Due to an increase in the number and duration of smartphone use, its side effects are also increasing. Overuse of smartphones can cause serious health problems like headaches. The objective of the study was to compare smartphone addiction and headache among male and female young adults. In this cross-sectional survey, data were collected through a non-probability sampling technique from 400 adults of either gender aged between 18 and 35 years from Rawalpindi, Islamabad, and Taxila. Data was collected via smartphone Addiction Scale Short Version (SAS-SV), Headache Disability Index (HDI), and Visual Analogue Scale (VAS). The data were analyzed using the statistical package for the social sciences (SPSS) version 27. There was 187 male and 213 female with mean age (23.20 ± 4.41) ranging 18-35 years. There was more significant difference between females and males regarding pain (p<0.05, Cohen’s d=0.27), total HDI (p<0.05, Cohen’s d=0.32), Functional HDI (p<0.05, Cohen’s d=0.25), Emotional HDI (p<0.05, Cohen’s d=0.36) but there was no difference regarding smartphone Addiction (p=0.094, Cohen’s d=0.16). It was concluded that females have high disability index and pain, but there was no significant difference in smartphone addiction between females and males.

Headache, Smartphone, Addiction, Adults, Headache disability index, Visual analogue scale.

Most people today have access to smartphones. In 2017, there were projected to be 4.7 billion mobile phone users worldwide. Particularly for young people, smartphones are regarded as a crucial tool.[1] According to a recent study, 79% of persons between the ages of 18 and 44 kept a smartphone with them virtually always, meaning the typical person spends only two hours of their waking day without it.[2] Due to the growing popularity of smartphones, they have increased in functions and have a wide range of applications. The changes in the impact of global technology are felt deeply in everyone’s lives. Drug addiction, which includes reliance on substances like alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, and stimulants; and behavior addiction, which includes reliance on electronic media like games, the internet, and even smartphones, are the two main categories of addiction.[3] The number of smartphone and cell phone users globally is estimated to be over 4.5 billion, and a large proportion comprises youth. Academics claim that some users are more dependent on their smartphones than they are aware of.[4,5] Several studies have been conducted on the issues caused by excessive smartphone use. Some mobile phone users experience headaches, insomnia, amnesia, and vertigo.[6,7]

Smartphone addiction is referred to as “smartphone dependence “. It can harm a student’s ability to focus and interact.[8] Migraine is also the second leading cause of disability worldwide, caused by smartphone addiction. It is crucial to investigate the negative effects of this technological advancement on its users.[9] Increasing usage of the internet has been linked to several problems, including exposure to undesirable images and content, a lack of privacy, and online addiction among a small minority. Regardless of whether disordered internet use is an addiction, research has repeatedly shown that excessive internet use in a small percentage of people can result in psychological and behavioral issues, including worries about their physical health (e.g., dry eyes, neck, back, and shoulder pain, regular headaches, numbness pain in the thumb, index, and middle fingers). Several studies have shown the negative impacts of excessive adolescent internet use, including poor food habits, physical inactivity, inadequate sleep, increased melancholy and loneliness, and social anxiety, regardless of whether it is a dependency, addiction, or problem.[10] The four main components of the proposed criteria to determine whether a person has smartphone dependence are compulsive phone use, tolerance shown by longer and more frequent use, withdrawal symptoms, and functional impairment by interfering with other tasks of daily living. It has been suggested that it is connected to physical health conditions like vision loss, musculoskeletal problems, ear pain, migraines, and sleep disorders.[11] Cell phones are extremely interesting to youth because they make them feel powerful, authentic, and credible. It also serves as a form of entertainment.[12] The study’s goal was to compare male and female young adults’ levels of smartphone addiction and headaches.

This comparative cross-sectional study was conducted on the general population of Rawalpindi, Islamabad, and Taxila. After approval, the questionnaires were given to adults aged between 18 and 35 years. The duration of the study was four months. The participants must be healthy both mentally and physically, while participants having any disease like epilepsy, Alzheimer’s, multiple sclerosis (MS), Schizophrenia, and obsessive-compulsive disorder (OCD) were excluded from this study.

The sample size was n=377, calculated through Rao software with a 20,000 population size, 95% confidence interval, and 5% margin of error, and the data collected was from 400 people.

The data was collected using non-probability approach also known as Convenience sampling. According to this technique, the population being studied fulfills criteria like easy availability, proximity to the study site, etc. The main purpose of convenience sampling is to collect information from subjects who are easily accessible to the researcher.[17] The questionnaires used for the study were SAS-SV, HDI, and VAS.

The SAS-SV questionnaire has 10 items, closed-ended. Items are scored on a 6-point Likert scale as follows: 6 = strongly agree, 5 = agree, 4 = weakly agree, 3 = weakly disagree, 2 = disagree, 1 = strongly disagree.

HDI was used for measuring disability caused by smartphone addiction both emotionally and functionally. It has 25 items, out of which 13 are functional domains and 12 are emotional domains. It was scored as Yes, Sometimes, or No. Yes = 4 points, sometimes = 2 points, No = 0. Total score of 10-28 was considered mild disability, 30-48 was moderate disability, 50-68 was severe disability, and 72 or more was complete disability.

VAS was used to measure the severity of headaches caused by smartphone addiction. It showed a straight line 0 to 10, with 0 showing no pain, 5 showing distressing pain, and 10 showing unbearable pain.

The categorical variable’s frequency and percentages were calculated as part of the data analysis, which was done using SPSS version 27. For continuous variables, the means and standard deviations were computed. The Chi-square test was used to identify the variables that are connected to headache and smartphone addiction.

There were 400 adults who took part in the study. Out of which 187 (46.8%) were males and 213 (53.3%) were females. Most participants came from Islamabad, which had 160 participants, then 143 from Taxila, and 97 from Rawalpindi, which had the lowest participation. The participants having an age between 18 -23 years were 262 (65.5%), the 24-29 years category had a frequency of 88(22%), and the 30-35 years category had a frequency of 50 (12.5%). Out of 400 participants 259(64.8%) were students, 126(31.5%) were professionals and 15(3.8%) were others. The descriptive statistics of the study population were age (23.20±4.41), Functional HDI (21.10±11.62), Emotional HDI (19.99±12.47), HDI-Sum (41.09±22.90), and SAS-Sum (33.48±11.35).

The overall pain score showed that females are more significantly positive (p<0.05) than males. The Headache Disability Index and its functional and emotional domains also showed (p<0.05) that females experience more and frequent headache disabilities than males. There was no significant difference (p=0.094) between males and females regarding smartphone addiction.

Table 1: Pain, SAS, HDI, and its domains (Level of significance: p<0.001***, p<0.01**, p<0.05*)

The primary objective of this study was to compare headache and smartphone addiction among male and female young adults. The results of the current study showed that there was a significant difference in pain, total HDI, and its domains, and there was no significant difference in smartphone addiction among male and female young adults.

Only a few studies that properly explain the cause-and-effect relationships have linked mobile phone use to a variety of various sorts of health consequences.[13] Several studies have looked at how exposure to mobile phones may affect a variety of symptoms. Provocation research in controlled contexts has focused on acute effects. The biases inherent in the cross-sectional technique limit the interpretation of some cross-sectional population research that relates mobile phone use to a greater incidence of headaches, sleep problems, concentration problems, or diminished well-being. Not only are adults who get headaches restricted in their everyday activities. Frequent headaches can lower the quality of life and limit social connections, academic achievement, and career options in kids and teenagers. Increasing evidence suggests that underreporting of headaches in kids and teens occurs. As a result, society doesn’t give it enough attention when it comes to prevention and therapy. The global scale of the social and economic consequences associated with children’s and teenagers’ frequent headaches must therefore be properly illustrated.[14,15]

According to the study, higher smartphone usage (51%) was associated with more headache issues than lower smartphone usage (34.4%) (p=0.02). Heavy smartphone users had longer and more frequent headache bouts than light smartphone users or smartphone non-users (p=0.05 for all). Both the frequency and duration of headache attacks were significantly more positively correlated with the Smartphone Addiction Scale scores (r=0.549, p=0.001, p=0.001 and r=0.523, respectively). Moreover, smartphone users had higher headaches than non-users (p=0.001) while using analgesics. The findings of the present analysis reveal that headaches may be associated with using a smartphone. As a result, smartphone users should be considered for headache monitoring.[16,17]

Youths were more likely to become addicted to their smartphones due to their user-friendly and modern applications. Young adults and teenagers both use smartphones for employment. In addition to their professions, students are attached to their smartphones. According to our research, 99 percent of adults are dependent on their smartphones, which lowers their standard of living and gives them headaches. Men have headaches less frequently than women do; therefore, when compared with Men who are addicted to their smartphones, women report experiencing worse headaches. Female students are more likely to be internet addicts than male students, who tend to be more phubbed. Female students exhibited less self-control than their male counterparts, and as a result, they were more dependent on their smartphones.[18]

The results revealed that adolescent females had much higher levels of smartphone reliance and impact than adolescent boys. Teenage guys’ vitality and mental health were found to be positively correlated with how long they used their smartphones on the weekends, but they were negatively correlated with how dependent they became on them.  The results showed that teenage girls’ smartphone use has a significant impact on them. The use of smartphones may have a negative impact on male adolescents’ energy and mental health.[19] According to some research, women are more likely than men to be addicted to their smartphones. Based on their higher self-reporting scores, female participants in a South Korean study appeared to be more cognizant of their addiction. Demirci stated that the average SAS score for female students was substantially higher than the average score for male students.[20]

29.8% of participants reported having a smartphone addiction (30.3% of men and 29.3% of women). According to the study’s findings, there are no appreciable variations between men and women in the prevalence of smartphone addiction (30.3% vs. 29.3%, p>0.05). This is consistent with findings from some earlier studies. The rate of smartphone addiction is higher among female participants in some research than among male participants.[21] The initial research showed that males had the opposite tendency and that females were more prone to smartphone addiction than internet addiction. Although there is still some debate, new research on smartphone addiction, poor self-control, and problematic mobile phone use has led to findings that are consistent with the findings of this study. Contradictory findings about gender differences in internet use, however, have also been observed.[22]

The PSS score in female subjects significantly correlated with the average daily phone call frequency. Increases in headache intensity in both sexes were substantially linked with increases in the length of a single phone call. The length of a mobile phone call was linked to the severity of headaches but not to stress, sleep, cognitive performance, or sadness. According to this study, there is an association between the average length of a phone call and the intensity of headaches in both sexes.[13]

In contrast with other research, our study found that women who use smartphones are far more likely than men to get headaches. Additional research results showed how distress causes headaches to become more intense. In our study, headache severity does not differ significantly between people who have a serious smartphone addiction, yet its levels rise. Headaches brought by addiction also impact children and grown-ups, but also elders and teens. That is due to the unchecked need for phones during downtime. Our lifestyles and well-being are impacted as well. Humans need to identify the underlying causes of problems to successfully stop people from being addicted to their smartphones and live healthy lives. Many participants in our research were heavy phone users who frequently experienced headaches. Our own obligation should be to maintain our health, enhance the quality of life, plus effectively carry out our daily tasks. The upper back, neck, and wrists/hands revealed increased pain prevalence in the past week and year, according to the findings of the current study. The pain in the participants’ upper backs, waists, and hands made it impossible for them to carry out their regular jobs at their homes or places of employment for at least a day.

Smartphone use on a typical day, smartphone ownership for a long time, and the presence of musculoskeletal pain in the neck, wrists/hands, shoulders, and upper back were all linked to smartphone addiction. According to the results of the logistic regression analysis, there was a high incidence of musculoskeletal pain in the neck, shoulders, wrists/and hands. Furthermore, having a smartphone for more than nine years was also strongly linked to a high prevalence of musculoskeletal pain in the neck and wrists/hands. The prevalence of musculoskeletal pain in the upper back, wrists, and neck was substantially correlated with smartphone addiction. It was substantially correlated with smartphone use for more than six hours per day.[2] When people use cellphones compulsively and develop smartphone addictions, they may start experiencing a range of psychological, emotional, and physical health issues at a young age. Teenagers’ family issues and the fact that girls were more likely than boys to become addicted to smartphones were the factors that led to this addiction. Furthermore, adolescent smartphone addiction results in sleep issues, depressed symptoms, and lower academic performance.[23]

According to research on cell phones, 21.65% of those who reported having a headache did so because of their use of a cell phone. Although they both perform the same broad job, the varied capabilities of smartphones and traditional mobile phones may be the cause of these disparate results. Additionally, the study only included information about general headaches. Now that smartphones have advanced in functionality, they can compete with computers. Because of this, smartphone users may also have health issues related to computer use.[24] The effects of a severe headache are typically incapacitating for the sufferers, interfering with daily tasks. Significant physical and psychological impairments of this magnitude can have a negative influence on family, social, professional, and academic lives. In addition, compared to men, women tend to get headaches at a ratio of over 3 to 1.[25]

One tool for determining headache disability is the HDI questionnaire, which was developed by Jacobson et al. in 1994. Regarding headache disability and interference with everyday living over the previous month, the HDI evaluates various dimensions. In both clinical practice and research, it is frequently utilized and advised for impact assessment. There are 25 items in all, separated into functional and emotional scales, on the HDI questionnaire. The person is ranked from not participating to the most severe level of handicap based on their overall score, which ranges from 0-100 points. The emotional domain covers issues such as feeling tense, losing control, not socializing, having issues with your spouse, family, and friends, feeling like you’re going crazy, discrediting your worldview, feeling desperate, stress in your relationships, and feeling angry, confused, and frustrated because of a headache. It also covers issues such as feeling angry, losing control, discrediting your worldview, feeling desperate, and feeling stressed out in your relationships. The functional domain includes inquiries about limitations on everyday activities, disabilities, reading challenges, and being unable to focus on anything other than the headache. The new social participation domain includes inquiries about the impact of headaches, restrictions on leisure activities, anxiety of leaving the house, feelings of injury, avoiding other people, failure to enjoy social events, and refusal to travel due to headaches.[26]

That investigation demonstrates a connection between headaches and phone addictions via Pearson correlation. This fails to address headache treatment, which is just as crucial. There remains a lot to learn about different forms of headaches and additional difficulties involving Neurological illnesses, eyesight, and auditory disorders. Also, it is critical to spread knowledge about the disorders linked to prolonged use of screens. More longitudinal studies on public of all years must be conducted because of its widespread use around world and the fact it also harms elderly people.

This study concluded that females have high disability index and pain, but there was no significant difference in smartphone addiction between females and males.

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Corresponding Author:
Ummar Gill
Physical Therapy (Physiotherapy and Rehabilitation)
Sarhad University of Information & Technology, Peshawar, Pakistan
Email: ummargill52@gmail.com

Co-Authors:
Sabahat Zahid Chaudhary
Department of Physical Therapy
Shifa Tameer-e-Millat University, Islamabad, Pakistan

Laraib Hayat, Malaika Manzoor Awan
Department of Allied Health Sciences
University of Haripur, Khyber Pakhtunkhwa, Pakistan

All authors contributed to the conceptualization, investigation, and data curation by acquiring and critically reviewing the selected articles. They were collectively involved in the writing – original draft preparation, and writing – review & editing to refine the manuscript. Additionally, all authors participated in the supervision of the work, ensuring accuracy and completeness. The final manuscript was approved by all named authors for submission to the journal.

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https://doi.org/10.63096/medtigo30622419

Ummar G, Sabahat Z. C, Laraib H, Malaika M. A. The Comparison Between Smartphone Addiction and Headache Among Males and Females. medtigo J Med. 2024;2(4):e30622419. doi:10.63096/medtigo30622419 Crossref