Identifying drivers for bedtime social media use despite sleep costs: The adolescent perspective

Intense and problematic social media use and sleep difficulties of adolescents in 40 countries

INTRODUCTION

Social media has become a ubiquitous part of everyday life; however, evidence suggests patterns of social media use can affect sleep health in children and adolescents. This study aimed to examine the associations of intense and problematic social media use (SMU) with sleep-onset difficulties in adolescence.

METHODS

We analysed data from 212,613 adolescents aged 11-15 years (51.1% girls) from 40 European and North American countries that participated in the 2017/2018 Health Behaviour in School-aged Children survey. Intense SMU assessed how often respondents had online contact through social media, and problematic SMU was assessed by symptoms of addiction to social media. Sleep-onset difficulties were assessed using a self-reported item. Multilevel mixed-effects logistic regression was used to obtain the estimates.

RESULTS

Sleep-onset difficulties were more common among girls than boys (27.1% vs 20.8%). Intense SMU was significantly associated with sleep-onset difficulties in boys in 17 countries and in girls in 25 countries, while problematic SMU was significantly associated in most of the participating countries. Overall, exposure to problematic SMU alone was highly associated with sleep-onset difficulties both in girls (OR 2.20, 2.04-2.38) and boys (OR 1.88, 1.73-2.04), while the association estimates for intense SMU were smaller and comparable across gender (Girls: OR 1.27, 1.23-1.31; Boys: OR 1.22, 1.18-1.27). Sensitivity analyses supported the above findings.

CONCLUSIONS

Intense and/or problematic SMU were associated with sleep-onset difficulties across gender with associations being higher for problematic compared to intense SMU. Prospective research with objective measures is needed to understand the causal mechanisms underlying these relationships.

Nighttime Texting on Social Media, Sleep Parameters, and Adolescent Sadness: A Mediation Analysis

OBJECTIVES

The use of social media during bedtime has increased in the past years among adolescents, contributing to disturbed sleep quality, which could potentially be related to emotional problems. This study aimed to analyze the mediation effects of sleep parameters on the relationship between NightTime Texting (NTT) on social media and adolescent sadness.

METHODS

We used a cross-sectional study and evaluated a total of 1464 Swedish students aged 15-17 (55.7% girls) to examine their frequency of NTT on social media, sleep parameters, and adolescent sadness. Bivariate and mediation analyses were performed.

RESULTS

Approximately 60% (n = 882) of adolescents engaged in nighttime instant messaging, with 37% (n = 330) reporting texting every night. Higher frequency of NTT was significantly associated with later bedtimes (η2 > 0.12), extended weekend wake-up times (η2 = 0.07), increased social jetlag (η2 = 0.07), and reduced sleep duration on schooldays (η2 = 0.10). Multicategorical parallel mediation analyses revealed that sleep duration on schooldays had an indirect effect on the relationship between both Occasional NTT (a11b1 = 0.05, p < .05) and Daily NTT (a21b1 = 0.12, p < .05) with sadness. Mediation effects were not moderated by gender (p > .05), however, the association between Occasional NTT and higher sadness was significantly linked to boys (t = 2.72; p = .007).

CONCLUSIONS

Findings showed a large percentage of adolescents engaging in nighttime social media use with worse quality of sleep, and underlined sleep duration on schooldays as a mediator associated with emotional problems in adolescents. These insights can aid in developing strategies for healthier habits to address the misuse of social media and prevent related health problems.

The impact of screen use on sleep health across the lifespan: A National Sleep Foundation consensus statement

OBJECTIVE

To achieve consensus on whether screen-based digital media (1) in general, (2) via prebedtime content, and (3) via prebedtime light impairs sleep health in (a) childhood, (b) adolescence, and (c) adulthood. Furthermore, to address whether employing behavioral strategies and interventions may reduce the potential negative effects of screens on sleep health.

METHODS

The National Sleep Foundation convened a 16-person multidisciplinary expert panel ("Panel"). Panelists met virtually 5 times throughout 2023, during which they followed a modified Delphi RAND/UCLA Appropriateness Method to reach consensus.

RESULTS

The Panel conducted a literature review starting with 2209 articles, narrowed down to 522 relevant empirical articles and 52 relevant review articles. The search was refined to include 35 experimental/intervention studies that examined whether there was a causal link between screen-based digital media and sleep. In addition, panelists reviewed 5 recent relevant systematic review articles. After reviewing the summarized current literature, panelists voted on 10 candidate statements about whether screen use impairs sleep health. The Panel met virtually to discuss the results of the first round of votes, which was then followed by a second round of voting, ultimately achieving consensus on 5 out of the 10 statements.

CONCLUSIONS

The Panel achieved consensus that (1) in general, screen use impairs sleep health among children and adolescents, (2) the content of screen use before sleep impairs sleep health of children and adolescents, and (3) behavioral strategies and interventions may attenuate the negative effects of screen use on sleep health.

A bidirectional model of sleep and technology use: A theoretical review of How much, for whom, and which mechanisms

The link between technology and sleep is more complex than originally thought. In this updated theoretical review, we propose a new model informed by the growing body of evidence in the area over the past 10 years. The main theoretical change is the addition of bi-directional links between the use of technology and sleep problems. We begin by reviewing the evidence to date for the originally proposed mechanisms of bright light, arousal, nighttime sleep disruptions, and sleep displacement. Then, in support of the new direction of effect (sleep problems preceding technology use), we propose two new mechanisms: technology before sleep might be used as a time filler and/or as an emotional regulation strategy to facilitate the sleep-onset process. Finally, we present potential moderators of the association between technology and sleep, in recognition of protective and vulnerability factors that may mitigate or exacerbate the effects of technology on sleep and vice versa. The goal of this theoretical review is to update the field, guide future public health messages, and to prompt new research into how much technology and sleep affect each other, for whom it may be problematic, and which mechanisms may explain their association.

Adolescents' mental health in the social-media era: The role of offline and online need-based experiences

INTRODUCTION

Debate about the precise role of social media use (SMU) in the mental health of today's adolescents is still ongoing. The present study adds to the literature by focusing on adolescents' experiences during SMU and in their offline activities through the lens of basic psychological needs, which are central to self-determination theory.

METHODS

To examine the joint and supplementary effects of need-experiences in the offline and SMU domain (i.e., SMU satisfaction, offline satisfaction, SMU frustration, offline frustration) on several indicators of adolescents' mental health (i.e., vitality, life satisfaction, sleep quality, anxiety, and depression), polynomial regression analyses were used. Three cross-sectional samples were collected in Belgium, including early to mid-adolescents during the COVID-pandemic (Sample 1; N = 447; Mage = 14.26; 54.4% female) as well as postpandemic (Sample 2; N = 179, Mage = 15.25; 54.2% female), and among college students in postpandemic times (Sample 3; N = 4977; Mage = 20.72; 69.1% female).

RESULTS

The results showed that need-experiences common to both domains were a robust factor associated with mental health. This finding was obtained across all samples and outcomes, with need satisfaction playing a beneficial and need frustration a harmful role. We further found that offline need-experiences serve as a more crucial predictor of adolescents' mental health than need experiences on social media.

CONCLUSIONS

Adolescents' experiences of need satisfaction and need frustration on social media and in offline activities are central to their mental health. However, only relying on SMU as a single source of need satisfaction may not be recommended, given that offline experiences seem to be more decisive.

The Double-Edged Sword Effect of Leaders' Fear of Missing Out on Leaders' Creativity: An Experience Sampling Method Study

Purpose

Fear of Missing out (FoMO) is a widely observed phenomenon in the workplace. Previous research has primarily focused on employees' FoMO, with limited exploration of leaders' FoMO and its impact on their creativity. This study aims to investigate how leaders' FoMO affects their creativity, based on the transactional stress theory.

Patients and Methods

Using an experience sampling method, we collected 836 observations from 102 leaders across various industries in China for two consecutive weeks (10 working days). Subsequently, hierarchical regression analysis and structural equation modeling were employed to test the hypotheses.

Results

This study suggests that both challenge stress and hindrance stress mediate the relationship between leaders' FoMO and their creativity. Role breadth self-efficacy moderates the relationship between leaders' FoMO and challenge stress and hindrance stress, and moderates the positive and negative mediating effects of challenge stress and hindrance stress in the relationship between leaders' FoMO and their creativity.

Conclusion

Research has shown that leaders' FoMO can either enhance creative performance by increasing challenge stress or inhibit it by increasing hindrance stress. Role breadth self-efficacy significantly amplifies the positive relationship between leaders' FoMO and challenge stress, while moderating the negative effect of leaders' FoMO on hindrance stress.

Innovations

Firstly, this study expands workplace FoMO research by illustrating the double-edged sword effect of leaders' FoMO on their creativity. Secondly, this study contributes to the academic community's comprehension of the underlying mechanisms linking leaders' FoMO and its outcomes by demonstrating the mediating role of challenge stress and hindrance stress. Thirdly, the study shows the boundary conditions for the effects of leaders' FoMO by validating the moderating role of their role breadth self-efficacy.

Using structural equation modeling to explore the influences of physical activity, mental health, well-being, and loneliness on Douyin usage at bedtime

Douyin is the Chinese version of TikTok. Using Douyin at bedtime is a very common behavior among Douyin users. However, the reasons why users like using Douyin before sleep are yet unclear. We conducted a cross-section survey from January 1st to January 16th, 2023 to capture data to examine the associations of depression, anxiety, life satisfaction, well-being, loneliness, and physical activity with Douyin usage at bedtime. The mediation role of insomnia in these associations was examined. A total of 3,392 participants who met the inclusion criteria were included for analysis. Our structural equation modeling analysis showed that depression on (β = 0.08; p < 0.05), anxiety (β = 0.06; p < 0.05), and loneliness (β = 0.14; p < 0.05) were directly associated with increased Douyin usage at bedtime, and were also indirectly associated with Douyin usage through insomnia (depression: β = 0.18; p < 0.05, anxiety: β = 0.16; p < 0.05, and loneliness: β = 0.12; p < 0.05). Life satisfaction (β = -0.05; p < 0.05) and well-being (β = -0.20; p < 0.05) were directly associated with decreased Douyin usage at bedtime, and were also indirectly associated with Douyin usage through insomnia (life satisfaction: β = -0.09; p < 0.05, and well-being: β = -0.11; p < 0.05). However, physical activity was unexpectedly associated with increased Douyin usage at bedtime (β = 0.20; p < 0.05). In conclusion, our findings shed new light on the specific reasons why Douyin users like using Douyin at bedtime.

'Our mind could be our biggest challenge': A qualitative analysis of urban adolescents' sleep experiences and opportunities for mind-body integrative health approaches to improve sleep

Objective

To inform the development of a combined sleep and mind-body integrative health (MBIH) intervention, we explored urban adolescents' sleep experiences and perceptions of MBIH techniques.

Methods

We conducted eight focus groups with school-based health center patients in New York City, exploring sleep experiences; mindfulness, body awareness, tapping, acupressure, and self-hypnosis; and intervention delivery preferences. We recorded, transcribed, and analyzed the discussions applying methods from grounded theory.

Results

Participants (n = 25) were ages 14-17, predominantly female (64%), Latino (60%), and Black (40%). Participants reported social, physical, and internal sleep barriers, but had limited success implementing sleep improvement strategies. Participants viewed MBIH techniques positively, noted audio-guided techniques' accessibility, and were intrigued by less-familiar techniques. Preferences varied around domains of intervention delivery.

Conclusion

Results underscore the need for adolescent-informed interventions offering sleep improvement strategies. Participants' interest and willingness to engage in MBIH techniques present an opportunity for practitioners to develop and deliver sleep interventions incorporating MBIH components to urban adolescents. Varied intervention preferences highlight the need to be adaptable to adolescents' lived experiences, comfort levels, and learning styles.

Innovation

This study elucidates the perspectives of underrepresented adolescents whose perspectives on MBIH have rarely been explored, an important first step in developing tailored interventions.

Perspective: Teenagers and the sleep paradox

STUDY OBJECTIVES

Teenagers experience sleep deficits as they try to manage expectations with school, their social media presence, and increasingly competitive extracurriculars. Late-night screen time is a barrier to sleep hygiene. It is important to acknowledge and understand lifestyle challenges that can prevent teenagers from receiving adequate sleep every night. A teenager perspective on these issues and recommendations can incite better ways to outreach, educate, and support teenagers in maintaining good sleep.

METHODS

We describe what is known and not known about sleep health among teenagers and challenges to maintaining adequate sleep from the perspective of a third-year high school student. We also provide recommendations for outreach to promote early recognition of issues and tools that can support sleep hygiene to reinforce future mental and physical health.

RESULTS

While teenagers enjoy good sleep, this is limited by heavy loads of homework along with increasingly competitive extracurriculars, keeping up with social and cultural demands, and early school starts. Also, teenagers may not understand what adequate sleep entails and the full impact of sleep on well-being.

CONCLUSIONS

Social media provides a channel to extend outreach to teenagers to communicate the importance of consistent quality and quantity of sleep, increase awareness of sleep tracking tools, and highlight the impact of sleep on mental health. Additionally, better engagement is needed with schools and community to manage academic and extracurricular schedules that allow teenagers to schedule consistent bedtimes and wake times.

CITATION

Ramar S, Lloyd RM Perspective: teenagers and the sleep paradox. J Clin Sleep Med. 2023;19(8):1569-1571.

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.

Adolescent sleep, distress, and technology use: weekday versus weekend

BACKGROUND

In adolescents, technology use at bedtime is linked to disrupted sleep and psychological distress. Adolescents are known to sleep later on weekends compared to weekdays but whether this leads to greater technology use, and, hence, additional psychological distress is not known. At greater risk maybe adolescents with a late compared to early chronotype, that is a preference for late versus early sleep onset and offset times.

METHOD

Self-reported measures of sleep timing, chronotype (early, neither early nor late, late), technology medium (social media/texting, TV/streaming, and gaming), and psychological distress (DASS-21) were collected from 462 students attending one Australian high school.

RESULTS

Technology use at bedtime was greater on weekends and especially in adolescents with a late chronotype. Social media/texting on weekends was predictive of delayed sleep onset times (β = .120), and shorter sleep (β = -.172). Shorter sleep on weekdays but not on weekends was associated with greater psychological distress. Technology medium and chronotype were not predictive of psychological distress.

CONCLUSIONS

This study confirmed that technology use and its impact on sleep differed on weekdays compared to weekends and that a late chronotype was associated with greater technology use. However, neither technology medium nor chronotype was found to affect psychological distress. While greater autonomy may be granted to adolescents over the weekend regarding sleep behaviour, young people, parents, and clinicians should be mindful of the link between technology use and sleep.

The beauty and the beast of social media: an interpretative phenomenological analysis of the impact of adolescents' social media experiences on their mental health during the Covid-19 pandemic

Despite extensive research, the mental health implication of social media in adolescents is not yet understood due to mixed and inconsistent findings and more in-depth qualitative studies are needed to expand our understanding of the impact of social media on adolescent mental health during the Covid-19 pandemic. The purpose of this study was to explore why and how adolescents use social media, adolescents' lived experiences on social media, how they make sense of these experiences having impact on their mental health, and the influence of the Covid-19 pandemic on their use of social media and mental health. In-depth interviews were conducted with eleven adolescents aged 14-16 (five female, six male) across England. The interviews were audio-recorded, transcribed verbatim and analysed using interpretative phenomenological analysis. Two key themes were identified: the beauty of social media that captured positive experiences and emotions of adolescents and the beast of social media that captured negative experiences and emotions. From the adolescents' accounts, social media has both positive and negative impacts on their mental health, but mostly positive impacts during the Covid-19 pandemic. The results were discussed in relation to the study aims and previous study findings. Strengths and methodological limitations of the study, implications for future research that emerged from the study were discussed.

Exploring adolescents' perspectives on social media and mental health and well-being - A qualitative literature review

Many quantitative studies have supported the association between social media use and poorer mental health, with less known about adolescents' perspectives on social media's impact on their mental health and wellbeing. This narrative literature review aimed to explore their perspectives, focusing on adolescents aged between 13 and 17. It reviewed qualitative studies published between January 2014 and December 2020, retrieved from four databases: APA Psychinfo, Web of Science, PubMed and Google Scholar. The literature search obtained 24 research papers. Five main themes were identified: 1) Self-expression and validation, 2) Appearance comparison and body ideals, 3) Pressure to stay connected, 4) Social engagement and peer support and 5) Exposure to bullying and harmful content. This review has highlighted how social media use can contribute to poor mental health - through validation-seeking practices, fear of judgement, body comparison, addiction and cyberbullying. It also demonstrates social media's positive impact on adolescent wellbeing - through connection, support and discussion forums for those with similar diagnoses. Future research should consider adolescent views on improvements to social media, studying younger participants, and the impact of COVID-19 on social media use and its associated mental health implications.

Is psychological distress the key factor in the association between problematic social networking sites and poor sleep quality?

BACKGROUND AND AIMS

Problematic Social Networking Sites Use (PSNSU) has been indicated as potentially detrimental for users' mental and sleep health. The present study tested whether PSNSU is directly associated with poor sleep quality and indirectly via psychological distress (stress, anxiety, depression) in a healthy adult sample of Social Networking Sites (SNSs) users.

DESIGN

Cross-sectional study among Italian adults who completed online questionnaires between December 2020 and January 2021.

SETTING

Italy.

PARTICIPANTS

A convenient sample of N = 726 SNSs users (51.8% females; mean age = 28.59 years, SD = 8.19 years).

MEASUREMENTS

Self-report data were collected on problematic social networking sites use, sleep quality, psychological distress (stress, anxiety, depression), and socio-demographics.

FINDINGS

PSNSU was not directly associated with poor sleep quality. Depression and stress mediated such association.

CONCLUSION

Healthcare providers should consider psychological distress and PSNSU when encountering sleep problems, with consideration of the potentially important role of users' age and mental health status.

Passive Sensing of Preteens' Smartphone Use: An Adolescent Brain Cognitive Development (ABCD) Cohort Substudy

BACKGROUND

Concerns abound regarding childhood smartphone use, but studies to date have largely relied on self-reported screen use. Self-reporting of screen use is known to be misreported by pediatric samples and their parents, limiting the accurate determination of the impact of screen use on social, emotional, and cognitive development. Thus, a more passive, objective measurement of smartphone screen use among children is needed.

OBJECTIVE

This study aims to passively sense smartphone screen use by time and types of apps used in a pilot sample of children and to assess the feasibility of passive sensing in a larger longitudinal sample.

METHODS

The Adolescent Brain Cognitive Development (ABCD) study used passive, objective phone app methods for assessing smartphone screen use over 4 weeks in 2019-2020 in a subsample of 67 participants (aged 11-12 years; 31/67, 46% female; 23/67, 34% White). Children and their parents both reported average smartphone screen use before and after the study period, and they completed a questionnaire regarding the acceptability of the study protocol. Descriptive statistics for smartphone screen use, app use, and protocol feasibility and acceptability were reviewed. Analyses of variance were run to assess differences in categorical app use by demographics. Self-report and parent report were correlated with passive sensing data.

RESULTS

Self-report of smartphone screen use was partly consistent with objective measurement (r=0.49), although objective data indicated that children used their phones more than they reported. Passive sensing revealed the most common types of apps used were for streaming (mean 1 hour 57 minutes per day, SD 1 hour 32 minutes), communication (mean 48 minutes per day, SD 1 hour 17 minutes), gaming (mean 41 minutes per day, SD 41 minutes), and social media (mean 36 minutes per day, SD 1 hour 7 minutes). Passive sensing of smartphone screen use was generally acceptable to children (43/62, 69%) and parents (53/62, 85%).

CONCLUSIONS

The results of passive, objective sensing suggest that children use their phones more than they self-report. Therefore, use of more robust methods for objective data collection is necessary and feasible in pediatric samples. These data may then more accurately reflect the impact of smartphone screen use on behavioral and emotional functioning. Accordingly, the ABCD study is implementing a passive sensing protocol in the full ABCD cohort. Taken together, passive assessment with a phone app provided objective, low-burden, novel, informative data about preteen smartphone screen use.

A Review of the Relationship Between Social Media Use and Online Prosocial Behavior Among Adolescents

Social media (SoMe) activity constitutes a large part of the lives of adolescents. Even though the behavior on SoMe is complex, the research on SoMe has mostly focused on negative effects, bad content, and online antisocial behavior (OAB). Less research has been conducted on online prosocial behavior (OPB), and to what extent OPBs are widespread is relatively unknown. A review was conducted to investigate to what extent OPB is related to SoMe use among adolescents based on studies published from 2014 to May 2021. To be included, the studies had to be quantitative, non-experimental, have participants aged 13–18, include measures of SoMe and OPB, and be published in peer-reviewed journals with full text available in English, Swedish, Danish or Norwegian. A research was conducted in databases PsychINFO, Ovid MEDLINE(R), EMBASE, COCHRANE Database of Systematic Reviews, Web of Science, Sociological Abstracts, Sociological Services Abstracts, and Eric. Two studies met the eligibility criteria. Both studies found an association between OPB and SoMe use. Methodological issues, however, were identified through a quality assessment using an adapted version of the Newcastle-Ottawa Scale (NOS) for cross-sectional studies, and the small samples in the studies prevent us from drawing any firm conclusions. Possible reasons for the scarcity of eligible studies and directions for future research are discussed.

Systematic Review Registration: PROSPERO; ID CRD42020162161 and CRISTIN; ID 2038994.

Associations Between Social Media, Bedtime Technology Use Rules, and Daytime Sleepiness Among Adolescents: Cross-sectional Findings From a Nationally Representative Sample

BACKGROUND

Social media use is associated with poor sleep among adolescents, including daytime sleepiness, which affects adolescents' mental health. Few studies have examined the associations among specific aspects of social media, such as frequency of checking and posting, perceived importance of social media for social belonging, and daytime sleepiness. Identifying whether certain adolescents are more at risk or protected from the effects of social media on sleepiness may inform future interventions for social media, sleep, and mental health.

OBJECTIVE

This study aims to examine the association between social media use frequency and importance, daytime sleepiness, and whether the perceived importance of social media for social interactions and parental rules around bedtime technology moderated these relationships.

METHODS

This cross-sectional survey study was conducted with a sample of 4153 adolescents from across the United States. Qualtrics was used to collect data via panel recruitment from a national sample representing the US demographics of teens aged 12 to 17 years. Participants completed measures of daytime sleepiness, frequency of social media checking and posting, and the importance of social media for social interactions. Parents reported whether they had a household rule around bedtime media and screen use. Hierarchical regressions and moderation analyses were conducted, covarying for age, gender, and age at first smartphone use.

RESULTS

Participants had a mean age of 14.64 (SD 1.66) years in grades 6 to 12, 46.45% (1929/4153) identified as female, and 67.93% (2821/4153) identified as White. The results indicated that adolescents who posted (B=0.70, SE 0.04; P<.001) or checked (B=0.76, SE 0.04; P<.001) social media more frequently or who perceived social media to be more important for social belonging (B=0.36, SE 0.02; P<.001) had higher levels of daytime sleepiness. Moderation analyses indicated that the relationship between social media use frequency and daytime sleepiness was exacerbated by higher levels of perceived social media importance (B=0.04, SE 0.01; P<.001). Adolescents without household rules around bedtime technology use were more likely to be affected by social media checking (B=-0.34, SE 0.09; P<.001) and importance (B=-0.16, SE 0.04; P<.001) on daytime sleepiness.

CONCLUSIONS

The findings suggest that social media use frequency and perceived importance of social interactions are associated with daytime sleepiness among adolescents. It is important to consider youth's perceptions of social media when assessing the potential effects of social media use frequency on youth well-being. Furthermore, youth who did not have parental rules around bedtime technology use were most likely to be affected by social media use and perceived importance. The findings may extend to other mental health outcomes and may guide future prevention and intervention programs designed to improve social media use, sleep, and mental health.

How Our Technology Use Changed in 2020: Perspectives From Three Youths

The Technology and Adolescent Mental Wellness program (TAM) is a research program with the primary goals of promoting research on the topic of adolescent technology use and mental wellness, creatively disseminating that research, and fostering community among stakeholders. Our foundational question is this: How can technology support adolescent mental wellness? Youth are key stakeholders in pursuit of this foundational question. In this commentary, we invited 3 members of TAM's youth advisory board to respond to the following question: "How did your technology use change in 2020?" Jessica, Jared, and Babayosimi describe their technology use during COVID-19 as dynamic, and neither uniformly positive nor negative. Further, these 3 youths differ in their perceptions of the same technologies-social media and online school, for example-as well as their perceived ability to self-regulate use of those technologies. We invite you to weigh these perspectives just as we do at TAM-not as empirical findings in themselves, but as examples of youth ideas for future empirical investigation.

Quantity, Content, and Context Matter: Associations Among Social Technology Use and Sleep Habits in Early Adolescents

PURPOSE

This study aimed to investigate the associations of social technology access and content, bedtime behaviors, parental phone restrictions, and timing and duration of sleep on school nights in early adolescents.

METHODS

Adolescents (aged 11-15 years, n = 772) in the Northeast U.S. completed an online survey during or after school in spring 2019.

RESULTS

Quantity of social technology use (e.g., checking social media, problematic internet behaviors, mobile use), content viewed (e.g., emotional or violent videos, risky behaviors), and social context (e.g., bedtime behaviors, starting social media at an early age) were significantly related to later bedtimes and fewer hours of sleep on school nights. Parental rules restricting mobile phone and online use before bed and obtaining a smartphone at a later age were associated with increased sleep time and earlier bedtime.

CONCLUSIONS

Quantity, content, and context of social technology use may affect sleep timing and duration in early adolescents.

Daily bidirectional associations between adolescent negative peer interactions and sleep in rural China: The moderating effect of parental migration

Left-behind adolescents' biobehavioral adjustment, such as sleep, is poorly understood by research. Using daily data over one week from 90 middle school students (M_age  = 13.69) in rural China, this study investigated daily bidirectional associations between negative peer interactions and sleep disturbances, and how these associations varied by parental migration. On days when adolescents reported higher levels of negative peer interactions, they also reported greater daytime dysfunction the following day. Conversely, when adolescents had more nighttime disturbances the previous night, they also reported higher levels of negative peer interactions. The effects of other sleep disturbance indicators (poor sleep quality the previous night and daytime dysfunction on the same day) on negative peer interactions were significant for adolescents with at least one parent migrating and for those with both parents migrating. Findings highlight the importance of considering dynamic interrelations between interpersonal and biobehavioral factors for the healthy development of left-behind adolescents.

Daytime and nighttime smartphone use: A study of associations between multidimensional smartphone behaviours and sleep among 24,856 Danish adults

The around-the-clock smartphone use and its relation to disturbed sleep is a public health concern. The present study aimed to quantify the effects of different dimensions of smartphone behaviours (frequency of daytime use, problematic use, use before sleep and use during the sleep period) on disturbed sleep (sleep quality and sleep quantity) and to disentangle their inter-relationship in a large population-based sample of 24,856 Danish adults aged ≥16 years. Data come from the SmartSleep Experiment, which is a web-based survey carried out using a citizen science approach. Tested items were used to evaluate smartphone use and disturbed sleep was evaluated with the Karolinska Sleep Questionnaire (KSQ). Linear and multinomial logistic regression was employed to evaluate the relationship between smartphone use and disturbed sleep. While several of the smartphone measures were associated with disturbed sleep when assessed individually, smartphone use during the sleep period was the only dimension consistently associated with disturbed sleep when assessed independently of other smartphone behaviours. Weekly smartphone use during the sleep period versus no use was associated on average with a 0.96 point higher score (95% confidence interval [CI] 0.90-1.02) on the 5-point KSQ scale, and a higher risk of both short (odds ratio [OR] 1.32, 95% CI 1.08-1.62) and long (OR 1.94, 95% CI 1.63-2.32) sleep duration. Smartphone use during the sleep period is the factor strongest associated to disturbed sleep relative to other dimensions of smartphone use. Recommendations around smartphone use during the sleep period are warranted in order to protect the fundamentally important biological and mental processes of sleep.

Nodding off but can't disconnect: development and validation of the iNOD index of Nighttime Offline Distress

BACKGROUND

There is a pressing need to update sleep models, education and treatment to better reflect the realities of sleep in a 24/7 connected social world. Progress has been limited to date by available measurement tools, which have largely focused on the frequency or duration of individuals' social media use, without capturing crucial sleep-relevant aspects of this inherently social and interactive experience.

METHODS

Survey data from 3008 adolescents (aged 10-18 years) was used to rigorously develop and validate a new self-report measure that quantifies difficulty disengaging from social media interactions at night: the index of Nighttime Offline Distress (iNOD). Exploratory and Confirmatory Factor analyses in a random split sample produced a ten-item two-factor solution, with subscales capturing concerns about Staying Connected and Following Etiquette (Cronbach's alphas = 0.91 and 0.92 respectively).

RESULTS

Those with higher scores on these subscales tended to report using social media for longer after they felt they should be asleep (r_s = 0.41 and 0.26, respectively), shorter sleep duration (r_s = -0.24 and -0.17, respectively) and poorer sleep quality (r_s = -0.33 and -0.31, respectively). Results also pointed towards a potentially fragmented process of sleep displacement for those who may struggle to disconnect - and to stay disconnected - from social interactions in order to allow sufficient uninterrupted sleep opportunity.

CONCLUSIONS

These findings can inform current models for understanding normal and disordered sleep during adolescence, whilst highlighting specific social concerns as important potential targets for sleep education efforts.

Social Media Use and Adolescents' Sleep: A Longitudinal Study on the Protective Role of Parental Rules Regarding Internet Use before Sleep

The popularity of social media use among adolescents has raised concerns about the potentially harmful effects of social media use on adolescents' sleep. Since longitudinal research considering this relationship is scarce, the present two-wave longitudinal study of 2021 secondary school students (Mage = 13.86, SD = 1.25) examined whether frequency of social media use and problematic social media use predicted adolescents' bedtime and quality of sleep. Moreover, the protective role of parental rules regarding Internet and smartphone use one hour before sleep was examined. The findings indicated that strict parental rules about Internet and smartphone use before sleep might prevent negative consequences of social media use on bedtime and sleep quality, but only among less engaged social media users. Once adolescents are highly engaged social media users, strict parental rules do not seem to prevent negative media influences on sleep. This implies that limiting Internet accessibility before bedtime can help prevent adolescents' sleep problems, but that regulation is less effective for adolescents who are already highly involved in social media use.

"I Want to Sleep, but I Can't": Adolescents' Lived Experience of Sleeping Difficulties

Sleeping difficulties are increasingly prevalent among adolescents and have negative consequences for their health, well-being, and education. The aim of this study was to illuminate the meanings of adolescents' lived experiences of sleeping difficulties. The data were obtained from narrative interviews with 16 adolescents aged 14-15 in a Swedish city and were analyzed using the phenomenological hermeneutic method. The findings revealed four themes: feeling dejected when not falling asleep, experiencing the night as a struggle, searching for better sleep, and being affected the next day. The comprehensive understanding illuminates that being an adolescent with sleeping difficulties means it is challenging to go through the night and to cope the next day. It also means a feeling of being trapped by circumstances. As the adolescents' lived experiences become apparent, the possibility for parents, school nurses, and other professional caregivers to support adolescents' sleep increases.

Social media use predicts later sleep timing and greater sleep variability: An ecological momentary assessment study of youth at high and low familial risk for depression

INTRODUCTION

Social media (SM) use has been increasingly recognized as a potential contributor to poor sleep. Few studies have examined SM use and sleep using ecological momentary assessment (EMA), compared different types of media use (SM, television, gaming), or examined whether youth at high and low familial risk for depression are differentially affected by SM use.

METHODS

The current study included 76 youth (46% female; Mean age = 11.28 years) who were recruited based on parental history of recurrent depression (N = 35 high risk; N = 41 low risk) in the United States. Youth completed a 9-day EMA protocol, which included current activity at time of prompt and daily sleep onset and offset times. Regression and multilevel models were conducted to examine the effects of media use on sleep.

RESULTS

Results indicated that youth who used more SM (mean and number of days) went to sleep later, but did not have shorter sleep duration. Youth with more SM use also had higher levels of variability of both sleep timing and sleep duration across the 9-day period. There were no effects of gaming or TV on sleep, and youth at high risk for depression did not have differences in SM use or its effects on sleep compared to low-risk youth.

CONCLUSIONS

These findings indicate a unique impact of SM use on sleep timing and variability for youth (regardless of risk status), which may suggest a unique and modifiable pathway through which SM use contributes to poor health.

Teenage sleep and technology engagement across the week

BACKGROUND

Throughout the developed world, adolescents are growing up with increased access to and engagement with a range of screen-based technologies, allowing them to encounter ideas and people on a global scale from the intimacy of their bedroom. The concerns about digital technologies negatively influencing sleep are therefore especially noteworthy, as sleep has been proven to greatly affect both cognitive and emotional well-being. The associations between digital engagement and adolescent sleep should therefore be carefully investigated in research adhering to the highest methodological standards. This understood, studies published to date have not often done so and have instead focused mainly on data derived from general retrospective self-report questionnaires. The value of this work has been called into question by recent research showing that retrospective questionnaires might fail to accurately measure these variables of interest. Novel and diverse approaches to measurement are therefore necessary for academic study to progress.

METHODS

This study analyses data from 11,884 adolescents included in the UK Millennium Cohort Study to examine the association between digital engagement and adolescent sleep, comparing the relative effects of retrospective self-report vs. time-use diary measures of technology use. By doing so, it provides an empirical lens to understand the effects of digital engagement both throughout the day and before bedtime and adds nuance to a research area primarily relying on retrospective self-report.

RESULTS

The study finds that there is a small negative association relating digital engagement to adolescent sleep both on weekdays and weekend days (median standardized association βweekday = -0.06 and βweekend = -0.03). There is a more negative association between digital engagement and total sleep time on weekdays compared to weekend days (median standardized βweekday = -0.08, median standardized βweekend = -0.02), while there is no such difference when examining adolescents' bedtime. Surprisingly, and contrary to our expectations, digital technology use before bedtime is not substantively associated with the amount of sleep and the tardiness of bedtime in adolescents.

CONCLUSIONS

Results derived from the use of transparent Specification Curve Analysis methods show that the negative associations in evidence are mainly driven by retrospective technology use measures and measures of total time spent on digital devices during the day. The effects are overall very small: for example, an additional hour of digital screen time per day was only related to a 9 min decrease in total time spent sleeping on weekdays and a 3 min decrease on weekends. Using digital screens 30 min before bed led to a 1 min decrease in total time spent sleeping on weekdays and weekends. The study shows that more work should be done examining how to measure digital screen time before interventions are designed.

Social media use and adolescent sleep patterns: cross-sectional findings from the UK millennium cohort study

OBJECTIVES

This study examines associations between social media use and multiple sleep parameters in a large representative adolescent sample, controlling for a wide range of covariates.

DESIGN

The authors used cross-sectional data from the Millennium Cohort Study, a large nationally representative UK birth cohort study.

PARTICIPANTS

Data from 11 872 adolescents (aged 13-15 years) were used in analyses.

METHODS

Six self-reported sleep parameters captured sleep timing and quality: sleep onset and wake times (on school days and free days), sleep onset latency (time taken to fall asleep) and trouble falling back asleep after nighttime awakening. Binomial logistic regressions investigated associations between daily social media use and each sleep parameter, controlling for a range of relevant covariates.

RESULTS

Average social media use was 1 to <3 hours per day (31.6%, n=3720). 33.7% were classed as low users (<1 hour; n=3986); 13.9% were high users (3 to <5 hours; n=1602) and 20.8% were very high users (5+ hours; n=2203). Girls reported spending more time on social media than boys. Overall, heavier social media use was associated with poorer sleep patterns, controlling for covariates. For example, very high social media users were more likely than comparable average users to report late sleep onset (OR 2.14, 95% CI 1.83 to 2.50) and wake times (OR 1.97, 95% CI 1.32 to 2.93) on school days and trouble falling back asleep after nighttime awakening (OR 1.36, 95% CI 1.10 to 1.66).

CONCLUSIONS

This study provides a normative profile of UK adolescent social media use and sleep. Results indicate statistically and practically significant associations between social media use and sleep patterns, particularly late sleep onset. Sleep education and interventions can focus on supporting young people to balance online interactions with an appropriate sleep schedule that allows sufficient sleep on school nights.