Different Types of Media Have Differing Effects on Teens' Sleep

Megan Brooks

May 14, 2011

May 14, 2011 (Honolulu, Hawaii) — Watching television and playing computer/video games seem to have differing effects on how much nightly shut-eye US teenagers get, new research shows.

Presented here at the American Psychiatric Association (APA) 2011 Annual Meeting, the study found that video games and the Internet show a negative correlation to sleep time, whereas television shows no apparent association with nightly sleep. These data "allude to a fundamental difference between exposure to TV and gaming/Internet in regard to sleep," the researchers note.

"We need to know more about how these different media affect sleep among teens," study investigator Caris Fitzgerald, MD, of University of Arkansas for Medical Sciences in Little Rock, told Medscape Medical News.

Today's Teens Sleep Challenged

Teenagers have "several challenges" when it comes to sleep, Dr. Fitzgerald said. Not only are they more independent and go to bed later than younger children, "today there is 24/7 technology and late-night texting; the social networking that goes on late at night is kind of a new phenomenon cutting into teen sleep time.

"We know that light affects the circadian system," Dr. Fitzgerald noted, "and there have been some studies that even light from TV, computers, and LCD screens might affect this system."

Dr. Caris Fitzgerald

To quantify the association among media exposure, physical activity, and self-reported sleep time in teenagers, Dr. Fitzgerald, with assistance and guidance from her mentor, Erick Messias, MD, PhD, analyzed data from the 2009 Youth Risk Behavior Survey (YRSB).

The YRBS, an ongoing initiative led by federal health officials at the Centers for Disease Control and Prevention, monitors behavior that influences health in US high school students.

The current findings are based on a nationally representative sample of more than 16,000 students whose average age was 16 years.

"One of the most interesting findings," Dr. Fitzgerald said, was how many teenagers were meeting sleep recommendations. "Only 10% of the sample slept within the recommended sleep time, which is 9 hours. The highest group was at 7 hours," she noted.

Teens sleeping less than 7 hours per night were more likely than those getting more nightly sleep to report "heavy" video game/Internet use (adjusted odds ratio [aOR], 1.6; 95% confidence interval [CI] 1.4 – 1.8). They were also less likely to meet recommended physical activity levels (aOR, 0.7; 95% CI, 0.7 – 0.8).

Not Enough Physical Activity

"This sample is of American teenagers in the public school system, so you would think that they would be meeting their physical activity levels, but that was not the case," said Dr. Fitzgerald. "Thirty-five percent of them reported that they did not meet federal physical activity standards."

In contrast to video games/Internet exposure, television exposure did not show statistical association with self-reported sleep duration in this sample of teenagers, but Dr. Fitzgerald says this finding should be interpreted cautiously.

"We are confined by the specific questions on the survey, so computer and video games are lumped into 1 question and TV is off by itself. TV really didn't have an association with sleep, but was that because the students who had low amounts of TV time were playing video games or on the computer? We don't know. The people who had low video game exposure — was that because they were watching TV? Again, we don't know."

Reached for comment, Nancy A. Collop, MD, director of the Emory Sleep Center in Atlanta, Georgia, and president-elect of the American Academy of Sleep Medicine, said the lack of sleep noted in the study population is "not at all surprising; the shifts in circadian rhythm that occur in teenagers (later to bed, later to rise) have been noted before."

Dr. Collop, who was not involved in the study, said it would be interesting to know the timing of when the teenagers watch/play these activities; "the light stimulus at night may prevent that ability to fall asleep (in addition to the stimulation of the activity eg, TV more passive, video games more active)."

Clearly, more research is needed, but the data suggest that the type of impact different media exposures have on sleep may vary according to the source, with gaming/Internet having a greater negative impact than television, the researchers conclude. The greater level of "adrenergic stimulation seen with gaming" could explain the difference, they say.

Reached for comment on the study, Daniel J. Buysse, MD, of the University of Pittsburgh School of Medicine in Pennsylvania, said, "The greatest strength of the analysis is that it includes a very large, representative sample of American teens and that the data are recent."

Another strength, he said, is the "breadth of questions assessed rather than the depth in any 1 area. Such analyses raise important issues, such as the relationship between electronic media and sleep, that can be followed up in more specific studies in the future."

The main questions raised by this study, Dr. Buysse said, are "whether changing media exposure would lead to more and better sleep in teens and whether that sleep would have an impact on school performance, health, and emotional well-being.

"On balance, though, I don't think we need the answers to those questions to make commonsense recommendations. Less media exposure and more sleep are very likely to have positive effects on teen health."

The study authors and Dr. Buysse have disclosed no relevant financial relationships.

American Psychiatric Association (APA) 2011 Annual Meeting: Abstract NR01-23. Presented May 14, 2011.

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