Elsevier

Sleep Medicine

Volume 56, April 2019, Pages 211-218
Sleep Medicine

Original article
Associations between screen time and sleep duration are primarily driven by portable electronic devices: evidence from a population-based study of U.S. children ages 0–17

https://doi.org/10.1016/j.sleep.2018.11.009Get rights and content

Highlights

  • Children and adolescents who spent more time on screens slept fewer hours.

  • Short sleep was more strongly associated with portable electronic devices vs. stationary devices.

  • This was especially true among adolescents.

  • Associations held when controlled for demographics as well as BMI, mood disorders, and physical activity.

Abstract

Study objectives

Excessive screen time in child and adolescent populations is associated with short sleep duration, but the unique effects of portable vs. non-portable electronic devices has received little attention. Moreover, it is unknown whether the effects of these devices change across childhood. To address these gaps, the current study compared the association of portable vs. non-portable electronic devices with sleep duration throughout childhood.

Methods

Data were from a 2016 national survey of the caregivers of 43,755 children and adolescents ages 0–17 administered by the U.S. Census Bureau.

Results

Children and adolescents who spent more time on screens slept fewer hours and were more likely to get insufficient sleep. In multivariate regressions including time spent on TV and video game consoles and portable electronic devices, associations with sleep duration were primarily due to portable electronic devices. These results remained when demographic variables, diagnoses of anxiety or depression, physical activity, and BMI were included in the model. Moreover, time spent using both portable and non-portable devices was important for sleep duration in children under age 10, but the importance of non-portable devices diminished in children over 10.

Conclusions

Spending multiple hours a day on electronic devices is associated with shorter sleep duration across all ages. However, portable electronic devices have a stronger association with sleep duration than non-portable electronic screens, with non-portable devices less relevant for sleep duration in children over age 10. The findings suggest that future interventions should uniquely target portable electronic devices while also accounting for the age group of children targeted.

Section snippets

Do portable electronic devices have a greater impact on sleep?

There are three key reasons why portable devices specifically could have a stronger effect on sleep duration than non-portable devices. First, portable electronic devices can more directly displace and delay sleep because a child can bring these devices into the bedroom and the bed itself, use them right before bedtime, and when the child is supposed to be sleeping. The ease with which children can use these devices at bedtime is particularly problematic because evening screen time can exert a

Electronic device use across childhood

It should come as little surprise that the landscape of electronic device use changes across the spectrum of childhood. As children grow older they become more likely to have electronic devices (and more of them) in the bedroom, use cell phones, watch TV in bed, and spend less time playing video games [5], [21], [22]. The changes in what devices older children use may also co-occur with changes in what these devices are used for. For instance, the proportion of children electronically

Study purpose

Overall, evidence suggests that portable electronic devices may be a specific risk factor for insufficient sleep duration, and that this effect may change with age. For instance, the association of portable electronic devices with sleep duration may be more pronounced as children grow older and more universally adopt them. To examine these possibilities, this study analyzed survey data collected in 2016 on a national sample of 43,755 children in the United States ages 0–17. In this survey,

Participants

Participants were the caregivers of 49,700 children 0–17 years of age in the U.S. in the National Survey of Children's Health (NSCH) conducted in 2016 by the U.S. Census Bureau.

Households were contacted by mail at random to identify those with children 17 years old or younger. In every household, one child was randomly selected to be the subject of the survey. The questions were administered via online and paper surveys. The response rate was 40.7%. Data are publicly available on the National

Results

Across all age groups, children and adolescents who spent more time on portable electronic devices slept for fewer hours. Children and adolescents who spent more time on TV and video game consoles also slept for fewer hours, except among older adolescents. The associations remained after demographic controls were applied (see Table 1).

Mean hours of screen time within the different age groups are presented in Table 2 along with correlations between the electronic device types. Use of TV/video

Discussion

Children and adolescents who spent more time on screens slept fewer hours and were more likely to get insufficient sleep, as found in previous research. However, these associations were primarily due to time spent on portable electronic devices such as phones, tablets, and handheld video games, rather than stationary devices such as TVs or video game consoles. Previous research has established that one reason electronic devices disturb sleep is by emitting blue light which then inhibits the

Conclusion

Across all ages, spending multiple hours a day on a variety of electronic devices is associated with reduced sleep duration. However, prior research has not compared the effect of portable vs. non-portable electronic devices, nor examined this effect across the full spectrum of childhood. Current findings indicate that portable electronic devices had a stronger independent connection with sleep duration than did non-portable electronic screens. Moreover, this effect was consistent across all

Conflict of interest

None declared.

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