Associations between adolescent sleep difficulties and active versus passive screen time across 38 countries

Area of Science:

• Adolescent Health
• Sleep Science
• Digital Media Studies

Background:

• Elevated screen use is associated with negative mental well-being.
• Limited understanding exists regarding active versus passive screen time's impact on adolescent sleep-onset difficulties.

Purpose of the Study:

• To investigate the association between different types of recreational screen time and sleep-onset difficulties in adolescents.
• To differentiate the impact of active (gaming, computer use) versus passive (television) screen time on sleep initiation.

Main Methods:

• Analysis of data from the 2014 Health Behaviour in School-aged Children (HBSC) survey across 38 European and North American countries.
• Self-reported sleep-onset difficulties (dichotomized from a 5-point Likert scale) and daily recreational screen time (hours/day) for television, electronic gaming, and computer use.
• Cross-sectional study including 195,668 adolescents (mean age 13.59 years, 51% girls).

Main Results:

• Approximately 25% of girls and 18% of boys reported sleep-onset difficulties.
• High electronic gaming (>4 h/day) increased odds of sleep difficulties by 30% in boys and 38% in girls.
• High computer use (>4 h/day) increased odds by 41% in boys and 61% in girls; high TV time (>4 h/day) increased odds by 15% in boys and 19% in girls.

Conclusions:

• Increased recreational screen time, particularly active forms like gaming and computer use, is associated with higher odds of sleep-onset difficulties in adolescents.
• Adverse effects on sleep appear more pronounced with active screen time compared to passive screen time.
• Further prospective research employing objective measures is necessary to establish causality.