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Sleep Duration, Restfulness, and Screens in the Sleep Environment
Open accessAbstract
BACKGROUND AND OBJECTIVE: Associations of inadequate sleep with numerous health outcomes among youth necessitate identifying its modifiable determinants. Television (TV) has been associated with sleep curtailment, but little is known about small screens (eg, smartphones), which can be used in bed and emit notifications. Therefore, we examined associations of different screens in sleep environments with sleep duration and perceived insufficient rest or sleep. METHODS: Participants included 2048 fourth- and seventh-graders participating in the Massachusetts Childhood Obesity Research Demonstration Study in 2012 to 2013. Using linear and log binomial regression, we examined cross-sectional associations of small screens and TVs in sleep environments and screen time with weekday sleep duration and perceived insufficient rest or sleep in the past week. RESULTS: Children who slept near a small screen (compared with never) reported 20.6 fewer minutes of sleep (95% confidence interval [CI], -29.7 to -11.4) and had a higher prevalence of perceived insufficient rest or sleep (prevalence ratio, 1.39; 95% CI, 1.21 to 1.60). Children who slept in a room with a TV (compared with no TV) reported 18.0 fewer minutes of sleep (95% CI, -27.9 to -8.1). TV or DVD viewing and video or computer game playing were associated with both sleep outcomes (P < .01). Some associations were stronger among Hispanic, non-Hispanic black, and older children (P < .05 for heterogeneity). CONCLUSIONS: Sleeping near a small screen, sleeping with a TV in the room, and more screen time were associated with shorter sleep durations. Presence of a small screen, but not a TV, in the sleep environment and screen time were associated with perceived insufficient rest or sleep. These findings caution against unrestricted screen access in children's bedrooms.
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“The results of this study indicated that 58% of the participants experienced poor sleep quality, which is higher than the 40% reported in a previous study (51).”
From Relationship of screen time with anxiety, depression, and sleep quality among adolescents: a cross-sectional study (2024) · cites this paper as [51]
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Nunes, S., Campbell, M. K., Klar, N. S., Reid, G. J., & Stranges, S. (2020) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2020.110279 · Cited by 26
Preschoolers' engagement with screen content and associations with sleep and cognitive development
Axelsson, E. L., Purcell, K., Asis, A., Paech, G. M., Metse, A. P., Murphy, D., & Robson, A. (2022) · Acta Psychologica · doi:10.1016/j.actpsy.2022.103762 · Cited by 31
Relationship between Sedentary Time, Physical Activity and Multiple Lifestyle Factors in Children
Sheldrick, M. P. R., Tyler, R., Mackintosh, K. A., & Stratton, G. (2018) · Journal of Functional Morphology and Kinesiology · doi:10.3390/jfmk3010015 · Cited by 30
Hubbard, J. T., Frisk, M. K., Ruppert, É., Tsai, J. W., Fuchs, F., Robin-Choteau, L., Husse, J., Calvel, L. Y., Gregor Eichele, C., Franken, P., et al. (2021) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2017364118 · Cited by 25
“Indeed, the present findings provide an explanation for the physiological and behavioral disturbances induced by the exposure to inappropriate lighting commonly observed in today’s society, currently ascribed solely to a misalignment of the behavior relative to circadian time (1, 2).”
BackgroundScreen time and obesity prevalence in adolescents: an isotemporal substitution analysis
Byun, D., Kim, Y., Jang, H., & Oh, H. (2024) · BMC Public Health · doi:10.1186/s12889-024-20639-x · Cited by 24
Media devices, family relationships and sleep patterns among adolescents in an urban area
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Drifting Off in Paradise: Why People Sleep in Virtual Reality
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“Such improvements may help with addressing related concerns in regards to sleeping near small screens [20].”
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“Une étude (91) a établi l’association entre le fait d’essayer”
Hashem, S. A., Refay, A. S. E., Mostafa, H. H., Kamel, I. H., & Sherif, L. S. (2020) · Open Access Macedonian Journal of Medical Sciences · doi:10.3889/oamjms.2020.5249 · Cited by 22
“Besides, the benefits related to rapid access to information and rapid mass communication, screen exposure cause many health and psychological problems among children and adolescents [28].”
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“11,15,21 Due to their portability, children use tablets and smartphones until sleeping time, often without supervision by parents or people responsible, and this behavior can cause addiction and affect the quantity and quality of sleep.”
Kontostoli, E., Jones, A., Pearson, N., Foley, L. S., Biddle, S., & Atkin, A. J. (2022) · International Journal of Behavioral Medicine · doi:10.1007/s12529-022-10077-7 · Cited by 24
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“15 In addition, video games may lead to mental arousal and thus affect sleep, 43 and the violent content of video games has a particularly pronounced effect on sleep conditions.”
BackgroundSleep Habits of Elementary and Middle School Children in South Texas
Surani, S., Hesselbacher, S. E., Surani, S., Sadasiva, S., Surani, Z., Surani, S. S., Khimani, A., & Subramanian, S. (2015) · Sleep Disorders · doi:10.1155/2015/179103 · Cited by 20
“, smartphones) and televisions in the bedroom have recently been associated with shorter sleep duration in a survey of 4th through 7th graders [22].”
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“48”
Rea, C. J., Smith, R. L., & Taveras, E. M. (2016) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.6274 · Cited by 19
“35 However, although both parent screen time and limiting TV time were associated with child sleep duration in univariate analysis, these associations were no longer significant after controlling for demographic characteristics.”
Sleep duration mediates the relationship between health behavior patterns and obesity
Kaar, J. L., Schmiege, S. J., Vadiveloo, M. K., Simon, S. L., & Tovar, A. (2018) · Sleep Health · doi:10.1016/j.sleh.2018.07.004 · Cited by 22
“Further, there may be other factors outside of diet and activity behaviors that impact sleep duration; including family routines and/or chaos.(34,35)”
BackgroundArora, T., AlBahri, A. F., Omar, O., Sharara, A., & Taheri, S. (2018) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2018.04.007 · Cited by 20
Donati, M. A., Sanson, F., Mazzarese, M., & Primi, C. (2019) · Psychology · doi:10.4236/psych.2019.1016139 · Cited by 19
“For example, previous papers (Falbe et al., 2015; Gentile et al., 2011) documented that video games use can lead to the development of anxiety, depression, social phobia, and sleep problems.”
BackgroundSleeping patterns and childhood obesity: an epidemiological study in 1,728 children in Greece
Kanellopoulou, A., Notara, V., Magriplis, E., Αntonogeorgos, G., Gil, A. P. R., Κornilaki, E. N., Lagiou, A., Yannakoulia, M., & Panagiotakos, D. B. (2021) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.9160 · Cited by 19
“36,37 Although in the present study sleep duration was positively associated with better dietary habits and inversely associated with the presence of a TV and or a PC/tablet in the children ’ s room, no signi fi cant interaction between sleep duration and dietary habits, playing video games, or…”
Waller, N. A., Zhang, N., Cocci, A. H., D'Agostino, C., Wesolek-Greenson, S., Wheelock, K. M., Nichols, L. P., & Resnicow, K. (2021) · Child Care Health and Development · doi:10.1111/cch.12869 · Cited by 18
Correa, V. S., Centofanti, S. A., Dorrian, J., Wicking, A., Wicking, P., & Lushington, K. (2022) · Sleep Health · doi:10.1016/j.sleh.2022.02.004 · Cited by 19
Metadata
- Authors
- Falbe, J., Davison, K. K., Franckle, R. L., Ganter, C., Gortmaker, S. L., Smith, L., Land, T., & Taveras, E. M.
- Affiliations
- University of California, Berkeley (US)
- Departments of Nutrition and
- Technische Universität Berlin (DE)
- Harvard University (US)
- National Institute for Children’s Health Quality (US)
- Massachusetts Department of Public Health (US)
- Massachusetts General Hospital (US)
- Corresponding author
- Falbe, Jennifer
- ORCID
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2015-02-01
- Volume
- 135
- Issue
- 2
- Pages
- e367-e375
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC4306800
- OpenAlex
- W2167535168
- Cited by
- 237
- References
- 49
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 18 · 2023: 25 · 2022: 24 · 2021: 33 · 2020: 25 · 2019: 22 · 2018: 26 · 2017: 16 · 2016: 18 · 2015: 12
- FWCI
- 35.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- PEDIATRICS (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- American Heart Association (#14POST20140055)
- National Institutes of Health
- Centers for Disease Control and Prevention (U18DP003370)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK007703., T32DK007703)
- National Center for Chronic Disease Prevention and Health Promotion (U18DP003370)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Education › Child Development and Digital Technology
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Keywords
- sleep duration, sleep environment, small displays, smartphones, television viewing, screen time, children, adolescents, Hispanic children, non-Hispanic Black children
- MeSH terms
- Child, Cross-Sectional Studies, Female, Health Surveys, Humans, Male, Massachusetts, Motor Activity, Rest, Risk Factors, Sleep, Sleep Deprivation, Social Environment, Television, Videodisc Recording, Video Games, Cell Phone, Pediatric Obesity
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