Efficacy of Psychological Intervention on Internet Addiction, Sleep Quality, and Anxiety among University Students: A Randomized Controlled Trial with 3-Month Follow-up

Abstract

The rapid proliferation of digital technologies into university students' academic and social lives has increased the prevalence of internet addiction, which often co-occurs with poor sleep quality and heightened anxiety. Recognizing these interrelated problems, evidence from randomized controlled trials testing integrated interventions remains sparse. This study investigated the effectiveness of a multi-component digital wellness intervention for reducing internet addiction, improving sleep quality and reducing anxiety symptoms among university students. In a single-blind randomized controlled parallel group design, 130 students aged 18 years to 25 years with moderate to severe internet addiction were assigned to an eight-week online digital wellness intervention. The multi-component intervention combined cognitive-behavioral therapy, mindfulness-based practices, sleep hygiene education, and behavioral habit-change strategies. Primary outcomes were internet addiction severity, sleep quality, and anxiety symptoms, assessed at baseline, post-intervention, and three-month follow-up. Secondary outcomes included academic performance and quality of life. Compared with the controls, the intervention group showed significant and sustained reductions in internet addiction and anxiety, along with significant improvements in sleep quality (all p < .001), corresponding with large to very large effect sizes. Gains were sustained at follow-up. Mediation analysis revealed that improved sleep quality accounted for 38% of the intervention's effect on anxiety reduction. No serious adverse events were reported. These findings add robust evidence for an integrated digital wellness program capable of disrupting the vicious cycle linking excessive internet use, sleep disturbances, and anxiety. Multi-component interventions may be a scalable and potent method to improve digital well-being and psychological health in university settings.