The impact of excessive television exposure on children has been well documented, but “small screen” devices (such as smartphones or tablets) may be even more harmful to a child’s sleep patterns. A new study in Pediatrics suggests that children who slept near a small screen in their room reported fewer minutes of sleep and later bedtimes than children who slept with a TV in their room (P>0.01).
In fact, the presence of a small screen appeared to impact a child’s sleep patterns more than a television. The study reported that children with small screens in their bedrooms also reported 20.6 fewer minutes of sleep per weekday (95% CI minus 29.7-minus 11.4) than those who never slept near a small screen, independent of having a TV in their room, while children with TVs in their bedrooms reported 18.0 fewer minutes of weekday sleep (95% CI minus 27.9-minus 8.1), independent of small screens.
Both small screens and television caused similar delays in sleep. Children sleeping near a small screen and sleeping with a TV in the room were associated with a 37.0 minute (95% CI 20.1 to 53.9) and 31.1 minute (95% CI 19.1 to 43.1) later bedtimes, respectively, the authors wrote.
Lead author, Jennifer Falbe, ScD, MPH, of the school of public health at the University of California in Berkeley, said the interactive nature of small screens is concerning. “These devices expose users to melatonin-delaying light, and they provide access to a variety of content like videos, games, and e-mails that could delay sleep,” she said.
Researchers surveyed 2,048 fourth and seventh grade students in two Massachusetts communities across 29 schools as part of the Massachusetts Childhood Obesity Research Demonstration Study (MA-CORD). The mean age for the study was 10.6 (SD +/- 1.5 years), with Hispanic (40%) and non-Hispanic white (38%) comprising the vast majority of the ethnic sample.
Exposure to screens was determined by asking “Some kids use devices to play games or send text messages or chats to their friends like cell phones, smart phones, and the iPod Touch. How often do you sleep with one of these devices near where you sleep or next to your bed?” with a response range from 0 to 7 days. Sleep duration was determined by asking “On a usual weekday this past week, when did you go to bed at night?” and “On a usual weekday this past week, when did you wake up the next morning?” and subtracting wake time from bedtime hours.
Given the association between sleep and emotional issues such as anxiety, depression, or even mental illness in children, this study has important implications for clinicians. Jay Reeve, PhD, president and CEO of the Apalachee Center in Tallahassee, Fla., and assistant professor, department of psychology at Florida State University said that questions about small screen device use may be a good addition to a set of questions pediatricians ask their patients.
“When the kid gets brought in for a visit, I don’t think it would necessarily be a bad thing to say ‘Does Junior have a cell phone or an iPhone or a Droid? Does he sleep with the cell phone or the iPhone or the Droid in his room? Does he sleep with it in his bed?’ and to let that lead them into a standard series of questions about sleep and sleep disturbance,” Reeve said.
However, as Falbe points out, there is no way to tell “which came first, poor sleep or the presence of screen media in the sleep environment.” She cites the study’s cross-sectional design as its primary limitation, and said there may be other factors contributing to poor sleep patterns in children, such as parenting style.
Reeve calls this “a valuable preliminary study” and said that a longitudinal study containing an observational component with a control set in it would be the next step for researchers in this field. But he said that results of this current study could still have useful applications for a variety of health professionals.
“These are the kinds of studies that if they’re followed up on and made available to general practitioners and to behavioral health clinicians are actually going to have a lot of impact on the way that people practice, and I think it could lead to some really positive results,” Reeve concluded.
The authors have indicated they have no financial relationships relevant to this article to disclose.
The authors have indicated they have no potential conflicts of interest to disclose.
Reviewed by F. Perry Wilson, MD,
MSCE Assistant Professor,
Section of Nephrology,
Yale School of Medicine and Dorothy Caputo, MA,
BSN, RN, Nurse Planner
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