Association between quality of sleep and screen time during the COVID-19 outbreak among adolescents in the United Arab Emirates

Insomnia severity and obesity mediated by health behaviors in adolescents

OBJECTIVE

Sleep difficulties in youth have been associated with numerous negative outcomes, such as higher risk of obesity. Though the relationship between sleep and obesity is not well clarified, past research has shown that modifiable health behaviors, such as diet, physical activity, and screen time, may explain this relationship. The purpose of this study was to simultaneously examine these health behaviors as mediators of the relationship between insomnia severity and obesity among a sample of adolescents aged 12-18 years.

METHOD

English-speaking parents/legal guardians of adolescents were invited to participate in an online survey focused on pediatric sleep patterns, health behaviors, and weight. Parents/guardians (N = 599) reported on their adolescent's diet (i.e., consumption of fruits/vegetables, fast food, and breakfast), physical activity, screen time, and BMI. A multiple mediation analysis was run to test these health behaviors as mediators of the relationship between insomnia severity and BMI, after controlling for sex, age, race, and poverty.

RESULTS

While insomnia was related to most health behaviors, screen time was the only significant mediator of the relationship between insomnia and BMI, after controlling for the effects of the other mediators and all covariates, ab = .04, 95% CrI [.01, .09].

CONCLUSIONS

Screen time has implications for both adolescents' sleep health and weight. Pediatric clinicians should systematically assess for, and provide, recommendations on ways to improve sleep and screen time use, in addition to providing traditional dietary and physical activity recommendations.

Prevalence of cardiovascular risk factors according to Life's Essential 8 in children and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis including 1 526 173 participants from 42 countries

INTRODUCTION

Cardiovascular health is a crucial aspect of overall health. The aim of this study was to estimate the prevalence of cardiovascular risk factors among children and adolescents during the COVID-19 pandemic based on the Life's Essential 8 domains.

METHODS

PubMed, Scopus and Web of Science were systematically searched until 24 February 2023. Studies had to meet the following criteria: (1) observational studies, (2) studies reporting proportion of selected risk factors, (3) studies involving children or adolescents, (4) studies that collected data during the COVID-19 pandemic and (5) studies with representative samples. The outcomes included were diet, physical activity, nicotine exposure, sleep health, obesity, dyslipidaemia, diabetes and elevated blood pressure.

RESULTS

Sixty-two studies with 1 526 173 participants from 42 countries were included. Of these, 41 studies were used in the meta-analyses. The overall pooled prevalence of risk factors in the behavioural domain was as follows: poor quality diet 26.69% (95% CI 0.00%-85.64%), inadequate physical activity 70.81% (95% CI 64.41%-76.83%), nicotine exposure 9.24% (95% CI 5.53%-13.77%) and sleep disorders 33.49% (95% CI 25.24%-42.28%). The overall pooled prevalence of risk factors in the health domain was as follows: obesity 16.21% (95% CI 12.71%-20.04%), dyslipidaemia 1.87% (95% CI 1.73%-2.01%), diabetes 1.17% (95% CI 0.83%-1.58%) and elevated blood pressure 11.87% (95% CI 0.26%-36.50%).

CONCLUSIONS

These results highlight the need for prevention strategies to maintain better cardiovascular health from an early age, particularly by increasing physical activity levels, sleep time and promoting the consumption of more fruits and vegetables.

Relationship of screen time with anxiety, depression, and sleep quality among adolescents: a cross-sectional study

Introduction

In the current digital age, people's use of electronic devices has significantly increased screen time, which may have an impact on different aspects of their lives. Adolescents today are exposed to excessive screen time, which may affect their sleep and contribute to anxiety and depression. The purpose of this study is to examine the relationship between screen time with sleep quality, anxiety and depression, among adolescents in Klang Valley, Malaysia.

Methods

This study is a cross-sectional study information was gathered from among 353 secondary school students in the Klang Valley using a questionnaire. The instrument that was used in this study was Pittsburgh Sleep Quality Index (PSQI) Malay version, screen-based media usage (SCREENS-Q) and Hopkins Symptom Check List-25 (HSCL-25) Malay version. The sampling method was stratified and convenience sampling method. The analysis study used the Smart Partial least squares (PLS) method to analyze the data.

Results

Using the Smart PLS technique, we examined the relationship between these variables and identified revealed that screen time has a direct, positive, and significant impact on anxiety level (Mean = 0.134, β = 0.123, p < 0.01) and depression levels (Mean = 0.202, β = 0.194, p < 0.01). Moreover, screen time has a low effect on sleep quality (Mean = 0.128, β = 0.117, p < 0.05). However, the mediating factor, sleep quality, was not significant in the indirect effect of screen time with anxiety (Mean = 0.047, β = 0.040, p  > 0.05) and depression (Mean = 0.044, β = 0.043, p  < 0.05).

Discussion

This study highlights the importance of understanding the association between screen use, sleep quality, anxiety and depression. Notably, excessive screen time appears to be associated with poorer sleep quality, ultimately increasing anxiety and depression. Understanding the effects of excessive screen time on sleep and well-being may have a substantial impact on public health policies and interventions. Enacting policies that promote better screen habits and sleep hygiene could improve people's overall quality of life and well-being in the digital age. However, more longitudinal research is needed to confirm the causality of these relationships and investigate potential intervention strategies.

The relationship between the use of screen-based devices and self-reported sleep quality in adolescents aged 13-19 years in Brunei

BACKGROUND

The widespread use of digital devices among adolescents has raised concerns about the potential impact of screen time on sleep quality. This study aimed to investigate the relationship between screen time and self-reported sleep quality in adolescents.

METHODS

A cross-sectional study was conducted on adolescents (13- to 19-year-olds) using multi-stage cluster sampling with probability proportional to the size of public schools. Data were collected in November 2022 through self-administered questionnaires. The questionnaire collected sociodemographic characteristics, sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and screen time on weekdays and weekends using the Screen Time Questionnaire (STQ). A scoring system was used in the PSQI and a global score of more than 5 indicates poor sleep quality. The relationship between screen time and sleep quality was analysed using simple and multiple linear regression.

RESULTS

A total of 547 adolescents participated in the study, with a mean (SD) age of 16.66 (1.54) years. The mean (SD) PSQI score was 5.98 (2.70), and 52% of participants had poor sleep quality. The sleep disturbance component had the highest mean (SD) score at 1.35 (0.5) out of a total score of 3.0. The mean (SD) screen time for a weekday was 537.6 (301.5) minutes, and a weekend day was 725.5 (339.2) minutes. The highest median screen time was spent on smartphones during the whole week. A significant linear relationship was observed between age and PSQI global score (p = 0.008), with a 0.2 increase in PSQI global score for each year increase in age (95% CI: 0.05, 0.35). Being female was also significantly associated with a high PSQI global score (p < 0.001). Additionally, a significant linear relationship was observed between screen time on a weekend and PSQI score (p = 0.032).

CONCLUSIONS

The study found that half of the adolescents had poor sleep quality, which was associated with being female, increased screen time on weekends, and older age. Future research endeavours should focus on conducting longitudinal studies to assess the temporal relationship between screen time and sleep quality.

Sleep quality and screen time among university professors: impact of emergency remote teaching amidst COVID-19 crisis

PURPOSE

Sleep plays a crucial role in maintaining physical and mental health. The COVID-19 pandemic has brought about unprecedented global changes, and disruptions in sleep quality have emerged as a challenge. The pandemic prompted a dramatic shift in the working landscape for university professors, necessitating emergency remote teaching (ERT). This transition substantially increased professors' screen time for academic and research endeavors. This study explores the relationship between screen time and sleep quality among university professors during the pandemic and examines associated factors, including psychological well-being.

METHODS

An electronic survey, covering demographics, education, screen time, sleep quality, and mental health, was administered to professors who worked during the spring semester of 2020. Standardized measures were used to assess sleep quality and mental health. Correlations, Mann-Whitney tests, and multivariate regression explored associations between screen time, sleep quality, and other variables.

RESULTS

One hundred sixty participants exhibited poor sleep quality, subthreshold insomnia, and mild depression. Increased screen time correlated with poorer sleep quality, elevated stress levels, and heightened depression severity. Evening screen users reported more insomnia than daytime users. Depression emerged as a significant predictor of poor sleep quality and insomnia, along with evening screen use.

CONCLUSION

This study among university professors underscores the impact of screen time on sleep quality during the COVID-19 pandemic. Participants faced poor sleep, largely influenced by heightened screen time due to ERT. Considering these findings, this study emphasizes the importance of curbing daytime screen exposure and abstaining from screens in the evening, especially for university professors reliant on technology for their professional responsibilities.

Parental Neglect and Childhood Obesity Amidst COVID-19: A Developmental Psychopathology Perspective on Health and Developmental Risks

The COVID-19 pandemic has profoundly impacted the mental health and developmental trajectories of children and adolescents, catalyzing a range of psychological and behavioral issues due to enforced lockdowns and other restrictions. This text explores these impacts through the lens of developmental psychopathology, which integrates clinical psychology and developmental science to examine the emergence and evolution of psychological disorders across a lifespan. This paper highlights how pandemic-related disruptions have exacerbated conditions such as anxiety and depression and, notably, increased childhood obesity due to changes in lifestyle and reductions in physical activity. The analysis includes a discussion of how isolation has not only restricted access to educational and psychological resources but also increased the risk of parental mental illness and related familial stress, thereby intensifying issues of neglect and their consequent impact on child health. By employing a developmental psychopathology framework, this paper argues for the necessity of targeted interventions that address these complex interplays of genetic, environmental, and psychological factors. Such interventions aim to support children through structured educational and health-oriented strategies, ensuring their well-being amidst the ongoing challenges posed by the pandemic. This approach underscores the importance of early, multifaceted strategies involving parents, educators, and healthcare providers to foster healthier developmental outcomes for children facing unprecedented global health crises.

Evaluation of the effectiveness of sleep hygiene education and FITBIT devices on quality of sleep and psychological worry: a pilot quasi-experimental study among first-year college students

Background

College students report disturbed sleep patterns that can negatively impact their wellbeing and academic performance.

Objectives

This study examined the effect of a 4-week sleep hygiene program that included sleep education and actigraph sleep trackers (FITBITs) on improving sleep quality and reducing psychological worry without control group.

Design settings and participants

A pilot quasi-experimental design, participants were randomly selected medical and health sciences from a university students in the United-Arab-Emirates.

Methods

Students were asked to wear FITBITs and log their daily sleep data and completed the Pittsburgh Sleep Quality Index (PSQI) and Penn State Worry Questionnaire (PSWQ). Extensive sleep hygiene education was delivered via lectures, a WhatsApp group, and the Blackboard platform. In total, 50 students completed pre-and post-assessments and returned FITBIT data.

Results

There was a significant difference in the prevalence of good sleep postintervention compared with pre-intervention (46% vs. 28%; p = 0.0126). The mean PSQI score was significantly lower post-intervention compared with pre-intervention (6.17 ± 3.16 vs. 7.12.87; p = 0.04, Cohen's d 0.33). After the intervention, subjective sleep quality, sleep latency, and daytime dysfunction were significantly improved compared with pre-intervention (p < 0.05). In addition, FITBIT data showed total sleep time and the number of restless episodes per night were significantly improved postintervention compared with pre-intervention (p = 0.013). The mean PSWQ score significantly decreased from pre-intervention to p = 0.049, Cohen' d = 0.25. The correlation between PSQI and PSWQ scores was significant post-intervention (β = 0.40, p = 0.02).

Conclusion

Our results may inform university educational policy and curricular reform to incorporate sleep hygiene awareness programs to empower students and improve their sleep habits.

Prevalence of mental health symptoms in children and adolescents during the COVID-19 pandemic: A meta-analysis

The COVID-19 pandemic and its accompanying infection control measures introduced sudden and significant disruptions to the lives of children and adolescents around the world. Given the potential for negative impacts on the mental health of youths as a result of these changes, we conducted a systematic review and meta-analysis to examine the prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances in children and adolescents during the pandemic. We searched major literature databases for relevant cross-sectional or longitudinal studies that included primary and secondary school students or children and adolescents ≤18 years of age. Prevalence values were extracted, logit-transformed, and pooled. Based on 191 included studies with 1,389,447 children and adolescents, we found the pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances to be 31%, 31%, and 42%, respectively. Age, grade levels, education levels, gender, geographical regions, and electronics use were correlated with the prevalence of mental health symptoms. The prevalence of mental health symptoms also increased with time, although signs of recovery and stabilization were also observed. Overall, the results from this review demonstrate the need for increased mental health research, monitoring, and intervention for children and adolescents during the current and future pandemics.