Screen Exposure in Early Childhood Linked to Shorter Sleep

Marcia Frellick

April 14, 2014

Exposure to screens in the critical developmental years of early childhood lead to longtime poor sleep habits and other self-regulation problems, say researchers in 2 new studies published online April 14 in Pediatrics.

In the first article, Jenny S. Radesky, MD, from the Division of General Pediatrics, Department of Pediatrics, Boston Medical Center, Massachusetts, and colleagues found that infants and toddlers who had trouble with sleep, excessive fussing, and attention viewed more media at age 2 years than those who did not have difficulty in these areas.

Researchers examined data from 7450 children in the Early Childhood Longitudinal Study of children born in 2001, in which parents completed the Infant Toddler Symptom Checklist (ITSC), a validated scale of self-regulation, when the baby was aged 9 months and 2 years.

The infants and toddlers whom parents described as most fussy also had the most exposure to forms of media, even after adjusting for sociodemographic factors and home environment.

Infants with poor self-regulation (9-month ITSC score, ≥3) viewed 0.23 hours per day (95% confidence interval [CI], 0.12 - 0.35 hours) more media at 2 years of age compared with those with a 9-month ITSC score of 0 to 2.

The study did not determine whether screen time was used in response to children's fussiness or whether it contributed to their difficulties.

"However, our findings raise the question of whether helping parents manage their child's difficult behaviors may be a way to prevent the development of excessive media use habits. Anticipatory guidance in pediatric practice could focus on discussing with parents their motivations behind media choices and recommending a healthier media diet toward more prosocial/educational content," Dr. Radesky and colleagues write.

In the second study, researchers found that more television viewing was linked with shorter sleep cycles from infancy through mid-childhood.

Parents of 1864 children reported children's daily television time and sleep (at age 6 months and annually, 1 - 7 years) and whether children had a television in their bedroom (annually, 4 - 7 years).

Elizabeth M. Cespedes, SM, from the Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, and colleagues found that each hour per day of average lifetime television viewing was associated with 7 fewer minutes per day (95% CI, 4 - 10 minutes) of sleep.

The authors found a more significant effect on boys than girls and noted that the results are consistent with other studies that have indicated that boys are particularly vulnerable to electronic media's influence on sleep.

They also found an association between bedroom television and shorter sleep, but it was different among racial groups.

Among racial/ethnic minority children, bedroom television was associated with 31 fewer minutes of sleep per day (95% CI, 16 - 45 minutes). However, among non-Hispanic whites, a television in the bedroom was linked with 8 fewer minutes of sleep per day (95% CI, −19 to 2 minutes).

They The authors write: "Given the associations between greater TV viewing and shorter sleep suggested by this study and the strong evidence that greater TV viewing and shorter sleep are associated with poor outcomes, screen time interventions have the potential to improve sleep."

Dr. Radesky has reported receiving support from the Health Resources and Services Administration, and one coauthor received support from the National Institutes of Health. Both studies were funded by the National Institutes of Health. The other authors have disclosed no relevant financial relationships.

Pediatrics. Published online April 14, 2014. Radesky abstract, Cespedes abstract

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