The Mediating Role of Visual Stimuli From Media Use at Bedtime on Psychological Distress and Fatigue in College Students: Cross-Sectional Study

BACKGROUND: Empirical research has linked psychological distress with fatigue. However, few studies have analyzed the factors (eg, stimuli from bedtime media use) that affect the relationship between psychological distress and fatigue. OBJECTIVE: The aim of this study was to examine whether visual stimuli from bedtime media use mediate the relationship between psychological distress and fatigue among college students. METHODS: The sample included 394 participants (92 males, 302 females) with a mean age of 19.98 years (SD 1.43 years), all of whom were Chinese college students at an occupational university in Sichuan Province, China. Data were collected using a paper-based questionnaire that addressed psychological distress, stimuli from bedtime media use, and fatigue. Mediation analysis was conducted using the PROCESS macro version 2.16.2 for SPSS 22, which provided the 95% CIs. RESULTS: Both psychological distress (r=.43, P<.001) and visual stimuli from bedtime media use (r=.16, P<.001) were positively related to fatigue. The association between auditory stimuli from bedtime media use and fatigue was not significant (r=.09, P=.08). The relationship between psychological distress and fatigue was partially mediated by visual stimuli from bedtime media use (beta=.01, SE 0.01, 95% CI 0.0023-0.0253). CONCLUSIONS: The findings imply that psychological distress has an indirect effect on fatigue via visual stimuli from bedtime media use. In contrast, auditory stimuli from bedtime media use did not have the same effect. We suggest that college students should reduce bedtime media use, and this could be achieved as part of an overall strategy to improve health. Mobile health apps could be an option to improving young students’ health in daily life.