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Cook G, Carter B, Wiggs L, Southam S. Parental sleep-related practices and sleep in children aged 1-3 years: a systematic review. J Sleep Res 2024; 33:e14120. [PMID: 38131158 DOI: 10.1111/jsr.14120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/01/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023]
Abstract
The current systematic review sought to identify the relationship between the range of different parental sleep-related practices that had been explored in relations to child sleep outcomes in children aged 1-3 years. A systematic literature review was carried out in CINAHL, The Cochrane Library, PsycArticles, PsycInfo, PubMed and Web of Science, as well as relevant grey literature in August 2022 using the terms; population (children, aged 1-3 years), exposure (parental sleep-related practice) and outcome (child sleep). Any quantitative study published between 2010 and 2022 that explored the relationship between parental sleep-related practices and the sleep of children aged 1-3 years were included. The Mixed Methods Appraisal Tool was employed to quality appraise included studies and results were narratively synthesised. In all, 16 longitudinal and cross-sectional quantitative studies met inclusion criteria. Parental presence or physical involvement, as well as broader parental practices including using screens or devices at bedtime and night-time breastfeeding were all related to poorer child sleep outcomes. Consistent and relaxing routines, sleeping in a cot, and spending all night in their own sleep location were associated with better child sleep outcomes. Acknowledging the plethora of diverse parental sleep-related practices, which may have varying relationships with child sleep outcomes, could be usefully considered in theoretical models and to inform clinical practice. Issues of definitional and measurement ambiguity are highlighted and discussed.
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Affiliation(s)
- Georgia Cook
- Centre for Psychological Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, Lancashire, UK
| | - Luci Wiggs
- Centre for Psychological Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Shannon Southam
- Centre for Psychological Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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Nathanson AI. Sleep and Technology in Early Childhood. Psychiatr Clin North Am 2024; 47:15-26. [PMID: 38302204 DOI: 10.1016/j.psc.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Research suggests that technology use is associated with poorer sleep outcomes among children less than 6 years of age. These associations are evident regardless of the type of technology studied, although evening exposure may have the greatest impact compared with technology use during other parts of the day. More work is needed, particularly given that technology use is relatively high among young children. Clinicians should assess patients' technology exposure, including before bedtime, to assess whether sleep issues stem from children's technology use. Moreover, clinicians should educate caregivers about the association between technology use and sleep problems among young children.
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Affiliation(s)
- Amy I Nathanson
- School of Communication, Ohio State University, Columbus, OH 43210, USA.
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Lee G, Kim S. Effects of emotion coaching group programme for mothers of preschool children with smart device overdependence: a mixed methods study. BMC Nurs 2023; 22:380. [PMID: 37833707 PMCID: PMC10571386 DOI: 10.1186/s12912-023-01554-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Smart device overdependence adversely affects the overall development of preschool children. This study aimed to provide an emotion coaching group programme to mothers raising preschool children who are overly dependent on smart devices and to confirm the programme's effectiveness. METHODS This concurrent embedded mixed methods study used a non-equivalent control group pre-post design to verify the quantitative effect of the programme, and a descriptive research design to verify the qualitative effect. The study collected data from June 2019 to March 2021 from 51 (25 experimental, 26 control) mothers raising children aged 3-6 years in South Korea. The quantitative study examined the effects of an eight-session programme, conducted once a week for two hours, on mothers' emotional intelligence, parenting behaviour, and their children's attachment stability and smart device overdependence using a non-equivalent control group pre-post design. The analysis used a generalized estimate equation. For qualitative research, focus group interviews were used as a descriptive research design method, and content analysis was used for analysis. RESULTS Quantitatively, the results showed significant differences between the experimental and control groups in terms of changes in maternal emotional intelligence (χ2 = 14.99, p = .001), maternal positive parenting behaviour (χ2 = 9.32, p = .009), children's unstable attachment to their mothers (χ2 = 9.49, p = .009), and children's overdependence on smart devices (χ2 = 14.48, p = .001). Qualitatively, the study derived five themes for the experiences of mothers who participated in the programme: "hope for desirable parenting without emotional difficulties," "feelings touched by reflection," "warm but authoritative parenting," "children who became responsible by gaining psychological stability," and "changed view of my home." CONCLUSIONS The emotion coaching group programme was effective in improving the emotional intelligence and parenting behaviour of mothers raising preschool children. The programme also improved preschool children's attachment stability to their mothers and overdependence on smart devices. The programme can be useful in community practice, and the present study can be used as evidence for education and research related to device overdependence.
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Affiliation(s)
- Gumhee Lee
- College of Nursing, Seoul National University, Seoul, Republic of Korea
| | - Sungjae Kim
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Wu HY, Lin WY, Huang JP, Lin CL, Au HK, Lo YC, Chien LC, Chao HJ, Chen YH. Effects of mobile device use on emotional and behavioral problems in the CBCL among preschoolers: Do shared reading and maternal depression matter? PLoS One 2023; 18:e0280319. [PMID: 37450499 PMCID: PMC10348560 DOI: 10.1371/journal.pone.0280319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/27/2022] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Although mobile devices are used ubiquitously, studies on their detrimental effects on preschoolers are limited. Furthermore, no study has considered shared reading and mobile device usage simultaneously. Therefore, this study examined the effects of mobile devices and shared reading on preschoolers' development along with the effects of maternal depression on this association. MATERIALS AND METHODS Mothers of 202 children aged 2-5 years were recruited in Taiwan. Maternal self-reported questionnaires on mobile device usage, shared reading, and child's emotional and behavioral development were collected. Multiple linear regression models were used for analyses. RESULTS Mothers' higher usage time on mobile devices and an education level of college or less were significantly associated with the child's exceeding recommended use of mobile devices. Particularly among depressed mothers, preschoolers' exceeding recommended use of mobile devices was associated with more sleep (β = 9.87, 95% confidence interval [CI] = 1.34, 18.40) and attention (β = 7.20, 95% CI = 1.50, 12.91) problems, whereas shared reading was associated with less somatic complaints (β = -16.19, 95% CI = -32.22, -0.15) and withdrawn (β = -21.50, 95% CI = -40.52, -2.47), compared with their respective counterparts. CONCLUSION Our study suggested the beneficial effects of shared reading. Moreover, we highlighted the adverse effects of preschoolers' exceeding recommended use of mobile device on sleep and attention problems, especially for children of mothers with depression.
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Affiliation(s)
- Hsin-Yi Wu
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Wen-Yi Lin
- Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Chen-Li Lin
- Department of Obstetrics and Gynecology, Taipei City Hospital, Taipei, Taiwan
| | - Heng-Kien Au
- Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yu-Chun Lo
- Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Ling-Chu Chien
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Hsing Jasmine Chao
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
- Ph. D. program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan
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Breda M, Belli A, Esposito D, Di Pilla A, Melegari MG, DelRosso L, Malorgio E, Doria M, Ferri R, Bruni O. Sleep habits and sleep disorders in Italian children and adolescents: a cross-sectional survey. J Clin Sleep Med 2023; 19:659-672. [PMID: 36661089 PMCID: PMC10071380 DOI: 10.5664/jcsm.10400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/14/2022] [Accepted: 11/14/2022] [Indexed: 01/21/2023]
Abstract
STUDY OBJECTIVES The aim was to describe sleep habits and epidemiology of the most common sleep disorders in Italian children and adolescents. METHODS This was a cross-sectional study in which parents of typically developing children and adolescents (1-18 years) completed an online survey available in Italy, gathering retrospective information focusing on sleep habits and disorders. RESULTS Respondents were 4,321 typically developing individuals (48.6% females). Most of our sample did not meet the age-specific National Sleep Foundation recommendations for total sleep duration (31.9% of toddlers, 71.5% of preschoolers, 61.6% of school-age children, and 41.3% of adolescents). Napping was described in 92.6% of toddlers and in 35.2% of preschoolers. Regarding geographical differences, children and adolescents of northern Italy showed more frequent earlier bedtimes and rise times than their peers of central and southern Italy. The most frequently reported sleep disorder in our sample was restless sleep (35.6%), followed by difficulties falling asleep (16.8%), > 2 night awakenings (9.9%), and bruxism (9.6%). Data also suggest that longer screen time is associated with later bedtimes on weekdays in all age groups. CONCLUSIONS The current study shows that Italian children are at risk of sleep disorders, particularly insufficient sleep, restless sleep, and difficulty falling asleep. The study also provides normative sleep data by age group in a large cohort of typically developing Italian children, emphasizing the importance of the developmentally, ecologically, and culturally based evaluation of sleep habits and disorders. CITATION Breda M, Belli A, Esposito D, et al. Sleep habits and sleep disorders in Italian children and adolescents: a cross-sectional survey. J Clin Sleep Med. 2023;19(4):659-672.
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Affiliation(s)
- Maria Breda
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Arianna Belli
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Dario Esposito
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Andrea Di Pilla
- Life Sciences and Public Health Department, Hygiene Section, Medicine and Surgery “A. Gemelli”—Catholic University of Sacred Heart, Rome, Italy
| | - Maria Grazia Melegari
- Department of Social and Developmental Psychology, Sapienza University of Roma, Rome, Italy
| | - Lourdes DelRosso
- Pulmonary and Sleep Medicine, University of Washington, Seattle Children’s Hospital, Seattle, Washington
| | - Emanuela Malorgio
- Italian Federation of Primary Care Pediatricians (Federazione Italiana Medici Pediatri [FIMP]), Torino, Italy
| | - Mattia Doria
- Italian Federation of Primary Care Pediatricians (Federazione Italiana Medici Pediatri [FIMP]), Venice, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Department of Neurology IC, Oasi Research Institute—IRCCS, Troina, Italy
| | - Oliviero Bruni
- Department of Social and Developmental Psychology, Sapienza University of Roma, Rome, Italy
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Swider-Cios E, Vermeij A, Sitskoorn MM. Young children and screen-based media: The impact on cognitive and socioemotional development and the importance of parental mediation. COGNITIVE DEVELOPMENT 2023. [DOI: 10.1016/j.cogdev.2023.101319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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Chu Y, Oh Y, Gwon M, Hwang S, Jeong H, Kim HW, Kim K, Kim YH. Dose-response analysis of smartphone usage and self-reported sleep quality: a systematic review and meta-analysis of observational studies. J Clin Sleep Med 2023; 19:621-630. [PMID: 36546366 PMCID: PMC9978438 DOI: 10.5664/jcsm.10392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 12/24/2022]
Abstract
STUDY OBJECTIVES Several studies have recently reported on the association between smartphone usage and self-reported sleep quality. However, no systematic review or meta-analysis has yet been performed. We aimed to analyze the association between smartphone usage time and self-reported sleep quality. METHODS We searched for articles published up to January 13, 2022, using the Embase and Medline databases. All observational studies were eligible for inclusion. The Newcastle-Ottawa scale was used to evaluate the risk of bias within studies. We used restricted cubic spline analysis to perform a dose-response analysis. RESULTS Seventeen studies with a total of 36,485 participants were included. The pooled odds ratio was 2.28 (confidence interval [CI]: 1.81-2.89; P < .001) and heterogeneity was 80%. In the dose-response analysis conducted on 5 studies, the regression coefficient between daily smartphone usage time (hours/day) and poor sleep quality was 1.042 (1.027-1.058), which confirmed a significantly positive association. CONCLUSIONS Smartphone overuse was closely associated with poor self-reported sleep quality, sleep deprivation, and sleep latency prolongation. Further studies using a more structured method and high-quality evidence (cohort or case-control) should be conducted. SYSTEMATIC REVIEW REGISTRATION CRD42022303371. CITATION Chu Y, Oh Y, Gwon M, et al. Dose-response analysis of smartphone usage and self-reported sleep quality: a systematic review and meta-analysis of observational studies. J Clin Sleep Med. 2023;19(3):621-630.
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Affiliation(s)
- Yoora Chu
- School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Yeongbiehn Oh
- School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Minseong Gwon
- School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Seokhyun Hwang
- School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Hyeokjun Jeong
- School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Hyun-Woo Kim
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Kihun Kim
- Department of Occupational and Environmental Medicine, Kosin University Gospel Hospital, Busan, Republic of Korea
| | - Yun Hak Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, Republic of Korea
- Department of Anatomy, School of Medicine, Pusan National University, Yangsan, Republic of Korea
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León Rojas D, Castorena Torres F, Alvarado Ramos S, del Castillo Morales A, Rodríguez-de-Ita J. Sleep Disturbances and Mental Well-Being of Preschool Children during the COVID-19 Pandemic in Mexico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4386. [PMID: 36901397 PMCID: PMC10002191 DOI: 10.3390/ijerph20054386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/17/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
COVID-19 pandemic confinement caused changes in families and children's routines worldwide. Studies conducted at the beginning of the pandemic have examined the harmful effects of these changes on mental health, including sleep disturbances. As sleep is essential for optimal childhood development, this study was designed to determine preschool-aged (3-6 years old) children's sleep parameters and mental well-being during the COVID-19 pandemic in Mexico. Using a cross-sectional design, a survey was applied to parents of preschool children, inquiring about their children's confinement status, routine changes, and electronics use. The parents responded to the Children's Sleep Habits Questionnaire and the Strengths and Difficulties Questionnaire to assess children's sleep and mental well-being. To provide objective sleep data, the children wore wrist actigraphy for seven days. Fifty-one participants completed the assessment. The children's mean age was 5.2 years, and the prevalence of sleep disturbances was 68.6%. The use of electronic tablets in the bedroom near bedtime and symptoms of mental health deterioration (i.e., emotional distress and behavioral difficulties) were associated with sleep disturbances and their severity. The COVID-19 pandemic's confinement-related routine changes greatly impacted preschool children's sleep and well-being. We recommend establishing age-tailored interventions to manage children at higher risk.
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Affiliation(s)
- Daniela León Rojas
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey 64710, NL, Mexico
| | - Fabiola Castorena Torres
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey 64710, NL, Mexico
| | - Salomon Alvarado Ramos
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey 64710, NL, Mexico
| | - Alfredo del Castillo Morales
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey 64710, NL, Mexico
| | - Julieta Rodríguez-de-Ita
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey 64710, NL, Mexico
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Hospital San José, TecSalud, Monterrey 64710, NL, Mexico
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Internet and Video Games: Causes of Behavioral Disorders in Children and Teenagers. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010086. [PMID: 36670637 PMCID: PMC9856521 DOI: 10.3390/children10010086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/24/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023]
Abstract
Even though video games have been present among children for many years, children are using them more continuously and in an abusive and indiscriminate way nowadays because of the "technological boom". It is affecting the behavior of children and adolescents. This is the reason why we are carrying out this systematic review. The main objective of this article is to investigate literature that directly connects the continuous and undifferentiated use of video games with the emergence of behavioral disorders in children and young people. The PRISMA statement was followed in the process of this article. We used SCOPUS, Web of Science and PubMed as databases, moreover, we searched studies with a scoping review. The results indisputably supported six out of seven of our hypotheses. We find that the excessive use of video games causes addiction to technology, aggressive behaviors, sleep disorders, and poor school performance. In addition, it hinders social relationships and the development of emotional intelligence. To conclude, it is necessary to correctly use video games in particular, and technologies in general, adapting their content to children's age, as well as the amount of time that they dedicate to use them.
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Drumheller K, Fan CW. Unprecedented times and uncertain connections: A systematic review examining sleep problems and screentime during the COVID-19 pandemic. SLEEP EPIDEMIOLOGY 2022; 2:100029. [PMID: 35692715 PMCID: PMC9076584 DOI: 10.1016/j.sleepe.2022.100029] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022]
Abstract
Objective Sleep has been impacted by the COVID-19 pandemic around the world. Furthermore, screen time has been reported to influence sleep and has increased during pandemic quarantines. This systematic review searched databases to determine if screen time affected sleep during the COVID-19 pandemic. Methods PubMed, Nursing and Allied Health Proquest, and Science Direct Health and Lifescience college edition were searched for articles that fit the inclusion criteria. There were 2750 articles initially screened. Then, 119 articles were further assessed to determine eligibility, creating a final sample of 18 articles that explored whether screen time affected sleep. Results After reviewing the included articles (n = 18), the main theme revealed that screen time negatively affected sleep during the COVID-19 pandemic, specifically aspects such as sleep duration, sleep quality, sleep onset latency, and wake time. However, several articles countered this implication. Therefore, it is important to consider other factors that may influence the relationship between screen time and sleep. Conclusions Although the number of articles included is limited, the overall synthesis suggests that COVID-19-related lifestyle changes, such as increased screen time, may negatively affect sleep health. However, other unidentified factors may have contributed to these findings and warrant further research. Nonetheless, community leaders must consider the long-term consequences of the pandemic and implement initiatives to address sleep challenges due to the intricate connection between sleep and well-being.
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Loo BKG, Okely A, Taylor R, Novotny R, Wickramasinghe P, Müller-Riemenschneider F, Waqa G, Pulungan A, Kusuda S, Tan KH. Asia-Pacific consensus statement on integrated 24-hour activity guidelines for the early years. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 32:100641. [PMID: 36785856 PMCID: PMC9918766 DOI: 10.1016/j.lanwpc.2022.100641] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/07/2022] [Accepted: 10/25/2022] [Indexed: 11/25/2022]
Abstract
Background Early childhood is a vital period for development and growth. Promoting beneficial lifestyle behaviours in early childhood can help optimise children's health, development and learning, shape their behaviours in adulthood and offer the best protection against future non-communicable diseases (NCDs). In the Asia-Pacific region, NCDs are significant causes of healthcare burden and mortality. Furthermore, there is also a high prevalence of adverse metabolic risk factors and unhealthy lifestyle behaviours among these children. Method Representatives from 19 Asia-Pacific nations and/or jurisdictions developed a consensus statement on integrated 24-hour activity guidelines for the early years using the GRADE-ADOLOPMENT framework. Findings These guidelines apply to all infants, toddlers and pre-schoolers below 5 years of age. The guidelines aim to provide a holistic and practical approach to lifestyle activities by framing physical activity, sedentary behaviour and sleep within a 24-hour period. Dietary patterns were included as they play an integral role in metabolic health and energy balance. Interpretation Aligned with the World Health Organization's Global Action Plan for the Prevention and Control of NCDs through health promotion interventions in early life, through cultivating healthy lifestyle behaviours in the children's early years, we aim to provide children with the best start in life and reduce the burden of future NCDs in the Asia-Pacific region. Funding Funded by Integrated platform for research in advancing metabolic health outcomes of women and children.
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Affiliation(s)
- Benny Kai Guo Loo
- Sport and Exercise Medicine Service, KK Women’s and Children’s Hospital, Singapore,Corresponding author. Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
| | - Anthony Okely
- School of Health and Society, University of Wollongong, Sydney, New South Wales, Australia
| | - Rachael Taylor
- Department of Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Rachel Novotny
- Department of Human Nutrition, Food and Animal Sciences, University of Hawaiʻi at Mānoa, Honolulu, HI, USA
| | | | | | - Gade Waqa
- School of Public Health and Primary Care, Fiji National University, Suva, Fiji
| | - Aman Pulungan
- Endocrinology Division, Child Health Department, Faculty of Medicine, Universitas Indonesia – Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Satoshi Kusuda
- Department of Pediatrics, Kyorin University, Mitaka, Tokyo, Japan
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore
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12
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Preschoolers' engagement with screen content and associations with sleep and cognitive development. Acta Psychol (Amst) 2022; 230:103762. [DOI: 10.1016/j.actpsy.2022.103762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/19/2022] [Accepted: 10/03/2022] [Indexed: 11/18/2022] Open
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13
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Sun H, Lim V, Low J, Kee S. The Development of a Parental Questionnaire (QQ-MediaSEED) on Bilingual Children's Quantity and Quality of Digital Media Use at Home. Acta Psychol (Amst) 2022; 229:103668. [PMID: 35843199 DOI: 10.1016/j.actpsy.2022.103668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 01/22/2023] Open
Abstract
The quantity and quality of children's digital screen media exposure is an emerging area of early childhood studies because of its strong social relevance, and this has been particularly true since the COVID-19 pandemic. The few existing parental questionnaires on children's digital screen media exposure mainly focus on monolingual children's media habits and address either the quantity or quality of children's media exposure. Inspired by the existing instruments, the current study introduces a new parental questionnaire to comprehensively assess the duration, frequency, content, design, and use of bilingual children's digital screen media exposure at home, before and since the COVID-19 pandemic. Focus group discussions and the first wave of our data collection on 141 3-6 years old Singaporean bilingual children indicate good face validity and internal consistency of the parental questionnaire. Our results reveal substantial differences in children's quantity and quality of daily digital screen media exposure, as well as the discrepancies in their digital media habits between English and their mother tongue languages, before and since the COVID-19 pandemic.
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Affiliation(s)
- He Sun
- National Institute of Education, Nanyang Technological University, Singapore.
| | - Victor Lim
- National Institute of Education, Nanyang Technological University, Singapore.
| | - Jiamin Low
- National Institute of Education, Nanyang Technological University, Singapore.
| | - Stephanie Kee
- National Institute of Education, Nanyang Technological University, Singapore.
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Silvani MI, Werder R, Perret C. The influence of blue light on sleep, performance and wellbeing in young adults: A systematic review. Front Physiol 2022; 13:943108. [PMID: 36051910 PMCID: PMC9424753 DOI: 10.3389/fphys.2022.943108] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: Blue light from electronic devices has a bad reputation. It has a wavelength which may influence our circadian rhythm and cause bad sleep. But there are other aspects of blue light exposure which are often overlooked, for example, it may influence performance and wellbeing. However, few resources summarize its effects systematically. Therefore, the goal of this systematic review was to distil the present evidence on blue light exposure and its influence on sleep, performance and wellbeing and discuss its significance for athletes.Methods: The databases that were searched were Cochrane, Embase, Pubmed, Scopus, and Virtual Health Library. The studies included investigated the influence of blue light exposure on either sleep, performance, wellbeing or a combination of those parameters on healthy humans. Quality assessment was done based on the quantitative assessment tool “QualSyst.”Results: Summarizing the influence of blue light exposure, the following results were found (expressed as proportion to the number of studies investigating the particular parameter): Fifty percent of studies found tiredness to be decreased. One fifth of studies found sleep quality to be decreased and one third found sleep duration to be decreased. Half of the studies found sleep efficacy to be decreased and slightly less than half found sleep latency to be increased. More than one half of the studies found cognitive performance to be increased. Slightly more than two thirds found alertness to be increased and reaction time to be decreased. Slightly less than half of the studies found wellbeing to be increased.Conclusion: Blue light exposure can positively affect cognitive performance, alertness, and reaction time. This might benefit sports reliant on team-work and decision-making and may help prevent injury. Blue light might also have negative effects such as the decrease in sleep quality and sleep duration, which might worsen an athlete’s physical and cognitive performance and recovery. Further research should explore if blue light can improve sleep, performance and wellbeing to significantly benefit athletic performance.
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Affiliation(s)
| | - Robert Werder
- Institute of Sports Medicine, Swiss Paraplegic Centre, Nottwil, Switzerland
| | - Claudio Perret
- Institute of Sports Medicine, Swiss Paraplegic Centre, Nottwil, Switzerland
- *Correspondence: Claudio Perret,
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15
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Galderisi A, Perilongo G, Caprio S, Da Dalt L, Di Salvo G, Gatta M, Giaquinto C, Rizzuto R, Robb A, Sly PD, Simonelli A, Staiano A, Vettor R, Baraldi E. Pediatric Preventive Care in Middle-High Resource Countries-The Padova Chart for Health in Children. Front Pediatr 2022; 10:803323. [PMID: 35498805 PMCID: PMC9047691 DOI: 10.3389/fped.2022.803323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/14/2022] [Indexed: 12/01/2022] Open
Abstract
Importance The Padova Chart for Health in Children (PCHC) aims to gather the evidence of healthcare promotion and protection for chidren and adolescents (i.e., aged <18 y) into a single document in order to guide families, healthcare providers and social actors on healthy choices. No more than 2% of Europeans and North Americans aged <30 y have a healthy lifestyle. This, together with metabolic and brain plasticity during childhood, creates the ideal opportunity to implement preventive strategies. Guided interventions promoting healthy lifestyle in children and families therefore have a key role in abating the unprecedented pandemic of non-communicable diseases (NCDs) in adulthood. Observations The PCHC is divided into four sections: nutrition, cardiovascular health, respiratory health, and mental and social health. Each section is structured in an ALICE approach (assessment, lobbying, intervention, call-for-action, evaluation): assessment of necessity, describing relevance to healthcare; lobbying to identify those who can effect the proposed interventions; interventions involving family, school and peers; a call-for-action to define priorities among the proposed interventions; and objective evaluation measures that can be applied on a population basis. Conclusions and Relevance Interventions promoting health in childhood require joint action from multiple institutional, local and family representatives, with the shared goal of promoting health across the entire age group. These lifestyle interventions have the potential to change the lifetime risk trajectory for NCDs.
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Affiliation(s)
- Alfonso Galderisi
- Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Giorgio Perilongo
- Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Sonia Caprio
- Department of Pediatrics, Yale University, New Haven, CT, United States
| | - Liviana Da Dalt
- Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Giovanni Di Salvo
- Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Michela Gatta
- Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Carlo Giaquinto
- Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
| | - Rosario Rizzuto
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Adelaide Robb
- Division of Psychiatry and Behavioral Sciences, Children's National Hospital, Washington, DC, United States
| | - Peter David Sly
- Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Alessandra Simonelli
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Annamaria Staiano
- Department of Translational Medical Science, Section of Pediatrics, University Federico II, Naples, Italy
| | - Roberto Vettor
- Department of Medicine, University Hospital of Padova, Padova, Italy
| | - Eugenio Baraldi
- Department of Woman and Child's Health, University Hospital of Padova, Padova, Italy
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16
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Effects of Screen Viewing Time on Sleep Duration and Bedtime in Children Aged 1 and 3 Years: Japan Environment and Children's Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073914. [PMID: 35409594 PMCID: PMC8997461 DOI: 10.3390/ijerph19073914] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023]
Abstract
This study aimed to clarify the effects of television/digital versatile disc (TV/DVD) viewing time and portable electronic device (PED) usage time on sleep duration and bedtime and the difference between the effects of TV/DVD and PED on sleep. The effect of TV/DVD viewing time or PED usage time on sleep duration and bedtime was analyzed using a multiple logistic regression analysis adjusted for covariates. A total of 74,525 participants were included in the analysis, using data from Japan Environment and Children’s Study. TV/DVD viewing was not associated with short sleep duration, but PED usage was associated with short sleep duration. In addition, the risk of short sleep duration increased as PED usage time increased. We also investigated the effects of sleep habits at age 1 year on sleep at age 3 years. This study showed that late bedtime at age 1 year posed a significant risk of late bedtime at age 3 years. In summary, particular caution should be paid to PED use from a child’s health perspective, and sleep habits should be focused on bedtime from the age of 1 year.
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17
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Marinho CARS, Duarte JC, Koch C, Santos MR. Padrão de sono em crianças de 12 a 36 meses de idade. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Avaliar o padrão de sono de crianças de 12 a 36 meses. Método Estudo transversal, realizado em uma amostra de 808 crianças com 12–36 meses de idade, que frequentavam creches no distrito de Viseu, Portugal. Coleta de dados realizada por meio de questionário aplicado aos pais, entre novembro de 2018 e setembro de 2019. Estudo aprovado pela comissão de ética do Instituto de Ciências Biomédicas Abel Salazar, Portugal. Resultados Verificou-se que durante a semana as crianças dormiam, por dia, entre 9h 30m e 18h (M=12h 25m ±1h 02m) e no fim de semana, entre 9h e 19h (M=12h 49m ±1h 15m). No fim de semana, as crianças deitavam-se e acordavam mais tarde que à semana (M=21h 42m ±40m, M=8h 15m ±50m, respetivamente). A maioria não dormia a sesta da manhã, somente a da tarde. Conclusão Os resultados indicam que a maioria das crianças (91,5% semana; 85,6% fim de semana) dorme o número de horas recomendado. As mais novas são as que dormem mais. Implicações para a prática É importante que, nas consultas de vigilância de saúde, os enfermeiros realizem educação para a saúde direcionada aos pais sobre a relevância de manter um padrão de sono adequado à criança.
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Affiliation(s)
| | | | - Cândida Koch
- Escola Superior de Enfermagem do Porto, Portugal
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18
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Hackl-Wimmer S, Eglmaier MTW, Eichen L, Rettenbacher K, Macher D, Walter-Laager C, Lackner HK, Papousek I, Paechter M. Effects of Touchscreen Media Use on Toddlers' Sleep: Insights from Longtime ECG Monitoring. SENSORS (BASEL, SWITZERLAND) 2021; 21:7515. [PMID: 34833593 PMCID: PMC8622356 DOI: 10.3390/s21227515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/08/2021] [Accepted: 11/08/2021] [Indexed: 11/25/2022]
Abstract
Wearable biomedical sensor technology enables reliable monitoring of physiological data, even in very young children. The purpose of the present study was to develop algorithms for gaining valid physiological indicators of sleep quality in toddlers, using data from an undisturbing and easy-to-use wearable device. The study further reports the application of this technique to the investigation of potential impacts of early touchscreen media use. Toddlers' touchscreen media use is of strong interest for parents, educators, and researchers. Mostly, negative effects of media use are assumed, among them, disturbances of sleep and impairments of learning and development. In 55 toddlers (32 girls, 23 boys; 27.4 ± 4.9 months; range: 16-37 months), ECG monitoring was conducted for a period of 30 (±3) h. Parents were asked about their children's touchscreen media use and they rated their children's sleep quality. The use of touchscreen media predicted the physiologically determined quality of sleep but not parent-reported sleep quality (such as sleep onset latency). Greater heart rate differences between restless sleep phases and restful sleep indicated poorer nighttime recovery in children with more frequent use of touchscreen media. The study demonstrates that the expert analysis of the ECG during sleep is a potent tool for the estimation of sleep quality in toddlers.
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Affiliation(s)
- Sigrid Hackl-Wimmer
- Educational Psychology Unit, Department of Psychology, University of Graz, 8010 Graz, Austria; (M.T.W.E.); (D.M.); (M.P.)
| | - Marina Tanja Waltraud Eglmaier
- Educational Psychology Unit, Department of Psychology, University of Graz, 8010 Graz, Austria; (M.T.W.E.); (D.M.); (M.P.)
| | - Lars Eichen
- Department of Early Childhood Education, University of Graz, 8010 Graz, Austria; (L.E.); (K.R.); (C.W.-L.)
| | - Karoline Rettenbacher
- Department of Early Childhood Education, University of Graz, 8010 Graz, Austria; (L.E.); (K.R.); (C.W.-L.)
| | - Daniel Macher
- Educational Psychology Unit, Department of Psychology, University of Graz, 8010 Graz, Austria; (M.T.W.E.); (D.M.); (M.P.)
| | - Catherine Walter-Laager
- Department of Early Childhood Education, University of Graz, 8010 Graz, Austria; (L.E.); (K.R.); (C.W.-L.)
| | - Helmut Karl Lackner
- Otto Loewi Research Center, Division of Physiology, Medical University of Graz, 8010 Graz, Austria
- Institute of Medical Engineering, Graz University of Technology, 8010 Graz, Austria
| | - Ilona Papousek
- Biological Psychology Unit, Department of Psychology, University of Graz, 8010 Graz, Austria;
| | - Manuela Paechter
- Educational Psychology Unit, Department of Psychology, University of Graz, 8010 Graz, Austria; (M.T.W.E.); (D.M.); (M.P.)
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19
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Eric O. The negative effects of new screens on the cognitive functions of young children require new recommendations. Ital J Pediatr 2021; 47:223. [PMID: 34742324 PMCID: PMC8572488 DOI: 10.1186/s13052-021-01174-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/23/2021] [Indexed: 11/10/2022] Open
Abstract
Television studies have shown that some negative effects of screens could depend on exposure time, but more importantly on the characteristics of the child, the type of content viewed, and the context in which it is viewed. Studies on newer screens show that these factors are still valid but new ones now play a negative role: portable screens increase the duration of exposure and lowered the age at which exposure begins. More worryingly, new screen persuasive designs and dark patterns largely used incite more frequent use, attracting the attention of children and parents, resultantly interfering deeply in parent/child relationships. In this text we suggest that current academic recommendations have to be more broadly shared but also that new recommendations are needed: especially to advise parents not to let their screen interactions compete with real interactions with their child which are the core of learnings (especially language) and emotional regulations but also of their security.
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Affiliation(s)
- Osika Eric
- Department of Pediatrics, Saint Camille Hospital, 2 Rue des Pères Camilliens, 94360, Bry-sur-Marne, France.
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20
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Vincent V, Blot N. Screens for infants and preschool children: Assessment of medical prevention with parents and assessment of exposure. Arch Pediatr 2021; 28:632-637. [PMID: 34690028 DOI: 10.1016/j.arcped.2021.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 07/18/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Regarding the massive increase of interactive mobile screen household equipment and the omnipresence of television, many recommendations are in favor of a limitation of use, especially among the youngest. OBJECTIVE We aimed to evaluate the proportion of parents who report having discussed the subject of their child's exposure to screens during a consultation with a health professional. We also aimed to assess preschool exposure to television and mobile media devices, and to explore parents' views on the benefits and risks of exposing their children under 3 years old. METHODS A questionnaire was administered to parents of children aged 6 months to 3 years in a pediatric emergency ward and several nurseries. This observational, cross-sectional and multicenter study was conducted from January to May 2019. RESULTS We included 451 responses in the analyses. Only 99 (22.7%; 95% CI: 18.7-26.6) parents reported having discussed their child's exposure to screens with a doctor, on the initiative of the parents themselves for 52 households (53.1%; 95% CI: 43.2-62.9). Feelings of a benefit of screens on child learning concerned 134 (34.5%; 95% CI: 29.8-39.3) parents; 300 (68.5%; 95% CI: 64.1-72.8) said they were sufficiently informed about benefits and risks. In a typical week, 240 (53.7%; 95% CI: 49.1-58.3), 160 (35.8%; 95% CI: 31.3-40.2), and 58 (13.0%; 95% CI: 9.9-16.1) children were exposed at least once a week to television, smartphones, and tablets, respectively. CONCLUSIONS Our study showed that the theme of exposure to screens was hardly addressed by physicians in consultation. Our findings help target prevention messages, including fighting the widespread belief that media are beneficial to child development, emphasizing the importance of screen-free time (eating, going to bed, after waking up) and encouraging support and interaction during exposure in families who choose to expose their children.
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Affiliation(s)
- V Vincent
- Service de pédiatrie, Hôpital Rives de Seine, 36 boulevard du Général Leclerc, Neuilly-sur-Seine 92200, France; Cabinet de médecine générale, 3 rue Pierre d'Artagnan, Le Plessis-Robinson 92350, France.
| | - N Blot
- Service de pédiatrie, Hôpital Rives de Seine, 36 boulevard du Général Leclerc, Neuilly-sur-Seine 92200, France
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21
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Byrne R, Terranova CO, Trost SG. Measurement of screen time among young children aged 0-6 years: A systematic review. Obes Rev 2021; 22:e13260. [PMID: 33960616 PMCID: PMC8365769 DOI: 10.1111/obr.13260] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/16/2022]
Abstract
The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.
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Affiliation(s)
- Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Caroline O. Terranova
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
| | - Stewart G. Trost
- School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children's Health Research (CCHR)Queensland University of Technology (QUT)South BrisbaneQueenslandAustralia
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22
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Infant media use: A harm reduction approach. Infant Behav Dev 2021; 64:101610. [PMID: 34298189 DOI: 10.1016/j.infbeh.2021.101610] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 05/28/2021] [Accepted: 07/05/2021] [Indexed: 11/23/2022]
Abstract
There are a myriad of potentially harmful developmental outcomes associated with infant digital media use. Studies revealing risk associated with early media use have informed the current American Academy of Pediatrics (AAP) recommendations that discourage most digital media use among children under 18 months of age. Recent research advances, however, suggest potential benefits of technology engagement in this age group. Additionally, surveys of parents reveal that most infants engage with digital media for at least 30 min a day, exceeding the AAP recommendations. In response to these discoveries and cultural trends, some scholars have made compelling cases to adapt the AAP guidelines for infants. A helpful model for developing infant digital media use guidelines for families may be the harm reduction approach. The intent of this review is to suggest adaptations to the AAP guidelines for infant media engagement using a harm reduction framework. This review describes the challenge of restrictive guidelines, briefly summarizes the harm reduction approach, provides a review of risks and benefits associated with infant media use in each developmental domain (physical, cognitive, and socioemotional), summarizes correlates of infant screen media use, and examines intervention strategies for reducing screen time. The paper concludes with examples of possible adaptations to current AAP infant media use recommendations using harm reduction and bioecological frameworks.
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23
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Courage ML, Frizzell LM, Walsh CS, Smith M. Toddlers Using Tablets: They Engage, Play, and Learn. Front Psychol 2021; 12:564479. [PMID: 34135793 PMCID: PMC8200401 DOI: 10.3389/fpsyg.2021.564479] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 04/26/2021] [Indexed: 11/15/2022] Open
Abstract
Although very young children have unprecedented access to touchscreen devices, there is limited research on how successfully they operate these devices for play and learning. For infants and toddlers, whose cognitive, fine motor, and executive functions are immature, several basic questions are significant: (1) Can they operate a tablet purposefully to achieve a goal? (2) Can they acquire operating skills and learn new information from commercially available apps? (3) Do individual differences in executive functioning predict success in using and learning from the apps? Accordingly, 31 2-year-olds (M = 30.82 month, SD = 2.70; 18 female) were compared with 29 3-year-olds (M = 40.92 month, SD = 4.82; 13 female) using two commercially available apps with different task and skill requirements: (1) a shape matching app performed across 3 days, and (2) a storybook app with performance compared to that on a matched paper storybook. Children also completed (3) the Minnesota Executive Functioning Scale. An adult provided minimal scaffolding throughout. The results showed: (1) toddlers could provide simple goal-directed touch gestures and the manual interactions needed to operate the tablet (2) after controlling for prior experience with shape matching, toddlers’ increased success and efficiency, made fewer errors, decreased completion times, and required less scaffolding across trials, (3) they recognized more story content from the e-book and were less distracted than from the paper book, (4) executive functioning contributed unique variance to the outcome measures on both apps, and (5) 3-year-olds outperformed 2-year-olds on all measures. The results are discussed in terms of the potential of interactive devices to support toddlers’ learning.
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Affiliation(s)
- Mary L Courage
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Lynn M Frizzell
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Colin S Walsh
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Megan Smith
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
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24
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Bacaro V, Gavriloff D, Lombardo C, Baglioni C. Sleep Characteristics in the Italian Pediatric Population: A Systematic Review. CLINICAL NEUROPSYCHIATRY 2021; 18:119-136. [PMID: 34909029 PMCID: PMC8629036 DOI: 10.36131/cnfioritieditore20210302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE During childhood sleep duration, quality and patterns evolve and change greatly and relate strongly to healthy development. This systematic review aims to summarize the literature on sleep characteristics in the Italian pediatric population, adopting a cultural perspective. METHOD Pubmed, PsycINFO and Medline databases were systematically searched. Eligible studies had to: include Italian children and adolescents; report data for one or more sleep-related variables; be published in English or Italian. RESULTS Twenty-nine studies were selected including 18551 Italian children or adolescents. Studies were categorized by age group: infancy and toddlerhood (0-3 years); preschool and school age (3-12 years); adolescence (12-18 years) and mixed age groups. Overall, studies showed that the Italian pediatric population present shorter sleep duration and longer sleep onset latency compared to international recommendations. Furthermore, data indicate high prevalence of dysfunctional sleep habits, such as late bed-time (all age groups), involvement of parents during bed-time (infancy and toddlerhood), and high variability between sleep times on week-days vs. weekends (adolescence). Nevertheless, most studies lacked comprehensive data on sleep patterns, focusing instead on isolated variables. CONCLUSION These results suggest a strong trend among Italian children and adolescents towards unhealthy sleep patterns. Comprehensive data are still lacking and large studies evaluating a broad range of sleep characteristics in Italian pediatric populations are needed. Data strongly suggest that Italian Pediatric Primary Care should place higher focus on sleep problems and implement clinical protocols directed towards improving sleep patterns in children and adolescents.
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Affiliation(s)
- Valeria Bacaro
- Department of Human Sciences, University of Rome Guglielmo Marconi, Rome, IT
| | - Dimitri Gavriloff
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | - Chiara Baglioni
- Department of Human Sciences, University of Rome Guglielmo Marconi, Rome, IT.,Department of Psychiatry and Psychotherapy, Medical Center - Faculty of Medicine, University of Freiburg, Germany
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Kahn M, Barnett N, Glazer A, Gradisar M. Sleep and screen exposure across the beginning of life: deciphering the links using big-data analytics. Sleep 2021; 44:5896445. [PMID: 32832981 DOI: 10.1093/sleep/zsaa158] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/28/2020] [Indexed: 02/03/2023] Open
Abstract
STUDY OBJECTIVES Evidence for the association between screen time and insufficient sleep is bourgeoning, and recent findings suggest that these associations may be more pronounced in younger compared to older children, and for portable compared to non-portable devices. However, these effects have yet to be investigated within the beginning of life. Importantly, there are no data for the relationship between screen exposure and objectively measured infant sleep. This study examined the moderating role of age for both touchscreens' and television's relationship with sleep, using auto-videosomnography within a big-data sample of infants. METHODS The sleep of 1074 infants (46% girls) aged 0-18 months was objectively assessed using computer-vision technology in this cross-sectional study. Sleep was additionally reported by parents in an online survey, as was infant exposure to screens. RESULTS Age significantly moderated the relationship between daytime touchscreen exposure and sleep with a distinct pattern for younger infants, in which screen exposure was associated with decreased daytime sleep, but with a proposed compensatory increase in nighttime sleep consolidation. Compared to touchscreens, television exposure was less likely to be associated with sleep metrics, and age moderated this relationship only for daytime and 24-hour sleep duration. CONCLUSIONS In young infants, a daytime-nighttime sleep "trade-off" emerged, suggesting that the displacement of daytime sleep by screens may lead to greater accumulation of sleep homeostatic pressure, which in turn facilitates more consolidated nighttime sleep.
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Affiliation(s)
- Michal Kahn
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | | | | | - Michael Gradisar
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
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26
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Bellagamba F, Presaghi F, Di Marco M, D'Abundo E, Blanchfield O, Barr R. How Infant and Toddlers' Media Use Is Related to Sleeping Habits in Everyday Life in Italy. Front Psychol 2021; 12:589664. [PMID: 33828502 PMCID: PMC8020901 DOI: 10.3389/fpsyg.2021.589664] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 02/24/2021] [Indexed: 01/31/2023] Open
Abstract
Background Heavy media use has been linked to sleep problems in children, which may also extend to the infancy period. While international parent-advisory agencies, such as the American Academy of Pediatrics (2016), advise no screen time before 18 months, parents often do not follow this recommendation. Research on Italian infants’ early access to media is sparse, and only very few studies have investigated links with sleeping habits. Method To address this gap, we examined concurrent associations between parent-reported surveys of child technology use and sleeping patterns. The Italian version of the 60 item Comprehensive Assessment of Family Media Exposure (CAFE) Survey, developed as part of a larger international study, (Barr et al., 2020), the Brief Screening Questionnaire for Infant Sleep Problems (BISQ) Sadeh, 2004) were completed online by 264 Italian parents of 8- to 36-month-olds and a subset (n = 134) completed the Parenting Stress Index (PSI) Abidin, 1995) between April 2017 and April 2018. Results More devices located in the child’s room and the more time spent watching TV or using an iPad were associated with less hours of sleep at night. Furthermore, more time spent watching TV or using a smartphone, as well as the number of devices in the room was associated with going to sleep later at night. Instrumental media use was associated with less sleep. Conclusion Like other countries, Italian infants have high levels of exposure to media, and differences in media patterns were associated with sleep patterns. Cultural factors influence both instrumental reasons for media use and sleep practices. Further research should explore how media use may serve to regulate emotion as a function of both contextual factors and individual differences.
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Affiliation(s)
- Francesca Bellagamba
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Fabio Presaghi
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Martina Di Marco
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Emilia D'Abundo
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Olivia Blanchfield
- Department of Psychology, Georgetown College, Georgetown University, Washington, DC, United States
| | - Rachel Barr
- Department of Psychology, Georgetown College, Georgetown University, Washington, DC, United States
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Paulus FW, Möhler E, Recktenwald F, Albert A, Mall V. Electronic Media and Early Childhood: A Review. KLINISCHE PADIATRIE 2021; 233:157-172. [PMID: 33662997 DOI: 10.1055/a-1335-4936] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND This review summarizes the state of knowledge of use of new media on the development in early childhood in 6 sections: descriptive utilization data, psychosocial and emotional development, cognition and language, motor development, nutrition and sleep, and influence of parental media consumption. METHODS The review is based on a literature search of this topic in peer-reviewed journals. We included 87 articles, books, and book chapters. The used literature data bases were ERIC, PsycARTICLES, PsycINFO and PSYNDEX. RESULTS Manifold studies describe in young children's utilization data the pervasive nature of digital exposure and impressive usage times and availability. They confirm adverse influences of electronic media use (television, video games) on children's emotional and behavioral problems and well-being, e. g. on physical activity, sleep and obesity. In general a positive effect in sense of knowledge transfer of age could be found for high quality educational media, however predominantly the impact of media use at younger age was negative. CONCLUSIONS High frequent media use in early childhood is likely to have a negative impact on psychosocial development, positive effects such as knowledge transfer may be seen beyond the age of 18 months. As parental media use is a strong predictor of child media habits, reducing parental media use and enhancing parent-child interactions might be important areas to address when trying to change the media behavior of young children. In view of the scarcity of studies for early childhood, it is advisable to use digital play and communication devices cautiously and restrictively in this vulnerable development phase.
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Affiliation(s)
- Frank W Paulus
- Child and Adolescent Psychiatry, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany
| | - Eva Möhler
- Child and Adolescent Psychiatry, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany
| | - Franziska Recktenwald
- Child and Adolescent Psychiatry, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany
| | - Amélie Albert
- Child and Adolescent Psychiatry, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany
| | - Volker Mall
- Children Hospital, Technische Universität München, München, Germany
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Cassanello P, Ruiz-Botia I, Díez-Izquierdo A, Cartanyà-Hueso À, Martínez-Sanchez JM, Balaguer A. How do infants and toddlers sleep in Spain? A cross-sectional study. Eur J Pediatr 2021; 180:775-782. [PMID: 32827061 DOI: 10.1007/s00431-020-03786-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/10/2020] [Accepted: 08/18/2020] [Indexed: 01/17/2023]
Abstract
There is limited information on sleep patterns among infants and toddlers in Spain. The aim of this study was to assess sleep patterns in children three to 36 months of age in Spain. A cross-sectional study was conducted between February 2017 and February 2018. Sociodemographic data and sleep variables were collected using an expanded version of the validated Spanish version of the brief infant sleep questionnaire. A total of 1,404 parental reports on children (725 males; 679 females) with a mean age of 18.8 ± 9.5 months were collected. Parents who perceived their child's sleep as problematic (39% of our sample) reported fewer sleep hours (median 9 versus 10 h), more night awakenings (median 2 versus 1), and longer periods of nocturnal awakenings (median 0.5 versus 0.08 min) (p < 0.001). Parental presence at the time of sleep onset and later and irregular bedtime routines were significantly associated with a reduction in total sleep time, longer sleep latency, and disruptive night awakenings (p < 0.001). These findings highlight the need for further studies to assess how to improve sleep patterns as a relevant modifiable lifestyle factor.Conclusion: A substantial percentage of the population perceived that their children slept poorly, which was evident in a variety of sleep patterns, including sleep duration and sleep quality. What is known: • Previous research has established that sleep difficulties among pediatric population affect up to 30% of all children and up to 20-30% of infants and toddlers. • A positive relationship between less parental bedtime involvement and sleep consolidation in infants and toddlers has been established. What is new: • More than a third of Spanish parents perceived their infants and toddlers sleep as problematic and their children reportedly have shorter night sleep hours, more night awakenings, and longer periods of nocturnal awakenings. • Later and irregular parental bedtime routines were associated with worst infants and toddlers sleep.
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Affiliation(s)
- Pia Cassanello
- Pediatric Division, Hospital Universitari General de Catalunya, Barcelona, Spain. .,Universitat Internacional de Catalunya, Barcelona, Spain. .,AdSalutem Institute Sleep Medicine Barcelona, Barcelona, Spain.
| | | | - Ana Díez-Izquierdo
- Pediatric Division, Hospital Universitari General de Catalunya, Barcelona, Spain.,Universitat Internacional de Catalunya, Barcelona, Spain
| | | | | | - Albert Balaguer
- Pediatric Division, Hospital Universitari General de Catalunya, Barcelona, Spain.,Universitat Internacional de Catalunya, Barcelona, Spain
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Shinomiya Y, Yoshizaki A, Murata E, Fujisawa TX, Taniike M, Mohri I. Sleep and the General Behavior of Infants and Parents during the Closure of Schools as a Result of the COVID-19 Pandemic: Comparison with 2019 Data. CHILDREN (BASEL, SWITZERLAND) 2021; 8:168. [PMID: 33671816 PMCID: PMC7926370 DOI: 10.3390/children8020168] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 01/19/2023]
Abstract
This study compared cross-sectional data from online surveys describing the sleep behavior of infants and caregivers in March 2020 (the school closure period during the early stages of the COVID-19 pandemic; n = 295, 23.8 ± 3.8 months old) and March 2019 (before the pandemic; n = 2017, 24.2 ± 3.8 months old). In comparing those two points in time, no significant differences were found in wake-up times (2019: 7:19 ± 0:46 am vs. 2020: 7:18 ± 0:47 am, p = 0.289), bedtimes (21:01 ± 0:48 pm vs. 21:04 ± 0:53 pm, p = 0.144), or nocturnal sleep times (593.7 ± 43.9 min vs. 588.1 ± 50.3 min, p = 0.613). Regarding the caregivers, in 2020, wake-up times (2019: 6:46 ± 0:50 am vs. 2020: 6:39 ± 0:50 am, p = 0.017) and bedtimes (22:53 ± 1:17 pm vs. 22:42 ± 1:04 pm, p = 0.016) became significantly earlier compared to 2019. Among infants staying at home, total sleep time and percentage of outdoor play decreased significantly, and media use increased significantly in 2020. Lower levels of exercise and more frequent media viewing may have caused prolonged sleep latency in these children. The percentage of caregivers responding with "negative childcare feelings" was significantly higher in the group with less than three nursery school attendance days. Caregivers and infants staying at home are a high-risk group during the pandemic.
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Affiliation(s)
- Yasuaki Shinomiya
- Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan; (Y.S.); (A.Y.); (E.M.)
| | - Arika Yoshizaki
- Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan; (Y.S.); (A.Y.); (E.M.)
| | - Emi Murata
- Molecular Research Center for Children’s Mental Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan; (Y.S.); (A.Y.); (E.M.)
| | - Takashi X. Fujisawa
- Research Center for Child Mental Development, University of Fukui, Fukui 910-1193, Japan;
| | - Masako Taniike
- Department of Child Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan;
| | - Ikuko Mohri
- Department of Child Development, United Graduate School of Child Development, Osaka University, Osaka 565-0871, Japan;
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30
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Alghamdi S, Bawageeh D, Alkhaibari H, Almutairi A, Aljuhani S. Media use and behavioral disorders among Saudi Arabian children. BELITUNG NURSING JOURNAL 2021; 7:31-36. [PMID: 37469794 PMCID: PMC10353598 DOI: 10.33546/bnj.1294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/19/2021] [Accepted: 02/05/2021] [Indexed: 07/21/2023] Open
Abstract
Background Despite children's frequent use of electronic devices, there is a lack of evidence showing how such media use influences their behavior. Objective This study was to assess the relationship between media use and behavior among a sample of children aged three to 11 years. Methods This was a descriptive cross-sectional study. An electronic self-administered questionnaire was completed from January 2020 to March 2020 by a convenience sample of 234 parents with healthy children in the target age group. Descriptive statistics and One-Way Analysis of Variance (ANOVA) were used for data analysis. Results There was no significant difference in children's behavior according to the type of media [F(3, 230) = 1.673, p = 0.174]. In contrast, there was a significant difference in children's behavior according to hours per day of media use [F(4, 229) = 2.701, p = 0.031]. The most commonly used mobile device was the smartphone (n = 87, 37.2%). More than a quarter of the children spent three hours a day using media. Conclusions This study offers insight into associations between children's frequent media use and their behavior. The results suggest that the significant factor associated with behavioral problems is not the type of media but the time spent using it. Nurses are encouraged to use these findings in developing educational programs that raise awareness among parents and children regarding the consequences of excessive media use.
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Affiliation(s)
- Salmah Alghamdi
- Maternity and Child Health Department, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Duaa Bawageeh
- Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hessa Alkhaibari
- Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amwaj Almutairi
- Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shoug Aljuhani
- Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
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31
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Sohn SY, Krasnoff L, Rees P, Kalk NJ, Carter B. The Association Between Smartphone Addiction and Sleep: A UK Cross-Sectional Study of Young Adults. Front Psychiatry 2021; 12:629407. [PMID: 33737890 PMCID: PMC7961071 DOI: 10.3389/fpsyt.2021.629407] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 02/01/2021] [Indexed: 12/12/2022] Open
Abstract
Background: In a large UK study we investigated the relationship between smartphone addiction and sleep quality in a young adult population. Methods: We undertook a large UK cross-sectional observational study of 1,043 participants aged 18 to 30 between January 21st and February 30th 2019. Participants completed the Smartphone Addiction Scale Short Version, an adapted Pittsburgh Sleep Quality Score Index and reported smartphone use reduction strategies using both in-person (n = 968) and online (n = 75) questionnaires. A crude and adjusted logistic regression was fitted to assess risk factors for smartphone addiction, and the association between smartphone addiction and poor sleep. Results: One thousand seventy one questionnaires were returned, of which 1,043 participants were included, with median age 21.1 [interquartile range (IQR) 19-22]. Seven hundred and sixty three (73.2%) were female, and 406 reported smartphone addiction (38.9%). A large proportion of participants disclosed poor sleep (61.6%), and in those with smartphone addiction, 68.7% had poor sleep quality, compared to 57.1% of those without. Smartphone addiction was associated with poor sleep (aOR = 1.41, 95%CI: 1.06-1.87, p = 0.018). Conclusions: Using a validated instrument, 39% young adults reported smartphone addiction. Smartphone addiction was associated with poor sleep, independent of duration of usage, indicating that length of time should not be used as a proxy for harmful usage.
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Affiliation(s)
- Sei Yon Sohn
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Lauren Krasnoff
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Philippa Rees
- Population Policy Practice, National Institute of Health Research, Great Ormond Street Hospital Biomedical Research Centre Institute of Child Health, University College London, London, United Kingdom
| | - Nicola J Kalk
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, Beckenham, United Kingdom
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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32
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Ricci C, Poulain T, Rothenbacher D, Genuneit J. The Associations Between Media Use, Midpoint of Sleep, and Sleep Quality in German Preschoolers: A Mediation Analysis Based on the Ulm SPATZ Health Study. Nat Sci Sleep 2021; 13:1025-1035. [PMID: 34262374 PMCID: PMC8273753 DOI: 10.2147/nss.s307821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/16/2021] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION The relation of electronic media use with sleep quality among preschoolers is a matter of ongoing debate. Longitudinal data are scarce and do not account for sleeping schedules. METHODS We used the German Children's Sleep Habits Questionnaire to measure parent-reported child's sleep quality; its score is computed by the sum of 34 items defined by a 1-3 level Likert scale (score ranging 34-102), with higher values representing lower sleep quality. A causal mediation analysis of these relations using data from the Ulm SPATZ Health Study in Germany was conducted. Repeated data on electronic media use, book reading, sleep quality, sleep duration, and midpoint of sleep were prospectively collected yearly from ages 4 to 6 years (n=563) during parent's working days and free days. RESULTS We observed negative correlations of sleep quality with sleep duration and midpoint of sleep at ages 4-5 (R=-0.21 to -0.10), which attenuated with age 6 years. Sleep duration and midpoint of sleep were strongly positively correlated at all ages (R=0.55-0.95). We observed significant negative associations between total electronic media use and TV/DVD watching, while book reading did neither affect the sleep quality score nor sleep duration or midpoint of sleep. We found little evidence for an indirect negative effect of media use on sleep quality via sleep duration or midpoint of sleep, indicating that media use acts independently on sleep duration, midpoint of sleep, and sleep quality. Non-statistically significant associations of sleep duration and midpoint of sleep on sleep quality indicate that these are independent aspects of sleep adequacy. Evidence for this was stronger during free days. CONCLUSION Media use acted on sleep quality through a direct effect in a prospective fashion. Thus, we conclude that electronic media use increases the risk for sleep impairments in German preschoolers, while book reading seems to be a safe and healthy alternative.
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Affiliation(s)
- Cristian Ricci
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Tanja Poulain
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany.,Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Germany
| | | | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany.,Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
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Abstract
Research suggests that technology use is associated with poorer sleep outcomes among children less than 6 years of age. These associations are evident regardless of the type of technology studied, although evening exposure may have the greatest impact compared with technology use during other parts of the day. More work is needed, particularly given that technology use is relatively high among young children. Clinicians should assess patients' technology exposure, including before bedtime, to assess whether sleep issues stem from children's technology use. Moreover, clinicians should educate caregivers about the association between technology use and sleep problems among young children.
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Affiliation(s)
- Amy I Nathanson
- School of Communication, Ohio State University, Columbus, OH 43210, USA.
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34
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Benita N, Gordon-Hacker A, Gueron-Sela N. Sleep Through Toddlerhood: The Distinct Roles of Overall Media Use and Use of Media to Regulate Child Distress. J Dev Behav Pediatr 2020; 41:690-697. [PMID: 32618818 DOI: 10.1097/dbp.0000000000000836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Excessive media exposure has been associated with various sleep disturbances in early childhood. However, previous research mostly addressed the overall amount of media use while neglecting the role of media use practices. The purpose of this study was to examine whether media use practices (specifically, maternal use of media to regulate child distress) and overall media use predict distinct aspects of children's sleep. We hypothesized that frequent maternal use of media to regulate child distress will predict difficulties in sleep regulation, whereas higher child screen time will predict lower sleep duration. METHODS One-hundred fifty-one mothers (predominantly from the United Kingdom) completed anonymous online questionnaires via the Prolific platform that assessed child sleep latency and duration, use of media to regulate child distress, overall child screen time, and demographic covariates at 2 time points: 22 months (T1) and 26 months (T2) of children's age. RESULTS Maternal use of media to regulate child distress at T1 (but not screen time) predicted longer sleep latency at T2. Conversely, screen time (but not media to regulate distress) at T1 predicted shorter sleep duration at T2. These results were obtained while controlling for multiple covariates and sleep and media use at both time points. CONCLUSION Findings suggest that media use practices and overall use have differential effects on sleep. Specifically, the use of media-based regulation strategies may interfere with the development of children's ability to self-soothe and regulate arousal in contexts that require the use of regulatory skills, such as transition to sleep.
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Affiliation(s)
- Noy Benita
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Noa Gueron-Sela
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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35
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Yoshizaki A, Mohri I, Yamamoto T, Shirota A, Okada S, Murata E, Hoshino K, Kato-Nishimura K, Matsuzawa S, Kato T, Taniike M. An Interactive Smartphone App, Nenne Navi, for Improving Children's Sleep: Pilot Usability Study. JMIR Pediatr Parent 2020; 3:e22102. [PMID: 33122163 PMCID: PMC7738258 DOI: 10.2196/22102] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/29/2020] [Accepted: 10/27/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Healthy sleep is important not only for physical health but also for brain development in children. Several reports have revealed that Japanese adults and children have later bedtimes and shorter sleep durations compared with those in other countries, possibly because of Japanese culture and lifestyles. Therefore, an intervention tool that is suitable to the Japanese sociocultural environment is urgently needed to improve children's sleep problems in their early years. OBJECTIVE To provide appropriate sleep health literacy to caregivers and change their parenting behavior, we developed a smartphone app that allows reciprocal interaction between caregivers and pediatric sleep experts. This paper describes a preliminary study to examine the app's basic design and functions and to establish its acceptability and usability in a small sample. METHODS A total of 10 caregivers and 10 infants (aged 18-28 months; 4/10, 40% boys) living in Japan participated in the study. At the start of the trial, the e-learning content regarding sleep health literacy was delivered via a smartphone. Thereafter, caregivers manually inputted recorded data about their own and their infant's sleep habits for 8 consecutive days per month for 2 months. After pediatric sleep experts retrieved this information from the Osaka University server, they specified the problems and provided multiple sleep habit improvement suggestions to caregivers. Caregivers then selected one of the feasible pieces of advice to practice and reported their child's sleep-related behaviors via the app. Actigraphy was used to monitor children's sleep behaviors objectively. The concordance between the information provided by caregivers and the actigraphy data was assessed. The acceptability and usability of the app were evaluated using self-report questionnaires completed by caregivers; qualitative feedback was obtained via semistructured interviews after the intervention. RESULTS There was no significant difference between the information provided by the caregivers and the actigraphy data for bedtimes and wake-up times (P=.13 to P=.97). However, there was a difference between the actigraphy data and the caregivers' reports of nighttime sleep duration and nighttime awakenings (P<.001 each), similar to prior findings. User feedback showed that 6 and 5 of the 10 caregivers rated the app easy to understand and easy to continue to use, respectively. Additionally, 6 of the 10 caregivers rated the app's operativity as satisfactory. Although this was a short-term trial, children's sleep habits, caregivers' sleep health consciousness, and parenting behaviors improved to some extent. CONCLUSIONS The present findings suggest that the app can easily be used and is acceptable by Japanese caregivers. Given the user feedback, the app has the potential to improve children's sleep habits by sending individualized advice that fits families' backgrounds and home lives. Further studies are needed to confirm the efficacy of the app and facilitate social implementation.
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Affiliation(s)
- Arika Yoshizaki
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Ikuko Mohri
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan.,United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Tomoka Yamamoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Ai Shirota
- Department of Oral Physiology, Graduate School of Dentistry, Osaka University, Suita, Osaka, Japan
| | - Shiho Okada
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Emi Murata
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Kyoko Hoshino
- Segawa Memorial Neurological Clinic for Children, Chiyoda, Tokyo, Japan
| | - Kumi Kato-Nishimura
- United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan.,Ota Memorial Sleep Center, Kawasaki, Kanagawa, Japan
| | - Shigeyuki Matsuzawa
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Graduate School of Dentistry, Osaka University, Suita, Osaka, Japan
| | - Masako Taniike
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan.,United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
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36
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Leppänen MH, Sääksjärvi K, Vepsäläinen H, Ray C, Hiltunen P, Koivusilta L, Erkkola M, Sajaniemi N, Roos E. Association of screen time with long-term stress and temperament in preschoolers: results from the DAGIS study. Eur J Pediatr 2020; 179:1805-1812. [PMID: 32462485 PMCID: PMC7547983 DOI: 10.1007/s00431-020-03686-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/30/2020] [Accepted: 05/11/2020] [Indexed: 02/06/2023]
Abstract
Screen time is increasing rapidly in young children. The aim of this study was to examine associations of long-term stress and temperament with screen time in Finnish preschool children and the moderating role of socioeconomic status. Cross-sectional DAGIS data were utilized. Long-term stress was assessed using hair cortisol concentration, indicating values of the past 2 months. Temperament was reported by the parents using the Children's Behavior Questionnaire (the Very Short Form), and three broad temperament dimensions were constructed: surgency, negative affectivity, and effortful control. Screen time was reported by the parents over 7 days. The highest education level in the household was used as an indicator of socioeconomic status. In total, 779 children (mean age, 4.7 ± 0.9 years, 52% boys) were included in the study. Of the temperament dimensions, a higher effortful control was associated with less screen time (B = - 6.70, p = 0.002). There was no evidence for an association between hair cortisol concentration and screen time nor a moderating role of socioeconomic status in the associations (p > 0.05).Conclusion: Our findings indicate that preschool children with a higher score in effortful control had less screen time. Because effortful control reflects general self-regulatory abilities, promoting these skills may be effective in reducing screen time in young children. What is Known: • Screen time has increased rapidly during the last decades, and higher screen time has been linked with numerous adverse health consequences in children. • There are no previous studies investigating associations of long-term stress and temperament with screen time in young children. What is New: • Of the temperament dimensions, effortful control was associated with higher screen time in preschool children, but there was no association found between long-term stress and screen time. • Since effortful control reflects general self-regulatory abilities, promoting these skills may be effective in reducing screen time in young children.
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Affiliation(s)
- Marja H. Leppänen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland
- Faculty of Medicine, Clinicum, University of Helsinki, PO BOX 21, 00014 Helsinki, Finland
| | - Katri Sääksjärvi
- Faculty of Educational Sciences, University of Helsinki, PO BOX 8, 00014 Helsinki, Finland
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, PO BOX 66, 00014 Helsinki, Finland
| | - Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, PO BOX 66, 00014 Helsinki, Finland
| | - Pauliina Hiltunen
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, PO BOX 66, 00014 Helsinki, Finland
| | - Leena Koivusilta
- Department of Social Research, University of Turku, Turku, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, PO BOX 66, 00014 Helsinki, Finland
| | - Nina Sajaniemi
- Faculty of Educational Sciences, University of Helsinki, PO BOX 8, 00014 Helsinki, Finland
- Philosophical Faculty, School of Applied Educational Science and Teacher Education, University of Eastern Finland, PO BOX 111, 80101 Joensuu, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, PO BOX 66, 00014 Helsinki, Finland
- Department of Public Health, Clinicum, University of Helsinki, PO BOX 20, 00014 Helsinki, Finland
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Chen JY, Strodl E, Huang LH, Chen YJ, Yang GY, Chen WQ. Early Electronic Screen Exposure and Autistic-Like Behaviors among Preschoolers: The Mediating Role of Caregiver-Child Interaction, Sleep Duration and Outdoor Activities. CHILDREN-BASEL 2020; 7:children7110200. [PMID: 33126543 PMCID: PMC7692375 DOI: 10.3390/children7110200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/22/2020] [Accepted: 10/24/2020] [Indexed: 12/17/2022]
Abstract
Research into early screen exposure has raised growing concerns about its impact upon children’s neuropsychological well-being. However, possible pathways remain unclear. This study therefore aimed not only to evaluate the association between screen exposure during the ages of 0–3 years and preschoolers’ autistic-like behaviors, but also the mediating roles of the frequency of caregiver-child interaction, sleep duration and level of participation in outdoor activities. Based on the 2017 survey of the Longhua Child Cohort Study, data of 29,595 child-caregiver dyads were obtained via a caregiver-reported questionnaire, with the data from 29,461 dyads included in the data analysis. Multiple linear and logistic regression models were employed to estimate the associations between screen exposure, caregiver-child interaction, sleep duration, outdoor activities, and children’s autistic-like behaviors. The results indicated that screen exposure during 0–3 years of age was associated with the presence of autistic-like behaviors at preschool age, and the strength of the association was enhanced with the increase of average daily screen time (Odds Ratios (ORs) ranging from 1.358 to 4.026). The frequency of caregiver-child interaction and sleep duration mediated 5.32% and 1.19% of the variance of the association respectively, but outdoor activities did not mediate the association. Our findings indicate that preschoolers who are exposed to screens at aged 0–3 years might have an increased risk of autistic-like behaviors, and that, the frequency of caregiver-child interaction and sleep duration might function as potential mediators of this association.
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Affiliation(s)
- Jing-Yi Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.-Y.C.); (L.-H.H.); (Y.-J.C.); (G.-Y.Y.)
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane 4059, Queensland, Australia;
| | - Li-Hua Huang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.-Y.C.); (L.-H.H.); (Y.-J.C.); (G.-Y.Y.)
| | - Ying-Jie Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.-Y.C.); (L.-H.H.); (Y.-J.C.); (G.-Y.Y.)
| | - Gui-You Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.-Y.C.); (L.-H.H.); (Y.-J.C.); (G.-Y.Y.)
| | - Wei-Qing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (J.-Y.C.); (L.-H.H.); (Y.-J.C.); (G.-Y.Y.)
- Department of Information Management, Xinhua College of Sun Yat-sen University, Guangzhou 510080, China
- Correspondence: ; Tel.: +86-20-87332199; Fax: +86-20-87330446
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Digital Devices Use and Language Skills in Children between 8 and 36 Month. Brain Sci 2020; 10:brainsci10090656. [PMID: 32967331 PMCID: PMC7563257 DOI: 10.3390/brainsci10090656] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Over the past decade, the use of digital tools has grown and research evidence suggests that traditional media and new media offer both benefits and health risks for young children. The abilities to understand and use language represent two of the most important competencies developed during the first 3 years of life through the interaction of the child with people, objects, events, and other environmental factors. The main goal of our study is to evaluate the relationship between digital devices use and language abilities in children between 8 and 36 month, also considering the influence of several factors. Materials and Methods: We conducted a cross-sectional observational study on digital devices use and language abilities in260 children (140 males = 54%) aged between 8 and 36 months (mean = 23.5 ± 7.18 months). All the parents completed a self-report questionnaire investigating the use of digital devices by their children, and a standardized questionnaire for the assessment of language skills (MacArthur-Bates). Linear regression analysis was used to evaluate the relation between different variables. Subsequent moderation analysis were performed to verify the influence of other factors. Results: We found a statistically significant negative relation between the total daily time of exposure to digital devices and the Actions and Gestures Quotient (ß = -0.397) in children between 8 and 17 months, and between the total daily time of exposure to digital devices and Lexical Quotient (ß = -0.224) in children between 18 and 36 months. Gender, level of education/job of parents, modality of use/content of digital device did not significantly affect the result of the regression analysis. Conclusion: In our study we found that a longer time of exposure to digital devices was related to lower mimic-gestural skills in children from 8-17 months and to lower language skills in children between 18 and 36 months, regardless of age, gender, socio-economic status, content, and modality of use. Further studies are needed to confirm and better understand this relation, but parents and pediatricians are advised to limit the use of digital devices by children and encourage the social interaction to support the learning of language and communication skills in this age group.
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Newton AT, Honaker SM, Reid GJ. Risk and protective factors and processes for behavioral sleep problems among preschool and early school-aged children: A systematic review. Sleep Med Rev 2020; 52:101303. [DOI: 10.1016/j.smrv.2020.101303] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 12/15/2022]
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Sleep problems increase the risk of musculoskeletal pain in boys but not girls: a prospective cohort study. Eur J Pediatr 2020; 179:1711-1719. [PMID: 32394267 PMCID: PMC7547975 DOI: 10.1007/s00431-020-03667-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 12/20/2022]
Abstract
Adults with sleep problems are at higher risk for onset of musculoskeletal pain, but the evidence is less clear for children. This prospective cohort study investigated whether children with sleep problems are at higher risk for onset of musculoskeletal pain and explored whether sex is a modifier of this association. In a prospective cohort study of Australian schoolchildren (n = 1239, mean age 9 years), the associations between sleep problems at baseline and new onset of both musculoskeletal pain and persistent musculoskeletal pain (pain lasting > 3 months) 1 year later were investigated using logistic regression. The potential modifying effect of sex was also assessed. One-year incidence proportion for musculoskeletal pain onset is 43% and 7% for persistent musculoskeletal pain. Sleep problems were associated with musculoskeletal pain onset and persistent musculoskeletal pain onset in boys, odds ratio 2.80 (95% CI 1.39, 5.62) and OR 3.70 (1.30, 10.54), respectively, but not girls OR 0.58 (0.28, 1.19) and OR 1.43 (0.41, 4.95), respectively.Conclusions: Rates of musculoskeletal pain are high in children. Boys with sleep problems are at greater risk of onset of musculoskeletal pain, but girls do not appear to have higher risk. Consideration of sleep health may help prevent persistent musculoskeletal pain in children. What is Known: • Sleep problems are associated with the onset of musculoskeletal pain in adults. • It is not clear if the association between sleep problems and the onset of musculoskeletal pain is present also in children and if sex plays a role in this association. What is New: • This is the first large population-based study that has prospectively investigated the relationship between sleep problems and onset of musculoskeletal pain in school-aged children. • Children, especially boys with sleep problems, were at increased risk for the development of persistent musculoskeletal pain.
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Hadjipanayis A, Efstathiou E, Altorjai P, Stiris T, Valiulis A, Koletzko B, Fonseca H. Social media and children: what is the paediatrician's role? Eur J Pediatr 2019; 178:1605-1612. [PMID: 31468108 DOI: 10.1007/s00431-019-03458-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
Social media use has become an integral part of children's and adolescents' lives. It has become a novel way of interaction among people and influences people's social lives and public opinion as well as people's purchasing decisions and businesses. Any website or platform that allows social interaction is considered to be a social media site. Social media use among children in 25 European countries has been reported to be 38% among 9-12 year olds and 77% among those aged 13-16 years. All these children report having their own profile on at least one social network site. While social networking provides children and adolescents with many opportunities and benefits, it also carries many risks. Among the benefits are socialization and communication enhancement, improving learning skills, positive impact on education and getting health information. Potential risks of social media use include falsifying age and identity, cyberbullying, sexting, Facebook depression, gamification, glamourization, cyberostracism and sleep disturbances.Conclusion: Paediatricians play a vital role in promoting the physical, mental and social welfare of all children. There is a critical need for paediatricians to play an active role, guiding children and families appropriately through the impact of social networking, in order to become a real driver of children's development.
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Affiliation(s)
- Adamos Hadjipanayis
- Department of Paediatrics, Larnaca General Hospital, Inomenon Polition, 6042, Larnaca, Cyprus. .,Medical School, European University of Cyprus, Nicosia, Cyprus. .,European Academy of Paediatrics, Brussels, Belgium.
| | - Elisavet Efstathiou
- Department of Paediatrics, Larnaca General Hospital, Inomenon Polition, 6042, Larnaca, Cyprus.,European Academy of Paediatrics, Brussels, Belgium
| | - Peter Altorjai
- European Academy of Paediatrics, Brussels, Belgium.,Association of Hungarian Primary Care Paediatricians, Budapest, Hungary
| | - Tom Stiris
- European Academy of Paediatrics, Brussels, Belgium.,Department of Neonatology, Oslo University Hospital, Oslo, Norway.,Faculty of medicine, University of Oslo, Oslo, Norway
| | - Arunas Valiulis
- European Academy of Paediatrics, Brussels, Belgium.,Vilnius University Medical Faculty, Institutes of Clinical Medicine and Health Sciences, Vilnius, Lithuania
| | - Berthold Koletzko
- European Academy of Paediatrics, Brussels, Belgium.,LMU - Ludwig-Maximilians-Universität Munich, Dr. von Hauner Children's Hospital, Univ. of Munich Medical Centre, Munich, Germany
| | - Helena Fonseca
- European Academy of Paediatrics, Brussels, Belgium.,Adolescent Medicine Division, Department of Paediatrics, University of Lisbon, Lisbon, Portugal
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The Implications of Screen Media Use for the Sleep Behavior of Children Ages 0–5: a Systematic Review of the Literature. CURRENT SLEEP MEDICINE REPORTS 2019. [DOI: 10.1007/s40675-019-00151-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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