Screen Use at Bedtime and Sleep Duration and Quality Among Youths.

IF 24.7 1区 医学 Q1 PEDIATRICS
Bradley Brosnan, Jillian J Haszard, Kim A Meredith-Jones, Shay-Ruby Wickham, Barbara C Galland, Rachael W Taylor
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引用次数: 0

Abstract

Importance: Although questionnaire-based cross-sectional research suggests that screen time before bed correlates with poor sleep, self-reported data seem unlikely to capture the complexity of modern screen use, requiring objective night-by-night measures to advance this field.

Objective: To examine whether evening screen time is associated with sleep duration and quality that night in youths.

Design, setting, and participants: This repeated-measures cohort study was performed from March to December 2021 in participant homes in Dunedin, New Zealand. Participants included healthy youths aged 11 to 14.9 years. Data were analyzed from October to November 2023.

Exposure: Objectively measured screen time, captured using wearable or stationary video cameras from 2 hours before bedtime until the first time the youth attempted sleep (shut-eye time) over 4 nonconsecutive nights. Video data were coded using a reliable protocol (κ = 0.92) to quantify device (8 options [eg, smartphone]) and activity (10 options [eg, social media]) type.

Main outcomes and measures: Sleep duration and quality were measured objectively via wrist-worn accelerometers. The association of screen use with sleep measures was analyzed on a night-by-night basis using mixed-effects regression models including participant as a random effect and adjusted for weekends.

Results: Of the 79 participants (47 [59.5%] male; mean [SD] age, 12.9 [1.1] years), all but 1 had screen time before bed. Screen use in the 2 hours before bed had no association with most measures of sleep health that night (eg, mean difference in total sleep time, 0 minutes [95% CI, -3 to 20 minutes] for every 10 minutes more total screen time). All types of screen time were associated with delayed sleep onset but particularly interactive screen use (mean difference, 10 minutes; 95% CI, 4 to 16 minutes for every additional 10 minutes of interactive screen time). Every 10 minutes of additional screen time in bed was associated with shorter total sleep time (mean difference, -3 minutes; 95% CI, -6 to -1 minute). The mean difference in total sleep time was -9 minutes (95% CI, -16 to -2 minutes) for every 10 minutes of interactive screen use and -4 minutes (95% CI, -7 to 0 minutes) for passive screen use. In particular, gaming (mean difference, -17 minutes; 95% CI, -28 to -7 minutes for every 10 minutes of gaming) and multitasking (mean difference, -35 minutes; 95% CI, -67 to -4 minutes on nights with vs without multitasking) were associated with less total sleep time.

Conclusions and relevance: In this repeated-measures cohort study, use of an objective method showed that screen time once in bed was associated with impairment of sleep, especially when screen time was interactive or involved multitasking. These findings suggest that current sleep hygiene recommendations to restrict all screen time before bed seem neither achievable nor appropriate.

青少年睡前使用屏幕与睡眠时间和质量。
重要性:尽管基于问卷的横断面研究表明,睡前使用屏幕的时间与睡眠质量差有关,但自我报告的数据似乎无法反映现代屏幕使用的复杂性,因此需要逐夜的客观测量来推动这一领域的发展:研究青少年晚间使用屏幕的时间是否与当晚的睡眠时间和质量有关:这项重复测量队列研究于 2021 年 3 月至 12 月在新西兰达尼丁的参与者家中进行。参与者包括 11-14.9 岁的健康青少年。数据分析时间为 2023 年 10 月至 11 月:客观测量屏幕时间,使用可穿戴式或固定式摄像机捕捉从睡前 2 小时到青少年首次尝试入睡(闭眼时间)的 4 个非连续夜晚的屏幕时间。视频数据采用可靠的协议(κ = 0.92)进行编码,以量化设备(8 个选项[如智能手机])和活动(10 个选项[如社交媒体])类型:睡眠时间和质量通过腕戴式加速度计进行客观测量。使用混合效应回归模型,将参与者作为随机效应,并根据周末进行调整,逐夜分析屏幕使用与睡眠测量之间的关系:在 79 名参与者(47 [59.5%] 名男性;平均 [SD] 年龄为 12.9 [1.1] 岁)中,除 1 名参与者外,其他人都在睡前使用过屏幕。睡前 2 小时使用屏幕与当晚睡眠健康的大多数指标没有关系(例如,总睡眠时间每增加 10 分钟,总睡眠时间的平均差异为 0 分钟 [95% CI,-3 至 20 分钟])。所有类型的屏幕使用时间都与睡眠开始时间延迟有关,尤其是互动屏幕使用时间(平均差异为 10 分钟;互动屏幕使用时间每增加 10 分钟,95% CI 为 4 至 16 分钟)。在床上使用屏幕的时间每增加 10 分钟,总睡眠时间就会缩短(平均差异为-3 分钟;95% CI 为-6 至-1 分钟)。交互式屏幕每使用 10 分钟,总睡眠时间的平均差异为-9 分钟(95% CI,-16 至-2 分钟),被动屏幕每使用 10 分钟,总睡眠时间的平均差异为-4 分钟(95% CI,-7 至 0 分钟)。尤其是游戏(平均差异为-17分钟;95% CI,每10分钟游戏时间为-28至-7分钟)和多任务处理(平均差异为-35分钟;95% CI,有多任务处理与无多任务处理的夜晚为-67至-4分钟)与总睡眠时间减少有关:在这项重复测量队列研究中,客观方法的使用表明,上床后的屏幕时间与睡眠受损有关,尤其是当屏幕时间是互动的或涉及多任务时。这些发现表明,目前关于限制睡前所有屏幕时间的睡眠卫生建议似乎既无法实现,也不合适。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JAMA Pediatrics
JAMA Pediatrics PEDIATRICS-
CiteScore
31.60
自引率
1.90%
发文量
357
期刊介绍: JAMA Pediatrics, the oldest continuously published pediatric journal in the US since 1911, is an international peer-reviewed publication and a part of the JAMA Network. Published weekly online and in 12 issues annually, it garners over 8.4 million article views and downloads yearly. All research articles become freely accessible online after 12 months without any author fees, and through the WHO's HINARI program, the online version is accessible to institutions in developing countries. With a focus on advancing the health of infants, children, and adolescents, JAMA Pediatrics serves as a platform for discussing crucial issues and policies in child and adolescent health care. Leveraging the latest technology, it ensures timely access to information for its readers worldwide.
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