There are studies reporting the negative impact of smartphone utilization on sleep. It is considered that reduction of melatonin secretion under the blue light exposure from smartphone displays is one of the causes. The viewing distance may cause sleep disturbance, because the viewing distance determines the screen illuminance and/or asthenopia. However, to date, there has been no study closely investigating the impact of viewing distance on sleep; therefore, we sought to determine the relationship between smartphone viewing distance and subjective sleep status. Twenty-three nursing students (mean age ± standard deviation of 19.7±3.1 years) participated in the study. Subjective sleep status was assessed using the Pittsburgh Sleep Quality Index, morningness-eveningness questionnaire, and the Epworth sleepiness scale. We used the distance between the head and the hand while holding a smartphone to measure the viewing distance while using smartphones in sitting and lying positions. The distance was calculated using the three-dimensional coordinates obtained by a noncontact motion-sensing device. The viewing distance of smartphones in the sitting position ranged from 13.3 to 32.9 cm among participants. In the lying position, it ranged from 9.9 to 21.3cm. The viewing distance was longer in the sitting position than in the lying position (mean ± standard deviation: 20.3±4.7 vs 16.4±2.7, respectively, P<0.01). We found that the short viewing distance in the lying position had a positive correlation to a poorer sleep state (R2=0.27, P<0.05), lower sleep efficiency (R2=0.35, P<0.05), and longer sleep latency (R2=0.38, P<0.05). Moreover, smartphone viewing distances in lying position correlated negatively with subjective sleep status. Therefore, when recommending ideal smartphone use in lying position, one should take into account the viewing distances.
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