The Impact of a Healthy Media Use Intervention on Sleep in Preschool Children

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Although observational studies have consistently reported an association between media use and child sleep problems, it is unclear whether the relationship is causal or if an intervention targeting healthy media use can improve sleep in preschool-aged children. WHAT THIS STUDY ADDS:This study demonstrates that a healthy media use intervention can improve child sleep outcomes and adds evidence that the relationship between media and sleep in preschool-aged children is indeed causal in nature. abstract BACKGROUND: Although observational studies have consistently reported an association between media use and child sleep problems, it is unclear whether the relationship is causal or if an intervention targeting healthy media use can improve sleep in preschool-aged children. METHODS:We conducted a randomized controlled trial of a healthy media use intervention in families of children aged 3 to 5 years. The intervention encouraged families to replace violent or ageinappropriate media content with quality educational and prosocial content, through an initial home visit and follow-up telephone calls over 6 months. Sleep measures were derived from the Child Sleep Habits Questionnaire and were collected at 6, 12, and 18 months after baseline; repeated-measures regression analyses were used. RESULTS:Among the 565 children analyzed, the most common sleep problem was delayed sleep-onset latency (38%). Children in the intervention group had significantly lower odds of "any sleep problem" at follow-up in the repeated-measures analysis (odds ratio = 0.36; 95% confidence interval: 0.16 to 0.83), with a trend toward a decrease in intervention effect over time (P = .07). Although there was no significant effect modification detected by baseline sleep or behavior problems, gender, or low-income status, there was a trend (P = .096) toward an increased effect among those with high levels of violence exposure at baseline. CONCLUSIONS:The significant effects of a healthy media use intervention on child sleep problems in the context of a randomized controlled trial suggest that the previously reported relationship between media use and child sleep problems is indeed causal in nature. Pediatrics 2012;130:492-499 AUTHORS:

Screen time exposure and sleep among children with developmental disabilities

“…Children with developmental disabilities have many challenges to overcome in their school environment to achieve optimal human capital. Paediatricians have an important role in addressing life‐style habits like sleep and media use, where small changes can have large ramifications . Furthermore, there is a role for routinely providing anticipatory guidance on sleep in children, especially from lower SES families, to allow prompt intervention to mitigate the ill effects of insufficient sleep and optimise their school functioning and physical well‐being.…”

“…Paediatricians have an important role in addressing life-style habits like sleep and media use, where small changes can have large ramifications. 47,48 Furthermore, there is a role for routinely providing anticipatory guidance on sleep in children, especially from lower SES families, to allow prompt intervention to mitigate the ill effects of insufficient sleep and optimise their school functioning and physical well-being. Older children with developmental disabilities should also be considered an 'at-risk' group and be identified early to receive guidance on sleep and media use.…”

Children and Adolescents and Digital Media

“…90 Increased duration of media exposure and the presence of a TV, computer, or mobile device in the bedroom in early childhood have been associated with fewer minutes of sleep per night, especially among children of racial/ethnic minority groups. 91 Later bedtimes after evening media use and violent content in the media also may be contributing factors, 92 and suppression of endogenous melatonin by blue light emitted from screens is another possible cause. 93 Associations between media and sleep are seen in infants as well; 6-to 12-month-olds who were exposed to screen media in the evening hours showed significantly shorter nighttime sleep duration than those who had no evening screen exposure.…”

Early Literacy Promotion in the Digital Age

“…Young children exposed to greater amounts of unmonitored or unregulated screen time are at increased risk of sleep disturbance and behavioral problems, including attention-deficit hyperactivity disorder, during the school-aged years. 18 Although some limited evidence suggests the possibility of e-books and digital tools to support other early-learning interventions, digital tools alone are unlikely to replace brain's evolutionary reliance on human interaction to develop the full range of early literacy skills. Most digital media does not require or prompt the serve and return adult-child interaction necessary to stimulate brain development.…”