Media devices, family relationships and sleep patterns among adolescents in an urban area

Associations between social loneliness trajectories and chronotype among adolescents

Late chronotype during adolescence is a critical risk factor for poor physical and mental health among adolescents. While social loneliness is confirmed to negatively influence sleep behaviors, the long-term effect of social loneliness on chronotype remains unknown. This study aims to investigate whether social loneliness trajectories from middle childhood to adolescence are associated with chronotype in late adolescence and examine the potential sex differences in these associations. Data were obtained from 2398 adolescents who participated in the Child and Adolescent Behaviors in Long-Term Evolution project. Chronotype was calculated as the midpoint of sleep on free days adjusted for sleep debt. Group-based trajectory modeling and multiple linear regression were employed to establish social loneliness trajectories and determine their associations with chronotype. Social loneliness trajectories were significantly associated with chronotype and varied by sex. Specifically, boys following a high-decreasing trajectory had earlier chronotype during late adolescence than did those following a low-decreasing trajectory (B =  - 0.07; p < 0.05). By contrast, girls following a low-to-moderate-increasing trajectory exhibited later chronotype than did those following a low-stable trajectory (B = 0.07; p < 0.01). Social loneliness trajectories, especially those displaying significant fluctuations over time, are critical indicators influencing chronotype among adolescents. Furthermore, these trajectories and their associations with chronotype display sex differences. These findings highlight the need for early interventions for psychological factors such as social loneliness to ensure that the late chronotype can be prevented. In addition, sex variations must be considered.

Screen use and sleep duration and quality at 15 years old: Cohort study

Objective/background

The evidence on the association between screen use and sleep of adolescents is mainly based on studies about time watching television, with a few examining time using computers, videogames, and mobile devices. Our aim was to investigate the association between screen time for entertainment (watching TV, using computer, or playing games on tablets, smartphones, or videogame consoles) and sleep duration and self-reported sleep quality, among adolescents aged 15 years.

Methods

With data from the 2004 Pelotas Birth Cohort, sleep duration was assessed with questions extracted from the Munich Chronotype Questionnaire and quality was self-reported. Adjusted β coefficients and prevalence ratios (PR) with (95% confidence intervals) were obtained, respectively, by linear and Poisson regressions.

Results

1,949 adolescents had information about screen time and sleep quality, and 1,851 about screen time and sleep duration. The median screen time was 4.5hs/24hs. The mean sleep duration was 7.6hs/24hs and the prevalence of bad sleep was 17.3% (15.7-19.0%). There was an inverse relationship between screen time and sleep duration. When compared with those with less than 2hs/24hs of screen time, adolescents with 6-8.8hs/24hs and ≥9hs experienced, respectively, 23.4 and 32.4 min reduction in sleep duration (β = -0.39; -0.62;-0.16 and β = -0.54; -0.77;-0.30). Adolescents with ≥9hs of screen time were 60% more likely to report bad sleep than those with less than 2hs/24hs (PR: 1.60; 1.10-2.32).

Conclusions

The median time spent using screens was longer than recommended. Screen use for ≥6hs/24hs was associated with a shorter sleep duration, and ≥9hs/24hs with poor sleep quality.

Sleep health and its related influencing factors in primary and middle school students in Fuzhou: A large multi-center cross-sectional study

Background

This current study set out to investigate the status of sleep health in 7–20-year-old students in Fuzhou and explore the related influencing factors of sleep health.

Methods

A total of 38,467 children and adolescents in Fuzhou were included in the study through a random stratified cluster sampling. Data were collected from May to June 2019, in 18 primary schools and 18 middle schools from nine districts, Fuzhou. Children's parents and adolescents of sampled classes were invited to fill out a series of questionnaires about the performance of the last 6 months (sociodemographic characteristics, sleep-related lifestyle behaviors, and electronic-products usage). Multiple linear regression was carried out to analyze data.

Results

Of the total 40,888 questionnaires we released, 38,467 were valid and effective with the response rate was 94.08%. The age of the surveyed participants was 11.85 ± 3.1, including 20,013 boys and 18,454 girls. The multiple linear regression analysis identified factors associated with sleep health (p < 0.05): Boy (coef = 0.073, 95% CI: 0.030–0.115), age (coef = 1.797, 95% CI: 0.224–0.243), key school (coef = 2.069, 95% CI: 0.105–0.193), urban (coef = 0.096, 95% CI: 0.054–0.139), excessive daytime sleepiness (coef = 0.535, 95% CI: 0.432–0.639), unhealthy sleep habits (coef = 0.363, 95% CI: 0.307–0.419), eating before sleep (coef = 0.578, 95% CI: 0.527–0.630), using electronic products in bedroom (coef = 0.074, 95% CI: 0.028–0.121), screen time per day during school (coef = 0.260, 95% CI: 0.235–0.284), frequency of using electronics 30 min before bedtime (coef = 0.150, 95% CI: 0.134–0.166), strained relationship with parents (coef = 0.361, 95% CI: 0.270–0.452), strained relationship with peers (coef = 0.267, 95% CI: 0.171–0.363), excessive homework or learning (coef = 0.189, 95% CI: 0.141–0.237), time for doing homework (coef = 0.266, 95% CI: 0.245–0.287), and mood swings frequently (coef = 1.174, 95% CI: 1.127–1.221) negatively impact sleep health. Sleep alone (coef = −0.204, 95% CI: −0.262–0.147) were the risk factors for sleep health. Furthermore, frequent mood swings was considered the most influential factor on overall variables.

Conclusions

Sleep health is associated with factors covered sociodemographic characteristics, family sleep habits, and routine activities before bedtime. Multiple measures should be taken to improve sleep quality in a targeted manner.

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.

Bedtime media use and sleep: evidence for bidirectional effects and associations with attention control in adolescents

OBJECTIVE/DESIGN

Bedtime media use has been associated with poor sleep and attention difficulties among adolescents, but much of this research has been cross-sectional, limiting current understanding of directionality of effects. This 2-wave prospective study tested bidirectional effects between bedtime media use and sleep measures, including time in bed, sleep onset latency, and daytime sleepiness, and further examined whether bedtime media use and sleep variables were related to attention control difficulties.

SETTING/PARTICIPANTS

Data were collected from 345 middle-schoolers (ages 12-14, 47% female) at baseline (T1) and at 6-month follow-up (T2).

MEASUREMENTS

Students self-reported their access to media devices and internet in their bedroom, bedtime media use, sleep, and attention control. Data were analyzed using cross-lagged panel modeling.

RESULTS

Greater bedtime media use (at T1) was associated with less time in bed and longer sleep onset latency at T2, controlling for T1 levels of these variables. In the case of sleep effects on bedtime media use, greater daytime sleepiness and less time in bed (at T1) were associated with greater bedtime media use at T2, controlling for T1 levels. Further, greater daytime sleepiness (at T2, controlling for T1 levels) was associated with greater attention control difficulties at T2.

CONCLUSIONS

Findings provide evidence for some reciprocal relations between bedtime media use and poor sleep in adolescents. Furthermore, higher daytime sleepiness was linked to greater attention control difficulties.

Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth

BACKGROUND

Children and youth who meet the physical activity, sedentary, and sleep behaviour recommendations in the Canadian 24-Hour Movement Guidelines are more likely to have desirable physical and psychosocial health outcomes. Yet, few children and youth actually meet the recommendations. The family is a key source of influence that can affect lifestyle behaviours. The purpose of this paper is to describe the process used to develop the Consensus Statement on the Role of the Family in the Physical Activity, Sedentary, and Sleep Behaviours of Children and Youth (0-17 years) and present, explain, substantiate, and discuss the final Consensus Statement.

METHODS

The development of the Consensus Statement included the establishment of a multidisciplinary Expert Panel, completion of six reviews (three literature, two scoping, one systematic review of reviews), custom data analyses of Statistics Canada's Canadian Health Measures Survey, integration of related research identified by Expert Panel members, a stakeholder consultation, establishment of consensus, and the development of a media, public relations, communications and launch plan.

RESULTS

Evidence from the literature reviews provided substantial support for the importance of family on children's movement behaviours and highlighted the importance of inclusion of the entire family system as a source of influence and promotion of healthy child and youth movement behaviours. The Expert Panel incorporated the collective evidence from all reviews, the custom analyses, other related research identified, and stakeholder survey feedback, to develop a conceptual model and arrive at the Consensus Statement: Families can support children and youth in achieving healthy physical activity, sedentary and sleep behaviours by encouraging, facilitating, modelling, setting expectations and engaging in healthy movement behaviours with them. Other sources of influence are important (e.g., child care, school, health care, community, governments) and can support families in this pursuit.

CONCLUSION

Family is important for the support and promotion of healthy movement behaviours of children and youth. This Consensus Statement serves as a comprehensive, credible, and current synopsis of related evidence, recommendations, and resources for multiple stakeholders.

Media use during adolescence: the recommendations of the Italian Pediatric Society

Background

The use of media device, such as smartphone and tablet, is currently increasing, especially among the youngest. Adolescents spend more and more time with their smartphones consulting social media, mainly Facebook, Instagram and Twitter because. Adolescents often feel the necessity to use a media device as a means to construct a social identity and express themselves. For some children, smartphone ownership starts even sooner as young as 7 yrs, according to internet safety experts.

Material and methods

We analyzed the evidence on media use and its consequences in adolescence.

Results

In literature, smartphones and tablets use may negatively influences the psychophysical development of the adolescent, such as learning, sleep and sigh. Moreover, obesity, distraction, addiction, cyberbullism and Hikikomori phenomena are described in adolescents who use media device too frequently. The Italian Pediatric Society provide action-oriented recommendations for families and clinicians to avoid negative outcomes.

Conclusions

Both parents and clinicians should be aware of the widespread phenomenon of media device use among adolescents and try to avoid psychophysical consequences on the youngest.

Association between insomnia and social network site use in Indonesian adolescents

OBJECTIVES

Sleep deprivation can cause serious physical and mental problems. Although sleep deprivation among adolescents is not a new phenomenon, this problem has recently gained more attention due to the frequent use of smartphones. This study aimed to explain the correlations among family support, academic stress, social network site (SNS) use, and insomnia in adolescents.

METHODS

This cross-sectional study included 180 adolescents aged 16 to 17 years, with simple random sampling. This study used a questionnaire that included the frequency and duration of social media use, reasons for using social media, family support, academic stress, and insomnia. Data were analyzed using multiple logistic regression with a degree of significance at P < 0.05.

RESULTS

This study showed that insomnia was associated with duration of SNS use (P = 0.011), reasons of SNS usage ( P = 0.004), and academic stress ( P = 0.013). The frequency of SNS use ( P = 0.645), types of SNS ( P = 0.965), and family support ( P = 0.150) were not associated with insomnia in adolescents.

CONCLUSIONS

The reasons of SNS usage, duration of SNS usage, and academic stress are major factors associated with insomnia in adolescents. These components should be embedded in multicomponent educational intervention addressed to both adolescents and parents to reduce insomnia.

Night-time screen-based media device use and adolescents' sleep and health-related quality of life

OBJECTIVE

The present study investigates the relationship between night-time screen-based media devices (SBMD) use, which refers to use within 1 h before sleep, in both lit and dark rooms, and sleep outcomes and health-related quality of life (HRQoL) among 11 to 12-year-olds.

METHODS

We analysed baseline data from a large cohort of 6616 adolescents from 39 schools in and around London, United Kingdom, participating in the Study of Cognition Adolescents and Mobile Phone (SCAMP). Adolescents self-reported their use of any SBMD (mobile phone, tablet, laptop, television etc.). Sleep variables were derived from self-reported weekday and/or weekend bedtime, sleep onset latency (SOL) and wake time. Sleep quality was assessed using four standardised dimensions from the Swiss Health Survey. HRQoL was estimated using the KIDSCREEN-10 questionnaire.

RESULTS

Over two-thirds (71.5%) of adolescents reported using at least one SBMD at night-time, and about a third (32.2%) reported using mobile phones at night-time in darkness. Night-time mobile phone and television use was associated with higher odds of insufficient sleep duration on weekdays (Odds Ratio, OR = 1.82, 95% Confidence Interval, CI [1.59, 2.07] and OR = 1.40, 95% CI [1.23, 1.60], respectively). Adolescents who used mobile phones in a room with light were more likely to have insufficient sleep (OR = 1.32, 95% CI [1.10, 1.60]) and later sleep midpoint (OR = 1.64, 95% CI [1.37, 1.95]) on weekends compared to non-users. The magnitude of these associations was even stronger for those who used mobile phones in darkness for insufficient sleep duration on weekdays (OR = 2.13, 95% CI [1.79, 2.54]) and for later sleep midpoint on weekdays (OR = 3.88, 95% CI [3.25, 4.62]) compared to non-users. Night-time use of mobile phones was associated with lower HRQoL and use in a dark room was associated with even lower KIDSCREEN-10 score (β = -1.18, 95% CI [-1.85, -0.52]) compared to no use.

CONCLUSIONS

We found consistent associations between night-time SBMD use and poor sleep outcomes and worse HRQoL in adolescents. The magnitude of these associations was stronger when SBMD use occurred in a dark room versus a lit room.