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Burnell K, Garrett SL, Nelson BW, Prinstein MJ, Telzer EH. Daily links between objective smartphone use and sleep among adolescents. J Adolesc 2024; 96:1171-1181. [PMID: 38698757 PMCID: PMC11303118 DOI: 10.1002/jad.12326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 03/21/2024] [Accepted: 03/28/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION Concerns abound on how digital technology such as smartphone use may impair adolescent sleep. Although these linkages are supported in cross-sectional studies, research involving intensive longitudinal assessments and objective measures has called into question the robustness of associations. METHODS In this study, a sample of ethnically diverse U.S. adolescents (N = 71; Mage = 16.49; 56% girls) wore Fitbit devices and submitted screenshots of their smartphone screen time, pickups, and notifications over a 14-day period in 2021. The Fitbits recorded nightly sleep quality and sleep onset. Adolescents also completed daily diaries reporting the previous night's sleep onset time and sleep quality. RESULTS On days when adolescents engaged in greater nighttime screen time and, to some extent, pickups relative to their own average, they also had poorer sleep outcomes that night. Greater screen time was associated with later self-reported and Fitbit-recorded sleep onset and poorer self-reported sleep quality. Greater pickups was associated with later self-reported and Fitbit-recorded sleep onset. Smartphone use during the day did not relate to sleep outcomes, indicating the importance of distinguishing nighttime from daytime use. CONCLUSIONS Parents and clinicians should help adolescents develop healthy digital skills to avoid exacerbating sleep problems that are known to occur during this developmental period.
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Affiliation(s)
- Kaitlyn Burnell
- Department of Psychology and Neuroscience, Chapel Hill, North Carolina, USA
| | - Shedrick L Garrett
- Department of Psychology and Neuroscience, Chapel Hill, North Carolina, USA
| | - Benjamin W Nelson
- Department of Psychology and Neuroscience, Chapel Hill, North Carolina, USA
| | | | - Eva H Telzer
- Department of Psychology and Neuroscience, Chapel Hill, North Carolina, USA
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Cerutti J, Burt KB, Moeller RW, Seehuus M. Declines in social-emotional skills in college students during the COVID-19 pandemic. Front Psychol 2024; 15:1392058. [PMID: 39077202 PMCID: PMC11284160 DOI: 10.3389/fpsyg.2024.1392058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 06/28/2024] [Indexed: 07/31/2024] Open
Abstract
Introduction The present study investigated whether social-emotional skills in first year college students differed before and after the coronavirus disease (COVID-19) lockdowns. Methods Participants (N = 1,685) consisted of first year college students (mean age 18.53 years) selected from a broader cohort enrolled in a longitudinal study on college mental health at liberal arts colleges in the United States. In a cohort-sequential design, participants completed an online survey assessing social-emotional skills in January of 2018, 2019, 2020, and 2022. Using analysis of covariance, we examined mean differences in social-emotional skills between students who were first years before (January 2018-2020) and after the lockdowns (January 2022), controlling for sociodemographic variables. Results The post-lockdown group scored significantly lower on emotional control and expressivity and marginally higher on social sensitivity compared to the pre-lockdown group. No group differences in social/emotional expressivity or social control were detected. Discussion These findings indicate that the COVID-19 lockdowns impaired some, but not all, social-emotional skills in first year college students. Addressing social-emotional skills in college may help to reduce the COVID-19 mental health burden.
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Affiliation(s)
- Janine Cerutti
- Department of Psychological Science, University of Vermont, Burlington, VT, United States
| | - Keith B. Burt
- Department of Psychological Science, University of Vermont, Burlington, VT, United States
| | - Robert W. Moeller
- Department of Psychology, Middlebury College, Middlebury, VT, United States
| | - Martin Seehuus
- Department of Psychology, Middlebury College, Middlebury, VT, United States
- Vermont Psychological Services, Burlington, VT, United States
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Nagata JM, Cheng CM, Shim J, Kiss O, Ganson KT, Testa A, He J, Baker FC. Bedtime Screen Use Behaviors and Sleep Outcomes in Early Adolescents: A Prospective Cohort Study. J Adolesc Health 2024:S1054-139X(24)00289-1. [PMID: 39046391 DOI: 10.1016/j.jadohealth.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 05/24/2024] [Accepted: 06/05/2024] [Indexed: 07/25/2024]
Abstract
PURPOSE To determine prospective associations between bedtime screen use behaviors and sleep outcomes one year later in a national study of early adolescents in the United States. METHODS We analyzed prospective cohort data from 9,398 early adolescents aged 11-12 years (48.4% female, 45% racial/ethnic minority) in the Adolescent Brain Cognitive Development Study (Years 2-3, 2018-2021). Regression analyses examined the associations between self-reported bedtime screen use (Year 2) and sleep variables (Year 3; self-reported sleep duration; caregiver-reported sleep disturbance), adjusting for sociodemographic covariates and sleep variables (Year 2). RESULTS Having a television or Internet-connected electronic device in the bedroom was prospectively associated with shorter sleep duration one year later. Adolescents who left their phone ringer activated overnight had greater odds of experiencing sleep disturbance and experienced shorter sleep duration one year later, compared to those who turned off their phones at bedtime. Talking/texting on the phone, listening to music, and using social media were all prospectively associated with shorter sleep duration, greater overall sleep disturbance, and a higher factor score for disorders of initiating and maintaining sleep one year later. DISCUSSION In early adolescents, several bedtime screen use behaviors are associated with adverse sleep outcomes one year later, including sleep disturbance and shorter weekly sleep duration. Screening for and providing anticipatory guidance on specific bedtime screen behaviors in early adolescents may be warranted.
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Affiliation(s)
- Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, California.
| | - Chloe M Cheng
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, California
| | - Joan Shim
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, California
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, California
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas
| | - Jinbo He
- Division of Applied Psychology, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, California; School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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Bou Ghannam A, Ibrahim H, Mansour H, Kheir WJ, Al Hassan S, S Saade J. Impact of online learning during COVID-19 pandemic on digital device related ocular health. Heliyon 2024; 10:e33039. [PMID: 38988532 PMCID: PMC11234015 DOI: 10.1016/j.heliyon.2024.e33039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 06/13/2024] [Accepted: 06/13/2024] [Indexed: 07/12/2024] Open
Abstract
Objective The aim of this study was to evaluate the impact of the COVID-19 pandemic on ocular health related to digital device usage among university students in Lebanon. Design A cross-sectional design was utilized to examine the association between the pandemic and ocular health. Participants A total of 255 university students in Lebanon participated in the study, selected based on their enrollment during the pandemic. Methods An online survey assessed participants' digital device usage, awareness of digital eye strain, and experienced symptoms. The study addressed the relationship between symptom frequency and screen time, especially in their connection to the pandemic and online learning. Results Prior to the pandemic, the majority of participants (73.0 %) were unaware of digital eye strain. Following the transition to online learning, nearly half of the participants (47.0 %) reported using digital devices for 12 or more hours. The majority (92.0 %) experienced a substantial increase in daily digital device usage for learning, with an average increase of 3-5 h. Symptoms of digital eye strain, including headache, burning of eyes, blurry vision, sensitivity to light, worsening of vision and dryness of the eyes intensified in both frequency and severity during the pandemic and online learning period. Conclusions The study emphasizes the importance of promoting healthy habits and implementing preventive measures to reduce the prevalence of digital eye strain symptoms among university students. Healthcare professionals and public health authorities should educate individuals on strategies to alleviate digital eye strain, considering the persistent reliance on digital devices beyond the pandemic.
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Affiliation(s)
- Alaa Bou Ghannam
- American University of Beirut Medical Center, Department of Ophthalmology, Beirut, Lebanon
| | - Hanadi Ibrahim
- American University of Beirut Medical Center, Department of Ophthalmology, Beirut, Lebanon
| | - Hana Mansour
- American University of Beirut Medical Center, Department of Ophthalmology, Beirut, Lebanon
| | - Wajiha Jurdi Kheir
- American University of Beirut Medical Center, Department of Ophthalmology, Beirut, Lebanon
| | - Sally Al Hassan
- American University of Beirut Medical Center, Department of Ophthalmology, Beirut, Lebanon
| | - Joanna S Saade
- American University of Beirut Medical Center, Department of Ophthalmology, Beirut, Lebanon
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Cheng C, Chen S, Chen S. Impact of National Lockdown Measures on the Association Between Social Media Use and Sleep Disturbance During COVID-19: A Meta-Analysis of 21 Nations. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2024. [PMID: 38916117 DOI: 10.1089/cyber.2023.0571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
During the COVID-19 pandemic, the extensive lockdown measures implemented for disease mitigation triggered a surge in round-the-clock social media use, giving rise to widespread concerns regarding its impact on sleep health. This meta-analysis examined the association between social media use and sleep disturbance during the pandemic, along with potential moderators. The dataset included 43 independent samples comprising 68,247 residents of 21 countries across 7 world regions. The three-level mixed-effects meta-analysis revealed a weak, positive overall effect size (r = 0.1296, 95% confidence interval: 0.0764-0.1828, k = 90). The magnitude of the effect size varied by the type of social media use: compulsive use exhibited a moderately strong effect size, whereas information-focused use showed marginal significance. The effect size was more pronounced in countries imposing stricter (vs. less strict) lockdown measures. Lockdown status also moderated this association, with a marginally significant effect size observed during lockdowns but a significant effect size after lockdowns. For demographics, samples involving emerging adults demonstrated moderately strong effect sizes, whereas those involving the general population had modest effect sizes. Notably, the interaction between the type of social media use and lockdown status was significant. Specifically, the positive association with information-focused use was significant only during lockdowns, whereas that with general use was significant after, but not during, lockdowns. However, compulsive use showed a moderately strong effect size both during and after lockdowns. These findings underscored the importance of considering multiple factors-such as the type of social media use, context, and demographics-when studying social media use and sleep health.
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Affiliation(s)
- Cecilia Cheng
- Department of Psychology, The University of Hong Kong, Hong Kong, Hong Kong
| | - Sihui Chen
- Department of Chinese and Bilingual Studies, Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Si Chen
- Department of Psychology, The University of Hong Kong, Hong Kong, Hong Kong
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Bonilla P, Shanks A, Nerella Y, Porcu A. Effects of chronic light cycle disruption during adolescence on circadian clock, neuronal activity rhythms, and behavior in mice. Front Neurosci 2024; 18:1418694. [PMID: 38952923 PMCID: PMC11215055 DOI: 10.3389/fnins.2024.1418694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 05/29/2024] [Indexed: 07/03/2024] Open
Abstract
The advent of artificial lighting, particularly during the evening and night, has significantly altered the predictable daily light and dark cycles in recent times. Altered light environments disrupt the biological clock and negatively impact mood and cognition. Although adolescents commonly experience chronic changes in light/dark cycles, our understanding of how the adolescents' brain adapts to altered light environments remains limited. Here, we investigated the impact of chronic light cycle disruption (LCD) during adolescence, exposing adolescent mice to 19 h of light and 5 h of darkness for 5 days and 12 L:12D for 2 days per week (LCD group) for 4 weeks. We showed that LCD exposure did not affect circadian locomotor activity but impaired memory and increased avoidance response in adolescent mice. Clock gene expression and neuronal activity rhythms analysis revealed that LCD disrupted local molecular clock and neuronal activity in the dentate gyrus (DG) and in the medial amygdala (MeA) but not in the circadian pacemaker (SCN). In addition, we characterized the photoresponsiveness of the MeA and showed that somatostatin neurons are affected by acute and chronic aberrant light exposure during adolescence. Our research provides new evidence highlighting the potential consequences of altered light environments during pubertal development on neuronal physiology and behaviors.
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Affiliation(s)
| | | | | | - Alessandra Porcu
- Department of Drug Discovery and Biomedical Science, University of South Carolina, Columbia, SC, United States
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Kiss O, Baker FC. The unique vulnerabilities of nighttime smartphone use: a commentary on "tracked and self-reported nighttime smartphone use, general health, and healthcare utilization: results from the SmartSleep Study" by Drews et al. Sleep 2024; 47:zsae073. [PMID: 38506147 DOI: 10.1093/sleep/zsae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Indexed: 03/21/2024] Open
Affiliation(s)
- Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
- School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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Firth J, Torous J, López-Gil JF, Linardon J, Milton A, Lambert J, Smith L, Jarić I, Fabian H, Vancampfort D, Onyeaka H, Schuch FB, Firth JA. From "online brains" to "online lives": understanding the individualized impacts of Internet use across psychological, cognitive and social dimensions. World Psychiatry 2024; 23:176-190. [PMID: 38727074 PMCID: PMC11083903 DOI: 10.1002/wps.21188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
Abstract
In response to the mass adoption and extensive usage of Internet-enabled devices across the world, a major review published in this journal in 2019 examined the impact of Internet on human cognition, discussing the concepts and ideas behind the "online brain". Since then, the online world has become further entwined with the fabric of society, and the extent to which we use such technologies has continued to grow. Furthermore, the research evidence on the ways in which Internet usage affects the human mind has advanced considerably. In this paper, we sought to draw upon the latest data from large-scale epidemiological studies and systematic reviews, along with randomized controlled trials and qualitative research recently emerging on this topic, in order to now provide a multi-dimensional overview of the impacts of Internet usage across psychological, cognitive and societal outcomes. Within this, we detail the empirical evidence on how effects differ according to various factors such as age, gender, and usage types. We also draw from new research examining more experiential aspects of individuals' online lives, to understand how the specifics of their interactions with the Internet, and the impact on their lifestyle, determine the benefits or drawbacks of online time. Additionally, we explore how the nascent but intriguing areas of culturomics, artificial intelligence, virtual reality, and augmented reality are changing our understanding of how the Internet can interact with brain and behavior. Overall, the importance of taking an individualized and multi-dimensional approach to how the Internet affects mental health, cognition and social functioning is clear. Furthermore, we emphasize the need for guidelines, policies and initiatives around Internet usage to make full use of the evidence available from neuroscientific, behavioral and societal levels of research presented herein.
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Affiliation(s)
- Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - John Torous
- Division of Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - José Francisco López-Gil
- One Health Research Group, Universidad de las Americas, Quito, Ecuador
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Jake Linardon
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Alyssa Milton
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Australian Research Council, Centre of Excellence for Children and Families over the Life Course, Sydney, NSW, Australia
| | | | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ivan Jarić
- Laboratoire Ecologie, Systématique et Evolution, Université Paris-Saclay, Gif-sur-Yvette, France
- Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic
| | - Hannah Fabian
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Center, KU Leuven, Leuven, Belgium
| | - Henry Onyeaka
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Felipe B Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Health Sciences, Universidad Autônoma de Chile, Providência, Chile
| | - Josh A Firth
- Department of Biology, University of Oxford, Oxford, UK
- School of Biology, University of Leeds, Leeds, UK
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Lazzareschi I, Curatola A, DE Pascalis S, Bernardo L, Gatto A, Ferretti S, Valentini P, Ferrara P. Use of multimedia devices in pediatric age: risks or advantages? A survey in an Italian center. Minerva Pediatr (Torino) 2024; 76:372-380. [PMID: 38842381 DOI: 10.23736/s2724-5276.22.06097-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
BACKGROUND Nowadays children live in a digital world, exposed to relevant risks for their health and safety. The aim of this study is to investigate the use of multimedia devices in a sample of children and adolescents. METHODS The study was performed between November 2018 and June 2019 in a third-level University Hospital, recruiting children and adolescents during general or specialistic follow-up visits. Anonymous, age-specific, questionnaires were distributed to 500 children and adolescents and 370 parents. RESULTS Among children, 25 (17.1%) had their own mobile device, of which 84% Italian. The 54.1% of them uses multimedia devices half an hour/an hour per day and many of them (37.5% of Italian and 40% of foreign) use it without their parents' control. Most of adolescents had a mobile phone since the age of 10-12 years old. WhatsApp (Meta Inc., Cambridge, MA, USA) is the most used social network, followed by Instagram and Facebook. The use of multimedia devices was widespread between teenagers during classroom hours, meals and before sleeping and they are an important mean for cyberbullying. In addition, in the 29.9% of cases there is no correspondence between information given by parents and respective sons/daughters. CONCLUSIONS This study shows more risks than advantages derived from the use of multimedia devices in children and adolescents. Therefore, it is essential to educate them about their correct and responsible use.
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Affiliation(s)
- Ilaria Lazzareschi
- Department of Pediatrics, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Antonietta Curatola
- Department of Pediatrics, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy -
| | | | - Luca Bernardo
- ASST FBF Sacco Pediatric Home, Macedonio Melloni Hospital, University of Milan, Milan, Italy
| | - Antonio Gatto
- Department of Pediatrics, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Serena Ferretti
- Department of Pediatrics, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Piero Valentini
- Department of Pediatrics, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Pietro Ferrara
- Pediatric Institute, Sacred Heart Catholic University, Rome, Italy
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Tang S, Liu Y, Gu Y, Yang Q, Wang Q. Effects of electronic screen exposure time on hypertensive disorders in pregnancy: a retrospective cohort study. BMC Public Health 2024; 24:1367. [PMID: 38773446 PMCID: PMC11110264 DOI: 10.1186/s12889-024-18793-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/08/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND We previously conducted a case-control study and found that exposure to electronic screen before nocturnal sleep was associated with hypertensive disorders in pregnancy (HDP). Hence, we carried out this cohort study aiming to identify the effects of screen exposure time on the incidence rate and severity of HDP. METHODS A retrospective cohort study was conducted from January 2022 and July 2022 from three hospitals in Wuxi and Changzhou cities. A total of 732 women were recruited and the information included socio-demographic characteristics, screen exposure and outcomes. Generalized estimating equations and binary non-conditional logistic models were applied to multivariate analysis, calculating the odds ratios (ORs) and 95% confidence intervals (CIs) of screen exposure time. RESULTS The duration order of total screen time was smartphone > computer > television, while the duration order of screen time before nocturnal sleep was smartphone > television > computer. Multivariate analyses showed that the susceptibility of HDP among women who exposed to television before nocturnal sleep was 81.5% percent higher than those not exposed (P = 0.018, OR[95%CI] = 1.815[1.106-2.981]). In addition, total daily exposure time of television in the third trimester of pregnancy significantly increased the severity of HDP (P = 0.021, OR[95%CI] = 3.641[1.213-10.927]). CONCLUSIONS Based on this preliminary study, we would suggest that pregnant women do not watch television before nocturnal sleep. While in the third trimester of pregnancy, total exposure time of television should be limited. Investigations from other areas and experimental studies should be conducted to verify the conclusion.
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Affiliation(s)
- Shaidi Tang
- Department of Education and Science, Liyang People's Hospital, Changzhou, 213300, Jiangsu, China
| | - Yun Liu
- Department of Obstetrics, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi, 214000, Jiangsu, China
| | - Ying Gu
- Department of Obstetrics, The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University, Wuxi, 214000, Jiangsu, China
| | - Qianqian Yang
- Department of Community Health, Service Center for Maternal-Child Health Care and Birth Control of Xinwu District, Wuxi, 214028, Jiangsu, China
| | - Qian Wang
- Department of Community Health, Service Center for Maternal-Child Health Care and Birth Control of Xinwu District, Wuxi, 214028, Jiangsu, China.
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Swisher VS, Liu S, Ricketts EJ. Bedtime Regularity and Sleep Sufficiency in Children With Tourette Syndrome. Pediatr Neurol 2024; 158:26-34. [PMID: 38945036 DOI: 10.1016/j.pediatrneurol.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 04/12/2024] [Accepted: 05/01/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Despite research demonstrating sleep disturbance in children with Tourette syndrome (TS), few studies have examined bedtime regularity and sleep sufficiency, two important sleep health dimensions. Therefore, this study examined bedtime regularity and sleep sufficiency in children with TS relative to matched healthy control subjects, and its associated demographic, clinical, and behavioral factors. METHODS Participants were 384 parents or caregivers of children aged three to 17 years, including 192 with current TS and 192 matched healthy control subjects drawn from the 2020-2021 cycle of the National Survey of Children's Health. Parents completed questions assessing demographic (i.e., age, race, sex), clinical (i.e., attention-deficit/hyperactivity disorder [ADHD], autism spectrum disorder, anxiety, depression, tic severity, behavioral or conduct problems, ADHD medication, health condition-related impairment), and behavioral (i.e., screen time) characteristics. Mann-Whitney U test and chi-square test of independence were performed to compare groups on bedtime regularity and sleep sufficiency, respectively. Ordinal regression and binary logistic regression without and with backward elimination were performed to evaluate indicators of bedtime regularity and sleep sufficiency, respectively, in children with TS. RESULTS Children with current TS had significantly poorer bedtime regularity, but not sleep sufficiency, relative to matched healthy control subjects. In children with TS, anxiety and two or more hours of daily screen time were associated with higher likelihood of poor bedtime regularity. Autism was associated with lower likelihood of insufficient sleep, and depression was associated with increased likelihood of insufficient sleep. CONCLUSIONS Findings put forth screen time, anxiety, and depression as intervention targets to optimize sleep health in children with TS.
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Affiliation(s)
- Valerie S Swisher
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
| | - Serene Liu
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California
| | - Emily J Ricketts
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California.
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Shalash RJ, Arumugam A, Qadah RM, Al-Sharman A. Night Screen Time is Associated with Cognitive Function in Healthy Young Adults: A Cross-Sectional Study. J Multidiscip Healthc 2024; 17:2093-2104. [PMID: 38736535 PMCID: PMC11086650 DOI: 10.2147/jmdh.s462458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/29/2024] [Indexed: 05/14/2024] Open
Abstract
Background In recent years, a significant shift toward remote work, virtual education, and social distancing measures was witnessed, thereby leading people to increasingly depend on digital devices for communication, work, and entertainment. This increased exposure to screens has raised concerns regarding its potential impact on cognitive function. Purpose This study investigated the relationship between screen time and cognitive function among healthy young adults. Methods One hundred forty-five healthy individuals (mean age 21.55 ± 2.84 years) participated in this cross-sectional study. Sociodemographic information including age, sex, height, weight, and level of education were obtained. Participants reported screen time using a screen time questionnaire. Cognitive function tests including, Paced Auditory Serial Addition Task (PASAT), Montreal Cognitive Assessment (MoCA) and Symbol Digit Modalities Test (SDMT) were conducted. Multilinear regression analyses were used to examine the associations between age, sex, level of education, screen time, and cognitive function. Results One hundred thirty-nine participants (76 women) completed the study. Increased night screen time, bachelor's educational level, and women were associated with lower PASAT scores (R2=0.258; p≤0.047). Moreover, increased night screen time was associated with lower MoCA scores (R2=0.029; p=0.035). However, no associations were found between night screen time and SDMT scores. Conclusion Participants who had higher night screen exposure had lower cognitive scores in the information speed processing, working memory, calculation, and attention domains. Considering these findings, this study emphasizes on the importance of setting a future recommended screen time guidelines for young adults as well as to promote healthy cognitive habits in order to preserve cognitive function and reduce the risk of developing neurodegenerative disease in the future. Future prospective cohort studies involving a more diverse age range is needed.
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Affiliation(s)
- Reime Jamal Shalash
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS–Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS–Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Science and Engineering, University of Sharjah, Sharjah, United Arab Emirates
- Adjunct Faculty, Manipal College of Health professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Raneen Mohammed Qadah
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS–Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Alham Al-Sharman
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS–Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
- Health Promotion research group -Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Poirier K, Gauvin L, Haddad S, Bélanger RE, Leatherdale ST, Turcotte-Tremblay AM. Evolution of Sleep Duration and Screen Time Between 2018 and 2022 Among Canadian Adolescents: Evidence of Drifts Accompanying the COVID-19 Pandemic. J Adolesc Health 2024; 74:980-988. [PMID: 38340126 DOI: 10.1016/j.jadohealth.2023.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/19/2023] [Accepted: 12/15/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE We quantified the joint evolution of sleep duration and screen time between 2018 and 2022 in a large sample of adolescents from Quebec, Canada, to ascertain changes that occurred during the COVID-19 pandemic. METHODS A natural experiment design was used to compare variations from year to year and in association with the pandemic outbreak. Using structural equation modeling on data collected between 2018 and 2022 among adolescents attending 63 high schools, we analyzed the joint evolution of sleep duration and screen time while adjusting for previous year values, concurrent flourishing score, sex, age, and family level of material deprivation. RESULTS A total of 28,307 adolescents, aged on average 14.9 years, were included in the analyses. Between 2019 and 2022, sleep duration increased by 9.6 (5.7, 13.5) minutes and screen time by 129.2 (120.5, 138.0) minutes on average. In 2022, the adolescents spent almost equal amounts of time sleeping and using screens. Lower flourishing scores were associated with shorter sleep duration and lengthier screen time. Girls' screen time became similar to boys' over time. DISCUSSION Adolescents now spend almost equal amounts of time sleeping and using screens, a situation that calls for urgent public health actions. These findings highlight the importance of tracking changes in adolescents' behaviours over time, to design and implement interventions adapted to the changing health needs of different groups.
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Affiliation(s)
- Krystel Poirier
- Centre de Recherche VITAM, CIUSSS de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Lise Gauvin
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Slim Haddad
- Centre de Recherche VITAM, CIUSSS de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Richard E Bélanger
- Centre de Recherche VITAM, CIUSSS de la Capitale-Nationale, Quebec City, Quebec, Canada; Department of Pediatrics, Faculty of Medicine - Université Laval, Ferdinand Vandry Pavillon, Quebec City, Quebec, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Anne-Marie Turcotte-Tremblay
- Centre de Recherche VITAM, CIUSSS de la Capitale-Nationale, Quebec City, Quebec, Canada; Faculty of Nursing, Université Laval, Quebec City, Quebec, Canada.
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Yang M, Chuang SYC, Kennedy SE. Sleep disturbances in children and adolescents after kidney transplantation. Pediatr Nephrol 2024; 39:1577-1585. [PMID: 38082092 DOI: 10.1007/s00467-023-06204-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 03/16/2024]
Abstract
BACKGROUND Disturbances of sleep are prevalent among children with chronic kidney disease. However, the aetiology of sleep disorders in children particularly after kidney transplantation is not clear. We sought to ascertain the prevalence and type of sleep disturbances in paediatric kidney transplant recipients and to identify predictors of sleep disturbances in this population. METHODS Caregivers of kidney transplant recipients completed online questionnaires about their child's sleep. The questionnaires utilised were the Sleep Disturbance Scale for Children (SDSC), the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD), questions about sleep hygiene, and questions about restless leg syndrome. Demographic and clinical details were collected from medical records. RESULTS Thirty-five children were included in the study, with a median (IQR) age of 14.1 years (9.5-16.1) and median years (IQR) since transplant of 3.7 (0.7-8.7) years, and 72.0% were identified to have at least one category of sleep disturbance according to scores on the SDSC. The most common sleep disturbances reported were disorders of initiating and maintaining sleep (DIMS) (40.0%) and disorders of excessive somnolence (DOES) (31.4%). Statistically significant predictors of sleep disturbances include low estimated glomerular filtration rate and increased age. Among children who screened positive for DIMS and DOES, the majority indicated use of electronic devices in 1 h before bed. CONCLUSIONS A high prevalence of sleep disturbances has been identified in children after kidney transplants, and some risk factors may be modifiable. Further studies are required to understand whether there are other readily modifiable predictors of sleep disturbances.
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Affiliation(s)
- Mian Yang
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia.
| | - Sandra Ya-Chu Chuang
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
- Respiratory Department, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Sean E Kennedy
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
- Nephrology Department, Sydney Children's Hospital, Randwick, NSW, Australia
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15
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Han X, Zhou E, Liu D. Electronic Media Use and Sleep Quality: Updated Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e48356. [PMID: 38533835 PMCID: PMC11077410 DOI: 10.2196/48356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/15/2023] [Accepted: 03/26/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND This paper explores the widely discussed relationship between electronic media use and sleep quality, indicating negative effects due to various factors. However, existing meta-analyses on the topic have some limitations. OBJECTIVE The study aims to analyze and compare the impacts of different digital media types, such as smartphones, online games, and social media, on sleep quality. METHODS Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the study performed a systematic meta-analysis of literature across multiple databases, including Web of Science, MEDLINE, PsycINFO, PubMed, Science Direct, Scopus, and Google Scholar, from January 2018 to October 2023. Two trained coders coded the study characteristics independently. The effect sizes were calculated using the correlation coefficient as a standardized measure of the relationship between electronic media use and sleep quality across studies. The Comprehensive Meta-Analysis software (version 3.0) was used to perform the meta-analysis. Statistical methods such as funnel plots were used to assess the presence of asymmetry and a p-curve test to test the p-hacking problem, which can indicate publication bias. RESULTS Following a thorough screening process, the study involved 55 papers (56 items) with 41,716 participants from over 20 countries, classifying electronic media use into "general use" and "problematic use." The meta-analysis revealed that electronic media use was significantly linked with decreased sleep quality and increased sleep problems with varying effect sizes across subgroups. A significant cultural difference was also observed in these effects. General use was associated with a significant decrease in sleep quality (P<.001). The pooled effect size was 0.28 (95% CI 0.21-0.35; k=20). Problematic use was associated with a significant increase in sleep problems (P≤.001). The pooled effect size was 0.33 (95% CI 0.28-0.38; k=36). The subgroup analysis indicated that the effect of general smartphone use and sleep problems was r=0.33 (95% CI 0.27-0.40), which was the highest among the general group. The effect of problematic internet use and sleep problems was r=0.51 (95% CI 0.43-0.59), which was the highest among the problematic groups. There were significant differences among these subgroups (general: Qbetween=14.46, P=.001; problematic: Qbetween=27.37, P<.001). The results of the meta-regression analysis using age, gender, and culture as moderators indicated that only cultural difference in the relationship between Eastern and Western culture was significant (Qbetween=6.69; P=.01). All funnel plots and p-curve analyses showed no evidence of publication and selection bias. CONCLUSIONS Despite some variability, the study overall confirms the correlation between increased electronic media use and poorer sleep outcomes, which is notably more significant in Eastern cultures.
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Affiliation(s)
- Xiaoning Han
- School of Journalism and Communication, Renmin University of China, Beijing, China
| | - Enze Zhou
- School of Journalism and Communication, Renmin University of China, Beijing, China
| | - Dong Liu
- School of Journalism and Communication, Renmin University of China, Beijing, China
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16
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Alexopoulou C, Fountoulaki M, Papavasileiou A, Kondili E. Sleep Habits, Academic Performance and Health Behaviors of Adolescents in Southern Greece. Healthcare (Basel) 2024; 12:775. [PMID: 38610197 PMCID: PMC11011514 DOI: 10.3390/healthcare12070775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
Adolescents often experience insufficient sleep and have unhealthy sleep habits. Our aim was to investigate the sleep patterns of secondary education students in Heraklion, Crete, Greece and their association with school performance and health habits. We conducted a community-based cross-sectional study with 831 students aged 13-19 years who completed an online self-reported questionnaire related to sleep and health habits. The data are mostly numerical or categorical, and an analysis was performed using t-tests, chi-square tests and multiple logistic regression. During weekdays, the students slept for an average of 7 ± 1.1 h, which is significantly lower than the 7.8 ± 1.5 h average on weekends (p < 0.001). Nearly 79% reported difficulty waking up and having insufficient sleep time, while 73.8% felt sleepy at school at least once a week. Having sufficient sleep time ≥ 8 h) was positively correlated with better academic performance (OR: 1.48, CI: 1.06-2.07, p = 0.022) and frequent physical exercise (never/rarely: 13.5%, sometimes: 21.2%, often: 65.3%; p = 0.002). Conversely, there was a negative correlation between adequate sleep and both smoking (OR: 0.29, CI: 0.13-0.63) and alcohol consumption (OR: 0.51, CI: 0.36-0.71, p = 0.001). In conclusion, this study shows that students in Heraklion, Crete frequently experience sleep deprivation, which is associated with compromised academic performance, reduced physical activity and an increased likelihood of engaging in unhealthy behaviors like smoking and alcohol consumption.
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Affiliation(s)
- Christina Alexopoulou
- Department of Intensive Care and Sleep Laboratory, University Hospital of Heraklion, 71110 Heraklion, Greece;
| | | | | | - Eumorfia Kondili
- Department of Intensive Care and Sleep Laboratory, University Hospital of Heraklion, 71110 Heraklion, Greece;
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Brunel L, Brossaud E, Lioret J, Jaffiol A, Vanderghote L, Cuisinier L, Peter-Derex L, Ricordeau F, Thieux M, Comajuan M, Plancoulaine S, Guyon A, Franco P. Effectiveness of an intervention program on physical activity in children with narcolepsy type 1. Sleep Med 2024; 116:138-146. [PMID: 38460419 DOI: 10.1016/j.sleep.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/27/2024] [Accepted: 03/03/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVES Physical activity (PA) is recommended as part of the management of narcolepsy type 1 (NT1). This study aimed at 1) characterizing PA in children and adolescents treated for NT1 using objective and subjective measurements, 2) evaluating how PA is associated with NT1 symptoms and comorbidities, and 3) evaluating the effects of an Adapted Physical Activity (APA) program on PA and clinical characteristics. PATIENTS/METHODS Patients with NT1 from the National Reference Center of Narcolepsy (Lyon, France) were consecutively included in an APA intervention protocol. Narcolepsy symptoms and comorbidities were collected using standardized questionnaires and sustained attention was evaluated using the Bron-Lyon Attention Stability Test before and after the four-week APA intervention. PA was measured objectively using actigraphy throughout the study. RESULTS Twenty-seven NT1 patients were included (median age 14.7 years [8.3-18.4], cataplexy 88.9%, obesity 37.0%). At baseline, 52.4% of the patients had satisfactory PA levels according to international recommendations. Patients with leisure-time PA (LTPA) showed higher quality of life than patients without. 45% of the patients increased PA during the intervention compared to baseline. These responsive patients had more depressive feelings and tended to have lower objective PA than non-responsive patients at baseline. No significant correlation was found between PA levels before and during the intervention and other clinical data. CONCLUSIONS Most children with NT1 showed satisfying PA levels despite their daytime sleepiness. LTPA engagement was associated with higher quality of life. An APA intervention could be effective in children with narcolepsy, especially for those with depressive feelings.
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Affiliation(s)
- Lisa Brunel
- INSERM U1028/ CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), University Lyon 1, CH Le Vinatier - Bâtiment 462, 95 boulevard Pinel, 69500, Bron, France; Pediatric Sleep Unit and National Reference Center for Narcolepsy, Mother-Children's Hospital, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Enzo Brossaud
- INSERM U1028/ CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), University Lyon 1, CH Le Vinatier - Bâtiment 462, 95 boulevard Pinel, 69500, Bron, France; Pediatric Sleep Unit and National Reference Center for Narcolepsy, Mother-Children's Hospital, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Julien Lioret
- INSERM U1028/ CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), University Lyon 1, CH Le Vinatier - Bâtiment 462, 95 boulevard Pinel, 69500, Bron, France; Pediatric Sleep Unit and National Reference Center for Narcolepsy, Mother-Children's Hospital, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France; Clinical Research Unit, Médipôle, 158 Rue Léon Blum, 69100, Villeurbanne, France
| | - Antoine Jaffiol
- Pediatric Sleep Unit and National Reference Center for Narcolepsy, Mother-Children's Hospital, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Louison Vanderghote
- E-HÔP Project, Mother-Children's Hospital, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Léa Cuisinier
- E-HÔP Project, Mother-Children's Hospital, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Laure Peter-Derex
- INSERM U1028/ CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), University Lyon 1, CH Le Vinatier - Bâtiment 462, 95 boulevard Pinel, 69500, Bron, France; Center for Sleep Medicine and Respiratory Disease, Croix-Rousse Hospital, Hospices Civils de Lyon, 103 Grande Rue, 69004, Lyon, France
| | - François Ricordeau
- Center for Sleep Medicine and Respiratory Disease, Croix-Rousse Hospital, Hospices Civils de Lyon, 103 Grande Rue, 69004, Lyon, France
| | - Marine Thieux
- INSERM U1028/ CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), University Lyon 1, CH Le Vinatier - Bâtiment 462, 95 boulevard Pinel, 69500, Bron, France; Pediatric Sleep Unit and National Reference Center for Narcolepsy, Mother-Children's Hospital, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Marion Comajuan
- INSERM U1028/ CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), University Lyon 1, CH Le Vinatier - Bâtiment 462, 95 boulevard Pinel, 69500, Bron, France; Pediatric Sleep Unit and National Reference Center for Narcolepsy, Mother-Children's Hospital, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Sabine Plancoulaine
- INSERM U1028/ CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), University Lyon 1, CH Le Vinatier - Bâtiment 462, 95 boulevard Pinel, 69500, Bron, France; Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Bâtiment Leriche, 16 Avenue Paul Vaillant-Couturier, 94800, Villejuif, France
| | - Aurore Guyon
- INSERM U1028/ CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), University Lyon 1, CH Le Vinatier - Bâtiment 462, 95 boulevard Pinel, 69500, Bron, France; Pediatric Sleep Unit and National Reference Center for Narcolepsy, Mother-Children's Hospital, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Patricia Franco
- INSERM U1028/ CNRS UMR 5292, Lyon Neuroscience Research Center (CRNL), University Lyon 1, CH Le Vinatier - Bâtiment 462, 95 boulevard Pinel, 69500, Bron, France; Pediatric Sleep Unit and National Reference Center for Narcolepsy, Mother-Children's Hospital, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France.
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18
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Yu DJ, Wing YK, Li TMH, Chan NY. The Impact of Social Media Use on Sleep and Mental Health in Youth: a Scoping Review. Curr Psychiatry Rep 2024; 26:104-119. [PMID: 38329569 PMCID: PMC10948475 DOI: 10.1007/s11920-024-01481-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE OF REVIEW Social media use (SMU) and other internet-based technologies are ubiquitous in today's interconnected society, with young people being among the commonest users. Previous literature tends to support that SMU is associated with poor sleep and mental health issues in youth, despite some conflicting findings. In this scoping review, we summarized relevant studies published within the past 3 years, highlighted the impacts of SMU on sleep and mental health in youth, while also examined the possible underlying mechanisms involved. Future direction and intervention on rational use of SMU was discussed. RECENT FINDINGS Both cross-sectional and longitudinal cohort studies demonstrated the negative impacts of SMU on sleep and mental health, with preliminary evidence indicating potential benefits especially during the COVID period at which social restriction was common. However, the limited longitudinal research has hindered the establishment of directionality and causality in the association among SMU, sleep, and mental health. Recent studies have made advances with a more comprehensive understanding of the impact of SMU on sleep and mental health in youth, which is of public health importance and will contribute to improving sleep and mental health outcomes while promoting rational and beneficial SMU. Future research should include the implementation of cohort studies with representative samples to investigate the directionality and causality of the complex relationships among SMU, sleep, and mental health; the use of validated questionnaires and objective measurements; and the design of randomized controlled interventional trials to reduce overall and problematic SMU that will ultimately enhance sleep and mental health outcomes in youth.
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Affiliation(s)
- Danny J Yu
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Tim M H Li
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
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Himelfarb M, Shatkin JP. Pediatric Insomnia. Psychiatr Clin North Am 2024; 47:121-134. [PMID: 38302201 DOI: 10.1016/j.psc.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Insomnia is the most common sleep disorder among all ages; unfortunately, however, child and adolescent insomnia is infrequently addressed. Given the importance of adequate sleep for proper brain development, pediatric populations are particularly vulnerable to the negative effects of insomnia. Therefore, proper clinical assessment and treatment of pediatric insomnia is crucial. This article is the result of a comprehensive literature review and serves as a guide to the disorder and how it presents differently across child development.
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Affiliation(s)
- Madeline Himelfarb
- Department of Child & Adolescent Psychiatry, New York University, One Park Avenue, 7th Floor, New York, NY 10016, USA
| | - Jess P Shatkin
- Department of Child & Adolescent Psychiatry, New York University, One Park Avenue, 7th Floor, New York, NY 10016, USA.
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Mutlu N, Dinleyici M. Evaluation of Screen Time in Children Under Five Years Old. Cureus 2024; 16:e54444. [PMID: 38510895 PMCID: PMC10951682 DOI: 10.7759/cureus.54444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Due to the rapid advancement of technology, there has been a noteworthy increase in the diversity and abundance of activities involving children. The most effective methods to enhance and facilitate children's media interactions are to minimize, reduce, use with caution, and establish healthy patterns. We aimed to evaluate media exposure of children below five years of age. MATERIAL AND METHODS This is a prospective, observational, cross-sectional study that was conducted between December 2017 and September 2019 in Eskişehir, Türkiye. To assess the frequency of electronic device usage among children under the age of five, including televisions, laptops, tablets, and mobile phones, as well as its impact on their sleep patterns and physical measurements, and to evaluate families' understanding of the terms "screen time" and "back screen time," we developed a questionnaire. RESULTS We analyzed a total of 731 questionnaires: 334 (45.7%) were girls, 397 (54.3%) were boys, and the mean age was 33.55±16.37 months. Upon examining the technical equipment accessible to the children in our study, we found that 98.6% possessed a television, 96.9% owned a mobile phone, 54% had a laptop, 49.5% had a tablet, and 34.1% possessed a gaming console. The study revealed the following proportions of electronic devices in children's rooms: 13% televisions, 11.9% tablets, 7.4% laptops, and 7% mobile phones. There has been a substantial increase in the amount of time they spend watching television and playing computer games among children who have at least one sibling. There was a statistically significant disparity between the television viewing periods and the body mass index of children older than two years old. Additionally, we have seen a significant disparity in the presence of media devices in children's bedrooms and the subsequent impact on their sleep duration and patterns throughout both nighttime and daytime. Around 65.8% of parents did not know of the concept of screen time, while 88.4% of parents did not know of the concept of back screen time. DISCUSSION Parental compliance with the current guidelines for screen time is insufficient, among parents with children under the age of five, even though exposure to screens begins in the first months of life. Our analysis highlighted the necessity for parents to establish and enforce a unified and logical media usage policy for all children residing in the household. It is crucial to allocate sufficient time during the routine healthcare visit to discuss these recommendations.
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Affiliation(s)
- Nese Mutlu
- Department of Pediatrics, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, TUR
| | - Meltem Dinleyici
- Department of Social Pediatrics, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, TUR
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Schønning V, Hysing M, Dovran A, Nilsen SA, Hafstad GS, Vedaa Ø, Sivertsen B. Sleep and childhood maltreatment: A matched-control study of sleep characteristics in Norwegian 16-19-year-olds. Scand J Psychol 2024; 65:119-128. [PMID: 37626444 DOI: 10.1111/sjop.12960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023]
Abstract
Sleep problems are an important but understudied health problem in adolescents exposed to childhood maltreatment. The current study aimed to examine sleep characteristics and insomnia in a population with maltreatment history and compare them to a general population sample of adolescents. Data from a sample of Norwegian 16-19-year-old adolescents with childhood maltreatment experiences (n = 62) were linked to an age- and sex-matched general population sample (n = 238). Independent samples t tests were used to compare the two groups on several detailed sleep parameters, while general linear models were used to control for mental health problems, assessed by the Strengths and Difficulties Questionnaire. Mental health was examined as a potential mediator between childhood maltreatment and sleep characteristics. Adolescents exposed to childhood maltreatment had longer sleep onset latency (1:15 h vs. 47 min, p < 0.001), longer wake after sleep onset (34 min vs. 15 min, p < 0.003), lower sleep efficiency in weekdays (77.8%, vs. 85%, p < 0.007), and lower sleep efficiency in weekends (81.8% vs. 88.9%, p < 0.001) than the reference group. Mental health problems fully mediated the association between childhood maltreatment exposure and longer sleep onset latency and wake after sleep onset. The rate of insomnia did not significantly differ between the groups. This study suggests that older adolescents exposed to childhood maltreatment have more sleep problems than the general adolescent population, and that these problems may be explained by co-existing mental health problems. These findings highlight the potential utility of assessing and providing sleep-focused treatment to adolescents with a history of childhood maltreatment and mental health problems.
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Affiliation(s)
- Viktor Schønning
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Mari Hysing
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Anders Dovran
- Stine Sofie's Foundation, Stine Sofie Centre, Grimstad, Norway
| | - Sondre A Nilsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Gertrud S Hafstad
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Øystein Vedaa
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Research & Innovation, Helse Fonna HF, Haugesund, Norway
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22
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Alhaque Roomi MHA, Srivastava A, Girdhar N, Jha C, Thakur S. A Study of the Correlation Between Screen Time and Hypertension Among Young Adults in North India: A Cross-Sectional Analysis. Cureus 2024; 16:e51667. [PMID: 38313899 PMCID: PMC10838163 DOI: 10.7759/cureus.51667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Hypertension is a major risk factor for coronary artery disease. Due to the increased accessibility of smartphones over the past decade, there has been an increase in the screen time of adolescents and young adults. However, the relationship between screen time and hypertension has not been adequately studied. Our study aims to find a correlation between screen time and blood pressure (BP) among young adults. METHODS A cross-sectional analysis was performed on a sample of medical students (n = 210) from New Delhi, India. Participants' screen time was monitored over three weeks and BP was recorded using a standardized sphygmomanometer by auscultatory method. Exclusion criteria included known cases of hypertension (with or without ongoing treatment), smokers > five pack year, heavy alcoholics, and participants having sleep time of less than seven hours or more than nine hours per day. Screen time was correlated with BP readings using standard statistical methods. RESULTS Participants with screen time >390 minutes (six hours and 30 minutes), >420 minutes (seven hours), and >480 minutes (eight hours) had higher odds of elevated BP (OR: 1.86, 95% CI: 1.05-3.30; OR: 1.86, 95% CI: 1.04-3.30; OR: 1.87, 95% CI: 1.02-3.43, respectively) compared to students with screen time <390 minutes. The findings were consistent after excluding participants with high BMI based on the WHO and Asia-Pacific criteria, which also showed higher odds of elevated BP with screen time >390 minutes (OR: 3.21, 95% CI: 1.58-6.49 and OR: 3.92, 95% CI: 1.49-10.31, respectively). Regression analysis showed no significant linear correlation between screen time and BP (p > 0.05). However, a significant association was observed between BMI and elevated BP (p < 0.001). CONCLUSION This study revealed an association exists between screen time and BP.
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Affiliation(s)
| | - Abhishyant Srivastava
- Internal Medicine, Dr. Baba Saheb Ambedkar Medical College & Hospital, New Delhi, IND
| | - Narinder Girdhar
- Medicine, Dr. Baba Saheb Ambedkar Medical College & Hospital, New Delhi, IND
| | - Chaitannya Jha
- Internal Medicine, Dr. Baba Saheb Ambedkar Medical College & Hospital, New Delhi, IND
| | - Shashwat Thakur
- Internal Medicine, Dr. Baba Saheb Ambedkar Medical College & Hospital, New Delhi, IND
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Zhang R, Zhang CQ, Gu D. Integrating perceived physical environments and the theory of planned behaviors when explaining adherence to 24-hour movement guidelines in Chinese adolescents. Scand J Med Sci Sports 2024; 34:e14530. [PMID: 37909309 DOI: 10.1111/sms.14530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 10/04/2023] [Accepted: 10/19/2023] [Indexed: 11/03/2023]
Abstract
PURPOSES Most adolescents worldwide do not meet 24-h movement guidelines, which recommend specific level of physical activity, sedentary behavior, and sleep for optimal health. Nevertheless, there remains a lack of understanding regarding how social cognitive and physical environmental factors influence adolescents' compliance with these guidelines. This prospective study aimed to examine the associations between perceived physical environments, constructs of the theory of planned behavior (TPB), habit strength, and adherence to 24-h movement guidelines in Chinese adolescents over a three-month period. METHODS A total of 629 Chinese adolescents (Mage = 14.59 years, SD = 0.64) completed a set of questionnaires comprising perceived physical environmental characteristics, constructs of the TPB, habit strength, and 24-h movement behaviors at baseline and 3 months later. Data analysis was conducted using variance-based structural equation modeling. RESULTS Attitude, subjective norm, and perceived behavioral control had a direct effect on intention and intention had a direct effect on number of the guidelines being met. Habit strength was a significant predictor of adherence to the guidelines, although its moderating effect on the intention-behavior relationship was not significant. Perceived neighborhood facility accessibility, school facility availability, and home physical activity equipment had significant indirect effects on intention through attitude, subjective norm, and perceived behavioral control. However, constructs of the TPB did not serve as mediators in the relationship between perceived physical environments and the number of guidelines being met. CONCLUSION This study offers preliminary evidence supporting the integration of perceived physical environments and the TPB in predicting adolescents' adherence to 24-h movement guidelines. Future research should consider using experimental study designs with rigorous measures of 24-h movement behaviors to establish causal relationships.
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Affiliation(s)
- Ru Zhang
- School of Physical Education & Sports Science, South China Normal University, Guangzhou, China
| | - Chun-Qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Dacheng Gu
- School of Physical Education & Health, Nanning Normal University, Nanning, China
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Wang W, Jiang J, Qi L, Zhao F, Wu J, Zhu X, Wang B, Hong X. Relationship between mental health, sleep status and screen time among university students during the COVID-19 pandemic: a cross-sectional study. BMJ Open 2023; 13:e073347. [PMID: 38070905 PMCID: PMC10729102 DOI: 10.1136/bmjopen-2023-073347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE On 20 July 2021, after the outbreak of COVID-19 at Nanjing Lukou International Airport, several universities started closed management and online teaching. This had a large impact on students' daily life and study, which may lead to mental health problems. The purpose of this study is to study the effect of screen time on mental health status of university students and the possible mediating effect of sleep status. METHODS This was a cross-sectional study. A web-based questionnaire survey was employed that included demographic characteristics, sleep status and mental health status (depression, anxiety and loneliness). The Pittsburgh Sleep Quality Index scale was used to assess sleep status, while the Centre for Epidemiologic Studies Depression (CES-D) scale, Generalised Anxiety Disorder-7 (GAD-7) scale and Emotional versus Social Loneliness Scale (ESLS) were used to assess depression, anxiety and loneliness, respectively. Linear and logistic regression models were developed and adjusted for confounding factors, and finally the mediating effects were tested using the Karlson-Holm-Breen method. RESULTS Finally, 1070 valid questionnaires were included. Among these, 604 (56.45%) indicated depressive symptoms (CES-D score ≥16) and 902 (84.30%) indicated anxiety symptoms (GAD-7 score ≥10). The mean ESLS score (for loneliness) was 26.51±6.64. The relationship between screen time and depressive symptoms (OR 1.118, 95% CI 1.072 to 1.166) and anxiety symptoms (OR 1.079, 95% CI 1.023 to 1.138) remained significant after adjusting for confounding factors. Meanwhile, sleep status plays an intermediary role in screen time and mental health status (depression and anxiety) and accounts for 13.73% and 19.68% of the total effects, respectively. We did not find a significant association between screen time and loneliness. CONCLUSION During the outbreak of COVID-19, screen time is inevitably prolonged among university students. There is a relationship between mental health and screen time, and sleep status plays a mediating role.
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Affiliation(s)
- Wei Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Jingfeng Jiang
- Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, China
| | - Lerong Qi
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Fanqi Zhao
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Jingying Wu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Xiaoqi Zhu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Bei Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Xiang Hong
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
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Cha JH, Choi YJ, Ryu S, Moon JH. Association between smartphone usage and health outcomes of adolescents: A propensity analysis using the Korea youth risk behavior survey. PLoS One 2023; 18:e0294553. [PMID: 38055658 DOI: 10.1371/journal.pone.0294553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/04/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVES We aimed to investigate the association between smartphone use and adverse behavioral health outcomes using nationwide Korea Youth Risk Behavior Web-based Survey data for 2017 and 2020. METHODS The 2020 data (N = 54,809) were used to analyze the relationships between daily smartphone usage time (non-user, 0-2 h [hour], 2-4 h, 4-6 h, 6-8 h, and > 8 h), and adverse health outcomes (stress, sleep, depression, suicide, substance use, and smartphone overdependence). A 1:1 propensity score matching (PSM) was used to control for confounding variables. RESULTS A total of 40,998 adolescents with < 4 h/day and > 4 h/day of usage were included. Adolescents' mean smartphone usage time in 2020 increased compared to that in 2017 (weighted % of > 2 h/day; 64.3% vs. 85.7%). The curvilinear relationships between smartphone usage time and adverse health outcomes were prominent after > 4 h/day. Adolescents using smartphones 2-4 h/day showed no increased adverse health outcomes compared to non-users, except for smartphone overdependence. Using a smartphone > 4 h/day was significantly associated with stress perception (1.16; 1.11-1.22), suicidal ideation (1.22; 1.13-1.31), and substance use (alcohol, 1.66; 1.57-1.75) after PSM. CONCLUSIONS Our study demonstrated the curvilinear relationship between smartphone usage time and adverse health outcomes in adolescents. Our findings can help establish smartphone usage guidelines for adolescents.
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Affiliation(s)
- Jong Ho Cha
- Department of Pediatrics, Hanyang University Medical Center, Seoul, Korea
| | - Young-Jin Choi
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Korea
| | - Soorack Ryu
- Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, Korea
| | - Jin-Hwa Moon
- Division of Pediatric Neurology, Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
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Echevarria P, Del-Ponte B, Tovo-Rodrigues L, Matijasevich A, Halal CS, Santos IS. Screen use and sleep duration and quality at 15 years old: Cohort study. Sleep Med X 2023; 5:100073. [PMID: 37305851 PMCID: PMC10251069 DOI: 10.1016/j.sleepx.2023.100073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/02/2023] [Accepted: 05/02/2023] [Indexed: 06/13/2023] Open
Abstract
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.
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Affiliation(s)
- Priscila Echevarria
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Bianca Del-Ponte
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Luciana Tovo-Rodrigues
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Camila S. Halal
- Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Iná S. Santos
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
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Tiraboschi GA, Garon-Carrier G, Smith J, Fitzpatrick C. Adolescent internet use predicts higher levels of generalized and social anxiety symptoms for girls but not boys. Prev Med Rep 2023; 36:102471. [PMID: 37881178 PMCID: PMC10594560 DOI: 10.1016/j.pmedr.2023.102471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/07/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023] Open
Abstract
Past research suggests that internet use can increase the risks of internalizing symptoms in adolescents. However, bidirectional relationships between adolescent internet use and anxiety symptoms have received very little attention. Furthermore, few studies have examined these links according to sex. The present study attempts to fill this gap by investigating longitudinal associations between Canadian boys' and girls' internet use and symptoms of generalized anxiety and social anxiety using data from the Quebec longitudinal Study of Child Development. A sample of 1324 adolescents (698 girls, 626 boys) self-reported the number of hours per week they spent on the internet and their symptoms of generalized and social anxiety at ages 15 and 17. We estimated two cross-lagged panel models with social or generalized anxiety symptoms and internet use at age 15 predicting those same variables at age 17. Sex was used as a grouping variable and socioeconomic status was included as a control variable. Internet use at 15 predicted generalized and social anxiety symptoms at age 17 in girls, but not boys. Social and generalized anxiety symptoms at age 15 did not predict internet use at age 17 for both boys and girls. These results suggest that internet use can be a significant risk factor for the development of anxiety symptoms in adolescent girls. Girls may be more vulnerable to the negative effects of internet use due to increased sensitivity to social comparisons. Thus, helping girls develop healthier internet use habits should be a target for promoting their mental health.
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Affiliation(s)
- Gabriel A. Tiraboschi
- Department d’enseignement au préscolaire et au primaire, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
- Département de psychoéducation, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
| | - Gabrielle Garon-Carrier
- Département de psychoéducation, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
| | - Jonathan Smith
- Department d’enseignement au préscolaire et au primaire, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
| | - Caroline Fitzpatrick
- Department d’enseignement au préscolaire et au primaire, Université de Sherbrooke, 2500 Bd de l'Université, Sherbrooke, Quebec, QC J1K 2R1, Canada
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28
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Garrett SL, Burnell K, Armstrong-Carter EL, Nelson BW, Prinstein MJ, Telzer EH. Links Between Objectively-Measured Hourly Smartphone Use and Adolescent Wake Events Across Two Weeks. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023:1-11. [PMID: 38039087 DOI: 10.1080/15374416.2023.2286595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
PURPOSE Psychosocial and bioregulatory pressures threaten sleep during adolescence. Although recent work suggests that the ubiquity of smartphone use throughout adolescence may also relate to poorer sleep outcomes, most existing research relies upon self-report and retrospective measures. This study drew upon objective measures of smartphone use and sleep at the hourly level to understand how smartphone use was associated with the duration of wake events during sleeping hours. METHODS Across a 14-day daily study, 59 racially and ethnically diverse adolescents ages 15 to 18 had their sleep assessed via Fitbit Inspire 2 devices and uploaded screenshots of their screen time, pickups, and notifications as logged by their iPhone's iOS. Multi-level modeling was performed to assess hourly level associations between adolescent smartphone use and wake-events during their sleep sessions (N = 4,287 hourly cases). RESULTS In hours during adolescents' sleep session with more screen time or pickups, adolescents had longer wake event duration. More notifications in a given hour were not associated with wake event duration in the same hour. CONCLUSIONS Using objectively measured smartphone and sleep data collected at the hourly level, we found that during sleeping hours, when adolescents are actively engaging with their smartphones, their sleep is disrupted, such that their wake events are longer in that hour.
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Affiliation(s)
- Shedrick L Garrett
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
| | - Kaitlyn Burnell
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
| | | | - Benjamin W Nelson
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
| | - Mitchell J Prinstein
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
| | - Eva H Telzer
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill
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29
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Zeghari R, Gindt M, Guivarch J, Auby P, Robert P, Rolling J, Schröder C, Valo P, Askenazy F, Fernandez A. July 14th 2016 Nice Terrorist Attack Court Trial: A Protocol on Sleep Quality and Somatic Symptoms as Markers of Risk for Traumatic Reactivation in Adolescents Exposed to This Attack. Healthcare (Basel) 2023; 11:2953. [PMID: 37998445 PMCID: PMC10671086 DOI: 10.3390/healthcare11222953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/05/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
The court trial of the 14th of July 2016 terrorist attack in Nice (France) opened in September 2022 and ended in December 2022. Engaging in court proceedings, whether as a victim or a witness, can lead to a significant risk of traumatic reactivation (i.e., the re-emergence of post-traumatic stress symptoms). The present protocol aimed to improve knowledge of the pathophysiology of traumatic reactivation due to the media coverage of the trial by assessing sleep disturbances and somatic symptoms that could reappear if there is a traumatic reactivation. Method and Analysis: This is a monocentric longitudinal study, with recruitment solely planned at the Nice Pediatric Psychotrauma Center (NPPC). We intended to include 100 adolescents aged 12 to 17 years who were directly or indirectly exposed to the attack and included in the "14-7" program). Assessments began one month before the trial, in August 2022, and were scheduled once a month until the end of the trial. A smartwatch recorded sleep activity. Somatic and PTSD symptoms and sleep were assessed through validated questionnaires. The main analyses comprised the variance and regression analyses of predictors of clinical evolution over time. Ethics and Dissemination: The National Ethics Committee "NORD OUEST III" approved the "14-7" program protocol (number 2017-A02212-51). The specific amendment for this research was approved in April 2022 by the same national ethical committee. Inclusions started in August 2022.
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Affiliation(s)
- Radia Zeghari
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Morgane Gindt
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Jokthan Guivarch
- Department of Child Psychiatry, APHM, 13009 Marseille, France;
- CANOP Institut de Neurosciences de la Timone, UMR 7289, CNRS, Aix Marseille University, 13005 Marseille, France
- Faculty of Medicine, Aix-Marseille University, 13005 Marseille, France
| | - Philippe Auby
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Philippe Robert
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Julie Rolling
- Regional Center for Psychotraumatism Great East, Strasbourg University Hospital, 67000 Strasbourg, France
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 67000 Strasbourg, France
- CNRS UPR3212-Research Team “Light, Circadian Rhythms, Sleep Homeostasis and Neuropsychiatry”, Institute of Cellular and Integrative Neurosciences, 67000 Strasbourg, France
- Excellence Centre for Autism and Neurodevelopmental Disorders STRAS&ND, 67091 Strasbourg, France
- Sleep Disorders Centre & International Research Centre for ChronoSomnology (Circsom), University Hospitals Strasbourg, 67091 Strasbourg, France
| | - Carmen Schröder
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, 67000 Strasbourg, France
- CNRS UPR3212-Research Team “Light, Circadian Rhythms, Sleep Homeostasis and Neuropsychiatry”, Institute of Cellular and Integrative Neurosciences, 67000 Strasbourg, France
- Excellence Centre for Autism and Neurodevelopmental Disorders STRAS&ND, 67091 Strasbourg, France
- Sleep Disorders Centre & International Research Centre for ChronoSomnology (Circsom), University Hospitals Strasbourg, 67091 Strasbourg, France
- Expert Centre for High-Functioning Autism, Fondation FondaMental, 67000 Strasbourg, France
| | - Petri Valo
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Florence Askenazy
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
| | - Arnaud Fernandez
- Nice Pediatric Psychotrauma Center (NPPC), Child and Adolescent Psychiatry Department, Hôpitaux Pédiatriques Universitaires Lenval, 06200 Nice, France
- CoBTeK (Cognition-Behaviour-Technology) Lab, Université Cote d’Azur, 06000 Nice, France
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Olorunmoteni OE, Fehintola FO, Seun-Fadipe C, Komolafe MA, Mosaku KS. Sleep quality and its relationship with school schedules and mental health of Nigerian secondary school adolescents. J Clin Sleep Med 2023; 19:1895-1904. [PMID: 37421328 PMCID: PMC10620664 DOI: 10.5664/jcsm.10708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 07/10/2023]
Abstract
STUDY OBJECTIVES This study aimed to determine the sleep quality of in-school Nigerian adolescents and its association with their schooling and mental health outcomes. METHODS The study was a descriptive cross-sectional study. It was conducted among adolescents attending public and private secondary schools within the Ife Central Local Government, Osun State, southwestern Nigeria. A multistage sampling technique was used to select study participants. The Pittsburgh Sleep Quality Index, 9-item Patient Health Questionnaire (PHQ-9), and 7-item General Anxiety Disorder questionnaires were used to determine sleep quality, depression, and anxiety, respectively. RESULTS We studied 448 adolescents aged between 10 and 19 years with a mean age of 15.0 ± 1.8 years. The majority of our respondents (85.0%) had poor sleep quality. More than half of the respondents (55.1%) had insufficient sleep during weekdays, while only 34.8% had insufficient sleep during weekends. The school closing time and school type showed a statistically significant association with sleep quality (P = .039 and .005, respectively). The odds of having poor sleep quality increased by 2-fold among adolescents in private schools when compared with those in public schools (adjusted odds ratio = 1.97, 95% confidence interval = 1.069-3.627). Using multiple linear regression, only depression showed a statistically significant association with sleep quality at 95% confidence interval (CI = 0.073 to 0.219, P < .001), such that for every unit change in depression scores (PHQ-9), there will be a corresponding increase of 0.103 in sleep quality. CONCLUSIONS Sleep quality is poor in adolescents and adversely associated with their mental health. This should also be addressed in the development of appropriate interventions. CITATION Olorunmoteni OE, Fehintola FO, Seun-Fadipe C, Komolafe MA, Mosaku KS. Sleep quality and its relationship with school schedules and mental health of Nigerian secondary school adolescents. J Clin Sleep Med. 2023;19(11):1895-1904.
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Affiliation(s)
| | - Funmito Omolola Fehintola
- Department of Community Health, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Dibben GO, Martin A, Shore CB, Johnstone A, McMellon C, Palmer V, Pugmire J, Riddell J, Skivington K, Wells V, McDaid L, Simpson SA. Adolescents' interactive electronic device use, sleep and mental health: a systematic review of prospective studies. J Sleep Res 2023; 32:e13899. [PMID: 37029099 PMCID: PMC10909457 DOI: 10.1111/jsr.13899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 04/09/2023]
Abstract
Optimal sleep, both in terms of duration and quality, is important for adolescent health. However, young people's sleeping habits have worsened over recent years. Access to and use of interactive electronic devices (e.g., smartphones, tablets, portable gaming devices) and social media have become deep-rooted elements of adolescents' lives and are associated with poor sleep. Additionally, there is evidence of increases in poor mental health and well-being disorders in adolescents; further linked to poor sleep. This review aimed to summarise the longitudinal and experimental evidence of the impact of device use on adolescents' sleep and subsequent mental health. Nine electronic bibliographical databases were searched for this narrative systematic review in October 2022. Of 5779 identified unique records, 28 studies were selected for inclusion. A total of 26 studies examined the direct link between device use and sleep outcomes, and four reported the indirect link between device use and mental health, with sleep as a mediator. The methodological quality of the studies was generally poor. Results demonstrated that adverse implications of device use (i.e., overuse, problematic use, telepressure, and cyber-victimisation) impacted sleep quality and duration; however, relationships with other types of device use were unclear. A small but consistent body of evidence showed sleep mediates the relationship between device use and mental health and well-being in adolescents. Increasing our understanding of the complexities of device use, sleep, and mental health in adolescents are important contributions to the development of future interventions and guidelines to prevent or increase resilience to cyber-bullying and ensure adequate sleep.
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Affiliation(s)
- Grace O. Dibben
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Anne Martin
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Colin B. Shore
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Avril Johnstone
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Christina McMellon
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Victoria Palmer
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | | | - Julie Riddell
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Kathryn Skivington
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Valerie Wells
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
| | - Lisa McDaid
- Institute for Social Science ResearchThe University of QueenslandBrisbaneQueenslandAustralia
| | - Sharon A. Simpson
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
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de Souza AA, Bandeira PFR, Vale SMCG, da Cunha GL, Mota JAPS, de Lucena Martins CM. Paths towards a healthier BMI among short and adequate sleepers: A pathway network analysis considering movement behaviors in low-income preschoolers. Am J Hum Biol 2023; 35:e23915. [PMID: 37269167 DOI: 10.1002/ajhb.23915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/27/2023] [Accepted: 05/07/2023] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION Short sleep duration has been seen as a predictor of higher body mass index (BMI) in youth. Sleep duration varies substantially along early childhood, and the paths towards a healthier BMI, considering the other movement behaviors (physical activity-PA and screen time) are unexplored in preschoolers. AIM To construct a sleep-BMI model to capture the direct and indirect paths to intervening towards a healthier BMI, according to low-income preschoolers' compliance with the other movement behaviors. METHODS Two hundred and seventy two preschoolers (4.5 ± 0.0; 138 boys) participated in the study. Sleep and screen time (ST) were assessed in a face-to-face interview with primary caregivers. PA was assessed using accelerometer (wGT3X-BT). Preschoolers were categorized as compliant or not with sleep, screen time, total and moderate to vigorous PA recommendations. BMIz-score was calculated according to preschoolers' sex and age. All the assessed variables, besides sex and age were included in a Network Pathway Analysis (NPA) according to age as nodes. RESULTS At 3 years old, a direct and negative path between sleep-BMIz score was observed. At four and 5 years old, this relationship became positive. Further, girls were more compliant with sleep, ST and total PA recommendations. Total PA (TPA) showed the highest expected influence value in the general, 3 and 4 years old NPA. CONCLUSION The NPA analysis showed different directions for the relationship between sleep and BMIz score, according to age. Intervention strategies to a healthier BMI among preschoolers compliant or not with sleep recommendations should focus in increasing TPA.
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Affiliation(s)
| | | | | | - Glacithane Lins da Cunha
- Programa de Pós-Graduação em Educação Física, Universidade Federal do Vale do São Francisco, Petrolina, Pernambuco, Brazil
| | - Jorge Augusto Pinto Silva Mota
- Research Centre of Physical Activity, Health and Leisure, Faculty of Sport Sciences, University of Porto, Porto, Portugal
| | - Clarice Maria de Lucena Martins
- Research Centre of Physical Activity, Health and Leisure, Faculty of Sport Sciences, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), University of Porto, Porto, Portugal
- Departamento de Educação Física, Universidade Federal da Paraíba, João Pessoa, Paraiba, Brazil
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Jeong D, Lee H, Kim J. Effects of sleep pattern, duration, and quality on premenstrual syndrome and primary dysmenorrhea in korean high school girls. BMC Womens Health 2023; 23:456. [PMID: 37641079 PMCID: PMC10464156 DOI: 10.1186/s12905-023-02600-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Sleep deprivation is known to be a risk factor for premenstrual syndrome and primary dysmenorrhea in adults. However, it has rarely been investigated in adolescents. The aim of this study was to investigate whether sleep pattern, duration, and quality independently affect premenstrual syndrome and primary dysmenorrhea in adolescent girls. An additional purpose was to investigate the sleep status in Korean adolescent girls during the COVID-19 pandemic. METHODS A cross-sectional survey study was conducted in 519 high school girls aged 15 to 18 years in Gyeonggido, South Korea, in 2021 during the COVID-19 lockdown. Menstrual pain intensity and menstrual symptoms were assessed using the visual analogue scale (VAS) and Cox menstrual symptom scale (CMSS), respectively. Premenstrual syndrome was assessed by the premenstrual symptoms screening tool (PSST). Sleep was assessed by the Pittsburgh Sleep Quality Index (PSQI). The known risk factors of dysmenorrhea, including menstrual and lifestyle characteristics and stress, were assessed as covariates. RESULTS During the pandemic, approximately 68% of girls slept 7 h or less, while about 60% reported poor sleep quality. Additionally, 64% of participants had a bedtime later after 1AM, and 34% woke up later after 8AM. Late bedtime significantly affected VAS (P = 0.05), CMSS severity and frequency (both P < 0.01), and PSST symptom (P < 0.01). Waking up late affected CMSS severity (P < 0.05), PSST symptom (P = 0.05), and PSST function (P < 0.05). However, the significance of these effects disappeared after controlling for covariates. Sleeping less than 5 h affected CMSS frequency (P < 0.05) and PSST symptoms (P < 0.001). After controlling for covariates, the significance of the effect on PSST symptom remained (P < 0.05). General sleep quality and PSQI components, including subjective sleep quality, sleep latency, sleep disturbance, use of sleeping medication, and daytime dysfunction, significantly affected CMSS frequency and severity and PSST symptom after controlling for covariates (P < 0.05, P < 0.01, or P < 0.001). The multiple regression analysis revealed that among sleep characteristics, sleep quality was the most important risk factor of premenstrual syndrome and dysmenorrhea. CONCLUSION Our study result heightens the importance of healthy sleep hygiene, especially sleep quality in the management of premenstrual syndrome and dysmenorrhea in adolescent girls.
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Affiliation(s)
- Daye Jeong
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae- ro 9-gil, Seodaemun-gu, Seoul, 03746, Republic of Korea
| | - Heakyong Lee
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae- ro 9-gil, Seodaemun-gu, Seoul, 03746, Republic of Korea
| | - Jaehee Kim
- Graduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae- ro 9-gil, Seodaemun-gu, Seoul, 03746, Republic of Korea.
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Mombelli S, Bacaro V, Curati S, Berra F, Sforza M, Castronovo V, Ferini-Strambi L, Galbiati A, Baglioni C. Non-pharmacological and melatonin interventions for pediatric sleep initiation and maintenance problems: A systematic review and network meta-analysis. Sleep Med Rev 2023; 70:101806. [PMID: 37406497 DOI: 10.1016/j.smrv.2023.101806] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/07/2023] [Accepted: 06/10/2023] [Indexed: 07/07/2023]
Abstract
Sleep initiation and maintenance problems are common in the pediatric population and while behavioral interventions are recommended, their efficacy remains to be evaluated in clinical trials. We conducted a systematic review and network meta-analysis to assess the efficacy of non-pharmacological treatments and melatonin for sleep initiation and maintenance problems in healthy pediatric populations. We included 30 studies in the systematic review and 15 in the meta-analysis. Three network meta-analyses were conducted for sleep onset latency (SOL), wake after sleep onset (WASO), and total sleep time (TST). For SOL variable, the results support greater effectiveness of light therapy and melatonin than evidence-based psychological interventions, whether implemented in combination with light therapy or not. Regarding WASO variable, evidence-based psychological interventions and a combination of those techniques plus light treatment were the most efficacious. Finally, for TST variable, a larger effect was shown for the combined treatment of evidence-based psychological intervention with light therapy in comparison to other interventions. In conclusion, we found a high variability between study protocols likely impacting the results of the meta-analysis. Future randomized control trials studies, stratified by pediatric age classes, are needed in order to provide clear suggestions in clinical settings.
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Affiliation(s)
- Samantha Mombelli
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Valeria Bacaro
- Department of Human Sciences, University of Rome Guglielmo Marconi, Rome, Italy; Department of Psychology, University of Bologna, Bologna, Italy
| | - Sara Curati
- Department of Human Sciences, University of Rome Guglielmo Marconi, Rome, Italy
| | - Francesca Berra
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marco Sforza
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Vincenza Castronovo
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luigi Ferini-Strambi
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Galbiati
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
| | - Chiara Baglioni
- Department of Human Sciences, University of Rome Guglielmo Marconi, Rome, Italy; Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, DE, Germany; Clinic for Sleep Psychotherapy, School of Cognitive Psychotherapy, SPC, Rome, Italy
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Kawuki J, Gatasi G, Sserwanja Q, Mukunya D, Musaba MW. Comprehensive knowledge about HIV/AIDS and associated factors among adolescent girls in Rwanda: a nationwide cross-sectional study. BMC Infect Dis 2023; 23:382. [PMID: 37286932 DOI: 10.1186/s12879-023-08187-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 03/21/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Limited comprehensive knowledge of HIV/AIDS is highlighted as one of the major factors linked to the high prevalence of HIV among adolescents and young girls. Thus, it is crucial to identify factors that facilitate or hinder adolescent girls from having comprehensive knowledge of HIV/AIDS. We, therefore, assessed the prevalence of comprehensive knowledge about HIV/AIDS and associated factors among adolescent girls in Rwanda. METHODS We used secondary data from the Rwanda Demographic and Health Survey (RDHS) 2020 comprising 3258 adolescent girls (aged 15 to 19 years). Comprehensive knowledge was considered if an adolescent girl answered correctly all the six indicators; always using condoms during sex can reduce the risk of getting HIV, having one sexual partner only who has no other partners can reduce the risk of getting HIV, a healthy-looking person can have HIV, can get HIV from mosquito bites, can get HIV by sharing food with persons who have AIDS, and can get HIV by witchcraft or supernatural means. We, then, conducted multivariable logistic regression to explore the associated factors, using SPSS (version 25). RESULTS Of the 3258 adolescent girls, 1746 (53.6%, 95%CI: 52.2-55.6) had comprehensive knowledge about HIV/AIDS. Adolescent girls with secondary education (AOR = 1.40, 95% CI: 1.13-3.20), health insurance (AOR = 1.39, 95% CI: 1.12-1.73), a mobile phone (AOR = 1.26, 95% CI: 1.04-1.52), exposure to television (AOR = 1.23, 95% CI: 1.05-1.44), and a history of an HIV test (AOR = 1.26, 95% CI: 1.07-1.49) had higher odds of comprehensive HIV knowledge, compared to their respective counterparts. However, girls residing in Kigali (AOR = 0.65, 95% CI: 0.49-0.87) and Northern (AOR = 0.75, 95% CI: 0.59-0.95) regions, and those of Anglican religion (AOR = 0.82, 95% CI: 0.68-0.99) had less odds of comprehensive knowledge compared to those in Southern region and of the Catholic religion. CONCLUSIONS To increase the comprehensive understanding of the disease at a young age, the need for expanded access to HIV preventive education through formal educational curriculum, and mass and social media via mobile phones is highlighted. In addition, the continued involvement of key decision-makers and community actors, such as religious leaders, is vital.
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Affiliation(s)
- Joseph Kawuki
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, SAR- China, Central Ave, Hong Kong.
| | - Ghislaine Gatasi
- Key Laboratory of Environmental Medicine Engineering, School of Public Health, Southeast University, 210009, Nanjing, Jiangsu Province, China
| | | | - David Mukunya
- Department of Public Health, Busitema University, Mbale, Uganda
| | - Milton W Musaba
- Department of Obstetrics and Gynaecology, Busitema University, Mbale, Uganda
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Gomes S, Ramalhete C, Ferreira I, Bicho M, Valente A. Sleep Patterns, Eating Behavior and the Risk of Noncommunicable Diseases. Nutrients 2023; 15:nu15112462. [PMID: 37299426 DOI: 10.3390/nu15112462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Sleep is extremely important for the homeostasis of the organism. In recent years, various studies have been carried out to address factors related to sleep patterns and their influence on food choices, as well as on the onset of chronic noncommunicable diseases. The aim of this article is to provide a scientific literature review on the possible role of sleep patterns on eating behavior and the risk of noncommunicable diseases. A search was performed on Medline (PubMed interface) using several keywords (e.g., "Factors Influencing Sleep" OR "Sleep and Chronic Diseases"). Articles published between 2000 and the present date that relate sleep to cyclic metabolic processes and changes in eating behavior were selected. Changes in sleep patterns are increasingly detected today, and these modifications are mainly caused by work and lifestyle conditions as well as a growing dependence on electronic devices. Sleep deprivation and the resultant short sleep duration lead to an increased appetite via an increase in the hunger hormone (ghrelin) and a decrease in the satiety hormone (leptin). Nowadays, sleep is undervalued, and thus often impaired, with consequences for the performance of various body systems. Sleep deprivation alters physiological homeostasis and influences eating behavior as well as the onset of chronic diseases.
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Affiliation(s)
- Sofia Gomes
- ATLÂNTICA-University Institute, 2730-036 Barcarena, Portugal
| | - Cátia Ramalhete
- ATLÂNTICA-University Institute, 2730-036 Barcarena, Portugal
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Av. Prof. Gama Pinto, 1649-003 Lisbon, Portugal
| | - Isabel Ferreira
- ATLÂNTICA-University Institute, 2730-036 Barcarena, Portugal
- Ecogenetics and Human Health Research Group, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine (FMUL), University of Lisbon, 1649-028 Lisbon, Portugal
| | - Manuel Bicho
- Ecogenetics and Human Health Research Group, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine (FMUL), University of Lisbon, 1649-028 Lisbon, Portugal
- Instituto de Investigação Científica Bento da Rocha Cabral, Calçada Bento da Rocha Cabral 14, 1250-012 Lisbon, Portugal
| | - Ana Valente
- ATLÂNTICA-University Institute, 2730-036 Barcarena, Portugal
- Ecogenetics and Human Health Research Group, Environmental Health Institute (ISAMB), Associate Laboratory TERRA, Faculty of Medicine (FMUL), University of Lisbon, 1649-028 Lisbon, Portugal
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Jahrami H. The Relationship between Nomophobia, Insomnia, Chronotype, Phone in Proximity, Screen Time, and Sleep Duration in Adults: A Mobile Phone App-Assisted Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11101503. [PMID: 37239789 DOI: 10.3390/healthcare11101503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
Earlier studies that have investigated the association between nomophobia and insomnia revealed that a strong relationship exists between both variables. This study aimed to explore possible associations between these variables and their impact on physical and mental health outcomes using a cross-sectional study design and mobile phone apps to collect data. Using a survey approach, data were collected from 444 participants (52% female, mean age 34 ± 12) using the Nomophobia Questionnaire (NMP-Q), the Insomnia Severity Index (ISI), the Morningness-Eveningness Questionnaire (MEQ) and three Android mobile phone apps. The Plees Tracker, screen time, and pedometer apps aided in collecting data on sleep duration, time spent on screen per day, and how close the phone was to the person. A statistically significant association was noted between nomophobia and insomnia, nomophobia and the eveningness chronotype, and nomophobia and screen time. The eveningness chronotype was also associated with an increased screen time use. The results show that NMP-Q, ISI, and screen time increase according to the chronotype. No statistically significant differences were noted in daily steps or sleep duration according to chronotype. The findings suggest that interventions targeting nomophobia may be beneficial in addressing insomnia among adults, particularly those with an evening chronotype. Future studies should consider exploring the causal relationship between them.
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Affiliation(s)
- Haitham Jahrami
- Government Hospitals, Manama P.O. Box 12, Bahrain
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama P.O. Box 26671, Bahrain
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Hagen I, Skjelstad S, Nayar US. Promoting mental health and wellbeing in schools: the impact of yoga on young people's relaxation and stress levels. Front Psychol 2023; 14:1083028. [PMID: 37265958 PMCID: PMC10229855 DOI: 10.3389/fpsyg.2023.1083028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/24/2023] [Indexed: 06/03/2023] Open
Abstract
This study aimed to examine students' experiences with yoga interventions in school. The findings revealed that practicing yoga made young people more aware of their need to relax and positively impacted their mental health and wellbeing. We explored the emphasis on relaxation among our study participants and how relaxation is related to other aspects, such as their experience of stress and sleep habits. This article is based on qualitative data gathered from teenagers in Norway who participated in the Norwegian part of the European research project "Hippocampus: Promoting Mental Health and Wellbeing among Young People through Yoga." The project introduced yoga to young people in schools with an emphasis on those who were disadvantaged, including those with mental health issues and other challenges related to their background. Data were collected from nine individual, semi-structured interviews and 133 logs collected in the spring of 2019. The major themes identified through the interviews and log material included becoming more relaxed and aware of the need to unwind. Thus, the focus on relaxation is based on the importance of the participants assigned to this theme. The study results suggest that yoga enhanced the students' awareness and skills and empowered them to make healthier lifestyle choices. We viewed the importance of relaxation from a salutogenic perspective, focusing on the factors that contribute to good health in contrast to a pathogenic perspective, where curing diseases is the goal.
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Affiliation(s)
- Ingunn Hagen
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Solbjørg Skjelstad
- Stabilisati Counseling Service, Psychological Counseling, Yoga and Meditation Guidance, Levanger, Norway
| | - Usha Sidana Nayar
- Department of Psychology, Tata Institute of Social Sciences (TISS), Mumbai, India
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Ochoa-Brezmes J, Ruiz-Hernández A, Blanco-Ocampo D, García-Lara GM, Garach-Gómez A. Mobile phone use, sleep disorders and obesity in a social exclusion zone. An Pediatr (Barc) 2023; 98:344-352. [PMID: 37087382 DOI: 10.1016/j.anpede.2022.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/29/2022] [Indexed: 04/24/2023] Open
Abstract
INTRODUCTION There is little information on the impact of mobile phone overuse (MPO) in areas in need of social transformation (ANST). Our objective was to estimate the prevalence of MPO in an ANST and its association with sleep disorders, academic performance and obesity. PATIENTS AND METHODS Consecutive sampling of patients aged 10-17 years who visited a primary care centre in an ARST between October 2019 and March 2020. The study involved performance of a clinical interview with collection of anthropometric, sociodemographic, mobile phone use and sleep data. RESULTS The analysis included 214 participants. The prevalence of MPO during weekdays (more than 2 h a day) was 37.5% in children aged 10-12 years and 65.2% in 13- to 17-year-olds; in the weekend, the prevalence increased to 66.6% and 81.3%, respectively. In weekdays, MPO was associated with an increased prevalence of obesity, lower maternal educational attainment, greater difficulty waking up, daytime sleepiness and higher frequency of school failure. The adjusted risk was double for excess weight (odds ratio [OR] 1.90, 95% confidence interval [95% CI] 1.04-3.47), obesity (OR 2.45, 95% CI 1.23-4.89) and sleep disorders or sleep duration of less than 7 h (OR 2.26; 95% CI 1.31-3.92). Weekend MPO was associated with sleep disorders or sleep duration of less than 7 h (OR 2.68; 95% CI 1.40-5.11). CONCLUSIONS The prevalence of mobile phone overuse is high in areas of social exclusion and is associated with sleep disorders, school failure and obesity.
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Affiliation(s)
- Javier Ochoa-Brezmes
- Servicio de Pediatría, Hospital Materno-Infantil Virgen de las Nieves de Granada, Granada, Spain.
| | | | | | | | - Ana Garach-Gómez
- Centro de Salud de Zaidín Sur, Distrito Sanitario Granada-Metropolitano, Granada, Spain
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Hori R, Shibata E, Okajima I, Matsunaga M, Umemura T, Narisada A, Suzuki K. Changes in the sleeping habits of Japanese university students during the COVID-19 pandemic: a 3-year follow-up study. Biopsychosoc Med 2023; 17:14. [PMID: 37016423 PMCID: PMC10071235 DOI: 10.1186/s13030-022-00257-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/12/2022] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has greatly changed our daily life. Owing to the imposed restrictions, many educational facilities have introduced remote teaching. This study aims to clarify the association between remote teaching and Japanese university students' sleeping habits. METHODS The participants were medical students at Aichi Medical University. We used data from an ongoing longitudinal sleeping habits survey. For the participants who enrolled in the university during 2018-2020, multilevel analyses of sleep duration during weekdays and weekends across 3 years were conducted, adjusting for sex, grade, place of stay, sleep problems and lifestyle habits. RESULTS Among the students enrolled in the university, the data of 677 in 2018, 657 in 2019, and 398 in 2020 was available for analysis. The mean sleep duration during weekdays (in minutes) was 407.6 ± 60.3 in 2018, 406.9 ± 63.0 in 2019, and 417.3 ± 80.9 in 2020. The mean sleep duration during weekends (in minutes) was 494.5 ± 82.5 in 2018, 488.3 ± 87.9 in 2019, and 462.3 ± 96.4 in 2020. Multilevel analysis conducted for the 684 participants who enrolled during 2018-2020 showed that sleep duration during weekdays was associated with the place of stay and survey year. Moreover, students reported significantly longer sleep duration during weekdays in 2020 than in 2019, but no significant difference in sleep duration was found between 2018 and 2019. The other multilevel analysis found sleep duration during weekends to be associated with the survey year, sex and always doing something before going to bed. Sleep duration during weekends was shorter in 2020 than in 2019 and longer for male students and students who always do something before going to bed. Ten students were reported to have a delayed sleep phase in 2020. CONCLUSIONS Students' sleep duration increased during weekdays and decreased during weekends in 2020. This difference could be explained by the COVID-19 pandemic and the introduction of remote teaching.
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Affiliation(s)
- Reiko Hori
- Department of Health & Psychosocial Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
| | - Eiji Shibata
- Department of Health & Psychosocial Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
- Yokkaichi Nursing and Medical Care University, 1200 Kayoucho, Yokkaichi, Mie, 512-8045, Japan
| | - Iwao Okajima
- Department of Health & Psychosocial Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Masahiro Matsunaga
- Department of Health & Psychosocial Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Tomohiro Umemura
- Department of Health & Psychosocial Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Akihiko Narisada
- Department of Health & Psychosocial Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
- Institute for Occupational Health Science, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan
| | - Kohta Suzuki
- Department of Health & Psychosocial Medicine, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
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Abojedi A, Alsheikh Ali AS, Basmaji J. Assessing the Impact of Technology Use, Social Engagement, Emotional Regulation, and Sleep Quality Among Undergraduate Students in Jordan: Examining the Mediating Effect of Perceived and Academic Stress. Health Psychol Res 2023; 11:73348. [PMID: 37025559 PMCID: PMC10070257 DOI: 10.52965/001c.73348] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
The quality of sleep is affected by several psychological factors. University students experience different types of stress and develop various strategies to cope with it. This study assesses the impact of technology use, social engagement, emotional regulation, and sleep quality among undergraduate students in Jordan, while examining the mediating effect of perceived and academic stress. A convenience sample of 308 undergraduate students was selected from the University of Jordan. The results indicated that the study model was fit, with significant direct negative impacts of social engagement, time management, and emotional regulation on perceived stress. Additionally, there was a significant direct negative relationship between technology use, time management, and emotional regulation on academic stress. The results show indirect significant standardized effects of social engagement, time management, and emotional regulation on the quality of sleep through the mediation of perceived stress.
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Affiliation(s)
- Amjed Abojedi
- Psychology and Counseling Department, An-Najah National University, Nablus, Palestine
- Resilience Counseling Research and Consultation, London, Ontario, Canada
| | | | - Judy Basmaji
- London Cross Cultural Learner Centre, London, Ontario, Canada
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Wolffsohn JS, Lingham G, Downie LE, Huntjens B, Inomata T, Jivraj S, Kobia-Acquah E, Muntz A, Mohamed-Noriega K, Plainis S, Read M, Sayegh RR, Singh S, Utheim TP, Craig JP. TFOS Lifestyle: Impact of the digital environment on the ocular surface. Ocul Surf 2023; 28:213-252. [PMID: 37062428 DOI: 10.1016/j.jtos.2023.04.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
Eye strain when performing tasks reliant on a digital environment can cause discomfort, affecting productivity and quality of life. Digital eye strain (the preferred terminology) was defined as "the development or exacerbation of recurrent ocular symptoms and/or signs related specifically to digital device screen viewing". Digital eye strain prevalence of up to 97% has been reported, due to no previously agreed definition/diagnostic criteria and limitations of current questionnaires which fail to differentiate such symptoms from those arising from non-digital tasks. Objective signs such as blink rate or critical flicker frequency changes are not 'diagnostic' of digital eye strain nor validated as sensitive. The mechanisms attributed to ocular surface disease exacerbation are mainly reduced blink rate and completeness, partial/uncorrected refractive error and/or underlying binocular vision anomalies, together with the cognitive demand of the task and differences in position, size, brightness and glare compared to an equivalent non-digital task. In general, interventions are not well established; patients experiencing digital eye strain should be provided with a full refractive correction for the appropriate working distances. Improving blinking, optimizing the work environment and encouraging regular breaks may help. Based on current, best evidence, blue-light blocking interventions do not appear to be an effective management strategy. More and larger clinical trials are needed to assess artificial tear effectiveness for relieving digital eye strain, particularly comparing different constituents; a systematic review within the report identified use of secretagogues and warm compress/humidity goggles/ambient humidifiers as promising strategies, along with nutritional supplementation (such as omega-3 fatty acid supplementation and berry extracts).
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Affiliation(s)
- James S Wolffsohn
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.
| | - Gareth Lingham
- Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Byki Huntjens
- Division of Optometry and Visual Sciences, City, University of London, EC1V 0HB, UK
| | - Takenori Inomata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Saleel Jivraj
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK
| | | | - Alex Muntz
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Karim Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL). Monterrey, 64460, Mexico
| | - Sotiris Plainis
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Laboratory of Optics and Vision, School of Medicine, University of Crete, Greece
| | - Michael Read
- Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Rony R Sayegh
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Sumeer Singh
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Tor P Utheim
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Jennifer P Craig
- College of Health & Life Sciences, School of Optometry, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
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Chau SW, Hussain S, Chan SS, Wong OW, Zhang J, Feng H, Lai KY, Ling S, So SH, Tsoi KK, Wing YK, Hung SF, Leung PW. A comparison of sleep-wake patterns among school-age children and adolescents in Hong Kong before and during the COVID-19 pandemic. J Clin Sleep Med 2023; 19:749-757. [PMID: 36692167 PMCID: PMC10071375 DOI: 10.5664/jcsm.10422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/22/2022] [Accepted: 11/22/2022] [Indexed: 01/25/2023]
Abstract
STUDY OBJECTIVES The lifestyles change of children and adolescents during the COVID-19 pandemic due to antipandemic measures can affect their sleep health. Existing studies have used convenient samples and focused on the initial months of the pandemic, leaving a knowledge gap on changes in young people's sleep patterns under the "new normal" under COVID-19. METHODS As part of a territory-wide epidemiological study in Hong Kong, this cross-sectional study recruited primary and secondary school students by stratified random sampling. Sleep parameters were collected using the structured diagnostic interview for sleep patterns and disorders. We investigated the pandemic's effects on sleep parameters by comparing data of participants recruited pre-COVID and those recruited during COVID using multivariate regression, adjusting for age, sex, household income, seasonality, and presence of mental disorders, and the moderators and mediators of the effects. RESULTS Between September 1, 2019 and June 2, 2021, 791 primary and 442 secondary school students were recruited and analyzed. Primary school and secondary school participants assessed before COVID had a longer sleep latency on school days (95% confidence interval [CI] = 1.0-5.2 minutes, adjusted P-value = .010; and 95% CI= 3.9-13.0 minutes, adjusted P-value = .004, respectively) and nonschool days (95% CI = 1.7-7.2 minutes, adjusted P-value = .005; 95% CI = 3.4-13.7 minutes, adjusted P-value = .014, respectively). Low household income was a moderator for later bedtime (adjusted P-value = .032) and later sleep onset (adjusted P-value = .043) during nonschool days among secondary school students. CONCLUSIONS Changes associated with COVID have a widespread and enduring effect on the sleep health of school-aged students in Hong Kong. Household income plays a role in adolescent sleep health resilience, and the impact of antiepidemic measures on the health gaps of the youth should be considered. CITATION Chau SWH, Hussain S, Chan SSM, et al. A comparison of sleep-wake patterns among school-age children and adolescents in Hong Kong before and during the COVID-19 pandemic. J Clin Sleep Med. 2023;19(4):749-757.
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Affiliation(s)
- Steven W.H. Chau
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Samara Hussain
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Sandra S.M. Chan
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Oscar W.H. Wong
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Hongliang Feng
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Kelly Y.C. Lai
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Suk Ling
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Suzanne H.W. So
- Department of Psychology, Faculty of Social Science, The Chinese University of Hong Kong, Hong Kong SAR
| | - Kelvin K.F. Tsoi
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Se Fong Hung
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR
| | - Patrick W.L. Leung
- Department of Psychology, Faculty of Social Science, The Chinese University of Hong Kong, Hong Kong SAR
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Heidbreder A, Trenkwalder C, Bachmann CG, Bartl M, Fulda S, Habersack L, Maihöfner C, Mathis J, Muntean L, Schneider B, Stefani A, Paulus J, Young P. Restless Legs Syndrom. SOMNOLOGIE 2023. [DOI: 10.1007/s11818-023-00399-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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45
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Uso de móviles, problemas de sueño y obesidad en una zona de exclusión social. An Pediatr (Barc) 2023. [DOI: 10.1016/j.anpedi.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Davidson-Urbain W, Servot S, Godbout R, Montplaisir JY, Touchette E. [Sleepiness among adolescents: etiology and multiple consequences]. L'ENCEPHALE 2023; 49:87-93. [PMID: 35970642 DOI: 10.1016/j.encep.2022.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 01/21/2023]
Abstract
Over the past century a dramatic decline in sleep duration among adolescents, such as more than one hour of sleep loss per night, has been reported. A debt in sleep duration could lead to sleep deprivation, a major risk factor associated with daytime sleepiness. Sleepiness refers to the inability to maintain an adequate level of alertness during the day which may result in more or less being able to control falling asleep at inappropriate times. This literature review updates on sleepiness regarding its characteristics, etiology and consequences on adolescents. Studies revealed that from 25 % to 78 % of adolescents had reported sleepiness. Its manifestations may include heavy lids, yawns, difficulties to concentrate and emotional irritability. In addition, while it is recommended that adolescents under 18 years-old should sleep from eight to ten hours a night, only 63 % of them actually do so. The etiology of sleep deprivation and sleepiness in this population can be explained by various biological and societal factors. First, the sleep-wake cycle of adolescents shows a biological shift from the beginning of pubertal maturation, described as a perfect storm. It refers to a social jetlag by going to sleep and waking up later and accumulating a sleep debt during weekdays which they try to reimburse during weekends. This phenomenon can be explained by physiological changes such as a slower accumulation of sleep pressure. In addition to this perfect storm, environmental and societal factors contribute to the social jetlag and reduce sleep duration in adolescents. Screen exposure before bedtime can delay sleep and wake onset, which is a risk factor for sleeping debt. Substance use such as caffeine, cigarettes or electronic vaporizer, ADHD or freely available medication, alcohol, cannabis use or drug consumption could further disrupt sleep-wake cycle by stimulating, depressing or otherwise disrupting the central nervous system. Early, before 8:30 am, class start times have been associated with chronic sleep deprivation, higher level of sleepiness and delayed melatonin peak secretion. Adolescents working or doing extracurricular occupations for more than 20hours a week are more at risk for reduced sleep duration and sleepiness. Parental supervision about sleep during the weekdays were associated with more appropriate bedtime. Adolescents from low socio-demographic characteristics and from minority ethnic groups have reported displaying a shorter sleep duration. Finally, sleep disorders of a physiological origin such as narcolepsy, sleep apnea or restless legs syndrome, may explain the sleep deprivation and sleepiness. Sleep deprivation and sleepiness in adolescents have consequences on their health. Cognitive functioning, such as problem solving, attention or memory, as well as school performance, can be compromised by sleep deprivation and sleepiness. At the psychological level, adolescents reporting sleepiness are more prone to display mental health problems: associations were found between sleepiness and subjective perception of depression, anxiety, somatic complaints as well as with antisocial behaviors. Finally, 68 % of 16 year-old adolescents reported they drove a car, and the reported sleepiness could lead to road accidents due to reduced attentional functioning, reaction time and decision-making abilities. In the United-States, from 7 % to 16.5 % of deadly accidents were related to driving while drowsy. Highlighting etiology and problems associated with sleep deprivation and sleepiness in adolescents could guide researchers and clinicians towards the development of possible interventions. Public health measures and knowledge transfer programs regarding modifiable psychosocial and societal factors associated with sleep-wake bioregulation could increase awareness in parents as well as in political and societal decision makers.
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Affiliation(s)
- W Davidson-Urbain
- Département de psychiatrie et addictologie, université de Montréal, Montréal, Canada
| | - S Servot
- Département de psychoéducation, université du Québec à Trois-Rivières, Québec, Canada; Centre de recherche universitaire sur les jeunes et les familles, Québec, Canada
| | - R Godbout
- Département de psychiatrie et addictologie, université de Montréal, Montréal, Canada; Laboratoire et Clinique du sommeil, hôpital en santé mentale Rivière-des-Prairies, CIUSSS du Nord-de-l'Île-de-Montréal, Montréal, Canada
| | - J-Y Montplaisir
- Département de psychiatrie et addictologie, université de Montréal, Montréal, Canada; Centre d'études avancées en médecine du sommeil, hôpital du Sacré-Cœur, Québec, Canada
| | - E Touchette
- Département de psychoéducation, université du Québec à Trois-Rivières, Québec, Canada; Centre de recherche universitaire sur les jeunes et les familles, Québec, Canada; Centre d'études avancées en médecine du sommeil, hôpital du Sacré-Cœur, Québec, Canada; Centre intégré universitaire de santé et de services sociaux du Nord-de-l'île-de-Montréal, Québec, Canada; Groupe de recherche en inadaptation psychosociale, Québec, Canada.
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Tanhan F, Özok Hİ, Kaya A, Yıldırım M. Mediating and moderating effects of cognitive flexibility in the relationship between social media addiction and phubbing. CURRENT PSYCHOLOGY 2023; 43:1-12. [PMID: 36713623 PMCID: PMC9871432 DOI: 10.1007/s12144-023-04242-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 01/26/2023]
Abstract
Presently, social media is widely used worldwide among different populations. Therefore, phubbing rapidly became a popular phenomenon in our daily life. However, little is known about the underlying mechanism and interaction between social media use and phubbing. Therefore, this research examines the mediating and moderating role of cognitive flexibility in the association between social media addiction and phubbing. Participants were 385 university students (280 females) studying at a state university in eastern Turkey and completed the self-reported measures of cognitive flexibility, social media addiction, and phubbing. The results showed that cognitive flexibility mediated and moderated the effect of social media addiction on phubbing. These findings may contribute to the discussion around the psychological consequences of using social media alongside increasing awareness about factors affecting and explaining the association between social media use and phubbing, which have important implications for research and practice.
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Affiliation(s)
| | | | | | - Murat Yıldırım
- Department of Psychology, Faculty of Science and Letters, Agrı Ibrahim Cecen University, Erzurum Yolu 4 Km 04100, Merkez, Ağrı, Turkey
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Edinborough L, Bruce-Low S, Hill J, Woodhouse J, Jarvis M, Pedlar C. Day Type and Start Time May Influence Sleep in Adolescent Professional Football Players. Int J Sports Med 2023; 44:336-343. [PMID: 36347431 DOI: 10.1055/a-1974-5441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This study assessed whether scheduling (start time and day type) and workload variables influenced sleep markers (activity monitor) in professional academy footballers (n=11; 17.3±0.7 yrs) over a 10-week in-season period. Separate linear mixed regressions were used to describe the effect of start time on the previous nights sleep, and the effect of day type (match day, match day+1) and workload on subsequent sleep. Workload variables were modelled by day (day), 7-day (acute), and 28-day (chronic) periods. Sleep duration following match day+1 (400 mins; 95%CI:368-432) was significantly reduced compared to all other day types (p<0.001). Sleep onset time following match day (00:35; CI:00:04-01:12) and wake time on match day+1 (09:00; CI:08:37-09:23) were also significantly later compared to all other day types (p<0.001). Sleep duration (19.1 mins; CI:9.4-28.79), wake time (18 mins; CI:9.3-26.6), and time in bed (16.8 mins; CI:2.0-31.5) were significantly increased per hour delay in start time. When no activity was scheduled, sleep duration (37 mins; CI:18.1-55.9), sleep onset (42.1 mins; CI:28.8-56.2), and wake times (86 mins; CI:72-100) were significantly extended, relative to a 09:00 start time. Day, acute, and chronic workloads were associated with sleep onset and wake times only. Scheduled start times were associated with changes in sleep duration. Therefore, delaying start times may increase sleep in this population.
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Affiliation(s)
- Luke Edinborough
- Sport Performance, Southampton FC, Southampton, United Kingdom of Great Britain and Northern Ireland.,Faculty of Sport, Health and Applied Science, St Mary's University, Twickenham, Twickenham, United Kingdom of Great Britain and Northern Ireland
| | - Stewart Bruce-Low
- Department of Applied Sport and Exercise Sciences, University of East London, London, United Kingdom of Great Britain and Northern Ireland
| | - Jessica Hill
- Faculty of Sport, Health and Applied Science, St Mary's University, Twickenham, Twickenham, United Kingdom of Great Britain and Northern Ireland
| | - Jonny Woodhouse
- Sport Performance, Southampton FC, Southampton, United Kingdom of Great Britain and Northern Ireland
| | - Mark Jarvis
- Sport Performance, Southampton FC, Southampton, United Kingdom of Great Britain and Northern Ireland
| | - Charles Pedlar
- Faculty of Sport, Health and Applied Science, St Mary's University, Twickenham, Twickenham, United Kingdom of Great Britain and Northern Ireland.,Division of Surgery and Interventional Science, University College London, London, United Kingdom of Great Britain and Northern Ireland
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Late-Night Digital Media Use in Relation to Chronotype, Sleep and Tiredness on School Days in Adolescence. J Youth Adolesc 2023; 52:419-433. [PMID: 36401709 PMCID: PMC9842555 DOI: 10.1007/s10964-022-01703-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 11/01/2022] [Indexed: 11/21/2022]
Abstract
Previous studies on late-night digital media use and adolescent sleep have not considered how chronotype, a natural tendency to be awake or asleep at certain time, is associated with this relationship. Therefore, the nature of the relationship between late-night digital media use and sleep in different chronotypes remains still unknown. The sample consisted of 15-20-year-old Finnish adolescents (n = 1084, mean age = 16.9 years, SD = 0.93, 45.7% female). This study examined whether chronotype, measured as diurnal type and midpoint of sleep, was associated with the time of evening/night when digital media was used. Associations between the use of different forms of digital media and sleep quality, sleep duration and tiredness on school days were also investigated. Finally, the mediation effect of late-night digital media use to the relationship between chronotype and sleep was examined. Generalized linear models showed that evening chronotype, weekend midpoint of sleep, and the time of evening or night at which digital media was used were associated with more insufficient sleep and tiredness, lower sleep quality and shorter sleep duration on school days. The total use of all media forms, i.e., late-night digital media for music, movies/series, social media, and studying, were associated with shorter sleep duration and more insufficient sleep and daytime tiredness. Late-night social media use also mediated the association between diurnal type and sleep quality. Watching movies or listening to music late at night was the strongest mediator of the association between diurnal type and sleep and tiredness. The most prominent finding shows that of the all different media forms, watching movies or listening to music late at night were associated with increased daytime tiredness, whereas late social media use was associated with poor sleep quality. These interactions were pronounced especially for evening-types. The findings of the current study suggest that the negative effects of late-night media use are reflected especially in sleep quality and daytime tiredness among evening-types during adolescence.
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Khan A, Reyad MAH, Edwards E, Horwood S. Associations between adolescent sleep difficulties and active versus passive screen time across 38 countries. J Affect Disord 2023; 320:298-304. [PMID: 36183824 DOI: 10.1016/j.jad.2022.09.137] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/08/2022] [Accepted: 09/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND High screen use has been adversely linked with mental wellbeing; however, little is known about how active versus passive screen time are associated with sleep-onset difficulties among adolescents. METHODS We analysed data from 38 European and North American countries that participated in the 2014 Health Behaviour in School-aged Children (HBSC) survey. Difficulties in falling sleep were assessed using a self-reported item with a 5-point Likert scale, and then dichotomised. Participants reported h/day of discretional time spent watching television, electronic gaming, and computer use. RESULTS Of the 195,668 participants (Mage 13.59 [1.62] years; 51 % girls), about 25 % of girls reported sleep-onset difficulties, while the rate was 18 % in boys. Adolescents who played electronic games >4 h/day (≤1 h/day as reference) had 30 % higher odds in boys (OR 1.30; 95 % CI: 1.23-1.38) and 38 % higher odds in girls (OR 1.38; 95 % CI: 1.31-1.45) of reporting sleep difficulties. High computer use (>4 h/day) increased the odds of sleep difficulties by 41 % in boys (OR 1.41, 95 % CI: 1.33-1.49) and 61 % in girls (OR 1.61, 95 % CI: 1.53-1.69). Similarly, high television time (>4 h/day) had increased the odds of sleep difficulties by 15 % in boys (OR 1.15, 95 % CI: 1.08-1.22) and 19 % in girls (OR 1.19, 95 % CI: 1.12-1.25). LIMITATIONS Cross-sectional analyses cannot establish causality of the associations. CONCLUSIONS Higher levels of recreational screen use of any type were associated with sleep-onset difficulties among adolescents with adverse effects being more prevalent in active than passive screen time. Prospective research with objective measures is warranted to understand causality of these relationships.
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Affiliation(s)
- Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia; Active Healthy Kids Bangladesh (AHKBD), Bangladesh.
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