Screen time exposure, sleep alterations, and their relationship with excess weight in children and adolescents

The digital era has led to an unprecedented increase in screen time exposure among youth, creating a critical intersection between technology use, sleep hygiene, and metabolic health.

To evaluate the association between daily screen time, sleep quality, and the prevalence of overweight and obesity in a pediatric clinical population.

A cross-sectional study was conducted on 70 patients (mean age 10.8 years). Subjects were categorized into obese (n = 44) and non-obese (n = 26) groups. Anthropometric data, body composition (perivisceral fat), biochemical parameters [insulin, Homeostasis Model Assessment (HOMA), lipid profile], and lifestyle habits (Krece Plus and KIDMED tests) were analyzed. Binary logistic regression was performed to estimate odds ratios (OR) for obesity and sleep disturbances.

Obesity was significantly associated with higher perivisceral fat (P < 0.001), systolic blood pressure (P = 0.009), insulin levels (P = 0.035), and HOMA index (P = 0.024), alongside lower high-density lipoprotein cholesterol (P < 0.001). Sociodemographic analysis revealed that maternal education level was significantly lower in the obese group (P = 0.006). Regarding lifestyle, obese children reported significantly higher daily screen time (2.9 hours vs 2.1 hours; P = 0.047) and shorter sleep duration (8.4 hours vs 9.1 hours; P = 0.021). The prevalence of chronic sleep disturbances was notably higher in obese subjects (39% vs 8.3%; P = 0.016). After adjusting for confounders, screen time was strongly associated with a higher risk of obesity (OR: 3.08; 95%CI: 1.53-7.90) and sleep problems (OR: 1.65; 95%CI: 0.96-2.99).

Excessive screen time and poor sleep quality are strongly associated with pediatric obesity and its metabolic comorbidities. Furthermore, lower maternal education level and family history of diabetes are significant compounding factors. Clinical interventions should address digital hygiene and sleep quality as essential pillars in the management of childhood excess weight.