Associations between daily screen time and sleep in a racially and socioeconomically diverse sample of US infants: a prospective cohort study

Sleep Duration Is Associated with Household Food Insecurity and Sugar-Sweetened Beverage Intake Among Women, Infants and Children Participating Children Ages 0-5

PURPOSE

To determine associations between child and household characteristics and sleep duration among low-income children in Los Angeles County.

DESIGN

Cross-sectional study.

SETTING

Survey data collected in 2017 and 2020 in Los Angeles County, California.

SAMPLE

Special Supplemental Nutrition Program for Women, Infants and Children (WIC) households with children ages 4-60 months.

MEASURES

Sleep duration for children 4-60 months old (less than recommended (LTR), recommended range, more than recommended (MTR)), household food insecurity (HFI), sociodemographics, and daily servings of sugar-sweetened beverages (SSB).

ANALYSIS

Multinomial logistic regression, stratified by child age, was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for associations between household/child characteristics and LTR or MTR sleep compared to recommended duration among WIC participating children 4-60 months old.

RESULTS

The final sample included 3512 children ages 4-23 months and 6035 children ages 24-60 months. In the study population, 32% (3-5 years old) to 44% (4-11months) of children under 5 did not meet the recommended hours of sleep per night. HFI was associated with higher odds of LTR (OR 1.27, CI 1.12-1.45) and MTR (OR 1.46, CI 1.15-1.87) sleep among 24-60 month-old children. Each additional daily SSB serving was associated with higher odds of LTR sleep (4-23 months: OR 1.10, CI 1.02-1.19; 24-59 months: OR 1.12, CI 1.08-1.17).

CONCLUSIONS

HFI and SSB intake are associated with not getting the recommended amount of sleep among low-income WIC participating children. Nutrition assistance program participants may benefit from receiving information about recommended sleep duration for young children and how to establish sleep routines to optimize sleep duration.

Touchscreens can promote infant object-interlocutor reference switching

We re-examine whether the type of object played with influences parent-infant joint attention. A within-participants comparison of 24 parent-9-month-old dyads, used head-mounted eye-tracking to measure parental naming and infant attention during play with touchscreen apps on a touchscreen tablet or matched interactive toys. Infants engaged in sustained attention more to the toy than the tablet. Parents named objects less in toy play. Infants exhibited more gaze shifts between the object and their parent during tablet play. Contrasting previous studies, these findings suggest that joint tablet play can be more interactive than with toys, and raise questions about the recommendation that infants should not be exposed at all to such technology.

Secular trends in motor performance in Swiss children and adolescents from 1983 to 2018

Introduction

Environmental changes, including globalization, urbanization, social and cultural changes in society, and exposure to modern digital technology undoubtedly have an impact on children’s activity and lifestyle behavior. In fact, marked reductions in children’s physical activity levels have been reported over the years and sedentary behavior has increased around the world. The question arises whether these environmental changes had an impact on general motor performance in children and adolescents. The study aimed to investigate secular trends of motor performance in Swiss children and adolescents, aged between 7 and 18 years, over a period of 35 years from 1983 to 2018.

Methods

Longitudinal data on the five motor components of the Zurich Neuromotor Assessment (ZNA) – pure motor (PM), fine motor (FM), dynamic balance (DB), static balance (SB), and contralateral associated movements (CAM) – were pooled with cross-sectional data on PM and FM from eight ZNA studies between 1983 and 2018. Regression models were used to estimate the effect of the year of birth on motor performance and body mass index (BMI) measurements. Models were adjusted for age, sex, and socioeconomic status.

Results

The secular trend estimates in standard deviation scores (SDS) per 10 years were − 0.06 [−0.33; 0.22, 95% Confidence Interval] for PM, −0.11 [−0.41; 0.20] for FM, −0.38 [−0.66; −0.09] for DB (−0.42 when controlled for BMI), −0.21 [−0.47; 0.06] for SB, and − 0.01 [−0.32; 0.31] for CAM. The mean change in BMI data was positive with 0.30 SDS [0.07; 0.53] over 10 years.

Discussion

Despite substantial societal changes since the 1980s, motor performance has remained relatively stable across generations. No secular trend was found in FM, PM, SB, and CAM over a period of 35 years. A secular trend in DB was present independent of the secular trend in body mass index.

Feeding, television, and sleep behaviors at one year of age in a diverse sample

Background

Healthy lifestyle behaviors that can prevent adverse health outcomes, including obesity, are formed in early childhood. This study describes feeding, television, and sleep behaviors among one-year-old infants and examines differences by sociodemographic factors.

Methods

Caregivers of one-year-olds presenting for well care at two clinics, control sites for the Greenlight Study, were queried about feeding, television time, and sleep. Adjusted associations between sociodemographic factors and behaviors were performed by modified Poisson (binary), multinomial logistic (multi-category), or linear (continuous) regression models.

Results

Of 235 one-year-olds enrolled, 81% had Medicaid, and 45% were Hispanic, 36% non-Hispanic Black, 19% non-Hispanic White. Common behaviors included 20% exclusive bottle use, 32% put to bed with bottle, mean daily juice intake of 4.1 ± 4.6 ounces, and active television time 45 ± 73 min. In adjusted analyses compared to Hispanic caregivers, non-Hispanic Black caregivers were less likely to report exclusive bottle use (odds ratio: 0.11, 95% confidence interval [CI] 0.03-0.39), reported 2.4 ounces more juice (95% CI 1.0-3.9), 124 min more passive television time (95% CI 60-188), and 37 min more active television time (95% CI 10-64). Increased caregiver education and higher income were associated with 0.4 (95% CI 0.13-0.66) and 0.3 (95% CI 0.06-0.55) more servings of fruits and vegetables per day, respectively.

Conclusion

In a diverse sample of one-year-olds, caregivers reported few protective behaviors that reduce the risk for adverse health outcomes including obesity. Differences in behavior by race/ethnicity, income, and education can inform future interventions and policies. Future interventions should strive to create culturally effective messaging to address common adverse health behaviors.

The influence of sleep patterns and screen time on the sleep needs of infants and toddlers: A cross-sectional study

PURPOSE

The purpose of this study was to examine the effects of screen time and sleep patterns on the sleep needs of infants and toddlers.

DESIGN AND METHODS

A descriptive cross-sectional data were collected from 304 parents of children aged 6 to 36 months old. The screen use of children and parents was assessed with seven questions and A Brief Infant Sleep Questionnaire (BISQ) was used to assess infant sleep.

RESULTS

The results of this study indicate that children's adherence to the recommended sleep standards is poor. The most important criteria that caused poor sleeping were the number of awakenings at night, the duration of sleeplessness at night and the minimum total sleep time of <9 h. The most frequently used screen type in all of the age groups and parents was TV, followed by smartphones. As the age of the children increased, the rate of all screen-type use also increased. Factors predicting sleep needs included bedtime, the PED usage of children, parents' watching TV and care of the children by the babysitter.

CONCLUSIONS

Sleep needs are associated with the sleep patterns and screen usage of the children and parents.

PRACTICE IMPLICATIONS

Given that screen usage behaviors are tracked from infancy to early childhood, these findings highlight the need for prevention and intervention efforts, as well as for education and policy measures, to limit screen use and exposure from an early age.

Relationships between screen viewing and sleep quality for infants and toddlers in China: A cross-sectional study

AIM

Currently young children have more opportunity to access all kinds of media, while their sleep duration has been steadily decreasing. However, little is known about the relationships between screen viewing and sleep quality, and the reasons of screen viewing for children under three years old in China. This study aimed to describe the relationships between screen viewing and sleep quality of infants and toddlers in mainland China.

METHODS

A cross-sectional study was conducted. Eight hundred twenty-seven children were recruited at a health care unit from a university affiliated hospital in China, and the questionnaires were completed by their parents. An extended Brief Infant Sleep Questionnaire and a Screen Viewing Questionnaire were used to collect information on children's sleep quality and screen viewing. Multivariate linear regression models were used to assess the relationships between screen viewing and sleep quality among infants and toddlers, adjusted for sociodemographic variables.

RESULTS

Of the 827 children, 26.9% of the infants and 61.4% of the toddlers did not comply with the World Health Organization (WHO) guideline on screen time. Even after adjusting for the sociodemographic covariates for both infants and toddlers, negative relationships between screen time and total sleep time (P < 0.001), and screen time and nighttime sleep (P < 0.001) existed. TV viewing time was negatively related to infants' total sleep time (β = -0.15, P < 0.001) and toddlers' nighttime sleep (β = -0.1, P < 0.05). Smartphone viewing time was negatively related to toddlers' total sleep time (β = -0.12, P < 0.05) and daytime sleep (β = -0.22, P < 0.05). Parents who offered screen media for children when they needed to do house chores were more likely to report that their children had less total sleep time (β = -0.1, P < 0.05) and shorter longest sleep episode (β = -0.1, P < 0.05).

CONCLUSION

The majority of toddlers did not meet the WHO guidelines on screen time in China. Screen time was negatively related to total sleep time and nighttime sleep among infants and toddlers. Practical strategies, such as education programs on children's screen viewing, more outdoor exercises and indoor parent-child activities, providing other educational materials instead of screening, early sleep, restricted use of TVs and smartphones, and screen co-viewing, are needed to improve young children's sleep quality and promote their development.