Small screen exposure associated with decreased sleep duration, quality

1. Fourth and 7^th graders sleeping near small screens or in rooms with TVs reported fewer minutes of sleep on school nights. Students sleeping with small screens nearby were more likely to report insufficient sleep.

2. More time in front of a screen was associated with decreased sleep duration. Sleep duration varied by race and ethnicity with shorter durations reported among non-Hispanic black and Hispanic participants compared to non-Hispanic white participants.

Evidence Rating Level: 2 (Good)

Study Rundown: Poor sleep quality in childhood is not only associated with decreased psychosocial health and school performance but also with health problems into adulthood including obesity, coronary heart disease, and stroke. Television (TV) use before bed is a known deterrent to proper sleep duration and quality.  Through this cross-sectional study, researchers aimed to explore how the use of small screen electronics such as smart phones and mp3 players influenced children’s sleep patterns. Children sleeping in rooms with TVs or small electronics experienced decreased sleep duration compared to children without those items in their bedrooms. In addition, children sleeping next to small screened electronics self-reported insufficient sleep compared with those that did not sleep with small screened electronics nearby. Finally, later bedtimes and thus decreased sleep duration, were more pronounced among non-Hispanic black students and Hispanic students, compared with non-Hispanic white students. These results support an adjustment to sleep hygiene recommendations that includes limiting access to small screen devices and additional attention to specific groups. This study not only supports previous research on the negative impact of TV on children’s sleep but also establishes the negative impact of small screen items such as cell phones on sleep. Although this study’s original contribution is strengthened by its large, diverse sample, the causal implications are limited due to its cross-sectional design and the use of self-report to assess sleep duration and quality.

Click to read the study published today in Pediatrics

Relevant Reading: Short sleep duration and body mass index: a prospective longitudinal study in preadolescence

In-Depth [cross-sectional study]: This study included 2048 (mean age 10.6 years + 1.5 years, 51.4% female, 40% Hispanic, 38% non-Hispanic white, 10% non-Hispanic black) 4^th and 7^th graders from 29 Massachusetts public schools participating in the Massachusetts Childhood Obesity Research Demonstration Study.  Self-reported sleep durations, bed times, wake times, and perceived sufficiency of rest were used as primary outcomes. Subjects were also asked to identify the presence of TVs and small screened electronics in their bedrooms to serve as the primary exposure. Children sleeping near a small screen slept 20.6 fewer minutes per week night (95% CI -29.7 to -11.4) than students who did not sleep near small screen electronics. Those sleeping in a room with a TV reported 18.0 fewer minutes of sleep (95% CI -27.9 to -8.1) compared to those without a TV in their room. The presence of a small screen in the sleep environment was associated with perceived insufficient sleep (PR 1.38, 95% CI 1.19 to 1.61, P < .001). Regardless of racial distinction, similar findings occurred across all groups, with certain racial groups more affected than others. For example, non-Hispanic black students sleeping near small screens had an additional 30.8 fewer minutes of sleep (95% CI, -52.8 to -8.9) compared with non-Hispanic white students.

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Image: PD

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