The Differential Association Between Background Versus Foreground Media Exposure and Child Sleep Outcomes

Sleep problems affect nearly 25% of 2- to 5-year-old children and are associated with poor cardiometabolic health and may contribute to poor emotional well-being. Given that exposure to background media can be conceptualized as a form of chronic noise exposure, which has been linked to reduced sleep quality, in this preregistered study (OSF https://osf.io/g7jbf/?view_only=830fcc92058f4ecca0e0c83413c4f0b9) we tested a) whether background TV is associated with the quantity and quality of sleep in children aged 2- to 5-years in Canada, Sweden and the United States and b) whether child daily screen use duration or foreground media was associated with sleep quality.

From February 2019 to August 2021, 885 parents recorded child exposure to background media and child sleep outcomes (sleep duration [daytime and nighttime], sleep interruptions, sleep latency, and parental concerns with child's sleep), as well as child age, parent socioeconomic status, and child daily screen use duration. Cluster analysis was used to produce sleep profiles to categorize children into poor and good sleepers.

Hierarchical regressions indicated background TV was not associated with sleep outcomes, controlling for family demographics and foreground media. However, longer foreground exposure was associated with poorer sleep quality and predicted poor sleep status. In addition, there were country-related differences in child sleep quality and media use.

Foreground media use was significantly associated with poor child sleep, while background media exposure was not. As sleep is an episodic event, future research should examine cumulative effects over time between media use and sleep.