Screen viewing behavior and sleep duration among children aged 2 and below

Few studies have investigated the association between screen viewing (SV) and sleep duration among young children. This study aims to examine the association between total and device-specific SV and sleep duration among children aged 2 and below.

We conducted a cross-sectional study of 714 Singaporean children aged 2 years and below. Parents were recruited during routine well-child clinic visits from two national polyclinics. In Singapore, all parents visit well-child clinics with their children at regular intervals for routine check-ups and vaccinations. Socio-demographic characteristics, duration of total and device-specific SV, and sleep duration were reported by parents via interviewer-administered questionnaires. Multiple linear regression analysis was used to assess associations between various types of SV and sleep duration, adjusted for socio-demographic variables. Due to significant interaction between SV and age, stratified analyses for children aged less than 6 months and those aged 7-24 months were performed.

The prevalence of daily SV among children was 53.1%; 28.3% in children up to 6 months and 73.8% in children aged 7 to 24 months. TV viewing was reported for 44.3% of all children and mobile device SV for 30.1%. Children's average sleep duration was 13.9 (SD = 3.5) hours daily and younger children had longer sleep duration than older ones (up to 6 months: mean = 15.6 h, SD = 3.9; 7-24 months: mean = 12.4 h, SD = 2.2; P < 0.01). In the regression analysis among all children, each 1 h per day increment in total SV was significantly associated with 0.26 h shorter sleep duration with similar significant associations for TV (β = - 0.28 h, 95%CI: -0.50, - 0.06) and mobile devices (β = - 0.35 h, 95%CI: -0.61, - 0.09). Stratified analysis revealed significantly greater reductions in sleep with higher SV among children aged 6 months and below (β = - 0.73 h, 95%CI: -1.12, - 0.34), while associations were weaker in older children (β = - 0.13 h, 95% CI: -0.24, - 0.01).

This study provides evidence for a substantial association between longer SV and shorter sleep duration among very young children. These associations appeared stronger among children aged 6 months and below as compared with those aged 7 to 24 months. Further studies are warranted to confirm our findings.