Electronic media play an important role in the everyday lives of children and adolescents and have been shown to be associated with sleep problems. The objective of this study was to assess the associations between time spent using different electronic media and insomnia complaints (IC) in German adolescents with particular respect to gender differences in use patterns and associations with IC. Cross-sectional data of a weighted total of 7533 adolescents aged 11-17 stem from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS study) that was conducted from 2003 to 2006. The assessment of IC and time spent using different electronic media (television, computer/internet, video games, total screen time, mobile phones, and music) was included in a self-report questionnaire. Binary logistic regression analyses were performed to assess associations between time spent per day with each electronic media and IC. Age, SES, emotional problems (anxiety/depression) and presence of a medical condition were considered as covariates in the adjusted model. Boys and girls were considered separately. For boys: computer/internet use of ≥3 h/d (AOR = 2.56, p < 0.05) and total screen time of ≥8 h/d (AOR = 2.45, p < 0.01) were associated with IC in users. Playing video games for 0.5-2 h/d reduced the odds for IC (AOR = 0.60, p < 0.05) compared to nonusers. For girls: Listening to music for ≥3 h/d was associated with IC (AOR = 4.24, p < 0.05) compared to non-listeners. Everyday use of electronic media devices is associated with IC in adolescents. Clinicians dealing with adolescents referred for sleep problems should be aware of gender-specific patterns of media use and sleep problems.

The purpose of the study was to study the associations of tobacco, alcohol, marijuana, and coffee use and insomnia complaints (IC) in adolescents with special consideration of the influence of coffee consumption on these relationships. 7698 Subjects aged 11-17 years were investigated in a cross-sectional study within the German Health Interview and Examination Survey for Children and Adolescents. Self-report questionnaires were distributed to the participants. Hierarchical regression analyses were performed to assess possible effects of coffee consumption on the association of tobacco, alcohol, and marijuana use with IC. Common risk factors for insomnia were included in the adjusted analyses. Tobacco, alcohol, marijuana and coffee use displayed significant bivariate associations with IC. After adjusting the first three substances for coffee consumption, their associations with IC were reduced considerably. After additionally adjusting for other potential confounders (age, gender, socio-economic status, externalizing and internalizing psychiatric problems, media use, bodyweight, medical condition), frequent coffee consumption, high alcohol intake and frequent smoking contributed to the prediction of IC in male subjects while frequent coffee consumption and high alcohol intake predicted the occurrence of IC in females. Coffee consumption could be an important risk factor for IC in adolescents and it significantly affects the association of smoking, alcohol, and marijuana with IC. Future research that includes long-term studies about psychoactive substance use (PSU) and sleep should also consider coffee consumption. Parents, educators, clinicians, and researchers should be aware of the potentially hazardous influence of PSU, especially coffee, alcohol and tobacco, on sleep in young individuals.

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