Impact of sleep duration, physical activity, and screen time on health-related quality of life in children and adolescents

Abstract

Background Existing studies on health-related quality of life (HRQoL) mainly covered single growth stages of childhood or adolescence and did not report on the trends in the relationships of HRQoL with sleep duration, physical activity, and screen time. This study aimed to establish the population norm of HRQoL in children and adolescents aged 6–17 years and examine the associations of screen time, sleep duration, and physical activity with HRQoL in this population. Methods We conducted a large-scale cross-sectional population-based survey study of Hong Kong children and adolescents aged 6 to 17 years. A representative sample of students were interviewed to assess their HRQoL using PedsQL and EQ-5D-Y-5L. Multivariable homoscedastic Tobit regression with linear form or restricted cubic spline of predictors was used to analyze the associations between screen time, sleep duration, and HRQoL. Multiple imputation by chained equations was performed to deal with missing data. Results A total of 7555 respondents (mean age 11.5, SD 3.2; 55.1% female) were sampled. Their EQ VAS scores, PedsQL physical summary scores, and psychosocial summary scores were positively correlated with sleep duration and moderate/vigorous activity but was negatively correlated with screen time. Conclusions Children and adolescents who had longer exposure to screen, shorter sleep duration, and lower physical activity levels appeared to have poorer HRQoL as assessed by PedsQL and EQ-5D-Y-5L. Advice and guidance on screen time allocation for children and adolescents should be provided at the levels of school, community, and family.

Results from the Hong Kong's 2022 report card on physical activity for children and adolescents

“…The grade D was assigned based on six data sources, with four studies having data collected before the COVID-19 outbreak including one old data source 16 , 30 , 31 , 32 and two during the pandemic. 24 , 33 Although increased screen time has been commonly reported among children and adolescents during COVID-19 related lockdowns, 4 not much difference was found in the proportions of children and adolescents meeting the recommendations of no more than 2 h of recreational screen time per day in Hong Kong.…”

Digital competence as a protective factor against gaming addiction in children and adolescents: A cross-sectional study in Hong Kong

“…Wong et al demonstrated that children and adolescents with longer screen time appeared to have a poorer health-related quality of life. 53 Prolonged use of digital devices has also been associated with other adverse health outcomes such as obesity, 54 myopia, 55 , 56 inattention, 57 and mental distress. 58 Our study showed that using digital devices for more than 3 hours per day significantly increased the likelihood of gaming addiction.…”

Comparison of the EQ-5D-Y-5L, EQ-5D-Y-3L and PedsQL in children and adolescents

“…Both the Y-3L and the PedsQL were used in children with acute Thalassemia with acceptable reliability on Cronbach's alpha but no comparison of performance between the two measures was made [46]. Similarly, the EQ-5D-Y-5L and PedsQL both showed a decrement in HRQoL with sleep deprivation, physical activity and screen time in a large general population sample in Hong Kong but no comparison between instrument performance was made [47].…”