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Screen time and sleep duration in pediatric critical care: Secondary analysis of a pilot observational study
Laura Beth Kalvas1, Tondi M Harrison2
1The Ohio State University Center for Clinical & Translational Science, 236A Newton Hall, 333 W. 10(th) Ave., Columbus, OH 43210, USA.
Insights
Critically ill children in the pediatric intensive care unit (PICU) experienced excessive screen time, negatively impacting their sleep duration and quality both before and during hospitalization. Further research is needed to understand this association.
Area of Science:
- Pediatric critical care medicine
- Sleep science
- Media studies
Background:
- Screen time is a growing concern in pediatric health.
- Understanding screen time's impact on critically ill children is crucial for optimizing care.
- Current recommendations for screen time may not be suitable for hospitalized children.
Purpose of the Study:
- To quantify screen time in critically ill children within a pediatric intensive care unit (PICU).
- To describe screen type, child engagement, and adult co-viewing during screen time.
- To determine the association between screen time and sleep duration before and during PICU admission.
Main Methods:
- Exploratory secondary analysis of video and actigraphy recordings in eight critically ill children (1-4 years old).
- Screen time coded using Noldus Observer XT® software and compared to AAP recommendations.
- Pre-hospital sleep assessed via the Brief Infant Sleep Questionnaire-Revised-Short Form (BISQ-R-SF); PICU sleep measured by actigraphy.
Main Results:
- Average daily screen time was 10.7 hours, significantly exceeding recommendations.
- Children and adults showed low active engagement with screen media.
- Increased screen time was associated with worse pre-hospital sleep quality/duration and reduced PICU sleep duration.
Conclusions:
- All children studied exceeded recommended screen time limits.
- Screen time demonstrated a significant negative association with sleep quality and duration.
- Further large-scale studies are warranted to investigate screen time and sleep disruption in the PICU.
Purpose:
Quantify and describe screen time (screen type, child engagement, adult co-viewing) in eight critically ill children and determine its association with sleep duration before (parent report) and during (actigraphy) a 24-h period in the PICU.
Design And Methods:
Exploratory secondary analysis of 24-h video and actigraphy recordings in eight children 1-4 years old in the PICU. Videos were coded for screen time using Noldus Observer XT® software. Screen time was compared to American Academy of Pediatrics recommendations (0 h/day <2 years, ≤1 h/day 2-5 years). Parents completed the Brief Infant Sleep Questionnaire-Revised-Short Form (BISQ-R-SF) to understand children's pre-hospital sleep. Actigraphy was used to measure PICU sleep duration. Associations between screen time and sleep were determined with bivariate analyses.
Results:
Average age was 23.1 months (SD = 9.7). Daily screen time was 10.7 h (SD = 7), ranging from 2.4 to 21.4 h. Children (15.1% of sampling intervals) and adults (16.3%) spent little time actively engaged with screen media. BISQ-R-SF scores ranged from 48.9 to 97.7. Children had an average of 7.9 (SD = 1.2) night shift (19:00-6:59) sleep hours. Screen time was associated with worse pre-hospital sleep quality and duration with large effect sizes (rs= -0.7 to -1) and fewer nighttime sleep hours with a medium effect size (rs= -0.5).
Conclusions:
All children exceeded screen time recommendations. Screen time was associated with worse pre-hospital sleep quality and duration, and decreased PICU sleep duration. Large-scale studies are needed to explore PICU screen time and sleep disruption.
Practice Implications:
Clinicians should model developmentally appropriate screen media use in PICU.
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