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Turan O, Garner J, Chang L, Isaiah A. Accuracy of parent-reported sleep duration among adolescents assessed using accelerometry. Pediatr Res 2024:10.1038/s41390-024-03393-z. [PMID: 38961167 DOI: 10.1038/s41390-024-03393-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 05/30/2024] [Accepted: 06/25/2024] [Indexed: 07/05/2024]
Abstract
IMPACT Parent-reported children's sleep duration is a primary outcome measure in population-level studies, and is the primary driver of pharmacotherapy such as melatonin. Accelerometry using the Fitbit suggests that few adolescents sleep for the optimal 9-12 h as recommended by the American Academy of Sleep Medicine, and most parent reports grossly overestimate average nightly sleep duration. Parent reports of adolescent sleep duration are unreliable, and quantitative assessment of children's sleep duration should be considered when a significant step such as pharmacotherapy is undertaken for sleep.
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Affiliation(s)
- Ozerk Turan
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jonathan Garner
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amal Isaiah
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA.
- Institute for Health Computing, University of Maryland, Bethesda, USA.
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Khan A, Thomas G, Karatela S, Morawska A, Werner-Seidler A. Intense and problematic social media use and sleep difficulties of adolescents in 40 countries. J Adolesc 2024; 96:1116-1125. [PMID: 38570320 DOI: 10.1002/jad.12321] [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: 08/08/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Social media has become a ubiquitous part of everyday life; however, evidence suggests patterns of social media use can affect sleep health in children and adolescents. This study aimed to examine the associations of intense and problematic social media use (SMU) with sleep-onset difficulties in adolescence. METHODS We analysed data from 212,613 adolescents aged 11-15 years (51.1% girls) from 40 European and North American countries that participated in the 2017/2018 Health Behaviour in School-aged Children survey. Intense SMU assessed how often respondents had online contact through social media, and problematic SMU was assessed by symptoms of addiction to social media. Sleep-onset difficulties were assessed using a self-reported item. Multilevel mixed-effects logistic regression was used to obtain the estimates. RESULTS Sleep-onset difficulties were more common among girls than boys (27.1% vs 20.8%). Intense SMU was significantly associated with sleep-onset difficulties in boys in 17 countries and in girls in 25 countries, while problematic SMU was significantly associated in most of the participating countries. Overall, exposure to problematic SMU alone was highly associated with sleep-onset difficulties both in girls (OR 2.20, 2.04-2.38) and boys (OR 1.88, 1.73-2.04), while the association estimates for intense SMU were smaller and comparable across gender (Girls: OR 1.27, 1.23-1.31; Boys: OR 1.22, 1.18-1.27). Sensitivity analyses supported the above findings. CONCLUSIONS Intense and/or problematic SMU were associated with sleep-onset difficulties across gender with associations being higher for problematic compared to intense SMU. Prospective research with objective measures is needed to understand the causal mechanisms underlying these relationships.
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Affiliation(s)
- Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - George Thomas
- Health and Wellbeing Centre for Research Innovation, The University of Queensland, Brisbane, Qld, Australia
| | - Shamshad Karatela
- School of Pharmacy, The University of Queensland, Brisbane, Qld, Australia
| | - Alina Morawska
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Qld, Australia
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3
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Tsai SY, Tung YC, Huang CM, Gordon CJ, Machan E, Lee CC. Sleep disturbance associations between parents and children with overweight and obesity. Res Nurs Health 2024. [PMID: 38940261 DOI: 10.1002/nur.22411] [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: 08/31/2023] [Revised: 05/21/2024] [Accepted: 06/19/2024] [Indexed: 06/29/2024]
Abstract
This cross-sectional study examined sleep disturbance associations between parents and their school-age children with overweight and obesity. A 7-day wrist-worn actigraph recording was performed on 246 children aged 6-9 years with overweight and obesity recruited from 10 public elementary schools in Taipei, Taiwan. Children's sleep disturbance was assessed using the Children's Sleep Habits Questionnaire. Parental subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index, with parental depressive symptoms measured using the Epidemiologic Studies-Depression Scale. General linear models were used to examine sleep disturbance associations within parent-child dyads. The results showed that 208 (84.6%) children had a clinically significant sleep disturbance score, and 123 (50%) parents had poor sleep quality. Higher children's sleep disturbance scores significantly predicted poorer parental sleep quality (b = 0.11, p < 0.001). Poorer parental sleep quality was associated with more severe sleep disturbances in children (b = 0.46, p < 0.001). This association was independent of children's actigraphic sleep (all p > 0.05) and was not attenuated by adjustment for parental depressive symptoms (b = 0.14, p < 0.001). Findings from our study suggest that sleep disturbances occur in both parents and their school-age children with overweight and obesity, with a significant bidirectional association between the two. Nurses and healthcare professionals should proactively assess and screen for sleep disturbances in parent-child dyads of children with overweight and obesity. Future studies should develop family-based sleep interventions and evaluate their effects on the sleep, health, and well-being of children with overweight and obesity and their parents.
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Affiliation(s)
- Shao-Yu Tsai
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Ching Tung
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Chuen-Min Huang
- Department of Information Management, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Christopher James Gordon
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Elizabeth Machan
- School of Medical Sciences, The Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
- CIRUS Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
| | - Chien-Chang Lee
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Hartstein LE, Mathew GM, Reichenberger DA, Rodriguez I, Allen N, Chang AM, Chaput JP, Christakis DA, Garrison M, Gooley JJ, Koos JA, Van Den Bulck J, Woods H, Zeitzer JM, Dzierzewski JM, Hale L. The impact of screen use on sleep health across the lifespan: A National Sleep Foundation consensus statement. Sleep Health 2024:S2352-7218(24)00090-1. [PMID: 38806392 DOI: 10.1016/j.sleh.2024.05.001] [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: 02/13/2024] [Revised: 04/30/2024] [Accepted: 05/02/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVE To achieve consensus on whether screen-based digital media (1) in general, (2) via prebedtime content, and (3) via prebedtime light impairs sleep health in (a) childhood, (b) adolescence, and (c) adulthood. Furthermore, to address whether employing behavioral strategies and interventions may reduce the potential negative effects of screens on sleep health. METHODS The National Sleep Foundation convened a 16-person multidisciplinary expert panel ("Panel"). Panelists met virtually 5 times throughout 2023, during which they followed a modified Delphi RAND/UCLA Appropriateness Method to reach consensus. RESULTS The Panel conducted a literature review starting with 2209 articles, narrowed down to 522 relevant empirical articles and 52 relevant review articles. The search was refined to include 35 experimental/intervention studies that examined whether there was a causal link between screen-based digital media and sleep. In addition, panelists reviewed 5 recent relevant systematic review articles. After reviewing the summarized current literature, panelists voted on 10 candidate statements about whether screen use impairs sleep health. The Panel met virtually to discuss the results of the first round of votes, which was then followed by a second round of voting, ultimately achieving consensus on 5 out of the 10 statements. CONCLUSIONS The Panel achieved consensus that (1) in general, screen use impairs sleep health among children and adolescents, (2) the content of screen use before sleep impairs sleep health of children and adolescents, and (3) behavioral strategies and interventions may attenuate the negative effects of screen use on sleep health.
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Affiliation(s)
- Lauren E Hartstein
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Gina Marie Mathew
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - David A Reichenberger
- Department of Biobehavioral Health, Pennsylvania State University, State College, Pennsylvania, USA
| | - Isaac Rodriguez
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Nicholas Allen
- Department of Psychology, University of Oregon, Eugene, Oregon, USA
| | - Anne-Marie Chang
- Department of Biobehavioral Health, Pennsylvania State University, State College, Pennsylvania, USA
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Dimitri A Christakis
- Department of Pediatrics, University of Washington, Special Olympics International, Seattle, Washington, USA
| | - Michelle Garrison
- Neuroscience & Behavioural Disorders Programme, Department of Public Health, Purdue University, Lafayette, Indiana, USA
| | - Joshua J Gooley
- Neuroscience and Behavioral Disorders Program, Duke-NUS Medical School, Singapore, Singapore
| | - Jessica A Koos
- Health Sciences Library, Stony Brook University, Stony Brook, New York, USA
| | - Jan Van Den Bulck
- Department of Communication and Media, University of Michigan, Ann Arbor, Michigan, USA
| | - Heather Woods
- School of Psychology and Neuroscience, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | | | - Lauren Hale
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA.
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Marušić E, Lušić Kalcina L, Pavlinac Dodig I, Đogaš Z, Valić M, Pecotić R. Daytime Sleepiness from Preschool Children's and Parents' Perspectives: Is There a Difference? CHILDREN (BASEL, SWITZERLAND) 2024; 11:568. [PMID: 38790563 PMCID: PMC11120150 DOI: 10.3390/children11050568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024]
Abstract
This cross-sectional study investigated the level of daytime sleepiness and sleep-related behaviors in preschool children and compared their self-evaluations with the evaluations of their parents. It was conducted in Split-Dalmatian County, Croatia, among 196 preschool children aged 6-7 years seen at regular medical examinations, accompanied by their parents, using the Epworth sleepiness scale for children and parents/caregivers. Compared to their child's reports, parents tended to underestimate their child's sleepiness while sitting in a classroom at school (p = 0.001) and overestimate their child's sleepiness when lying down to rest or nap in the afternoon (p < 0.001). Boys were sleepier while sitting in a classroom at school during the morning than girls (p = 0.032). As much as 48.2% of preschool children had their own cellphones/tablets. Boys used video games (p < 0.001) and cellphones/tablets more than girls did (p = 0.064). Parental estimation of children playing video games at bedtime was lower than the child's report (p < 0.001). Children who had a TV in their bedroom reported more daytime sleepiness (p = 0.049), and those who played video games at bedtime went to sleep later during the weekend (p = 0.024). Also, children owning cellphone/tablets had longer sleep latency during the weekend compared to children not owning a cellphone (p = 0.015). This study confirmed that parents tend to underestimate children's habits of playing video games at bedtime and children's sleepiness during morning classes. Preschool children who use electronic devices at bedtime more frequently have prolonged sleep latency. These findings provide further evidence of the effects of electronic media devices on preschoolers' sleep patterns and daytime sleepiness.
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Affiliation(s)
- Eugenija Marušić
- Department of Pediatrics, University Hospital of Split, 21000 Split, Croatia;
| | - Linda Lušić Kalcina
- Department for Neuroscience, University of Split School of Medicine, 21000 Split, Croatia; (L.L.K.); (I.P.D.); (Z.Đ.); (M.V.)
| | - Ivana Pavlinac Dodig
- Department for Neuroscience, University of Split School of Medicine, 21000 Split, Croatia; (L.L.K.); (I.P.D.); (Z.Đ.); (M.V.)
| | - Zoran Đogaš
- Department for Neuroscience, University of Split School of Medicine, 21000 Split, Croatia; (L.L.K.); (I.P.D.); (Z.Đ.); (M.V.)
| | - Maja Valić
- Department for Neuroscience, University of Split School of Medicine, 21000 Split, Croatia; (L.L.K.); (I.P.D.); (Z.Đ.); (M.V.)
| | - Renata Pecotić
- Department for Neuroscience, University of Split School of Medicine, 21000 Split, Croatia; (L.L.K.); (I.P.D.); (Z.Đ.); (M.V.)
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Sanchez G, Jenkins JH. Social media & subjectivity: Adolescent lived experiences with social media in a Southern California middle school. Soc Sci Med 2024; 348:116839. [PMID: 38581816 DOI: 10.1016/j.socscimed.2024.116839] [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: 10/30/2023] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/08/2024]
Abstract
The widespread use of social media (SM) platforms among adolescents has raised concerns over its role in increased adverse physical and mental health conditions. However, current research linking SM use with adolescent health relies on tenuous correlational associations, disproportionately focuses on harmful effects of its use, and seldom examines the perspectives of youth themselves (Odgers and Jensen, 2020; Schønning et al., 2020). This article examines adolescent lived experience in relation to SM platform engagement. Drawing from ethnographic fieldwork conducted in 2018-2019 and 2021-2022 among 75 middle-school adolescents living in an ethnically diverse and low-income Southern California community, we examine adolescent subjective experiences with SM platforms that illuminate adolescent concerns during this developmental stage. By attending to adolescent subjectivity, this article reveals the ways in which engagement with SM platforms is inextricable from cultural, social, political, and socio-emotional milieu.
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Affiliation(s)
- Giselle Sanchez
- Department of Anthropology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Janis H Jenkins
- Department of Anthropology and Psychiatry, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
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7
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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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8
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Bauducco S, Pillion M, Bartel K, Reynolds C, Kahn M, Gradisar M. A bidirectional model of sleep and technology use: A theoretical review of How much, for whom, and which mechanisms. Sleep Med Rev 2024; 76:101933. [PMID: 38657359 DOI: 10.1016/j.smrv.2024.101933] [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: 09/30/2023] [Revised: 03/01/2024] [Accepted: 04/05/2024] [Indexed: 04/26/2024]
Abstract
The link between technology and sleep is more complex than originally thought. In this updated theoretical review, we propose a new model informed by the growing body of evidence in the area over the past 10 years. The main theoretical change is the addition of bi-directional links between the use of technology and sleep problems. We begin by reviewing the evidence to date for the originally proposed mechanisms of bright light, arousal, nighttime sleep disruptions, and sleep displacement. Then, in support of the new direction of effect (sleep problems preceding technology use), we propose two new mechanisms: technology before sleep might be used as a time filler and/or as an emotional regulation strategy to facilitate the sleep-onset process. Finally, we present potential moderators of the association between technology and sleep, in recognition of protective and vulnerability factors that may mitigate or exacerbate the effects of technology on sleep and vice versa. The goal of this theoretical review is to update the field, guide future public health messages, and to prompt new research into how much technology and sleep affect each other, for whom it may be problematic, and which mechanisms may explain their association.
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Affiliation(s)
- Serena Bauducco
- Örebro University, School of Behavioural, Social and Legal Sciences, Sweden; Flinders University, College of Education, Psychology and Social Work, Australia.
| | - Meg Pillion
- Flinders University, College of Education, Psychology and Social Work, Australia
| | - Kate Bartel
- WINK Sleep Pty Ltd, Adelaide, Australia; Riverland Academy of Clinical Excellence, Riverland Mallee Coorong Local Health Network, Australia; Flinders University, College of Medicine and Public Health, Australia
| | - Chelsea Reynolds
- Flinders University, College of Education, Psychology and Social Work, Australia; WINK Sleep Pty Ltd, Adelaide, Australia
| | - Michal Kahn
- Tel Aviv University, School of Psychological Sciences, Israel
| | - Michael Gradisar
- WINK Sleep Pty Ltd, Adelaide, Australia; Sleep Cycle AB, Gothenburg, Sweden
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9
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Neville RD, Hopkins WG, McArthur BA, Draper CE, Madigan S. Associations Between Changes in 24-Hour Movement Behaviors in Children and Adolescents During the COVID-19 Pandemic: A Systematic Review and Mediation-Based Meta-Analysis. J Phys Act Health 2024; 21:323-332. [PMID: 38194951 DOI: 10.1123/jpah.2023-0346] [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: 07/08/2023] [Revised: 11/25/2023] [Accepted: 12/11/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Although 24-hour movement behaviors are known to be interconnected, limited knowledge exists about whether change in one behavior during the COVID-19 pandemic (eg, increased screen time) was associated with change in another (eg, reduced physical activity or sleep). This review estimates mediational associations between changes in children's physical activity, screen time, and sleep during the COVID-19 pandemic. METHODS We included studies published between January 1, 2020 and June 27, 2022, in the PubMed/MEDLINE, Embase, PsycINFO, SPORTDiscus, and Web of Science databases. Summary data were extracted from included studies and analyzed with random-effects meta-regression. RESULTS This review included 26 studies representing 18,959 children across 18 mid-high-income countries (53% male; mean age, 11.5 [2.9] y). There was very good evidence of decreased total daily physical activity (factor change, 0.62; 90% CI, 0.47-0.81) and strong evidence of increased screen time (1.56; 90% CI, 1.38-1.77). There was very good evidence of decreased moderate to vigorous physical activity (0.75; 90% CI, 0.62-0.90) and weak evidence of increased sleep (1.02; 90% CI, 1.00-1.04). Mediational analysis revealed strong evidence that most of the reduction in total daily physical activity from before, to during, the pandemic was associated with increased screen time (0.53; 90% CI, 0.42-0.67). We observed no further mediational associations. CONCLUSION Increased reliance on and use of screen-based devices during the COVID-19 pandemic can be linked with reduced child and adolescent physical activity. This finding links COVID-related restrictions to potential displacement effects within child and adolescent 24-hour movement behavior.
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Affiliation(s)
- Ross D Neville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - William G Hopkins
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, AL, Canada
- Alberta Children's Hospital Research Institute, Calgary, AL, Canada
| | - Catherine E Draper
- South African Medical Research Council Developmental Pathways for Health Research Unit, Department of Pediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AL, Canada
- Alberta Children's Hospital Research Institute, Calgary, AL, Canada
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10
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Jetiyanuwat S, Kawilapat S, Narkpongphun A, Pojanapotha P. Association between Family Functioning, Child Emotional and Behavioral Problems, and Parental Stress during the COVID-19 Pandemic in Thailand. Behav Sci (Basel) 2024; 14:270. [PMID: 38667066 PMCID: PMC11047722 DOI: 10.3390/bs14040270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/14/2024] [Accepted: 03/19/2024] [Indexed: 04/29/2024] Open
Abstract
The COVID-19 pandemic has had a huge impact on people of all ages, especially children. This is a cross-sectional study in Thailand to explore the emotional and behavioral problems of school-aged children and associated factors during the lockdown. An online survey was conducted with 942 parents of school-age children. Strengths and Difficulties Questionnaire (SDQ) scores showed that total difficulties and all subscale difficulties (hyperactivity, conduct problems, peer problems, and emotional problems) were increased, whereas prosocial behaviors were decreased in the pandemic period. The factors significantly associated with higher parental stress were higher emotional and peer problems after the COVID-19 outbreak, high family difficulty, and sleep problems. Sleep problems were associated with all children's difficulties, except prosocial behavior. High score in family difficulty subscale was associated with increased emotional problems, whereas poor family communication was associated with increased hyperactivity. Appetite change was negatively associated with parental stress and some children's difficulties. Higher household income, family time, physical activities, and recreational activities were associated with a decreased level of some difficulties and family functioning problems, but positively with an increase in the prosocial behavior of children. Additionally, higher screen time was associated with a higher level of hyperactivity, conduct problems, and poor family communication. This study demonstrated that Thai children were at high risk of developing mental health problems during the pandemic lockdown. We suggest that intervention to promote physical activities and reduce screen time is needed. Moreover, efficient monetary policy is urgently required. The limitations here include a recall bias with no baseline to compare and a potential selection bias due to parental selection and a webpage announcement.
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Affiliation(s)
| | - Suttipong Kawilapat
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (A.N.)
| | - Assawin Narkpongphun
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (A.N.)
| | - Pichaya Pojanapotha
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (S.K.); (A.N.)
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11
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Lien L, Bonsaksen T, Holte Stea T, Kleppang AL, Steigen AM, Leonhardt M. Time trends in self-reported depressive symptoms, prescription of antidepressants, sedatives and hypnotics and the emergence of social media among Norwegian adolescents. PLoS One 2023; 18:e0295384. [PMID: 38150420 PMCID: PMC10752533 DOI: 10.1371/journal.pone.0295384] [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: 01/16/2023] [Accepted: 11/20/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Research has shown increased mental health problems and use of prescription drugs among adolescents in recent years and social media use has been linked to poorer mental health. However, trend studies concerning these topics are scarce. The purpose of this study was to analyze gender-specific trends in a) symptoms of depression and loneliness, and b) prescription of antidepressants, hypnotics and sedatives, in relation to the emergence of social media among adolescents in Norway. METHODS This is an ecological study using data from the 'Young in Oslo' surveys from 1996 to 2021. The surveys included approximately 110 000 students, 14-17 years of age, and yielded a response rate varying from 95% in 1996 to 64% in 2021. A self-report questionnaire was used to collect information on symptoms of depression and loneliness. Information on antidepressant and sleep medication prescription was retrieved from the Norwegian Prescription Database for the age group 15 to 19 years. A graphical approach and logistic regression models were used to examine gender-specific time-trends between 1996 to 2021. RESULTS We found a doubling in self-reported symptoms of depression and loneliness among girls between 1996 and 2021, with the steepest increase in the period from 2006 to 2012, when Facebook and other social media were introduced. A similar trend was observed in the prescription of antidepressants among girls, with the steepest increase between 2011 and 2013. Among both boys and girls, 'worried too much about things' and 'had sleep problems' were the two symptoms with the greatest changes. CONCLUSION A significant upward trend in self-reported depressive symptoms and medication use was observed over the past 25 years, with variations in the rate of increase, including a steeper trajectory during certain periods immediately after the introduction of social media platforms in Norway.
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Affiliation(s)
- Lars Lien
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| | - Tore Bonsaksen
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Health, Faculty of Health Studies, VID Specialized University, Stavanger, Norway
| | - Tonje Holte Stea
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Annette Løvheim Kleppang
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Anne Mari Steigen
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Marja Leonhardt
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
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12
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Cook G, Carter B, Wiggs L, Southam S. Parental sleep-related practices and sleep in children aged 1-3 years: a systematic review. J Sleep Res 2023:e14120. [PMID: 38131158 DOI: 10.1111/jsr.14120] [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: 06/12/2023] [Revised: 11/01/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023]
Abstract
The current systematic review sought to identify the relationship between the range of different parental sleep-related practices that had been explored in relations to child sleep outcomes in children aged 1-3 years. A systematic literature review was carried out in CINAHL, The Cochrane Library, PsycArticles, PsycInfo, PubMed and Web of Science, as well as relevant grey literature in August 2022 using the terms; population (children, aged 1-3 years), exposure (parental sleep-related practice) and outcome (child sleep). Any quantitative study published between 2010 and 2022 that explored the relationship between parental sleep-related practices and the sleep of children aged 1-3 years were included. The Mixed Methods Appraisal Tool was employed to quality appraise included studies and results were narratively synthesised. In all, 16 longitudinal and cross-sectional quantitative studies met inclusion criteria. Parental presence or physical involvement, as well as broader parental practices including using screens or devices at bedtime and night-time breastfeeding were all related to poorer child sleep outcomes. Consistent and relaxing routines, sleeping in a cot, and spending all night in their own sleep location were associated with better child sleep outcomes. Acknowledging the plethora of diverse parental sleep-related practices, which may have varying relationships with child sleep outcomes, could be usefully considered in theoretical models and to inform clinical practice. Issues of definitional and measurement ambiguity are highlighted and discussed.
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Affiliation(s)
- Georgia Cook
- Centre for Psychological Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, Lancashire, UK
| | - Luci Wiggs
- Centre for Psychological Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Shannon Southam
- Centre for Psychological Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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13
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Shakya H, Acharya S, Pradhan S, KC D. High Problematic Screen Exposure among Children Aged 2-5 Years Visiting the Department of Pediatrics of a Tertiary Care Centre. JNMA J Nepal Med Assoc 2023; 61:927-930. [PMID: 38289758 PMCID: PMC10792710 DOI: 10.31729/jnma.8364] [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: 11/29/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction The effects of problematic screen exposure in the early years have adverse effects on cognition, reasoning, executive, and social skills, and physical health. The study aimed to assess the prevalence of problematic screen exposure in children between 2 to 5 years of age visiting the Department of Paediatrics of a tertiary care centre. Methods A descriptive cross-sectional study was conducted among caregivers of children aged 2 to 5 years of age in a tertiary care centre from 16 July 2023 to 30 September 2023 after an ethical clearance from the Institutional Review Committee. This study excluded children with chronic disease and behavioural disorders. The problematic screen exposure was assessed using the Problematic Screen Exposure Score. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results Among 310 respondents, 216 (69.67%) (64.55-74.79, 95% Confidence Interval) children had a high problematic screen exposure score. The mean age of children was 3.46±1.033 with 89 (41.20%) children having their first exposure before 12 months of age, 131 (60.64%) exceeding daily usage of >2 hr, and 198 (91.66%) children viewing age-inappropriate media content. Conclusions The prevalence of high problematic screen exposure was comparable to that of the prevalence found in studies done in similar settings. Keywords children; preschool; screen time.
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Affiliation(s)
- Henish Shakya
- Department of Pediatrics, KIST Medical College and Teaching Hospital, Mahalaxmi, Lalitpur, Nepal
| | - Sharda Acharya
- Department of Pediatrics, KIST Medical College and Teaching Hospital, Mahalaxmi, Lalitpur, Nepal
| | - Shikhar Pradhan
- Department of Pediatrics, KIST Medical College and Teaching Hospital, Mahalaxmi, Lalitpur, Nepal
| | - Divya KC
- Department of Pediatrics, KIST Medical College and Teaching Hospital, Mahalaxmi, Lalitpur, Nepal
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14
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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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Bérard M, Manneville F, Minary L, Ligier F, Bitar S, Agrinier N. Mediating effect of sleep in the association between social media use and mental health among French adolescents during the COVID-19 sanitary crisis. Sleep Med 2023; 112:223-231. [PMID: 37922784 DOI: 10.1016/j.sleep.2023.10.020] [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: 05/22/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE/BACKGROUND Social media use could have deleterious effects on mental health through short sleep duration and poor sleep quality among adolescents. This study aimed to investigate the mediating role of both sleep duration and sleep quality in the association between social media use and mental health among adolescents. PATIENTS/METHODS We used cross-sectional data collected from adolescents in the EXIST pilot project conducted during COVID-19 pandemic. Adolescents self-reported wellbeing (WEMWBS), anxiety and depression (HADS) as mental health outcomes. We used ad-hoc questionnaires to assess social media use during weekdays and weekend days, and sleep duration and quality. Mediation analyses were carried out following Baron and Kenny's method, using adjusted linear regression models. RESULTS A total of 340 adolescents (13.5 ± 0.6 years, 45.3 % girls) were included. Greater social media use, poorer sleep quality, and shorter sleep duration were associated with poorer mental health. Greater social media use was associated with poorer sleep quality only during the weekend days. The total effect of social media use during weekend days on anxiety (β = 2.54; 95%CI [-1.59; 6.68]) was significantly conveyed through sleep quality (β = 1.22; 95%CI [0.17; 2.62]; mediated proportion = 48.0 %) and duration (mediated proportion = 46.8 %). Mediated proportions ranged from 12.5 % to 20.6 % for wellbeing and depression. Mediating effects were not evident during weekdays. CONCLUSIONS Sleep duration and quality mediated the association between social media use and mental health among adolescents during weekend days but not weekdays. Our findings highlight the importance of promoting healthy social media habits, especially during periods of increased reliance on digital platforms, such as COVID-19 pandemic.
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Affiliation(s)
- M Bérard
- Université de Lorraine, APEMAC, F-54000, Nancy, France
| | - F Manneville
- Université de Lorraine, APEMAC, F-54000, Nancy, France; CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, F-54000, Nancy, France.
| | - L Minary
- Université de Lorraine, APEMAC, F-54000, Nancy, France
| | - F Ligier
- Université de Lorraine, APEMAC, F-54000, Nancy, France
| | - S Bitar
- Université de Lorraine, APEMAC, F-54000, Nancy, France
| | - N Agrinier
- Université de Lorraine, APEMAC, F-54000, Nancy, France; CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, F-54000, Nancy, France
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16
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Lemke T, Hökby S, Wasserman D, Carli V, Hadlaczky G. Associations between sleep habits, quality, chronotype and depression in a large cross-sectional sample of Swedish adolescents. PLoS One 2023; 18:e0293580. [PMID: 37917651 PMCID: PMC10621812 DOI: 10.1371/journal.pone.0293580] [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: 05/17/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE To investigate behavioral sleep habits, self-perceived quality of sleep, and chronotype, and to examine their association with clinically relevant levels of depression in Swedish adolescents. METHOD Questionnaire data were obtained from a representative sample of Swedish adolescents (n = 8449; 50.8% girls; aged 12-16). Depression was defined as >13 BDI-II scores. Logistic regression modelling estimated the effects of sleep duration, sleep quality, and chronotype on depression, adjusted for socio-demographic factors. RESULTS On weekdays, approximately 46% of adolescents slept less than the recommended length of eight hours per night (depressed: 68%, non-depressed: 40%). On weekends, however, only 17% slept shorter than recommended. Short weekday sleep duration was more common among girls than boys (53% vs. 38%) and girls reported worse sleep quality. The regression model showed that depression was predicted by weekday sleep duration (OR = 0.773, p < .0001), sleep quality (OR = 0.327, p < .0001), and late chronotype (OR = 1.126, p = .0017), but not by weekend sleep duration. A 30-minute increase in weekday sleep duration was associated with about 10% lower odds of depression. CONCLUSIONS A substantial proportion of Swedish adolescents do not seem to meet the sleep recommendations of eight hours per night. Short sleep duration on weekdays, poor sleep quality, and late chronotype were associated with increased risk of depression. Interventions promoting longer weekday sleep duration (e.g., later school start times) seem relevant in this context, but further research is needed to investigate the directionality and underlying mechanisms of these associations.
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Affiliation(s)
- Theresa Lemke
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Sebastian Hökby
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
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17
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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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18
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Paulus MP, Zhao Y, Potenza MN, Aupperle RL, Bagot KS, Tapert SF. Screen media activity in youth: A critical review of mental health and neuroscience findings. JOURNAL OF MOOD AND ANXIETY DISORDERS 2023; 3:100018. [PMID: 37927536 PMCID: PMC10624397 DOI: 10.1016/j.xjmad.2023.100018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
This review has two primary objectives: (1) to offer a balanced examination of recent findings on the relationship between screen media activity (SMA) in young individuals and outcomes such as sleep patterns, mood disturbances, anxiety-related concerns, and cognitive processes; and (2) to introduce a novel multi-level system model that integrates these findings, resolves contradictions in the literature, and guides future studies in examining key covariates affecting the SMA-mental health relationship. Key findings include: (1) Several meta-analyses reveal a significant association between SMA and mental health issues, particularly anxiety and depression, including specific negative effects linked to prolonged screen time; (2) substantial evidence indicates that SMA has both immediate and long-term impacts on sleep duration and quality; (3) the relationship between SMA and cognitive functioning is complex, with mixed findings showing both positive and negative associations; and (4) the multifaceted relationship between SMA and various aspects of adolescent life is influenced by a wide range of environmental and contextual factors. SMA in youth is best understood within a complex system encompassing individual, caregiver, school, peer, and environmental factors, as framed by Bronfenbrenner's ecological systems theory, which identifies five interrelated systems (microsystem, mesosystem, exosystem, macrosystem, and chronosystem) that influence development across both proximal and distal levels of the environment. This model provides a framework for future research to examine these interactions, considering moderating factors, and to develop targeted interventions that can mitigate potential adverse effects of SMA on mental well-being.
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Affiliation(s)
- Martin P. Paulus
- Laureate Institute for Brain Research, 6655S. Yale Ave., Tulsa, OK 74136, USA
- School of Community Medicine, The University of Tulsa, 1215 South Boulder Ave. W., Tulsa, OK 74119, USA
| | - Yihong Zhao
- Columbia University School of Nursing, 560W 168th Street, Room 614, New York, NY 10032, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Marc N. Potenza
- Department of Psychiatry, Child Study Center, Department of Neuroscience, Yale University School of Medicine, 1 Church Street, Room 726, New Haven, CT 06510, USA
- Connecticut Mental Health Center, 1 Church Street, Room 726, New Haven, CT 06510, USA
- Connecticut Council on Problem Gambling, Wethersfield, 1 Church Street, Room 726, New Haven, CT 06510, USA
- Wu Tsai Institute, Yale University, 1 Church Street, Room 726, New Haven, CT 06510, USA
| | - Robin L. Aupperle
- Laureate Institute for Brain Research, 6655S. Yale Ave., Tulsa, OK 74136, USA
| | - Kara S. Bagot
- iIcahn School of Medicine at Mount Sinai, Departments of Psychiatry and Pediatrics, USA
| | - Susan F. Tapert
- Department of Psychiatry, UCSD Health Sciences, 9500 Gilman Drive, La Jolla, CA 92093, USA
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19
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Roberto DMT, Pereira LJ, Vieira FGK, Di Pietro PF, de Assis MAA, Hinnig PDF. Association between Sleep Timing, Being Overweight and Meal and Snack Consumption in Children and Adolescents in Southern Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6791. [PMID: 37754650 PMCID: PMC10531239 DOI: 10.3390/ijerph20186791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023]
Abstract
Sleep timing is one of the dimensions of sleep that refers to the time of day when sleep occurs. It has been included in sleep-related research because of the potential associations between being overweight and the consumption of meals and snacks. This cross-sectional study aimed to investigate associations between sleep timing, meal and snack consumption and weight status in 1333 schoolchildren aged 7-14 years. The midpoint of sleep was used as a sleep timing measure obtained by the midpoint between bedtime and wake-up time, classified as Early, Intermediate, and Late. Schoolchildren in the Early group were less likely to be overweight (OR: 0.83, 95% CI 0.69; 0.99), and had higher odds of mid-morning snack consumption (OR: 1.95, 95% CI 1.56; 2.44) and lower probability to consume an evening snack (OR: 0.75, 95% CI 0.59; 0.94) compared with the Intermediate group. The Late group had lower odds of mid-morning snack consumption (OR: 0.67, 95% CI 0.55, 0.80) than the Intermediate group. The consumption of mid-morning and evening snacks was associated with the Early and Late midpoints of sleep. These results suggest that bedtime and wake-up time are relevant to consuming meals and snacks and may also be related to a greater probability of being overweight in children and adolescents.
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Affiliation(s)
| | | | | | | | | | - Patrícia de Fragas Hinnig
- Post-Graduation Program in Nutrition, Health Sciences Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
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20
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Suchert V, Hanewinkel R, Neumann C, Hansen J. Regional Socioeconomic Deprivation in Germany and Adherence to the 24-h Movement Guidelines among Children and Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1392. [PMID: 37628391 PMCID: PMC10453420 DOI: 10.3390/children10081392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/07/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023]
Abstract
To examine the relationship between regional socioeconomic deprivation and adherence to the 24-h movement guidelines among children and adolescents, a cross-sectional study was conducted. A total of 17,433 students aged 9-17 participated in a survey in winter 2021/2022. Daily screen time (ST), moderate-to-vigorous physical activity (MVPA), and sleep behavior were outcome variables. The German Index of Socioeconomic Deprivation (GISD), a regional socioeconomic objective measure, was the exposure variable. Associations between GISD and health behaviors were examined using regression models. Models were adjusted for age, gender, school type, and individual self-reported socioeconomic status (SES). The proportions of meeting the MVPA, ST, and sleep duration guidelines were 14%, 22%, and 34%, respectively. A total of 2.3% met all guidelines. Students from the most deprived communities were half as likely to meet all three guidelines compared to students from the most affluent regions (OR = 0.49 [0.28; -0.03], p = 0.010). There was a consistent relationship between GISD and lower levels of adherence to screen time guidelines (most deprived compared to most affluent: OR = 0.49 [0.38; 0.64], p < 0.001). There was no association between GISD and adherence to sleep time guidelines. We found mixed results for the association between GISD and MVPA. Regional SES appears to be an important factor associated with screen time. Screen time should be limited through intervention programs, especially in disadvantaged areas. Parents should be made aware of their children's increased media consumption. Recommendations for screen time should be clearly communicated, as should the health disadvantages of increased media consumption in childhood and adolescence.
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Affiliation(s)
- Vivien Suchert
- Institute for Therapy and Health Research, IFT-Nord, Harmsstraße 2, 24114 Kiel, Germany
| | - Reiner Hanewinkel
- Institute for Therapy and Health Research, IFT-Nord, Harmsstraße 2, 24114 Kiel, Germany
| | - Clemens Neumann
- Institute for Therapy and Health Research, IFT-Nord, Harmsstraße 2, 24114 Kiel, Germany
| | - Julia Hansen
- Institute for Therapy and Health Research, IFT-Nord, Harmsstraße 2, 24114 Kiel, Germany
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21
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Nagata JM, Singh G, Yang JH, Smith N, Kiss O, Ganson KT, Testa A, Jackson DB, Baker FC. Bedtime screen use behaviors and sleep outcomes: Findings from the Adolescent Brain Cognitive Development (ABCD) Study. Sleep Health 2023; 9:497-502. [PMID: 37098449 PMCID: PMC10823798 DOI: 10.1016/j.sleh.2023.02.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 04/27/2023]
Abstract
OBJECTIVES To determine associations between bedtime screen time behaviors and sleep outcomes in a national study of early adolescents. METHODS We analyzed cross-sectional data from 10,280 early adolescents aged 10-14 (48.8% female) in the Adolescent Brain Cognitive Development Study (Year 2, 2018-2020). Regression analyses examined the association between self-reported bedtime screen use and self- and caregiver-reported sleep measures, including sleep disturbance symptoms, controlling for sex, race/ethnicity, household income, parent education, depression, data collection period (pre- vs. during COVID-19 pandemic), and study site. RESULTS Overall, 16% of adolescents had at least some trouble falling or staying asleep in the past 2 weeks and 28% had overall sleep disturbance, based on caregiver reports. Adolescents who had a television or an Internet-connected electronic device in the bedroom had a greater risk of having trouble falling or staying asleep (adjusted risk ratio 1.27, 95% CI 1.12-1.44) and overall sleep disturbance (adjusted risk ratio 1.15, 95% CI 1.06-1.25). Adolescents who left their phone ringer activated overnight had more trouble falling/staying asleep and greater overall sleep disturbance compared to those who turned off their cell phones at bedtime. Streaming movies, playing video games, listening to music, talking/texting on the phone, and using social media or chat rooms were all associated with trouble falling/staying asleep and sleep disturbance. CONCLUSIONS Several bedtime screen use behaviors are associated with sleep disturbances in early adolescents. The study's findings can inform guidance for specific bedtime screen behaviors among early adolescents.
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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, USA.
| | - Gurbinder Singh
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, California, USA
| | - Joanne H Yang
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, California, USA
| | - Natalia Smith
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, California, USA
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, California, USA
| | - 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, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, California, USA; School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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22
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Nagata JM, Yang JH, Singh G, Kiss O, Ganson KT, Testa A, Jackson DB, Baker FC. Cyberbullying and Sleep Disturbance Among Early Adolescents in the U.S. Acad Pediatr 2023; 23:1220-1225. [PMID: 36581100 PMCID: PMC10291005 DOI: 10.1016/j.acap.2022.12.007] [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: 09/03/2022] [Revised: 12/09/2022] [Accepted: 12/17/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To determine the association between cyberbullying (victimization and perpetration) and sleep disturbance among a demographically diverse sample of 10-14-year-old early adolescents. METHODS We analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (Year 2, 2018-2020) of early adolescents (10-14 years) in the US. Modified Poisson regression analyses examined the association between cyberbullying and self-reported and caregiver-reported sleep disturbance measures. RESULTS In a sample of 9,443 adolescents (mean age 12.0 years, 47.9% female, 47.8% white), 5.1% reported cyberbullying victimization, and 0.5% reported cyberbullying perpetration in the past 12 months. Cyberbullying victimization in the past 12 months was associated with adolescent-reported trouble falling/staying asleep (risk ratio [RR] 1.87, 95% confidence interval [CI] 1.57, 2.21) and caregiver-reported overall sleep disturbance of the adolescent (RR: 1.16 95% CI 1.00, 1.33), in models adjusting for sociodemographic factors and screen time. Cyberbullying perpetration in the past 12 months was associated with trouble falling/staying asleep (RR 1.95, 95% CI 1.21, 3.15) and caregiver-reported overall sleep disturbance of the adolescent (RR: 1.49, 95% CI 1.00, 2.22). CONCLUSIONS Cyberbullying victimization and perpetration are associated with sleep disturbance in early adolescence. Digital media education and counseling for adolescents, parents, teachers, and clinicians could focus on guidance to prevent cyberbullying and support healthy sleep behavior for early adolescents.
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Affiliation(s)
- Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics (JM Nagata, JH Yang, and G Singh), University of California, San Francisco.
| | - Joanne H Yang
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics (JM Nagata, JH Yang, and G Singh), University of California, San Francisco
| | - Gurbinder Singh
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics (JM Nagata, JH Yang, and G Singh), University of California, San Francisco
| | - Orsolya Kiss
- Center for Health Sciences (O Kiss, FC Baker), SRI International, Menlo Park, Calif
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work (KT Ganson), University of Toronto, Toronto, Ontario, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health (A Testa), University of Texas Health Science Center at Houston
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health (DB Jackson), Johns Hopkins University, Baltimore, Md
| | - Fiona C Baker
- Center for Health Sciences (O Kiss, FC Baker), SRI International, Menlo Park, Calif; School of Physiology (FC Baker), University of the Witwatersrand, Parktown, Johannesburg, South Africa
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23
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Boniel-Nissim M, Tynjälä J, Gobiņa I, Furstova J, van den Eijnden RJJM, Marino C, Klanšček HJ, Klavina-Makrecka S, Villeruša A, Lahti H, Vieno A, Wong SL, Villberg J, Inchley J, Gariépy G. Adolescent use of social media and associations with sleep patterns across 18 European and North American countries. Sleep Health 2023; 9:314-321. [PMID: 36804326 DOI: 10.1016/j.sleh.2023.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 11/23/2022] [Accepted: 01/10/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVE Over the past decade, concurrent with increasing social media use (SMU), there has been a shift toward poorer sleep among adolescents in many countries. The purpose of this study was to examine the cross-national associations between adolescent SMU and sleep patterns, by comparing 4 different categories of SMU (nonactive, active, intense, and problematic use). DESIGN, SETTING, AND PARTICIPANTS Data were from 86,542 adolescents in 18 European and North American countries that participated in the 2017/18 Health Behaviour in School-aged study. MEASUREMENTS Mixed-effects linear regression models were used to examine cross-national associations between 4 SMU categories and adolescent sleep duration, bedtime and social jetlag derived from self-reported data. RESULTS For all countries combined, nonactive SMU was associated with longer sleep, earlier bedtimes, and less social jetlag, compared to active SMU, although the differences were minor. By comparison, intense and problematic SMU were associated with less sleep and later bedtimes on both school and nonschool days, and greater social jetlag, compared to active SMU. While findings were relatively consistent between countries, some differences were observed, suggesting that the national and cultural context may be important in interpreting results. CONCLUSIONS These findings suggest that both intense and problematic SMU are associated with poorer sleep patterns in adolescents across most countries. Further research is needed to identify effective policies, programs, and messaging to promote the healthy use of social media and prevent potential negative impacts on adolescent sleep.
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Affiliation(s)
- Meyran Boniel-Nissim
- Department of Educational Counselling, The Max Stern Academic College of Emek Yezreel, Emek Yezreel, Israel
| | - Jorma Tynjälä
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Institute of Public Health, Riga Stradins University, Riga, Latvia
| | - Jana Furstova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | | | - Claudia Marino
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | | | | | - Anita Villeruša
- Department of Public Health and Epidemiology, Institute of Public Health, Riga Stradins University, Riga, Latvia
| | - Henri Lahti
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Alessio Vieno
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Suzy L Wong
- Public Health Agency of Canada, Ottawa, Canada
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Joanna Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Geneviève Gariépy
- Public Health Agency of Canada, Ottawa, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada.
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24
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Han CH, Lee S, Chung JH. Association between COVID-19 lockdown and sleep behaviors in Korean adolescents. Medicine (Baltimore) 2023; 102:e33809. [PMID: 37233444 PMCID: PMC10219643 DOI: 10.1097/md.0000000000033809] [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: 02/15/2023] [Accepted: 04/27/2023] [Indexed: 05/27/2023] Open
Abstract
To find the effect of coronavirus disease 2019 (COVID-19)-related sleep behavior changes using school-based self-reported data from a nationally representative Korean adolescent population. We analyzed web-based self-reported data from the Korean Youth Risk Behavior Web-based Survey in 98,126 participants (51,651 in 2019 [before the COVID-19 pandemic]; 46,475 in 2020 [during COVID-19 pandemic] 12 through 18 years old were included in this study. Self-report questionnaires were used to assess socioeconomic status, health behaviors, psychological factors, and sleep patterns. During the COVID-19 pandemic, Korean adolescents had a later weekend bedtime (≥1:00 am: 68.2% vs 71.5%, P < .001) and late weekend wake time (≤7:00 am: 13.3% vs 10.7%, P < .001) compared to before COVID-19 pandemic. Average sleep duration (434.7 ± 102.6 vs 428.2 ± 100.4 minutes; P < .001) was significantly lower during the COVID-19 pandemic and weekend catch-up sleep >2 hours (42.1% vs 43.7%; P < .001), late chronotype (17.1% vs 22.9%, P < .001) were significantly higher during COVID-19 pandemic. After adjusting for multiple confounding variables, short sleep duration (≦5 hours, odds ratio [OR] 1.14; 95% confidence interval [CI] 1.10-1.19), 6 hours, OR 1.07; 95% CI 1.03-1.12), long weekend catch-up sleep (OR, 1.08; 95% CI, 1.06-1.11) and late chronotype (OR, 1.43; 95% CI, 1.38-1.47) were significantly associated with COVID-19 pandemic. The COVID-19 pandemic was associated with changes in sleep behavior among Korean adolescents, resulting in later bed and wake-up times, increased weekend catch-up sleep, and a shift of chronotype toward eveningness.
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Affiliation(s)
- Chang Hoon Han
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | | | - Jae Ho Chung
- Department of Internal Medicine, International St. Mary`s Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
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25
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Cerimoniale G, Dalpiaz I, Becherucci P, Malorgio E, Ceschin F, Rosati GV, Ragni G, Minardo G, Brambilla P, Gambotto S, Bottaro G, Tucci PL, Chiappini E. The digital child: A cross-sectional survey study on the access to electronic devices in paediatrics. Acta Paediatr 2023. [PMID: 37341150 DOI: 10.1111/apa.16817] [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: 01/11/2023] [Revised: 04/14/2023] [Accepted: 05/05/2023] [Indexed: 06/22/2023]
Abstract
AIM To explore the use of electronic devices in children and possible risk factors for smartphone ownership and cyberbullying. METHODS A cross-sectional survey study was conducted involving 62 Italian general paediatricians who administered a close-ended questionnaire about the use of electronic devices to 1732 parents/caregivers. RESULTS Data of 2563 children aged 0-14 years were collected. Investigating the electronic device use by parents/caregivers of children aged 0-1 years, 72.5% of mothers were revealed to have the habit to use a smartphone during breastfeeding and bottle-feeding. The ownership of a smartphone was found in 29.5% of children aged 2-14 years, 68.1% considering only children aged 10-14. A higher parental degree level was identified as a protective factor for smartphone ownership by children (OR 0.59; 95% CI 0.36-0.98; p = 0.04 for father; OR 0.51; 95% CI 0.33-0.78; p = 0.002 for mother). A higher risk of cyberbullying was found when caregivers did not use any restrictions on smartphone use (OR 11.92; 95% CI 3.41-41.68; p < 0.001). CONCLUSION The absence of rules for smartphone use represents a risk factor for cyberbullying. In this context, the general paediatrician might play an important role in helping parents/caregivers and their children adopt safer use of electronic devices.
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Affiliation(s)
- Giovanni Cerimoniale
- Italian Society of Paediatric Primary Care, National Board of Directors, Milan, Italy
| | - Irene Dalpiaz
- Department of Health Science, Anna Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Paolo Becherucci
- Italian Society of Paediatric Primary Care, National Board of Directors, Milan, Italy
| | - Emanuela Malorgio
- Italian Society of Paediatric Primary Care, National Board of Directors, Milan, Italy
| | - Flavia Ceschin
- Italian Society of Paediatric Primary Care, Milan, Italy
| | | | - Giuseppina Ragni
- Italian Society of Paediatric Primary Care, National Board of Directors, Milan, Italy
| | - Grazia Minardo
- Italian Society of Paediatric Primary Care, National Board of Directors, Milan, Italy
| | - Paolo Brambilla
- Italian Society of Paediatric Primary Care, National Board of Directors, Milan, Italy
| | - Silvia Gambotto
- Italian Society of Paediatric Primary Care, National Board of Directors, Milan, Italy
| | | | | | - Elena Chiappini
- Department of Health Science, Anna Meyer Children's Hospital, University of Florence, Florence, Italy
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26
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Pagerols M, Bosch R, Prat R, Pagespetit È, Cilveti R, Chaparro N, Esteve A, Casas M. The Sleep Disturbance Scale for Children: psychometric properties and prevalence of sleep disorders in Spanish children aged 6-16 years. J Sleep Res 2023:e13871. [PMID: 36914164 DOI: 10.1111/jsr.13871] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/20/2023] [Accepted: 02/23/2023] [Indexed: 03/14/2023]
Abstract
The present research aimed to investigate, for the first time, the validity and reliability of the Sleep Disturbance Scale for Children (SDSC) in a sample of 2733 Spanish children aged 6-16 years. We also described the prevalence and sociodemographic correlates of sleep disorder symptoms among young people, which had never been studied in Spain. Confirmatory factor analysis supported the original six-factor model and Cronbach's alpha for the total questionnaire was 0.82, which indicated good reliability. Moreover, all the SDSC subscales correlated positively and significantly with the total score (range = 0.41-0.70), thus showing convergent validity. Considering T-scores >70 as pathological, we identified at least one sleep disorder in 116 participants (4.24%), including disorders of excessive somnolence (DOES; 5.82%), sleep-wake transition disorders (SWTD; 5.27%), and disorders of initiating and maintaining sleep (DIMS; 5.09%) among the most common problems. Students in secondary education and those from families with a low socioeconomic status were more likely to have DIMS, disorders of arousal, and DOES. Subjects with clinically elevated levels of sleep breathing disorders were more frequently of foreign origin and from disadvantaged families. Boys and primary school students were more prone to sleep hyperhidrosis, while SWTD were overrepresented among children with a low socioeconomic status. According to our results, the Spanish version of the SDSC seems to be a good instrument for assessing sleep disturbances in school-age children and adolescents, which is essential to prevent the significant implications of poor sleeping on the overall welfare of young people.
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Affiliation(s)
- Mireia Pagerols
- Programa MIND Escoles, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Departament de Fonaments Clínics, Unitat de Farmacologia, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Rosa Bosch
- Programa MIND Escoles, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Raquel Prat
- Programa MIND Escoles, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Centre for Health and Social Care Research (CEES), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Èlia Pagespetit
- Programa MIND Escoles, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Departament de Medicina, Facultat de Medicina, Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Vic, Spain
| | | | | | | | - Miquel Casas
- Programa MIND Escoles, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.,Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain.,Fundació Privada d'Investigació Sant Pau (FISP), Barcelona, Spain
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27
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Rietz M, Schmidt-Persson J, Rasmussen MGB, Egebaek HK, Wedderkopp N, Kristensen PL, Grøntved A. Recreational screen time trajectories during early childhood and imaging-measured body composition at age 7 in the Odense child cohort. Paediatr Perinat Epidemiol 2023. [PMID: 36799105 DOI: 10.1111/ppe.12956] [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: 09/09/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Children spend increasing amounts of time on recreational screen media, which may lead to an obesogenic environment. OBJECTIVES We investigated the association of trajectories of screen time across ages 3, 5 and 7 years with body composition at age 7 in the Odense Child Cohort. METHODS Data were collected in the Municipality of Odense, Denmark, between 2010 and 2019. Group-based trajectory modelling was applied to group participants into four trajectories of prospective parent-reported screen time. Body composition was assessed using dual-energy x-ray absorptiometry with calculated fat-mass index (FMI) as the primary outcome. Primary models were linear multivariable regression models adjusted for participants' sex, age, birthweight, maternal origin, maternal education, maternal body-mass-index, and maternal age. Further models were adjusted for additional possible confounders. Selection bias was addressed by inverse probability weighting. RESULTS In total, 803 children (48.2% female) were included in the primary analysis. Participants with screen time at all time points were assigned to four trajectory groups [constant low screen time (12.7%), low increase (36.3%), high increase between ages 3 and 5 (33.5%) and high increase in screen time (17.5%)]. Sample characteristics differed across missing data status and trajectories. Mean FMI (kg/m2 ) and standard deviation (SD) were 3.7 (SD 1.3) and 3.9 (SD 1.6) for the constant low versus high screen time, respectively. No differences in FMI were found between screen time trajectory groups at age 7 (adjusted mean difference 0.1 kg/m2 , 95% confidence interval -0.3, 0.5 for constant low versus high screen time). No consistent associations between screen time groups and secondary body composition outcomes were found. CONCLUSIONS Results from this study do not suggest that recreational screen time from age 3 to 7 years is associated with adiposity or other measures of body composition.
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Affiliation(s)
- Marlene Rietz
- Center for Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jesper Schmidt-Persson
- Center for Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Martin Gillies Banke Rasmussen
- Center for Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Heidi Klakk Egebaek
- Center for Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,University College South Denmark, Haderslev, Denmark
| | - Niels Wedderkopp
- The Pediatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Peter Lund Kristensen
- Center for Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Anders Grøntved
- Center for Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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28
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Chaput JP, McHill AW, Cox RC, Broussard JL, Dutil C, da Costa BGG, Sampasa-Kanyinga H, Wright KP. The role of insufficient sleep and circadian misalignment in obesity. Nat Rev Endocrinol 2023; 19:82-97. [PMID: 36280789 PMCID: PMC9590398 DOI: 10.1038/s41574-022-00747-7] [Citation(s) in RCA: 87] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 01/21/2023]
Abstract
Traditional risk factors for obesity and the metabolic syndrome, such as excess energy intake and lack of physical activity, cannot fully explain the high prevalence of these conditions. Insufficient sleep and circadian misalignment predispose individuals to poor metabolic health and promote weight gain and have received increased research attention in the past 10 years. Insufficient sleep is defined as sleeping less than recommended for health benefits, whereas circadian misalignment is defined as wakefulness and food intake occurring when the internal circadian system is promoting sleep. This Review discusses the impact of insufficient sleep and circadian misalignment in humans on appetite hormones (focusing on ghrelin, leptin and peptide-YY), energy expenditure, food intake and choice, and risk of obesity. Some potential strategies to reduce the adverse effects of sleep disruption on metabolic health are provided and future research priorities are highlighted. Millions of individuals worldwide do not obtain sufficient sleep for healthy metabolic functions. Furthermore, modern working patterns, lifestyles and technologies are often not conducive to adequate sleep at times when the internal physiological clock is promoting it (for example, late-night screen time, shift work and nocturnal social activities). Efforts are needed to highlight the importance of optimal sleep and circadian health in the maintenance of metabolic health and body weight regulation.
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Affiliation(s)
- Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, ON, Canada.
- Department of Paediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Andrew W McHill
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Rebecca C Cox
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Josiane L Broussard
- Sleep and Metabolism Laboratory, Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Caroline Dutil
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, ON, Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Bruno G G da Costa
- Research Center in Physical Activity and Health, Department of Physical Education, School of Sports, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Hugues Sampasa-Kanyinga
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Kenneth P Wright
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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29
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Abstract
Inflammatory bowel diseases (IBDs) are chronic, immune-mediated disorders that include Crohn's disease and ulcerative colitis. A pediatric onset of disease occurs in about 10% of all cases. Clinical presentation of IBD with rectal bleeding or perianal disease warrants direct referral for endoscopic evaluation. In the absence of red-flag symptoms, a combination of patient history and blood and fecal biomarkers can help to distinguish suspected IBD from other causes of abdominal pain or diarrhea. The therapeutic management of pediatric IBD has evolved by taking into account predictors of poor outcome, which justifies the upfront use of anti-tumor necrosis factor therapy for patients at high risk for complicated disease. In treating patients with IBD, biochemical or endoscopic remission, rather than clinical remission, is the therapeutic goal because intestinal inflammation often persists despite resolution of abdominal symptoms. Pediatric IBD comes with unique additional challenges, such as growth impairment, pubertal delay, the psychology of adolescence, and development of body image. Even after remission has been achieved, many patients with IBD continue to experience nonspecific symptoms like abdominal pain and fatigue. Transfer to adult care is a well-recognized risk for disease relapse, which highlights patient vulnerability and the need for a transition program that is continued by the adult-oriented IBD team. The general pediatrician is an invaluable link in integrating these challenges in the clinical care of patients with IBD and optimizing their outcomes. This state-of-the-art review aims to provide general pediatricians with an update on pediatric IBD to facilitate interactions with pediatric gastrointestinal specialists.
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30
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Idelji-Tehrani S, Dubicka B, Graham R. The clinical implications of digital technology. Clin Child Psychol Psychiatry 2023; 28:338-353. [PMID: 36525979 PMCID: PMC9893300 DOI: 10.1177/13591045221145400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The proliferation of digital technology within the lives of children and young people (CYP) provides arguably one of the most significant clinical and ethical paradigm shifts in Child and Adolescent Psychiatry. One can argue that mental health research has taken a myopic approach to understanding the interaction between young people's technology use and their mental health. Mental health clinicians also need a better understanding of the digital lives of CYP and how technology may be supporting or harming their mental health. Within this paper, we argue that greater longitudinal research is required, particularly in vulnerable groups, and that there is an essential need for a standardised digital use assessment (DUA) tool, which assimilates CYP use of technology and their vulnerabilities/resilience to online risks. We subsequently offer a series of questions clinicians can use to explore technology use by CYP. Such an aide memoire may empower clinicians to have wider discussions around digital technology use with CYP, while also helping to develop appropriate safety and management plans.
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Affiliation(s)
- Saam Idelji-Tehrani
- Department of Child and Adolescent Psychiatry, Institute of Child Health, 11700University College London (UCL), UK
| | - Bernadka Dubicka
- Department of Child and Adolescent Psychiatry, Hull & York Medical School, 8748University of York, UK.,Department of Child and Adolescent Psychiatry, 9022Greater Manchester Mental Health Trust, UK.,Manchester Academic Health Science Centre (MAHSC), University of Manchester, UK
| | - Richard Graham
- Department of Child and Adolescent Psychiatry, Stem4, London, UK.,Keeping Well Southeast London Community, UK.,Digital Well-Being Consultant to Own it App Project
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31
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Digital media use and sleep in late adolescence and young adulthood: A systematic review. Sleep Med Rev 2022; 68:101742. [PMID: 36638702 DOI: 10.1016/j.smrv.2022.101742] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 12/08/2022] [Accepted: 12/22/2022] [Indexed: 01/01/2023]
Abstract
Despite much attention on digital media use and young peoples' sleep, the literature on digital media and its impact on sleep in older adolescents and young adults remains to be synthesized. We conducted a systematic review of studies including young people aged 16-25 years. We searched Medline, Web of Science, and CINAHL for observational studies, identifying 60 studies. These studies were assessed for methodological quality. Only studies rated as moderate or high-quality studies were included (n = 42). A narrative synthesis summarized the impact of digital media use on eight sleep outcomes: Bedtime; Sleep onset latency or problems falling asleep; Sleep duration; Early awakening; Sleep disturbance; Daytime tiredness and function; Sleep deficits; Sleep quality. In summary, digital media use was associated to shorter sleep duration and poorer sleep quality. These associations were found for general screen use and use of mobile phone, computer, internet, and social media, but not for television, game console, and tablet use. Most studies investigating bedtime or nighttime use found associations to poor sleep outcomes. Later bedtime and daytime tiredness were associated with mobile phone use at night. Additional research is warranted to draw solid conclusions about the causal direction and to understand the underlying mechanisms.
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32
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Garbers S, Umar NQ, Hand RE, Usseglio J, Gold MA, Bruzzese JM. Mind-Body Integrative Health (MBIH) Interventions for Sleep among Adolescents: A Scoping Review of Implementation, Participation and Outcomes. ADOLESCENT RESEARCH REVIEW 2022; 7:565-589. [PMID: 36619475 PMCID: PMC9815202 DOI: 10.1007/s40894-021-00176-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/24/2021] [Indexed: 05/17/2023]
Abstract
Adolescents get insufficient sleep, adversely affecting health. Mind-body integrative health interventions for adolescents have been shown to reduce stress, a barrier to good sleep. This scoping review aimed to synthesize mind-body integrative health interventions for adolescents, how interventions were implemented, who was reached. A systematic search of four online databases was conducted. Randomized, quasi-experimental, and single-group designs with participants ages 10-24 years were included. Twelve studies covering 10 interventions using mindfulness, qigong, aromatherapy, or yoga were identified. Participants were predominantly female; only one study reported participants' race or ethnicity (81% non-Hispanic white). Most (n=6) interventions were delivered in groups, and half reported significant improvements in subjective sleep quality. Mindfulness-based stress reduction and mindfulness-based cognitive therapy were the most commonly used modalities, with reported impact on sleep outcomes measured objectively. The two interventions that found statistically significant, moderate improvements in objectively-measured sleep onset latency and sleep efficiency were of higher intensity and used mindfulness. Four interventions were self-directed; participants in these struggled with adherence; significant impacts on sleep were not found. While findings were mixed, stemming in part from the quality of the underlying studies, this review identified several promising features of interventions, including using mindfulness, ensuring sufficient intervention dose, and targeting interventions towards adolescents with poor sleep at baseline (rather than a general population of adolescents). The findings suggests that sleep interventions for adolescents may improve psychological well-being as an intermediate effect, as sleep improvements were observed mostly among participants with poor sleep quality or anxiety symptoms at baseline. This review identified several gaps in the literature. Despite documented racial and ethnic disparities in sleep quality among adolescents, published evidence of mind-body integrative health-based sleep interventions among Black and Latinx adolescents is lacking. None of the studies in this review assessed developmental stage or age differences, despite documented differences in sleep across age groups of adolescents. These two gaps in the evidence should be addressed in future intervention research.
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Affiliation(s)
- Samantha Garbers
- Columbia University Mailman School of Public Health, Heilbrunn Department of Population & Family Health, New York, NY
| | - Nawal Q. Umar
- Columbia University Mailman School of Public Health, New York, NY
| | - Rachel E. Hand
- Columbia University Mailman School of Public Health, New York, NY
| | - John Usseglio
- Augustus C. Long Health Sciences Library, Columbia University Irving Medical Center, New York, NY
| | - Melanie A. Gold
- Columbia University Mailman School of Public Health, Heilbrunn Department of Population & Family Health, New York, NY
- Columbia University Irving Medical Center, Department of Pediatrics, Division of Child and Adolescent Health, New York, NY
- New York-Presbyterian, School-Based Health Centers, New York, NY
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Inhulsen MMR, Busch V, Kalk R, van Stralen MM. Adolescent sleep duration: associations with social‐cognitive determinants and the mediating role of sleep hygiene practices. J Sleep Res 2022; 32:e13774. [PMID: 36367212 DOI: 10.1111/jsr.13774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/19/2022] [Accepted: 10/16/2022] [Indexed: 11/13/2022]
Abstract
Insufficient sleep duration among adolescents is a widespread public health problem. Gaining better insight into social-cognitive determinants associated with adolescent sleep duration is necessary for developing effective preventive interventions to support healthy sleep. This study aimed to explore whether social-cognitive determinants regarding sufficient sleep duration were associated with sleep duration, and if these associations were mediated by collective sleep hygiene practices. Furthermore, we examined these associations for social-cognitive determinants related to not using media before bedtime and doing relaxing activities and considered whether these associations were mediated by specific sleep hygiene practices. Data were collected amongst second- and third-grade adolescents from 10 Dutch high schools. A total of 878 adolescents (mean [SD] age 13.3 [0.71] years) completed data on sleep duration, social-cognitive determinants of the Theory of Planned Behaviour (i.e., attitude, subjective norms from parents, subjective norms from peers, perceived behavioural control, intention), and sleep hygiene practices. Single- and multivariable path models were constructed and mediation by sleep hygiene practices was analysed by Monte Carlo simulation. All social-cognitive determinants except for subjective norms from peers were associated with longer sleep duration (p < 0.01). Sleep hygiene practices mediated all associations between social-cognitive determinants and sleep duration (mediation ranging from 16% to 72%). Although some of the significant associations and mediation disappeared in the multivariable model, behavioural arousal was the strongest mediator, but collective sleep hygiene practices and cognitive/emotional arousal also explained parts of the associations. The findings indicate that social-cognitive factors should not be overlooked when targeting adolescent sleep duration.
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Affiliation(s)
- Maj‐Britt M. R. Inhulsen
- Department of Health Sciences, Faculty of Science Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute Amsterdam the Netherlands
- Public Health Service Sarphati Amsterdam Amsterdam the Netherlands
| | - Vincent Busch
- Public Health Service Sarphati Amsterdam Amsterdam the Netherlands
| | - Rianne Kalk
- Department of Health Sciences, Faculty of Science Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute Amsterdam the Netherlands
| | - Maartje M. van Stralen
- Department of Health Sciences, Faculty of Science Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute Amsterdam the Netherlands
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Hartley S, Royant-Parola S, Zayoud A, Gremy I, Matulonga B. Do both timing and duration of screen use affect sleep patterns in adolescents? PLoS One 2022; 17:e0276226. [PMID: 36264928 PMCID: PMC9584513 DOI: 10.1371/journal.pone.0276226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 10/03/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Sleep duration has declined in adolescents over the last 30 years and screen use has been identified as a risk factor. Studies have examined the duration of screen use and screen-based activities but have not differentiated between evening and night-time use. METHODS Cross sectional questionnaire survey of adolescents recruited in schools. Sleep habits on school nights and weekends, symptoms of insomnia and daytime repercussions were recorded using an online questionnaire administered in the classroom setting. Sleep deprivation (<7 hours in bed /night), school night sleep restriction (≥2 hours difference in sleep duration on school nights vs weekends), excessive sleepiness (score >6 on a visual analogue scale), duration of screen use and timing of screen use (evening vs after bedtime) were determined. RESULTS 2513 students (53.4% female, median age 15 years) were included. 20% were sleep deprived and 41% sleep restricted. A clear dose effect relationship in a model controlling for age, sex, school level and sociodemographic class was seen with all levels of night-time screen use on sleep deprivation and sleep restriction (>2 hours use sleep deprivation OR 5.23[3.03-9.00]. sleep restriction OR 2.05[1.23-3.42]) and > 2 hours evening use (>2 hours use sleep deprivation OR 2.72[2.15-3.44] sleep restriction OR 1.69[1.36-2.11]) but not moderate evening use. All night-time use and > 2 hours evening use increased the risk of insomnia, non refreshing sleep, and affected daytime function (daytime sleepiness, lack of energy and irritability). CONCLUSIONS Both duration of screen use and timing are associated with adverse effects on sleep and daytime functioning in adolescents. More than 2 hours evening use and all night-time use should be avoided.
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Affiliation(s)
- Sarah Hartley
- Réseau Morphée, Garches, France
- APHP Hôpital Raymond Poincaré, Sleep Center, Université de Versailles Saint-Quentin en Yvelines, Garches, France
| | | | - Ayla Zayoud
- Institut Paris Région, Observatoire Régional de Santé, Paris, France
| | - Isabelle Gremy
- Institut Paris Région, Observatoire Régional de Santé, Paris, France
| | - Bobette Matulonga
- Institut Paris Région, Observatoire Régional de Santé, Paris, France
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Ramdhany YD, Devi Goorah SS, Cheeneebash J, Niketan Oodun R. Factors Associated with Poor Sleep among Young People in Mauritius: A Survey-Based Study. INTERNATIONAL JOURNAL OF MEDICAL STUDENTS 2022. [DOI: 10.5195/ijms.2022.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Poor sleep quality in young people is a global concern. This study was conducted to explore sleep quality and its contributory factors in young people of Mauritius.
Methods: This cross-sectional study comprised 202 participants aged between 14 to 29 years. The Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS) and the Adolescent Sleep Hygiene Scale (ASHS) were used to measure sleep quality, daytime sleepiness, and sleep hygiene respectively. Chi-squared tests were conducted to evaluate relationships between the collected variables. Multivariate logistic regression was used to identify associated factors with poor sleep quality.
Results: The mean global PSQI was 4.81 (95%CI: 4.4, 5.22). Prevalence of poor sleep quality (global PSQI score > 5) was 30.7%. The male gender reported better sleep (p=0.008). Sleep quality was significantly associated with longer sleep duration (p<0.0001), pre-bedtime relaxing activities (p=0.01), and daytime physical exercise (p=0.001). In contrast, alcohol consumption after 18:00 (p<0.0001), tobacco smoking after 18:00 (p<0.0001), pre-bedtime awakening activities (p=0.001), and poor sleep environment (p<0.0001) negatively influenced sleep quality. Multivariate logistic regression confirmed that female gender and sleep environment factors were associated with higher likelihood of poor sleep quality, while participants with longer duration of sleep (>7 hours), cognitive/emotional and sleep stability factors were found to be less likely to have poor sleep quality.
Conclusion: This study showed that the prevalence of poor sleep in young people in Mauritius was 30.7%. Female gender and sleep environment factors were main contributory factors. These initial results can guide further research on sleep quality
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Bozzola E, Spina G, Agostiniani R, Barni S, Russo R, Scarpato E, Di Mauro A, Di Stefano AV, Caruso C, Corsello G, Staiano A. The Use of Social Media in Children and Adolescents: Scoping Review on the Potential Risks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19169960. [PMID: 36011593 PMCID: PMC9407706 DOI: 10.3390/ijerph19169960] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/10/2022] [Indexed: 05/24/2023]
Abstract
In recent years, social media has become part of our lives, even among children. From the beginning of COVID-19 pandemic period, media device and Internet access rapidly increased. Adolescents connected Internet alone, consulting social media, mostly Instagram, TikTok, and YouTube. During "lockdown", the Internet usage allowed communication with peers and the continuity activities such as school teaching. However, we have to keep in mind that media usage may be related to some adverse consequences especially in the most vulnerable people, such as the young. Aim of the review is to focus on risks correlated to social media use by children and adolescents, identifying spies of rising problems and engaging in preventive recommendations. The scoping review was performed according to PRISMA guidelines, searching on PubMed the terms "social media" or "social network", "health", and "pediatrics". Excluding articles not pertinent, we found 68 reports. Out of them, 19 were dealing with depression, 15 with diet, and 15 with psychological problems, which appeared to be the most reported risk of social media use. Other identified associated problems were sleep, addiction, anxiety, sex related issues, behavioral problems, body image, physical activity, online grooming, sight, headache, and dental caries. Public and medical awareness must rise over this topic and new prevention measures must be found, starting with health practitioners, caregivers, and websites/application developers. Pediatricians should be aware of the risks associated to a problematic social media use for the young's health and identify sentinel signs in children as well as prevent negative outcomes in accordance with the family.
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Affiliation(s)
- Elena Bozzola
- Pediatric Unit, IRCCS Bambino Gesù Children Hospital, 00100 Rome, Italy
- The Italian Pediatric Society, 00100 Rome, Italy
| | - Giulia Spina
- Pediatric Unit, IRCCS Bambino Gesù Children Hospital, 00100 Rome, Italy
- The Italian Pediatric Society, 00100 Rome, Italy
| | - Rino Agostiniani
- The Italian Pediatric Society, 00100 Rome, Italy
- Department of Pediatrics, San Jacopo Hospital, 51100 Pistoia, Italy
| | - Sarah Barni
- Pediatric Unit, IRCCS Bambino Gesù Children Hospital, 00100 Rome, Italy
- The Italian Pediatric Society, 00100 Rome, Italy
| | - Rocco Russo
- The Italian Pediatric Society, 00100 Rome, Italy
| | - Elena Scarpato
- The Italian Pediatric Society, 00100 Rome, Italy
- Department of Translational Medical Sciences-Section of Pediatric, University Federico II, 80100 Naples, Italy
| | | | | | | | - Giovanni Corsello
- The Italian Pediatric Society, 00100 Rome, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90100 Palermo, Italy
| | - Annamaria Staiano
- The Italian Pediatric Society, 00100 Rome, Italy
- Department of Translational Medical Sciences-Section of Pediatric, University Federico II, 80100 Naples, Italy
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Association between Recreational Screen Time and Sleep Quality among Adolescents during the Third Wave of the COVID-19 Pandemic in Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159019. [PMID: 35897389 PMCID: PMC9332431 DOI: 10.3390/ijerph19159019] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/14/2022] [Accepted: 07/21/2022] [Indexed: 01/27/2023]
Abstract
The study objective was to verify whether recreational screen time was associated with sleep quality among adolescents during the third wave of the COVID-19 pandemic in Canada. Data collection took place in four high schools in the region of Chaudière-Appalaches (Quebec, Canada) from the end of April to mid-May 2021. Recreational screen time and sleep quality were measured using the French versions of validated questionnaires specifically designed for adolescents. A total of 258 adolescents (14−18 years; 66.3% girls) answered the online survey. Adolescent boys had a higher total mean recreational screen time (454.3 ± 197.5 vs. 300.5 ± 129.3 min/day, p < 0.0001) and a higher total mean sleep quality score (4.2 ± 0.9 vs. 3.9 ± 0.8, p = 0.0364) compared to girls. Recreational screen time (β = −0.0012, p = 0.0005) and frequency of concurrent screen use (sometimes: β = −0.3141, p = 0.0269; often: β = −0.4147, p = 0.0048; almost always or always: β = −0.6155, p = 0.0002) were negatively associated with sleep quality while being a boy (β = 0.4276, p = 0.0004) was positively associated with sleep quality and age (p = 0.6321) was not. This model explained 16% of the variance in adolescents’ sleep quality. Public health interventions during and after the COVID-19 pandemic should target recreational screen time, concurrent screen use and especially girls to possibly improve sleep quality and promote adolescents’ physical and mental health.
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Lambert L, Joshanloo M, Marquez JM, Cody B, Arora T, Warren M, Aguilar L, Samways M, Teasel S. Boosting Student Wellbeing Despite a Pandemic: Positive Psychology Interventions and the Impact of Sleep in the United Arab Emirates. INTERNATIONAL JOURNAL OF APPLIED POSITIVE PSYCHOLOGY 2022; 7:271-300. [PMID: 35600501 PMCID: PMC9112268 DOI: 10.1007/s41042-022-00066-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/29/2022]
Abstract
Positive psychology interventions hold great promise as schools around the world look to increase the wellbeing of young people. To reach this aim, a program was developed to generate positive emotions, as well as improve life satisfaction, mental toughness and perceptions of school kindness in 538 expatriate students in Dubai, United Arab Emirates. Starting in September 2019, the program included a range of positive psychology interventions such as gratitude, acts of kindness and mental contrasting as examples. Life satisfaction and mental toughness at mid-year were sustained or grew by the end of the year. Positive affect, emotional wellbeing and social wellbeing increased at post-intervention 1, compared to baseline. However, this improvement reverted to baseline levels at post-intervention 2, when data were collected during the COVID-19 pandemic. Only psychological wellbeing, negative affect, perceptions of control, and school kindness were increased at post-intervention 2. During the lockdown, students moved less, but slept and scrolled more. Those who extended their sleep duration reported greater wellbeing. Boosting wellbeing through the use of positive psychology interventions works – even in a pandemic – and extended sleep duration appears to be a driving factor for this observation.
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Affiliation(s)
- L. Lambert
- Middle East Journal of Positive Psychology, Canadian University Dubai, Dubai, United Arab Emirates
| | - M. Joshanloo
- Department of Psychology, Keimyung University, Daegu, South Korea
| | - J. M. Marquez
- Faculty of Education, University of Cambridge, Cambridge, UK
| | - B. Cody
- United Arab Emirates University, Box 15551, Al Ain, United Arab Emirates
| | - T. Arora
- College of Natural and Health Sciences, Department of Psychology, Zayed University, Abu Dhabi, United Arab Emirates
| | - M. Warren
- Western Washington University, Bellingham, WA USA
| | - L. Aguilar
- Western Washington University, Bellingham, WA USA
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Elavsky S, Blahošová J, Lebedíková M, Tkaczyk M, Tancos M, Plhák J, Sotolář O, Smahel D. Researching the Links between Smartphone Behavior and Adolescent Wellbeing: The Study Protocol for the FUTURE (WP4) Ecological Momentary Assessment Study (Preprint). JMIR Res Protoc 2021; 11:e35984. [PMID: 35258467 PMCID: PMC8941440 DOI: 10.2196/35984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 12/31/2021] [Accepted: 01/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background Smartphone ownership has increased among teens within the last decade, with up to 89% of adolescents owning a smartphone and engaging daily with the online world through it. Although the results of recent meta-analyses suggest that engaging digital technology plays only a small role in adolescent well-being, parents, professionals, and policymakers remain concerned about the impact that the instant connectivity of smartphones has on adolescent well-being. Objective Herein, we introduce the protocol of a research study investigating the associations between adolescent smartphone use and different facets of well-being (social, physical, and psychological), with the aim to apply innovative methods to address the limitations of existing empirical studies. Methods This 12-month prospective study of adolescents uses a repeated measurement-burst design with the ecological momentary assessment methodology. Adolescents (N=203; age range 13-17 years) complete baseline assessments through online questionnaires, four 14-day intensive data collection bursts, and an online questionnaire at the end of the study. As part of the 4 measurement bursts, adolescent smartphone behavior is assessed objectively by passive data collection of smartphone data logs and through self-reports in short questionnaires administered via a custom-built Android app. Results The protocol describes the study objectives, research tools (including the development of the Android app and specialized software), and process (including pilot studies, the main study, and targets for machine learning approaches). Two of the 203 enrolled participants provided no data during the first data collection burst of the main study. Preliminary analyses of the data from the first data collection burst indicated an acceptable level of compliance (72.25%) with the daily questionnaires. The design of the study will allow for the assessment of both within- and between-person variabilities in smartphone behavior, as well as short-term variation and long-term change in smartphone behavior and how it impacts the indicators of social, physical, and psychological well-being. Conclusions The innovative methods applied in this study (objective smartphone logs, ecological momentary assessment, and machine learning) will allow for a more nuanced assessment of the links between smartphone use and well-being, informing strategies to help adolescents navigate the online world more constructively in terms of the development of their physical, social, and psychological well-being. International Registered Report Identifier (IRRID) DERR1-10.2196/35984
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Affiliation(s)
- Steriani Elavsky
- Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Jana Blahošová
- Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | | | - Michał Tkaczyk
- Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Martin Tancos
- Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Jaromír Plhák
- Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - Ondřej Sotolář
- Faculty of Informatics, Masaryk University, Brno, Czech Republic
| | - David Smahel
- Faculty of Informatics, Masaryk University, Brno, Czech Republic
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