Increased Screen Time in Adolescents Associated With Poor Sleep Quality

A review published in Reports in Public Health found that adolescents aged 10 to 19 years had poorer sleep quality if they used a mobile device before going to sleep. Sleep in adolescents acts as a component of physical growth and biological and mental development, making identifying sleep disturbances vital to adolescent health.

The researchers for this study used MEDLINE/PubMed, LILACS, SciELO, Scopus, Embase, Web of Science, IBECS, Cochrane Library, ClinicalTrials.gov, and Open Gray to look for applicable studies. A manual search of journals including Sleep & Breathing, Journal of Clinical Sleep Medicine, Journal of Sleep Research, Nature and Science of Sleep, Sleep Medicine, and Sleep Health was also conducted.

Studies that evaluated screen usage time and sleep duration and quality in adolescents aged 10 to 19 years was included in the review. Case reports or series, letters to editors, literature reviews, theses, and dissertations were excluded. The Newcastle-Ottawa Scale was used to assess the quality of the articles.

There were 23 studies included in this review; 21.73% occurred between 2010 and 2015, 33.43% occurred in 2017, 8.69% in 2018, 26.08% in 2019, and 13.04% in 2020. The 23 studies were from multiple geographic areas, with 39.13% conducted in Europe, 34.78% in Asia, 13.04% in South America, 8.69% in North America, and 4.34% in Oceania. There were 20 transversal studies and 3 cohort studies included.

There were 13 studies that found that sleep quality was hampered by use of a mobile device, computer, or television before bed. Sleep duration was also affected, as 6 studies found that adolescents who spent time on their devices before bed had shorter sleep duration compared with those who did not.

Only 4 studies found that children attained sufficient sleep duration, which led to lower performance in social and school activities and greater daytime sleepiness. An association between poor sleep quality and symptoms of depression was found in 1 of the studies as well.

Cell phone device use was the most associated with poor sleep quality compared with other electronic devices that have digital screens, due to ease of access and practicality. A study found that using the mobile phone after the lights have been switched off was associated with poor sleep quality in adolescents.

A study found that refraining from digital screens for an hour prior to sleeping was effective in producing more melatonin, which regulates the body’s circadian rhythm. The light from digital screens reduces the amount of melatonin produced, which can lead to poorer sleep quality.

Quality of life was also found to be affected by digital device use before sleep, as poor sleep associated with excessive use of digital screens has been related to adverse effects on cognitive processes. Poor sleep quality can also reduce daytime alertness, lower one’s ability to learn new information, and hinder sports, driving, and working.

There were some limitations to this review. Most studies included were cross-sectional and therefore causal relationships could not be gathered. Sample losses and team calibration were some methodological limitations observed in the studies. There was a lack of standardization in the data collection methods of the chosen studies.

The researchers concluded that the systematic review demonstrated that the use of digital screens prior to sleep was detrimental to adolescents’ sleep quality and quality of life.

Reference

Silva SS, Silveira MAC, Almeida HCR, Nascimento MCP, Santos MAM, Heimer MV. Use of digital screens by adolescents and association on sleep quality: a systematic review. Cad Saude Publica. 2022;38(10):e00300721. doi:10.1590/0102-311xen300721