{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:57:21Z","timestamp":1790575041743,"version":"4.1.0"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Poor sleep and reduced academic performance among medical and dental students have been linked to social media use; however, whether the amount, purpose, and timing of use are independently associated with these outcomes remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, 364 students enrolled in MBBS or BDS programs at ten institutions in Khyber Pakhtunkhwa, Pakistan, were recruited through convenience sampling and completed a paper-based questionnaire between October 2023 and April 2024. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and academic performance was assessed using self-reported percentage marks from the most recent professional examination. The models were adjusted for background characteristics and other social media exposures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Poor sleep quality (PSQI &amp;gt; 5) was present in 312 students (85.7%, 95% CI 81.7\u201388.9). Duration of pre-sleep social media use was the only exposure independently associated with the PSQI global score (B\u202f=\u202f1.594, 95% CI 1.081 to 2.106,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), while total daily use was not. Conversely, each one-category increase in total daily use was associated with examination scores that were 1.40 percentage points lower (B\u202f=\u202f\u22121.404, 95% CI \u22122.053 to \u22120.756,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). The classification of platform-derived purpose was not associated with either outcome; however, a secondary measure of purpose, the proportion of use devoted to academic work, was associated with a higher examination percentage (B\u202f=\u202f2.148, 95% CI 1.513 to 2.782,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Thus, conclusions about purpose depended on how it was measured. Nocturnal checking was not associated with either outcome. Fitting both outcomes in a single model supported outcome specificity, most clearly for pre-sleep use (difference in standardized \u03b2\u202f=\u202f\u22120.271,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.006; total daily use, 0.235,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.023).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sleep quality was primarily associated with when social media was used, while examination performance was related to how much social media was used. These exploratory associations from a convenience sample cannot establish causal direction, apply to the participating institutions rather than to Pakistani students generally, and require replication with prospective designs and objective measures in future studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1968305","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:45:23Z","timestamp":1790574323000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Differential associations of the timing and amount of social media use with sleep quality and academic performance among undergraduate medical and dental students in Pakistan: a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Kanza","family":"Atif","sequence":"first","affiliation":[{"name":"College of Medicine, Alfaisal University","place":["Riyadh, Saudi 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Umair","family":"Amjad","sequence":"additional","affiliation":[{"name":"Peshawar Medical College, Riphah International University","place":["Peshawar, Khyber Pakhtunkhwa, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Tafheem","family":"Khan","sequence":"additional","affiliation":[{"name":"Peshawar Medical College, Riphah International University","place":["Peshawar, Khyber Pakhtunkhwa, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Kakakhel","sequence":"additional","affiliation":[{"name":"Peshawar Medical College, Riphah International University","place":["Peshawar, Khyber Pakhtunkhwa, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Qasim","sequence":"additional","affiliation":[{"name":"Peshawar Medical College, Riphah International University","place":["Peshawar, Khyber Pakhtunkhwa, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Talha","family":"Bin Shakoor","sequence":"additional","affiliation":[{"name":"Peshawar Medical College, Riphah International University","place":["Peshawar, Khyber Pakhtunkhwa, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Latif","sequence":"additional","affiliation":[{"name":"Peshawar Medical College, Riphah International University","place":["Peshawar, Khyber Pakhtunkhwa, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadia","family":"Qazi","sequence":"additional","affiliation":[{"name":"Department of Anatomy, College of Medicine, Alfaisal University","place":["Riyadh, Saudi 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