internet Use; EIU) scale consisting of 5 components indicating compulsion; neglect of family, friends, and study; anxiety if not online; and failure to eat or sleep because of being online.

Respondents were asked to estimate how often they experienced each of these, scoring them from 1 ('never') to 4 ('very often') to provide an overall average. 

And they provided information on how many times during the most recent school year they had played truant and/or had been absent due to illness, ranging from 'not at all' through to 'daily or almost daily'.

The EIU scale average score was just under 2; and just over 2% (1881) of participants scored the maximum of 4. Girls spent more time online than boys: they were 96% more likely to fall into the excessive internet use category than boys (79%), possibly because they tend to use social media more than boys, suggest the researchers.

On average, the teens slept 8 hours on school nights, and 9 hours on weekend nights. But more than  a third (35%) clocked up fewer than 8 hours on school nights, and 11% slept fewer than 8 hours at the weekend.

Participants reported physical activity for at least an hour on 4 days of the preceding week and vigorous physical activity for 2-3 hours a week. But a third reported low levels of physical activity—fewer than 3 days a week. Boys were more likely than girls to report no, or daily, physical activity.

Overall, 3-4% of respondents reported high rates of school absence. Boys reported more truancy than girls, who reported more medically explained absences than boys.

Older age was associated with a greater likelihood of truancy. But spending an excessive amount of time online was associated with an increased risk of both truancy (38% heightened risk) and medically explained school absences (24% heightened risk). 

Good parental relations, longer nightly weekday sleep, and physical activity all emerged as significantly protective, with more of each factor associated with a steadily decreasing risk of both truancy and school absences due to illness. 

Being able to talk about concerns with parents was most strongly associated with the lowest risk of either type of school absence. Teens who often felt able to share troubling issues with their parents were 59% less likely to play truant and 39% less likely to be absent from school due to illness.

This is an observational study, and as such, no firm conclusions can be drawn about causal factors, and the researchers acknowledge that the School Health Promotion study didn't include information on the type of internet use teens engaged in.

"Despite the limitations, our results have important implications for promotion of health and educational attainment," suggest the researchers.

"Our results are relevant for professionals organising and working in school health and wellbeing services, especially when professionals meet students whose school absences raise concern," they add.