The Impact of Sleep Loss on Screen Time in Children: Secondary Analyses of a Randomised Crossover Trial Using
R F Jackson1, K A Meredith-Jones1, J J Haszard2
1Department of Medicine, University of Otago, Dunedin, New Zealand.
Insights
Reduced sleep in children increases screen time, particularly in the afternoon and evening. This study objectively measured screen use and sleep duration to understand the relationship.
Area of Science:
- Pediatric Sleep Medicine
- Childhood Behavior and Technology Use
Background:
- The impact of insufficient sleep on children's screen time habits is not well understood.
- Limited research exists on how sleep duration affects objectively measured screen engagement in children.
Purpose of the Study:
- To investigate the relationship between reduced sleep and objectively measured screen time in children.
- To quantify changes in screen use associated with sleep extension versus sleep restriction.
Main Methods:
- A crossover trial involving 105 children (8-12 years) randomized to sleep extension or restriction for 7 nights.
- Sleep and awake time measured via accelerometry; screen time assessed using wearable cameras and questionnaires.
- Objective screen time data analyzed for within-person differences between sleep conditions.
Main Results:
- No significant difference in screen time before school or on weekends.
- Children exhibited greater screen time after school during sleep restriction compared to sleep extension (66.3 min difference).
- Parental reports corroborated increased total screen use during sleep restriction.
Conclusions:
- Reduced sleep in children is associated with increased screen time during weekday afternoons and evenings.
- Objective measurements confirm that less sleep leads to more screen engagement in children.
- Findings highlight a potential cycle of poor sleep and increased screen exposure in pediatric populations.
Background:
How reduced sleep impacts screen time in children is unclear.
Objectives:
To explore how reduced sleep impacts objectively measured screen use.
Methods:
One hundred and five children (8-12 years) with caregiver-reported sleep of 8-11 h/night were randomised to 7 nights sleep extension (go to bed 1 h earlier) or sleep restriction (bed 1 h later) in a crossover trial with a 7-night washout between conditions. Sleep and time awake were measured using waist-worn accelerometry (ActiGraph wGT3X-BT) and screen time using wearable cameras (Brinno TLC130 Timelapse) and questionnaires. Camera images were coded as time spent on screens (raw data), including imputation for blocked images (Rules 1 and 2). Within-person differences (95% CI) were calculated in those with matched camera data across sleep intervention weeks, in minutes and as percentage of awake time.
Results:
Screen time before school or on weekends did not differ in the 49 children (10.4 years, 51% female, 41% overweight, 78% European) with suitable camera data. After school, children appeared to have similar screen time using raw data (median difference; 25th, 75th percentiles: 18.7 min; -10.2, 72.5), but greater screen time during sleep restriction compared with extension after allowance for blocked images (Rule 2: 66.3 min; 7.5, 102.9 or 6% of awake time; 0.5, 10.0). Parents (n = 98) reported greater total screen use in children during the sleep restriction week (mean difference; 95% CI: 16.8 min; 1.8, 31.8).
Conclusions:
In this secondary analysis, getting less sleep appeared to increase screen time in children during the weekday afternoon and evening hours, compared to when they received more sleep.
Trial Registration:
ACTRN12618001671257 Australian New Zealand Clinical Trials Registry; ANZCTR.
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