Original article
What's Keeping Teenagers Up? Prebedtime Behaviors and Actigraphy-Assessed Sleep Over School and Vacation

https://doi.org/10.1016/j.jadohealth.2015.12.011Get rights and content

Abstract

Purpose

Technology-related behaviors (e.g., computer use) before bedtime (BT) have been associated with poorer and shorter sleep in adolescents; however, less is known about other behaviors in relation to sleep. This study characterized a range of behaviors in the hour before bed (i.e., pre-BT behaviors [PBBs]) and examined their relationship with sleep parameters during school and vacation periods (i.e., restricted and extended sleep opportunities, respectively). Mechanistic roles of chronotype and cognitive presleep arousal (PSAcog) were also examined.

Methods

During the last week of a school term and throughout a 2-week vacation, 146 adolescents (47.26% male, age M ± standard deviation = 16.2 ± 1.0 years) from the general community completed daily sleep measure using actigraphy, self-report measures on PBBs and PSAcog (Presleep Arousal Scale) for both school and vacation periods, and chronotype (Morningness–Eveningness Questionnaire).

Results

Adolescents engaged in a variety of behaviors before bed. Notably, playing video games was associated with significantly later school and vacation BT and shorter school sleep duration (controlling for chronotype). During vacation, online social media was associated with significantly longer sleep onset latency, and this relationship was mediated by higher PSAcog. In contrast, on school nights, spending time with family was associated with significantly earlier BT and longer sleep duration.

Conclusions

Technology-related PBBs video games and online social media were risk factors for shorter and poorer sleep, whereas time with family was protective of sleep duration. In addressing sleep problems in adolescents, therapeutic procedures that target the potentially addictive nature of technology use and reduce PSAcog were implicated.

Section snippets

Technology-related prebedtime behaviors

Technology-related PBBs are consistently associated with shorter sleep duration and lower sleep quality. More time spent watching television, using the Internet, and computer gaming are associated with later BT and shorter time in bed on weekdays and later RT on weekends [8]. Relevant to sleep are the location and timing of technology use. Compared with adolescents without bedroom access to this technology, those with access in bedrooms use these devices more and have later BT and shorter total

Participants

This study aimed to recruit a community sample of adolescents attending Years 10, 11, and 12 in schools in Melbourne, Australia. As described in the procedures, no exclusion criteria were applied at the time of recruitment.

Actigraphy

Actigraphy is widely used to study sleep/wake patterns in adolescents [23], providing objective estimates of sleep duration and quality close to PSG [24]. This study used comparable models of Actiwatch-2 and Actiwatch-64 (Mini Mitter, Bend, OR) [25]. Data were collected with

Sample characteristics

A total of 146 participants (47.3% male, age M ± SD = 16.2 ± 1.0 years) were recruited (65.1% Caucasian, 26.7% Asian). A small proportion of participants self-reported a depressive, anxiety, or attention deficit hyperactivity disorder (6.16%) or sleep conditions such as insomnia and bruxism (11.64%; see further details in [22]). These participants were not excluded to maintain the representativeness of a community sample. Three females were excluded from analysis, one due to the presence of

Discussion

Adolescents engaged in a variety of technology and nontechnology-related PBBs during school and vacation periods. During School, video games were associated with later BT and shorter TST, whereas time with family was associated with earlier BT and longer TST. During Vacation, video games were associated with later BT, whereas online social media was associated with longer SOL, and this relationship was partially mediated by higher PSAcog.

Acknowledgments

There is no off-label or investigational use in this study.

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    Conflicts of Interest: The authors have indicated no financial conflicts of interest.

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