“Using digital media or sleeping … that is the question”. A meta-analysis on digital media use and unhealthy sleep in adolescence

Pagano, Maria; Bacaro, Valeria; Crocetti, Elisabetta

doi:10.1016/j.chb.2023.107813

Cited by 19 publications

(4 citation statements)

References 101 publications

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“…Third, the used data-set contains no information about the content (social media activity, playing games, etc.) of after-midnight use of DMD, which probably would provide some explanation of the association of after-midnight use of DMD and insomnia symptoms, as indicated in a recent meta-analysis ( 15 ).…”

Section: Discussionmentioning

confidence: 92%

“…Second, another limitation of this study is its cross-sectional nature, limiting causal inference due to unknown temporal ordering of the observed measures. Since there is evidence of bidirectionality of the association of dysfunctional digital media use and sleep health ( 15 ), future longitudinal studies should take this into account when investigating the relation between late-night use of DMD and insomnia symptoms. The same applies for the relation between IRAB and insomnia symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Since the majority of the included observational studies in theses reviews were cross-sectional, it is difficult to infer the causal relationship between digital media use and sleep outcomes. A recent meta-analysis focusing exclusively on longitudinal studies ( 15 ) showed a significant negative effect of utilization time of digital media at one time point on sleep health on a later time point but not vice versa. Conversely, sleep health at one time point was significantly negatively associated with dysfunctional use of digital media on a later time point.…”

Section: Introductionmentioning

confidence: 99%

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The mediating effect of after-midnight use of digital media devices on the association of internet-related addictive behavior and insomnia in adolescents

Lederer-Hutsteiner,

Müller,

Penker

et al. 2024

Front. Public Health

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BackgroundThere is evidence that overexposure to digital media devices (DMD) can not only lead to addictive patterns of internet use, but also cause insomnia symptoms. The aim of this cross-sectional study among adolescents is to provide an estimate of the prevalence of sleep impairments and to explore the mediating role of after-midnight use of DMD between internet-related addictive behavior (IRAB) and insomnia.Methods2,712 school students from Styrian schools participated in a population-representative online survey in a supervised school setting in spring 2022. School students were screened using established and validated scales. Data analysis was carried out using multiple imputation, linear multilevel regression and mediation analysis.ResultsPrevalence estimation indicates high proportions of clinically relevant moderate [12.6% (11.3%; 14.1%)] and severe [3.6% (2.9%; 4.4%)] insomnia, with an additional 30.6% (29.0%; 32.2%) at subthreshold level. DMD are typically used after midnight an average of 1.66 (1.58; 1.75) evenings with subsequent school day per school week. Linear multilevel regression analysis shows significant associations for sleep disparities as outcome variable e.g., with generalized anxiety [b = 0.329 (0.287; 0.371)], after-midnight use of DMD [b = 0.470 (0.369; 0.572)] and IRAB [b = 0.131 (0.097; 0.165)]. Mediation analysis shows a mediated proportion of 18.2% (13.0%; 25.0%) of the association of IRAB and insomnia by after-midnight use of DMD [Indirect effect: b = 0.032 (0.023; 0.040), direct effect: b = 0.127 (0.083; 0.170)].ConclusionsAlthough the cross-sectional nature of this study limits causal inference, the results indicate a need for policies, which are already in preparation in Styria as part of a respective action plan.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The mediating effect of after-midnight use of digital media devices on the association of internet-related addictive behavior and insomnia in adolescents

Lederer-Hutsteiner,

Müller,

Penker

et al. 2024

Front. Public Health

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“…However, over the last decades, adolescents’ sleep duration has been significantly reduced, becoming a source of public health concern [ 6 , 7 ]. This dramatic decline could be due to the interplay between biological (e.g., changes in melatonin secretion; for a review, [ 8 ]) and psychosocial changes (e.g., irregular sleep patterns and changes in physical activity and digital use; for reviews, [ 9 , 10 ]) that happen during adolescence.…”

Section: Introductionmentioning

confidence: 99%

The Longitudinal Interplay between Sleep, Anthropometric Indices, Eating Behaviors, and Nutritional Aspects: A Systematic Review and Meta-Analysis

et al. 2023

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Sleep is fundamental for adolescents’ healthy development but undergoes dramatic changes in quantity and quality due to the conflict between biological and social rhythms. Insufficient sleep has been associated with worse physical health status and irregular eating behaviors in adolescents. This review aims to systematically synthesize the longitudinal associations between adolescents’ sleep dimensions (i.e., duration, timing, quality, and insomnia symptoms) and physical health indicators (i.e., anthropometric indices, fat percentage, and risk of obesity), eating behaviors, and nutritional aspects (i.e., type of diet related to the intake of specific foods and nutrients, amount and timing of food consumption, energy expenditure). A total of 28 longitudinal studies were included. The meta-analytic results showed that longer sleep duration, better sleep quality, and lower insomnia symptoms were associated with lower BMI and fat percentage and that shorter sleep duration (<7 h) and lower sleep quality were associated with a higher risk of obesity. Conversely, anthropometric indices were not related to sleep over time. Limited literature examined the bidirectional association between adolescents’ sleep and their eating behaviors and nutritional aspects. Such knowledge sheds new light on the role of sleep for adolescents’ health, highlighting the need to examine further the interplay between these variables.

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Screen Use at Bedtime and Sleep Duration and Quality Among Youths

Brosnan,

Haszard,

Meredith-Jones

et al. 2024

JAMA Pediatr

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ImportanceAlthough 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.ObjectiveTo examine whether evening screen time is associated with sleep duration and quality that night in youths.Design, Setting, and ParticipantsThis 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.ExposureObjectively 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 MeasuresSleep 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.ResultsOf 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 RelevanceIn 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.

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“Using digital media or sleeping … that is the question”. A meta-analysis on digital media use and unhealthy sleep in adolescence

Cited by 19 publications

References 101 publications

The mediating effect of after-midnight use of digital media devices on the association of internet-related addictive behavior and insomnia in adolescents

The mediating effect of after-midnight use of digital media devices on the association of internet-related addictive behavior and insomnia in adolescents

The Longitudinal Interplay between Sleep, Anthropometric Indices, Eating Behaviors, and Nutritional Aspects: A Systematic Review and Meta-Analysis

Screen Use at Bedtime and Sleep Duration and Quality Among Youths

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