Media multitasking and sleep problems: A longitudinal study among adolescents

Screen Use at Bedtime and Sleep Duration and Quality Among Youths

Importance

Although questionnaire-based cross-sectional research suggests that screen time before bed correlates with poor sleep, self-reported data seem unlikely to capture the complexity of modern screen use, requiring objective night-by-night measures to advance this field.

Objective

To examine whether evening screen time is associated with sleep duration and quality that night in youths.

Design, Setting, and Participants

This repeated-measures cohort study was performed from March to December 2021 in participant homes in Dunedin, New Zealand. Participants included healthy youths aged 11 to 14.9 years. Data were analyzed from October to November 2023.

Exposure

Objectively measured screen time, captured using wearable or stationary video cameras from 2 hours before bedtime until the first time the youth attempted sleep (shut-eye time) over 4 nonconsecutive nights. Video data were coded using a reliable protocol (κ = 0.92) to quantify device (8 options [eg, smartphone]) and activity (10 options [eg, social media]) type.

Main Outcomes and Measures

Sleep duration and quality were measured objectively via wrist-worn accelerometers. The association of screen use with sleep measures was analyzed on a night-by-night basis using mixed-effects regression models including participant as a random effect and adjusted for weekends.

Results

Of the 79 participants (47 [59.5%] male; mean [SD] age, 12.9 [1.1] years), all but 1 had screen time before bed. Screen use in the 2 hours before bed had no association with most measures of sleep health that night (eg, mean difference in total sleep time, 0 minutes [95% CI, -3 to 20 minutes] for every 10 minutes more total screen time). All types of screen time were associated with delayed sleep onset but particularly interactive screen use (mean difference, 10 minutes; 95% CI, 4 to 16 minutes for every additional 10 minutes of interactive screen time). Every 10 minutes of additional screen time in bed was associated with shorter total sleep time (mean difference, -3 minutes; 95% CI, -6 to -1 minute). The mean difference in total sleep time was -9 minutes (95% CI, -16 to -2 minutes) for every 10 minutes of interactive screen use and -4 minutes (95% CI, -7 to 0 minutes) for passive screen use. In particular, gaming (mean difference, -17 minutes; 95% CI, -28 to -7 minutes for every 10 minutes of gaming) and multitasking (mean difference, -35 minutes; 95% CI, -67 to -4 minutes on nights with vs without multitasking) were associated with less total sleep time.

Conclusions and Relevance

In this repeated-measures cohort study, use of an objective method showed that screen time once in bed was associated with impairment of sleep, especially when screen time was interactive or involved multitasking. These findings suggest that current sleep hygiene recommendations to restrict all screen time before bed seem neither achievable nor appropriate.

The Effect of Prebedtime Behaviors on Sleep Duration and Quality in Children: Protocol for a Randomized Crossover Trial

BACKGROUND

It is recommended that children should avoid eating dinner, being physically active, or using screens in the hour before bed to ensure good sleep health. However, the evidence base behind these guidelines is weak and limited to cross-sectional studies using questionnaires.

OBJECTIVE

The aim of this randomized crossover trial was to use objective measures to experimentally determine whether recommendations to improve sleep by banning electronic media, physical activity, or food intake in the hour before bed, impact sleep quantity and quality in the youth.

METHODS

After a baseline week to assess usual behavior, 72 children (10-14.9 years old) will be randomized to four conditions, which are (1) avoid all 3 behaviors, (2) use screens for at least 30 minutes, (3) be physically active for at least 30 minutes, and (4) eat a large meal, during the hour before bed on days 5 to 7 of weeks 2 to 5. Families can choose which days of the week they undertake the intervention, but they must be the same days for each intervention week. Guidance on how to undertake each intervention will be provided. Interventions will only be undertaken during the school term to avoid known changes in sleep during school holidays. Intervention adherence and shuteye latency (time from getting into bed until attempting sleep) will be measured by wearable and stationary PatrolEyes video cameras (StuntCams). Sleep (total sleep time, sleep onset, and wake after sleep onset) will be measured using actigraphy (baseline, days 5 to 7 of each intervention week). Mixed effects regression models with a random effect for participants will be used to estimate mean differences (95% CI) for conditions 2 to 4 compared with condition 1.

RESULTS

Recruitment started in March 2024, and is anticipated to finish in April 2025. Following data analysis, we expect that results will be available later in 2026.

CONCLUSIONS

Using objective measures, we will be able to establish if causal relationships exist between prebedtime behaviors and sleep in children. Such information is critical to ensure appropriate and achievable sleep guidelines.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12624000206527; https://tinyurl.com/3kcjmfnj.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/63692.

The effects of multitasking on metacognitive monitoring in primary and secondary school students

Influenced by the epidemic and the rapid popularization of smart devices, media multitasking has become increasingly common in people's lives and has attracted the attention of researchers, particularly among adolescents who are native to the digital era. However, previous studies have focused primarily on the relationship between multitasking and general cognitive functions, paying less attention to the connection between multitasking and metacognition, and there is a lack of research specifically addressing adolescents in this context. To address this gap, the current study conducted two experiments with upper primary and secondary school students to explore the relationship between multitasking and adolescents' metacognition under intrinsic and extrinsic cue conditions using metacognitive monitoring as an indicator. The results revealed that multitasking significantly reduced adolescents' metacognitive monitoring accuracy. However, the scores on the media multitasking questionnaire did not significantly correlate with metacognitive monitoring accuracy in the laboratory task. This finding suggested that multitasking, under both intrinsic and extrinsic cue conditions, impairs the accuracy of metacognitive monitoring for primary and secondary school students. However, daily media multitasking activities among these students were not significantly correlated with metacognitive monitoring accuracy.

Early life adversity and adolescent sleep problems during the COVID-19 pandemic

The COVID-19 pandemic resulted in a reorganization of adolescents' routines, especially their sleep schedules. Utilising 175 caregiver-adolescent dyads, the current study examined associations of biological (e.g., prenatal substance use), environmental (e.g., poverty), and relational (e.g., child maltreatment) subtypes of early life adversity (ELA) with various components of adolescents' sleep across the first year of the COVID-19 pandemic. Relational ELA explained unique variance in adolescents' sleep disturbances, but not other sleep components, following short- and longer-term exposure to the COVID-19 pandemic. However, the direction of this association switched such that relational ELA predicted decreased sleep disturbances during the initial phase of the U.S. COVID-19 pandemic in spring 2020 beyond pre-pandemic levels, but, over time, contributed to increased sleep disturbances beyond early-pandemic levels as the pandemic extended into the winter of 2020.

Digital social multitasking (DSMT) and digital stress among adolescents: A peer norm perspective

Background

Digital stress refers to the stress resulting from persistent use of digital media. Given its major implications for well-being, it is crucial to explore how the use of digital media would contribute to the stress. Drawing on the frameworks of DSMT (i.e., using a digital device during social interactions) and perceived peer norms, we explored whether and how perceived peer norms of DSMT and adolescents' own DSMT were associated with digital stress.

Method

Adolescents between the ages of 12 and 18 were recruited through the Qualtrics survey panels. A total of 2105 adolescents completed a one-time online survey (Mage = 15.39, S.D. = 1.82).

Results

Path analysis revealed that all three self-DSMT variables (level, positive self-perception, negative self-perception) were associated with higher digital stress, with level and negative self-perception having stronger associations than did positive self-perception. Furthermore, peer DSMT level was related to higher digital stress both directly and indirectly through all three self-DSMT variables. Positive peer perception of DSMT was indirectly related to higher digital stress through higher self-DSMT level and more positive self-perception of DSMT, but was related to lower digital stress through reduced negative self-perception of DSMT. Negative peer perception of DSMT contributed to higher digital stress both directly and indirectly by intensifying teens' own negative perception of DSMT. Judging from the total-paths coefficients, all three peer norm variables were related to higher digital stress, with level having the largest coefficient, followed by negative peer perception and finally positive peer perception of DSMT.

Discussion and conclusion

All three perceived peer norms of DSMT (level, positive perception, negative perception) had the potential to increase digital stress directly and/or via impacting teens' own engagement in and perceptions of DSMT, with perceived peer engagement and negative peer perception being the greater risk factors. At the individual level, a similar pattern emerged-self-DSMT level and negative self-perception had noticeably stronger associations with digital stress than did positive self-perception.

Adolescent use of social media and associations with sleep patterns across 18 European and North American countries

OBJECTIVE

Over the past decade, concurrent with increasing social media use (SMU), there has been a shift toward poorer sleep among adolescents in many countries. The purpose of this study was to examine the cross-national associations between adolescent SMU and sleep patterns, by comparing 4 different categories of SMU (nonactive, active, intense, and problematic use).

DESIGN, SETTING, AND PARTICIPANTS

Data were from 86,542 adolescents in 18 European and North American countries that participated in the 2017/18 Health Behaviour in School-aged study.

MEASUREMENTS

Mixed-effects linear regression models were used to examine cross-national associations between 4 SMU categories and adolescent sleep duration, bedtime and social jetlag derived from self-reported data.

RESULTS

For all countries combined, nonactive SMU was associated with longer sleep, earlier bedtimes, and less social jetlag, compared to active SMU, although the differences were minor. By comparison, intense and problematic SMU were associated with less sleep and later bedtimes on both school and nonschool days, and greater social jetlag, compared to active SMU. While findings were relatively consistent between countries, some differences were observed, suggesting that the national and cultural context may be important in interpreting results.

CONCLUSIONS

These findings suggest that both intense and problematic SMU are associated with poorer sleep patterns in adolescents across most countries. Further research is needed to identify effective policies, programs, and messaging to promote the healthy use of social media and prevent potential negative impacts on adolescent sleep.

Longitudinal association between problematic smartphone use and sleep disorder among Chinese college students during the COVID-19 pandemic

BACKGROUND

Problematic smartphone use (PSU) and sleep disorders (SD) are common public health problems among college students. While previous cross-sectional studies have found a relationship between PSU and SD, the causal direction of this relationship remains unclear. This study aims to examine the longitudinal changes of PSU and SD during the COVID-19 pandemic, determine the causal relationship between them, and identify confounding factors that affect this association.

METHODS

The study sample consisted of 1186 Chinese college students (47.7% male) with a mean age of 18.08 years. Participants completed the Smartphone Addiction Scale - Short Version (SAS-SV) and the Pittsburgh Sleep Quality Index (PSQI) at both baseline and follow-up surveys, conducted one year apart. The cross-lagged panel model (CLPM) was used to examine the causal relationship between PSU and SD, stratified by gender and duration of daily physical activity. The fixed effect panel regression was used to confirm the findings of CLPM.

RESULTS

The results of the CLPM analysis showed a significant bidirectional relationship between PSU and SD for the overall sample, which was consistent with the fixed effects model findings. However, subgroup analyses revealed that the bidirectional association disappeared among males or those who engaged in daily physical activity for more than 1 h.

CONCLUSIONS

Our study shows a significant bidirectional association between PSU and SD, with variations across gender and daily physical activity levels. Encouraging physical activity may serve as a potential intervention to disrupt the bidirectional association between PSU and SD, which has important implications for public health strategies aimed at reducing the negative consequences of PSU and SD.

The complicated impact of media use before bed on sleep: Results from a combination of objective EEG sleep measurement and media diaries

Media use has been linked to sleep disturbance, but the results are inconsistent. This study explores moderating conditions. A media diary study with 58 free-living adults measured the time spent with media before bed, the location of use, and multitasking. Electroencephalography (EEG) captured bedtime, total sleep time, and the percent of time spent in deep (Stage N3), and rapid eye movement (REM) sleep. Media use in the hour before sleep onset was associated with an earlier bedtime. If the before bed use did not involve multitasking and was conducted in bed, that use was also associated with more total sleep time. Media use duration was positively associated with (later) bedtime and negatively associated with total sleep time. Sleep quality, operationalised as the percent of total sleep time spent in N3 and REM sleep, was unaffected by media use before bed. Bedtime media use might not be as detrimental for sleep as some previous research has shown. Important contextual variables moderate the relationship, such as location, multitasking, and session length.

Media use, attention, mental health and academic performance among 8 to 12 year old children

The rise in digital media consumption, especially among children, raises the societal question of its impact on cognition, mental health and academic achievement. Here, we investigate three different ways of measuring technology use--total hours of media consumed, hours of video game play and number of media used concurrently--in 118 eight-to-twelve year-old children. At stake is the question of whether different technology uses have different effects, which could explain some of the past mixed findings. We collected data about children's media uses as well as (i) attentional and behavioral control abilities, (ii) psychological distress, psychosocial functioning, and sleep, and (iii) academic achievement and motivation. While attentional control abilities were assessed using both cognitive tests and questionnaires, mental health and sleep were all questionnaire-based. Finally, academic performance was based on self-reported grades, with motivational variables being measured through the grit and the growth-mindset questionnaires. We present partial correlation analyses and construct a psychological network to assess the structural associations between different forms of media consumption and the three categories of measures. We observe that children consume large amounts of media and media multitask substantially. Partial correlation analyses show that media multitasking specifically was mostly correlated with negative mental health, while playing video games was associated with faster responding and better mental health. No significant partial correlations were observed for total hours on media. Psychological network analysis complement these first results by indicating that all three ways of consuming technology are only indirectly related to self-reported grades. Thus, technology uses appear to only indirectly relate to academic performance, while more directly affecting mental health. This work emphasizes the need to differentiate among technology uses if one is to understand how every day digital consumption impacts human behavior.

Electronic media use and sleep in children and adolescents in western countries: a systematic review

Background

Sleep is essential for child and adolescent health and well-being. There is an increasing interest in whether electronic media use affects children and young adolescents’ sleep. Prior reviews have focused on a school-aged population. Moreover, it is crucial that research continuously addresses the processes of technology and media use and the implication on sleep. This systematic review examines the evidence of electronic media use related to sleep among 0–15-year-olds.

Methods

Searches were carried out in four databases (CINAHL, Web of Science, EMBASE, and Medline). Inclusion criteria included age ≤ 15 years, and intervention, cohort, or cross-sectional studies from western countries. Methodological quality was rated using the Quality Assessment Tool for Quantitative Studies by two independent reviewers. Data was extracted using a standardized data extraction form. Synthesis was done by summarizing results across studies by age groups of 0–5, 6–12, and 13–15 years within four sleep domains: Bedtime and sleep onset; Sleep quality; Sleep duration; Daytime tiredness.

Results

The search identified 10,719 unique studies, of which 109 fulfilled inclusion and exclusion criteria and were assessed for methodological quality. In total, 49 studies were included in the review. The study designs were randomized controlled trials (n = 3), quasi-experimental studies (n = 2), prospective cohort studies (n = 15), and cross-sectional studies (n = 29). Evidence for an association between electronic media use and sleep duration was identified, with stronger evidence for 6–15-years-olds than 0–5-year-olds. The evidence for a relationship between electronic media use and other sleep outcomes was more inconclusive. However, for 6–12-year-old children, there was evidence for associations of electronic media use with delayed bedtime and poor sleep quality. For 13–15-year-olds, there was evidence for associations between screen time and problems falling asleep, and between social media use and poor sleep quality.

Conclusions

Overall, electronic media use was generally associated with shorter sleep duration in children and adolescents. Studies with stronger research design and of higher quality are needed to draw solid conclusions about electronic media’s impact on other sleep outcomes. Public awareness and interventions could be promoted about the potential negative impact on children’s sleep of electronic media devices that are used excessively and close to bedtime.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11640-9.

The reciprocal relationships between social media self-control failure, mindfulness and wellbeing: A longitudinal study

This paper aims to shed light on the question whether, and how, social media self-control failure is related to mindfulness and wellbeing. Using a 3-wave longitudinal design, the present study among 594 daily social media users examined the reciprocal relationships between social media self-control failure and mindfulness, and between social media self-control failure and wellbeing (as assessed by subjective vitality and life satisfaction). Results of the random-intercept cross-lagged panel model showed that social media self-control failure has a time-invariant negative association with mindfulness and subjective vitality. No full reciprocal influence was found between social media self-control failure and mindfulness, yet part of this trajectory was observed, suggesting that social media self-control failure could impair mindfulness, which, in turn, might increase future social media self-control failure. For wellbeing, life satisfaction was found to predict subsequent drops in social media self-control failure.

Media Multitasking: A Bibliometric Approach and Literature Review

Media multitasking became increasingly popular over the past decade. As this behavior is intensely taxing cognitive resources, it has raised interest and concerns among academics in a variety of fields. Consequently, in recent years, research on how, when, and why people media multitask has strongly emerged, and the consequences of the behavior for a great variety of outcomes (such as working memory, task performance, or socioemotional outcomes) have been explored. While efforts are made to summarize the findings of media multitasking research until date, these meta, and literature studies focused on specific research subdomains. Therefore, the current study adopted a quantitative method to map all studies in the broad field of media multitasking research. The bibliometric and thematic content analyses helped us identifying five major research topics and trends in the overall media multitasking domain. While media multitasking research started by studying its prevalence, appearance, and predictors, early research within the domain was also interested in the impact of this media consumption behavior on individuals' cognitive control and academic performance. Later on in 2007, scholars investigated the implications of media multitasking on the processing of media- and persuasive content, while its impact on socioemotional well-being received attention ever since 2009. Our analyses indicate that research within the field of media multitasking knows a dominant focus on adolescents, television watching, and cognitive depletion. Based on these findings, the paper concludes by discussing directions for future research.

Prospective associations between pre-sleep electronics use and same-night sleep in healthy school-aged children

Electronic devices are routinely associated with adverse effects on sleep; however, prospective studies among healthy children are unavailable. This study examined relationships among specific and total electronic device use within the hour before bed and same-night sleep patterns among 55 pre-pubertal children (7-11 years) without medical, psychiatric or sleep disorders. Sleep was assessed via subjective reports and actigraphy for 5 weeknights and pre-bed device use was assessed via daily diary. Neither total devices use nor any single type predicted sleep parameters the same night. The extent to which pre-bed electronics use impacts sleep in healthy children requires further investigation.

Chronic sleep disruption induces depression-like behavior in adolescent male and female mice and sensitization of the hypothalamic-pituitary-adrenal axis in adolescent female mice

Depression is a prevalent mood disorder responsible for reduced quality of life for over 264 million people. Depression commonly develops during adolescence and becomes twice as prevalent in females than in males. However, the mechanisms underlying adolescent depression onset and sex differences in the prevalence rate remain unclear. Adolescent exposure to stress and subsequent sensitization of the hypothalamic-pituitary-adrenal (HPA) axis contributes to mood disorder development, and females are particularly vulnerable to HPA sensitization. Repeated exposure to stressors common to adolescent development, like sleep disruption, could partially be responsible for adolescent female susceptibility to depression. To address this possibility, 80 adolescent and adult CD-1 mice (Male, n = 40; Female, n = 40) were manually sleep disrupted for the first four hours of each rest cycle or allowed normal rest for eight consecutive days. Depression-like behavior was assessed with the forced swim test. 5-HT_1A and glucocorticoid receptor expression and concurrent cellular activation via glucocorticoid receptor/c-Fos colocalization were examined in various brain regions to assess cellular correlates of depression and HPA-axis activation. Both adolescent male and female mice displayed significantly greater depression-like behavior and prelimbic c-Fos expression after chronic sleep disruption than non-sleep disrupted adolescent and sleep disrupted adult counterparts. However, sleep disrupted adolescent females demonstrated greater dorsal raphe 5-HT_1A expression than sleep disrupted adolescent males. Adolescent females and males had decreased medial prefrontal 5-HT_1A expression after chronic sleep disruption, but only adolescent females expressed decreased hippocampal 5-HT_1A expression compared to controls. Chronic sleep disruption significantly increased corticosterone release, glucocorticoid expression in the CA1, and activation of glucocorticoid immunoreactive cells in the prelimbic cortex of adolescent females but not in adolescent males. These findings suggest that chronic sleep disruption during adolescence could give rise to depressive symptoms in male and female adolescents through differing signaling mechanisms.

Prebedtime Screen Use in Adolescents: A Survey of Habits, Barriers, and Perceived Acceptability of Potential Interventions

PURPOSE

This study aimed to investigate (1) access to screens and screen use in the hour before bedtime and in bed; (2) attitudes and barriers to reducing screen time, and (3) perceptions of potential interventions to reduce screen time to benefit the sleep of New Zealand adolescents.

METHODS

Adolescents (aged 13-17 years, n = 4,811) living in New Zealand were recruited online between November 2015 and March 2016 with a direct link to complete a questionnaire about screen use in the hour before bedtime (including the types of screens used and activities) and screen use when in bed. Sleep patterns and quality were measured, and attitudes to reducing screen time using potential interventions were explored.

RESULTS

The most common prebedtime screen activities reported on most nights were social media (88%) and texting/instant messaging (77%). The majority of participants reported they used phones in bed (86%) and "agreed" they spent too much time on screens (70%), a perception that increased with age (p = .008). Being unable to communicate with friends was the most common barrier to reducing screen time (67% agreed).

CONCLUSIONS

Screen use in adolescents is complex; however, there is scope to improve sleep by reducing the impact of in-bed use of portable devices and addressing barriers to reduce screen time in adolescents.

Yawning while scrolling? Examining gender differences in the association between smartphone use and sleep quality

The negative consequences of deteriorated sleep have been widely acknowledged. Therefore, research on the determinants of poor sleep is crucial. A factor potentially contributing to poor sleep is the use of a smartphone. This study aims to measure the association between overall daily smartphone use and both sleep quality and sleep duration. To this end, we exploit data on 1,889 first-year university students. Compared with previous research we control for a large set of observed confounding factors. Higher overall smartphone use is associated with lower odds of experiencing a good sleep. In addition, we explore heterogeneous differences by socioeconomic factors not yet investigated. We find that the negative association between smartphone use and sleep quality is mainly driven by female participants.

Feasibility of Automated Cameras to Measure Screen Use in Adolescents

INTRODUCTION

The influence of screens and technology on adolescent well-being is controversial and there is a need to improve methods to measure these behaviors. This study examines the feasibility and acceptability of using automated wearable cameras to measure evening screen use in adolescents.

METHODS

A convenience sample of adolescents (aged 13-17 years, n=15) wore an automated camera for 3 evenings from 5:00pm to bedtime. The camera (Brinno TLC120) captured an image every 15 seconds. Fieldwork was completed between October and December 2017, and data analyzed in 2018. Feasibility was examined by quality of the captured images, wear time, and whether images could be coded in relation to contextual factors (e.g., type of screen and where screen use occurred). Acceptability was examined by participant compliance to the protocol and from an exit interview.

RESULTS

Data from 39 evenings were analyzed (41,734 images), with a median of 268 minutes per evening. The camera was worn for 78% of the evening on Day 1, declining to 51% on Day 3. Nearly half of the images contained a screen in active use (46%), most commonly phones (13.7%), TV (12.6%), and laptops (8.2%). Multiple screen use was evident in 5% of images. Within the exit interview, participants raised no major concerns about wearing the camera, and data loss because of deletions or privacy concerns was minimal (mean, 14 minutes, 6%).

CONCLUSIONS

Automated cameras offer a feasible, acceptable method of measuring prebedtime screen behavior, including environmental context and aspects of media multitasking in adolescents.

Media multitasking is associated with altered processing of incidental, irrelevant cues during person perception

BACKGROUND

Media multitasking (MMT)-using and switching between unrelated forms of media-has been implicated in altered processing of extraneous stimuli, resulting in performance deficits. Here, we sought to extend our prior work to test the hypothesis that MMT might be associated with enhanced processing of incidental environmental cues during person perception.

METHOD

We tested the relationship between individual differences in MMT and person perception, by experimentally manipulating the relevance of environmental cues that participants could use to make trait and personality judgements of an unfamiliar social target. Relevant environmental cues consisted of neat or messy arrangements of the target's belongings, whereas irrelevant cues consisted of similarly neat or messy arrangements of the testing room in which participants viewed a video of the target.

RESULTS

In general, relevant cues affected ratings of the target's conscientiousness. Additionally, and consistent with our hypothesis, there was a significant interaction between irrelevant cue condition and MMT, such that high media multitaskers more readily incorporated irrelevant environmental cues into their evaluations of the target's conscientiousness.

CONCLUSIONS

These results suggest that high media multitaskers are more responsive to irrelevant environmental cues, which in turn can lead them to form inaccurate impressions of others.