The association between problematic media use, sleep disturbances, and enuresis in children

Enuresis is a common pediatric urological condition in which sleep-related mechanisms (sleep fragmentation and impaired arousal) may contribute to nocturnal bladder control problems. In parallel, problematic digital media use has emerged as a potentially modifiable exposure that may disrupt sleep in children.

To investigate the relationship between problematic media use and sleep disorders in children diagnosed with enuresis and to identify sociodemographic and behavioral factors associated with increased sleep problems.

This cross-sectional study was conducted with the parents of 186 children aged 6-12 years who presented to the pediatric urology clinic with enuresis. Parents completed the Problematic Media Use Scale-Parent Form (PMUS-PF) and the Sleep Disorder Scale for Children (SDSC). One parent per child participated in the study The analyses used descriptive statistics, Mann-Whitney U, Kruskal-Wallis, t-test, ANOVA, and Spearman correlation tests.

The average age of the children is 8.1 ± 2.0, with 62.9% being boys and 37.1% being girls. A moderate positive correlation was found between problematic media use and sleep disorders (r = .445, p < .001); this relationship was particularly evident in the subscales of sleep initiation and maintenance disorders (r = .401; p < .001), sleep-wake transition disorders (r = .342; p < .001), and excessive sleepiness disorders (r = .283; p < .001). According to the variable of children's average daily internet usage time, statistically significant differences were found between the PMUS-PF total score and the SDSC total score, and the subscale scores for "Sleep Initiation and Maintenance Disorders" and "Sleep-Wake Transition Disorders" (p < .05). It was found that children who used the internet for more than 5 h per day had higher scores on the aforementioned scale and subscale compared to other groups.

Problematic media use is associated with sleep disturbances especially difficulty falling asleep, sleep-wake transition problems, and excessive daytime sleepiness in children diagnosed with enuresis. Incorporating the assessment of sleep patterns and digital media habits into the routine clinical evaluation of enuretic children may be valuable, and family-based behavioral interventions supporting healthy media use and sleep hygiene should be considered as adjunctive strategies in enuresis management.