The use of entertainment and communication technologies before sleep could affect sleep and weight status: a population-based study among children

Abstract

BackgroundShort sleep duration and poor sleep quality have been demonstrated to be associated with childhood obesity. It has been suggested that electronic entertainment and communication devices (EECDs) including TVs, computers, tablets, video games and cell phones interfere with sleep in children and youth. The aim of this study was to assess the impact that the use of EECDs in the hour before bedtime has on sleep and weight status to inform sleep promotion interventions and programs to prevent childhood obesity.MethodsA provincially representative sample of 2334 grade 5 children and their parents in Alberta, Canada was surveyed. Parents reported their child’s bedtime and wake-up time along with how often their child snored, felt sleepy during the day, woke-up at night and woke-up in the morning feeling unrefreshed. Sleep duration, sleep quality and sleep efficiency were derived from these indicators. Parents also reported on the presence of EECDs in their child’s bedroom, while children reported use of EECDs during the day and frequency of using each of these devices during the hour before sleep. The height and weight of children were measured. Multivariable mixed effect linear and logistic regression models were used to determine how sleep duration, sleep quality, sleep efficiency and weight status are influenced by (i) access to EECDs in children’s bedrooms, (ii) use of EECDs during the hour before sleep, and (iii) calming activities specifically reading during the hour before sleep.ResultsSleep duration was shorter by −10.8 min (cell phone), −10.2 min (computer) and −7.8 min (TV) for those with bedroom access to and used these EECDs during the hour before sleep compared to no access and no use. Good sleep quality was hindered by bedroom access to and use of all EECDs investigated during the hour before sleep, particularly among users of cell phones (OR = 0.64, 95% CI: 0.58–0.71) and computers (OR = 0.72, 95% CI: 0.65–0.80). Very good sleep efficiency was decreased by access to and frequent use of a TV (54%), cell phone (52%), tablet (51%) and video games (51%). Odds of obesity were doubled by bedroom access to and use of a TV and computer during the hour before sleep. Children who rarely read a printed book in the bedroom during the hour before sleep had a shorter sleep duration and poorer sleep quality and sleep efficiency compared to their peers. Having access to an EECD in the bedroom was associated with increased obesity despite frequently reading during the hour before sleep.ConclusionsOur findings suggest that sleep duration, sleep quality, sleep efficiency and weight status are better among children who do not have EECDs in the bedroom and frequently read a book during the hour before sleep as opposed to those who use EECDs during this hour. Education of limits against EECD use by parents may improve sleep outcomes. These findings will inform health promotion messages and may give rise to national recommendations regarding EECD use.Trial registrationClinicalTrials.gov NCT01914185. Registered 31 July ...

Excessive use of mobile devices and children's physical health

“…Kenney and Gortmaker () found that hours of device use (including smartphones and tablets) associated with increased obesity risk and less than 60 min of PA in the past 7 days. Another study (Dube et al, ) reported that access to cell phone in the bedroom (regardless of whether in use) was associated with greater obesity risk. Two studies specifically examined excessive use of social media and/or gaming and found significant association with sedentary behaviors or obesity.…”

“…Overall, these studies suggest that use of technology does adversely impact sleep duration. Ten of the included studies measured bedtime/nighttime media use using various methods, mainly self‐report or parent‐report, and either asked parents or youth to report on the amount of time using screen media before going to bed, or asked if any screens were present in the youth's bedroom (Arora, Broglia, Thomas, & Taheri, ; Dimitriou, Knight, & Milton, ; Dube, Khan, Loehr, Chu, & Veugelers, ; Lemola, Perkinson‐Gloor, Brand, Dewald‐Kaufmann, & Grob, ; Munezawa et al, ; Nathanson & Beyens, , ; Oshima et al, ; Scott & Woods, ; Seo, Kim, Yang, & Hong, ). All studies that focused on nighttime use specifically found that social media, tablet, or smartphone use was associated with shorter sleep duration.…”

“…Multiple studies measured overall sleep quality with commonly used inventories such as the Pittsburgh Sleep Quality Index (Liu, Zhou, Niu, & Fan, ; Woods & Scott, ; Xie, Dong, & Wang, ) or the School Sleep Habits Survey (Vernon, Barber, & Modecki, ; Vernon, Modecki, & Barber, ). A few studies developed measures specific to their research questions (Dube et al, ; Ekİncİ et al, ; Kubiszewski, Fontaine, Rusch, & Hazouard, ; Munezawa et al, ). Results from these nine studies suggest that bedtime use of mobile phones and social media, or addictive use of these devices, adversely affects subjective sleep quality.…”

The effect of using entertainment and communication devices before sleep on nocturnal enuresis

“…There are a number of etiological factors that can play a role in MNE, including genetic predisposition, sleep arousal dysfunction, altered diurnal antidiuretic hormone secretion, decreased bladder storage capacity, and maturational delay . Nocturnal enuresis is also closely related to such lifestyle habits as fluid intake, meal content, and urination before sleep . The therapeutic approach to the underlying reason is important.…”

“…The use of entertainment and communication devices (EECDs), including televisions, computers, tablets, video games, and mobile phones, is increasing among children. They can lead to impairment in sleep quality and sleep efficiency when used before sleep . It has been demonstrated that the sleep quality of nocturnal enuretic children is poor, and so the use of EECDs before sleep could contribute to the progress of nocturnal enuresis by impairing sleep quality.…”