The Interplay of Sleep Disturbance, Fear of Missing Out and Emotional Reactivity to Social Media Use in Adolescence
-
Sevara Mukhammadieva
,
Kadirova Munira
,
Jumaniyozova Muhayyo
,
Turakulova Iroda
,
Oripova Mokhidil
,
Rasulov Ilkhom
,
Tulenova Gulmira
,
Khatamova Sarvinoz
,
Erkin Ismoilov
Abstract
Objective: This study aims to transcend the limitations of aggregate screen time metrics by investigating the granular affective dynamics and emotional reactivity associated with specific social media behaviors in adolescents, while also incorporating the constructs of sleep quality and fear of missing out (FoMO).
Method: A cohort of 346 adolescents participated in a 21-day ecological momentary assessment (EMA) protocol, receiving five prompts daily. Participants reported real-time social media activities (passive scrolling versus active interaction), concurrent affect, and pre-sleep social media use. Baseline and follow-up depressive symptoms were assessed using the patient health questionnaire-9 (PHQ-9). Additional measures included the FoMO scale and the Pittsburgh sleep quality index (PSQI). We utilized dynamic structural equation modeling (DSEM) to analyze within-person temporal associations and machine learning (random forest) to identify behavioral predictors of depression.
Results: For 328 adolescents who completed the EMA protocol, DSEM revealed that passive scrolling predicted subsequent increases in negative affect (β = 0.31, P < 0.001), whereas active interaction predicted increased positive affect (β = 0.22, P = 0.003). High FoMO significantly moderated the relationship between passive use and negative affect (β = 0.15, P = 0.01). Furthermore, two distinct mediation pathways were identified. First, nighttime social media use mediated the association between daily passive scrolling and poorer next-day sleep quality (indirect effect = -0.10, 95% CI [-0.15, -0.05]). Second, aggregated poor sleep quality over the study period mediated the relationship between average passive scrolling and increased depressive symptoms at follow-up (indirect effect = 0.12, 95% CI [0.05, 0.19]). The machine learning model achieved high predictive accuracy for PHQ-9 scores (R² = 0.76, RMSE = 2.31), identifying high-frequency passive use, elevated FoMO, and delayed sleep onset as primary risk factors.
Conclusion: The findings demonstrate that the emotional impact of social media is contingent upon usage patterns and individual traits like FoMO. Passive consumption was prospectively associated with negative emotional spirals and disrupted sleep, highlighting the need for interventions targeting specific digital behaviors and evening routines rather than total screen time.
1. Nesi J, Telzer EH, Prinstein MJ. Adolescent Development in the Digital Media Context. Psychol Inq. 2020;31(3):229-34.
2. Nesi J, Telzer EH, Prinstein MJ. Adolescent Development in the Digital Media Context. Psychol Inq. 2020;31(3):229-34.
3. Eirich R, McArthur BA, Anhorn C, McGuinness C, Christakis DA, Madigan S. Association of Screen Time With Internalizing and Externalizing Behavior Problems in Children 12 Years or Younger: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2022;79(5):393-405.
4. Tang S, Werner-Seidler A, Torok M, Mackinnon AJ, Christensen H. The relationship between screen time and mental health in young people: A systematic review of longitudinal studies. Clin Psychol Rev. 2021;86:102021.
5. Murray A, Zhu X, Xiao Z, Shanahan L, Eisner M, Sonuga-Barke E, et al. Emotions following social media use and their relations to mental health in young people: An ecological momentary assessment study. Journal of Affective Disorders. 2025:121015.
6. O'Reilly M. Social media and adolescent mental health: the good, the bad and the ugly. J Ment Health. 2020;29(2):200-6.
7. Frielingsdorf H, Fomichov V, Rystedt I, Lindstrand S, Korhonen L, Henriksson H. Associations of time spent on different types of digital media with self-rated general and mental health in Swedish adolescents. Sci Rep. 2025;15(1):993.
8. Liu M, Kamper-DeMarco KE, Zhang J, Xiao J, Dong D, Xue P. Time Spent on Social Media and Risk of Depression in Adolescents: A Dose-Response Meta-Analysis. Int J Environ Res Public Health. 2022;19(9).
9. Towner E, Chierchia G, Blakemore SJ. Sensitivity and specificity in affective and social learning in adolescence. Trends Cogn Sci. 2023;27(7):642-55.
10. Wrzus C, Neubauer AB. Ecological Momentary Assessment: A Meta-Analysis on Designs, Samples, and Compliance Across Research Fields. Assessment. 2023;30(3):825-46.
11. Politte-Corn M, Dickey L, Abitante G, Pegg S, Bean CAL, Kujawa A. Social Media Use as a Predictor of Positive and Negative Affect: An Ecological Momentary Assessment Study of Adolescents with and without Clinical Depression. Res Child Adolesc Psychopathol. 2024;52(5):743-55.
12. Blahošová J, Tancoš M, Cho YW, Šmahel D, Elavsky S, Chow S-M, et al. Examining the reciprocal relationship between social media use and perceived social support among adolescents: a smartphone ecological momentary assessment study. Media Psychology. 2025;28(1):70-101.
13. Hall JA, Liu D. Social media use, social displacement, and well-being. Curr Opin Psychol. 2022;46:101339.
14. Meier A, Johnson BK. Social comparison and envy on social media: A critical review. Curr Opin Psychol. 2022;45:101302.
15. Brailovskaia J, Margraf J. From fear of missing out (FoMO) to addictive social media use: The role of social media flow and mindfulness. Comput Human Behav. 2024;150:107984.
16. Hattingh M, Dhir A, Ractham P, Ferraris A, Yahiaoui D. Factors mediating social media-induced fear of missing out (FoMO) and social media fatigue: A comparative study among Instagram and Snapchat users. Technological Forecasting and Social Change. 2022;185:122099.
17. Einstein DA, Dabb C, Fraser M. FoMO, but not self-compassion, moderates the link between social media use and anxiety in adolescence. Aust J Psychol. 2023;75(1):2217961.
18. Lee Y, Blebea J, Janssen F, Domoff SE. The Impact of Smartphone and Social Media Use on Adolescent Sleep Quality and Mental Health during the COVID‐19 Pandemic. Human Behavior and Emerging Technologies. 2023;2023(1):3277040.
19. Yu DJ, Wing YK, Li TMH, Chan NY. The Impact of Social Media Use on Sleep and Mental Health in Youth: a Scoping Review. Curr Psychiatry Rep. 2024;26(3):104-19.
20. Meyerson WU, Fineberg SK, Andrade FC, Corlett P, Gerstein MB, Hoyle RH. The association between evening social media use and delayed sleep may be causal: Suggestive evidence from 120 million Reddit timestamps. Sleep Med. 2023;107:212-8.
21. Silvani MI, Werder R, Perret C. The influence of blue light on sleep, performance and wellbeing in young adults: A systematic review. Front Physiol. 2022;13:943108.
22. Joo HJ, Kwon KA, Shin J, Park S, Jang SI. Association between sleep quality and depressive symptoms. J Affect Disord. 2022;310:258-65.
23. Rahnenführer J, De Bin R, Benner A, Ambrogi F, Lusa L, Boulesteix AL, et al. Statistical analysis of high-dimensional biomedical data: a gentle introduction to analytical goals, common approaches and challenges. BMC Med. 2023;21(1):182.
24. Kroemeke A, Dudek J, Sobczyk-Kruszelnicka M. The role of psychological flexibility in the meaning-reconstruction process in cancer: The intensive longitudinal study protocol. PLoS One. 2022;17(10):e0276049.
25. Hamilton JL, Chand S, Reinhardt L, Ladouceur CD, Silk JS, Moreno M, et al. Social media use predicts later sleep timing and greater sleep variability: An ecological momentary assessment study of youth at high and low familial risk for depression. J Adolesc. 2020;83:122-30.
26. Riley RD, Whittle R, Sadatsafavi M, Martin GP, Pate A, Collins GS, et al. A general sample size framework for developing or updating a predictive algorithm: with application to clinical prediction models. BMC Med Res Methodol. 2026;26(1).
27. Saidane M, Guelmami N, Dhahbi W, Ayachi F, Ceylan H, Barakat L, et al. Psychological distress, digital behavioral risks, and physical activity as predictors of subjective wellbeing: a machine learning study in a large sample of community-dwelling adults. Front Behav Neurosci. 2026;20:1876257.
28. Zoxirjonovna OR. Cognitive And Psychoemotional Disorders In Hypothyroidism And The Possibilities Of Cognitive-Behavioral Therapy Ollaberganova Rohila Zoxirjonovna, Ollaberganova Muxlisa Fazliddinovna, Ibodullayev Zarifboy Radjabovich Urgench State Medical Institute, Urgench, Uzbekistan. Journal of Science and Innovation. 2026;1(1).
29. Nuradinov A, Mambetalina A, Tussupbekova B, Assylbekova L, Gitikhmayeva L. Fear of missing out as an additive predictor of nomophobia beyond Big Five personality traits. Acta Psychol (Amst). 2026;268:107303.
30. Bekzod K, Dilnoza O, Matlyuba S, Dilorom X, Nigina T, Diloram A, et al. The association between sleep quality metrics and resistant hypertension progression. Revista Latinoamericana de Hipertension. 2026;21(4):237-43.
31. Ahmed W. Psychometric properties of positive and negative schedule scale for children-short form in diverse American adolescents. Journal of Psychoeducational Assessment. 2024;42(1):3-13.
32. Cranford JA, Shrout PE, Iida M, Rafaeli E, Yip T, Bolger N. A procedure for evaluating sensitivity to within-person change: can mood measures in diary studies detect change reliably? Pers Soc Psychol Bull. 2006;32(7):917-29.
33. Khaleghi A, Mohammadi MR, Moeini M, Zarafshan H, Fadaei Fooladi M. Abnormalities of Alpha Activity in Frontocentral Region of the Brain as a Biomarker to Diagnose Adolescents With Bipolar Disorder. Clin EEG Neurosci. 2019;50(5):311-8.
34. Pirzad Jahromi G, Gharaati Sotoudeh H, Mostafaie R, Khaleghi A. Auditory Steady-State Evoked Potentials in Post Traumatic Stress Disorder: Introduction of a Potential Biomarker. Iran J Psychiatry. 2024;19(2):238-46.
35. Khaleghi A, Birgani PM, Fooladi MF, Mohammadi MR. Applicable features of electroencephalogram for ADHD diagnosis. Research on Biomedical Engineering. 2020;36(1):1-11.
36. Gerber JP, Wheeler L, Suls J. A social comparison theory meta-analysis 60+ years on. Psychol Bull. 2018;144(2):177-97.
37. Thorisdottir IE, Sigurvinsdottir R, Asgeirsdottir BB, Allegrante JP, Sigfusdottir ID. Active and Passive Social Media Use and Symptoms of Anxiety and Depressed Mood Among Icelandic Adolescents. Cyberpsychol Behav Soc Netw. 2019;22(8):535-42.
38. Godard R, Holtzman S. Are active and passive social media use related to mental health, wellbeing, and social support outcomes? A meta-analysis of 141 studies. J Comput Mediat Commun. 2024;29(1):zmad055.
39. Mao J, Zhang B. Differential Effects of Active Social Media Use on General Trait and Online-Specific State-FoMO: Moderating Effects of Passive Social Media Use. Psychol Res Behav Manag. 2023;16:1391-402.
40. Brown L, Kuss DJ. Fear of Missing Out, Mental Wellbeing, and Social Connectedness: A Seven-Day Social Media Abstinence Trial. Int J Environ Res Public Health. 2020;17(12).
41. Vernon L, Barber BL, Modecki KL. Adolescent Problematic Social Networking and School Experiences: The Mediating Effects of Sleep Disruptions and Sleep Quality. Cyberpsychol Behav Soc Netw. 2015;18(7):386-92.
42. Marino C, Musetti A, Vieno A, Manari T, Franceschini C. Is psychological distress the key factor in the association between problematic social networking sites and poor sleep quality? Addict Behav. 2022;133:107380.
43. Chen Y, Li S, Tian Y, Li D, Yin H. Problematic social media use may be ruining our sleep: A meta-analysis on the relationship between problematic social media use and sleep quality. Int J Ment Health Addict. 2026;24(1):262-97.
44. Chkhaidze A, Millar BM, Revenson TA, Mindlis I. Scrolling Your Sleep Away: The Effects of Bedtime Device Use on Sleep Among Young Adults with Poor Sleep. Int J Behav Med. 2025;32(4):634-9.
45. Nesi J, Telzer EH, Prinstein MJ. Adolescent development in the digital media context. Psychological Inquiry. 2020;31(3):229-34.
2. Nesi J, Telzer EH, Prinstein MJ. Adolescent Development in the Digital Media Context. Psychol Inq. 2020;31(3):229-34.
3. Eirich R, McArthur BA, Anhorn C, McGuinness C, Christakis DA, Madigan S. Association of Screen Time With Internalizing and Externalizing Behavior Problems in Children 12 Years or Younger: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2022;79(5):393-405.
4. Tang S, Werner-Seidler A, Torok M, Mackinnon AJ, Christensen H. The relationship between screen time and mental health in young people: A systematic review of longitudinal studies. Clin Psychol Rev. 2021;86:102021.
5. Murray A, Zhu X, Xiao Z, Shanahan L, Eisner M, Sonuga-Barke E, et al. Emotions following social media use and their relations to mental health in young people: An ecological momentary assessment study. Journal of Affective Disorders. 2025:121015.
6. O'Reilly M. Social media and adolescent mental health: the good, the bad and the ugly. J Ment Health. 2020;29(2):200-6.
7. Frielingsdorf H, Fomichov V, Rystedt I, Lindstrand S, Korhonen L, Henriksson H. Associations of time spent on different types of digital media with self-rated general and mental health in Swedish adolescents. Sci Rep. 2025;15(1):993.
8. Liu M, Kamper-DeMarco KE, Zhang J, Xiao J, Dong D, Xue P. Time Spent on Social Media and Risk of Depression in Adolescents: A Dose-Response Meta-Analysis. Int J Environ Res Public Health. 2022;19(9).
9. Towner E, Chierchia G, Blakemore SJ. Sensitivity and specificity in affective and social learning in adolescence. Trends Cogn Sci. 2023;27(7):642-55.
10. Wrzus C, Neubauer AB. Ecological Momentary Assessment: A Meta-Analysis on Designs, Samples, and Compliance Across Research Fields. Assessment. 2023;30(3):825-46.
11. Politte-Corn M, Dickey L, Abitante G, Pegg S, Bean CAL, Kujawa A. Social Media Use as a Predictor of Positive and Negative Affect: An Ecological Momentary Assessment Study of Adolescents with and without Clinical Depression. Res Child Adolesc Psychopathol. 2024;52(5):743-55.
12. Blahošová J, Tancoš M, Cho YW, Šmahel D, Elavsky S, Chow S-M, et al. Examining the reciprocal relationship between social media use and perceived social support among adolescents: a smartphone ecological momentary assessment study. Media Psychology. 2025;28(1):70-101.
13. Hall JA, Liu D. Social media use, social displacement, and well-being. Curr Opin Psychol. 2022;46:101339.
14. Meier A, Johnson BK. Social comparison and envy on social media: A critical review. Curr Opin Psychol. 2022;45:101302.
15. Brailovskaia J, Margraf J. From fear of missing out (FoMO) to addictive social media use: The role of social media flow and mindfulness. Comput Human Behav. 2024;150:107984.
16. Hattingh M, Dhir A, Ractham P, Ferraris A, Yahiaoui D. Factors mediating social media-induced fear of missing out (FoMO) and social media fatigue: A comparative study among Instagram and Snapchat users. Technological Forecasting and Social Change. 2022;185:122099.
17. Einstein DA, Dabb C, Fraser M. FoMO, but not self-compassion, moderates the link between social media use and anxiety in adolescence. Aust J Psychol. 2023;75(1):2217961.
18. Lee Y, Blebea J, Janssen F, Domoff SE. The Impact of Smartphone and Social Media Use on Adolescent Sleep Quality and Mental Health during the COVID‐19 Pandemic. Human Behavior and Emerging Technologies. 2023;2023(1):3277040.
19. Yu DJ, Wing YK, Li TMH, Chan NY. The Impact of Social Media Use on Sleep and Mental Health in Youth: a Scoping Review. Curr Psychiatry Rep. 2024;26(3):104-19.
20. Meyerson WU, Fineberg SK, Andrade FC, Corlett P, Gerstein MB, Hoyle RH. The association between evening social media use and delayed sleep may be causal: Suggestive evidence from 120 million Reddit timestamps. Sleep Med. 2023;107:212-8.
21. Silvani MI, Werder R, Perret C. The influence of blue light on sleep, performance and wellbeing in young adults: A systematic review. Front Physiol. 2022;13:943108.
22. Joo HJ, Kwon KA, Shin J, Park S, Jang SI. Association between sleep quality and depressive symptoms. J Affect Disord. 2022;310:258-65.
23. Rahnenführer J, De Bin R, Benner A, Ambrogi F, Lusa L, Boulesteix AL, et al. Statistical analysis of high-dimensional biomedical data: a gentle introduction to analytical goals, common approaches and challenges. BMC Med. 2023;21(1):182.
24. Kroemeke A, Dudek J, Sobczyk-Kruszelnicka M. The role of psychological flexibility in the meaning-reconstruction process in cancer: The intensive longitudinal study protocol. PLoS One. 2022;17(10):e0276049.
25. Hamilton JL, Chand S, Reinhardt L, Ladouceur CD, Silk JS, Moreno M, et al. Social media use predicts later sleep timing and greater sleep variability: An ecological momentary assessment study of youth at high and low familial risk for depression. J Adolesc. 2020;83:122-30.
26. Riley RD, Whittle R, Sadatsafavi M, Martin GP, Pate A, Collins GS, et al. A general sample size framework for developing or updating a predictive algorithm: with application to clinical prediction models. BMC Med Res Methodol. 2026;26(1).
27. Saidane M, Guelmami N, Dhahbi W, Ayachi F, Ceylan H, Barakat L, et al. Psychological distress, digital behavioral risks, and physical activity as predictors of subjective wellbeing: a machine learning study in a large sample of community-dwelling adults. Front Behav Neurosci. 2026;20:1876257.
28. Zoxirjonovna OR. Cognitive And Psychoemotional Disorders In Hypothyroidism And The Possibilities Of Cognitive-Behavioral Therapy Ollaberganova Rohila Zoxirjonovna, Ollaberganova Muxlisa Fazliddinovna, Ibodullayev Zarifboy Radjabovich Urgench State Medical Institute, Urgench, Uzbekistan. Journal of Science and Innovation. 2026;1(1).
29. Nuradinov A, Mambetalina A, Tussupbekova B, Assylbekova L, Gitikhmayeva L. Fear of missing out as an additive predictor of nomophobia beyond Big Five personality traits. Acta Psychol (Amst). 2026;268:107303.
30. Bekzod K, Dilnoza O, Matlyuba S, Dilorom X, Nigina T, Diloram A, et al. The association between sleep quality metrics and resistant hypertension progression. Revista Latinoamericana de Hipertension. 2026;21(4):237-43.
31. Ahmed W. Psychometric properties of positive and negative schedule scale for children-short form in diverse American adolescents. Journal of Psychoeducational Assessment. 2024;42(1):3-13.
32. Cranford JA, Shrout PE, Iida M, Rafaeli E, Yip T, Bolger N. A procedure for evaluating sensitivity to within-person change: can mood measures in diary studies detect change reliably? Pers Soc Psychol Bull. 2006;32(7):917-29.
33. Khaleghi A, Mohammadi MR, Moeini M, Zarafshan H, Fadaei Fooladi M. Abnormalities of Alpha Activity in Frontocentral Region of the Brain as a Biomarker to Diagnose Adolescents With Bipolar Disorder. Clin EEG Neurosci. 2019;50(5):311-8.
34. Pirzad Jahromi G, Gharaati Sotoudeh H, Mostafaie R, Khaleghi A. Auditory Steady-State Evoked Potentials in Post Traumatic Stress Disorder: Introduction of a Potential Biomarker. Iran J Psychiatry. 2024;19(2):238-46.
35. Khaleghi A, Birgani PM, Fooladi MF, Mohammadi MR. Applicable features of electroencephalogram for ADHD diagnosis. Research on Biomedical Engineering. 2020;36(1):1-11.
36. Gerber JP, Wheeler L, Suls J. A social comparison theory meta-analysis 60+ years on. Psychol Bull. 2018;144(2):177-97.
37. Thorisdottir IE, Sigurvinsdottir R, Asgeirsdottir BB, Allegrante JP, Sigfusdottir ID. Active and Passive Social Media Use and Symptoms of Anxiety and Depressed Mood Among Icelandic Adolescents. Cyberpsychol Behav Soc Netw. 2019;22(8):535-42.
38. Godard R, Holtzman S. Are active and passive social media use related to mental health, wellbeing, and social support outcomes? A meta-analysis of 141 studies. J Comput Mediat Commun. 2024;29(1):zmad055.
39. Mao J, Zhang B. Differential Effects of Active Social Media Use on General Trait and Online-Specific State-FoMO: Moderating Effects of Passive Social Media Use. Psychol Res Behav Manag. 2023;16:1391-402.
40. Brown L, Kuss DJ. Fear of Missing Out, Mental Wellbeing, and Social Connectedness: A Seven-Day Social Media Abstinence Trial. Int J Environ Res Public Health. 2020;17(12).
41. Vernon L, Barber BL, Modecki KL. Adolescent Problematic Social Networking and School Experiences: The Mediating Effects of Sleep Disruptions and Sleep Quality. Cyberpsychol Behav Soc Netw. 2015;18(7):386-92.
42. Marino C, Musetti A, Vieno A, Manari T, Franceschini C. Is psychological distress the key factor in the association between problematic social networking sites and poor sleep quality? Addict Behav. 2022;133:107380.
43. Chen Y, Li S, Tian Y, Li D, Yin H. Problematic social media use may be ruining our sleep: A meta-analysis on the relationship between problematic social media use and sleep quality. Int J Ment Health Addict. 2026;24(1):262-97.
44. Chkhaidze A, Millar BM, Revenson TA, Mindlis I. Scrolling Your Sleep Away: The Effects of Bedtime Device Use on Sleep Among Young Adults with Poor Sleep. Int J Behav Med. 2025;32(4):634-9.
45. Nesi J, Telzer EH, Prinstein MJ. Adolescent development in the digital media context. Psychological Inquiry. 2020;31(3):229-34.
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How to Cite
1.
Mukhammadieva S, Munira K, Muhayyo J, Iroda T, Mokhidil O, Ilkhom R, Gulmira T, Sarvinoz K, Ismoilov E. The Interplay of Sleep Disturbance, Fear of Missing Out and Emotional Reactivity to Social Media Use in Adolescence. Iran J Psychiatry. 2026;:1-12.
