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Bérard M, Manneville F, Minary L, Ligier F, Bitar S, Agrinier N. Mediating effect of sleep in the association between social media use and mental health among French adolescents during the COVID-19 sanitary crisis. Sleep Med 2023; 112:223-231. [PMID: 37922784 DOI: 10.1016/j.sleep.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE/BACKGROUND Social media use could have deleterious effects on mental health through short sleep duration and poor sleep quality among adolescents. This study aimed to investigate the mediating role of both sleep duration and sleep quality in the association between social media use and mental health among adolescents. PATIENTS/METHODS We used cross-sectional data collected from adolescents in the EXIST pilot project conducted during COVID-19 pandemic. Adolescents self-reported wellbeing (WEMWBS), anxiety and depression (HADS) as mental health outcomes. We used ad-hoc questionnaires to assess social media use during weekdays and weekend days, and sleep duration and quality. Mediation analyses were carried out following Baron and Kenny's method, using adjusted linear regression models. RESULTS A total of 340 adolescents (13.5 ± 0.6 years, 45.3 % girls) were included. Greater social media use, poorer sleep quality, and shorter sleep duration were associated with poorer mental health. Greater social media use was associated with poorer sleep quality only during the weekend days. The total effect of social media use during weekend days on anxiety (β = 2.54; 95%CI [-1.59; 6.68]) was significantly conveyed through sleep quality (β = 1.22; 95%CI [0.17; 2.62]; mediated proportion = 48.0 %) and duration (mediated proportion = 46.8 %). Mediated proportions ranged from 12.5 % to 20.6 % for wellbeing and depression. Mediating effects were not evident during weekdays. CONCLUSIONS Sleep duration and quality mediated the association between social media use and mental health among adolescents during weekend days but not weekdays. Our findings highlight the importance of promoting healthy social media habits, especially during periods of increased reliance on digital platforms, such as COVID-19 pandemic.
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Affiliation(s)
- M Bérard
- Université de Lorraine, APEMAC, F-54000, Nancy, France
| | - F Manneville
- Université de Lorraine, APEMAC, F-54000, Nancy, France; CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, F-54000, Nancy, France.
| | - L Minary
- Université de Lorraine, APEMAC, F-54000, Nancy, France
| | - F Ligier
- Université de Lorraine, APEMAC, F-54000, Nancy, France
| | - S Bitar
- Université de Lorraine, APEMAC, F-54000, Nancy, France
| | - N Agrinier
- Université de Lorraine, APEMAC, F-54000, Nancy, France; CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, F-54000, Nancy, France
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Nagata JM, Singh G, Yang JH, Smith N, Kiss O, Ganson KT, Testa A, Jackson DB, Baker FC. Bedtime screen use behaviors and sleep outcomes: Findings from the Adolescent Brain Cognitive Development (ABCD) Study. Sleep Health 2023; 9:497-502. [PMID: 37098449 PMCID: PMC10823798 DOI: 10.1016/j.sleh.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 04/27/2023]
Abstract
OBJECTIVES To determine associations between bedtime screen time behaviors and sleep outcomes in a national study of early adolescents. METHODS We analyzed cross-sectional data from 10,280 early adolescents aged 10-14 (48.8% female) in the Adolescent Brain Cognitive Development Study (Year 2, 2018-2020). Regression analyses examined the association between self-reported bedtime screen use and self- and caregiver-reported sleep measures, including sleep disturbance symptoms, controlling for sex, race/ethnicity, household income, parent education, depression, data collection period (pre- vs. during COVID-19 pandemic), and study site. RESULTS Overall, 16% of adolescents had at least some trouble falling or staying asleep in the past 2 weeks and 28% had overall sleep disturbance, based on caregiver reports. Adolescents who had a television or an Internet-connected electronic device in the bedroom had a greater risk of having trouble falling or staying asleep (adjusted risk ratio 1.27, 95% CI 1.12-1.44) and overall sleep disturbance (adjusted risk ratio 1.15, 95% CI 1.06-1.25). Adolescents who left their phone ringer activated overnight had more trouble falling/staying asleep and greater overall sleep disturbance compared to those who turned off their cell phones at bedtime. Streaming movies, playing video games, listening to music, talking/texting on the phone, and using social media or chat rooms were all associated with trouble falling/staying asleep and sleep disturbance. CONCLUSIONS Several bedtime screen use behaviors are associated with sleep disturbances in early adolescents. The study's findings can inform guidance for specific bedtime screen behaviors among early adolescents.
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Affiliation(s)
- Jason M Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, California, USA.
| | - Gurbinder Singh
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, California, USA
| | - Joanne H Yang
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, California, USA
| | - Natalia Smith
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, California, USA
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, California, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, California, USA; School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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Khan A, Reyad MAH, Edwards E, Horwood S. Associations between adolescent sleep difficulties and active versus passive screen time across 38 countries. J Affect Disord 2023; 320:298-304. [PMID: 36183824 DOI: 10.1016/j.jad.2022.09.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/08/2022] [Accepted: 09/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND High screen use has been adversely linked with mental wellbeing; however, little is known about how active versus passive screen time are associated with sleep-onset difficulties among adolescents. METHODS We analysed data from 38 European and North American countries that participated in the 2014 Health Behaviour in School-aged Children (HBSC) survey. Difficulties in falling sleep were assessed using a self-reported item with a 5-point Likert scale, and then dichotomised. Participants reported h/day of discretional time spent watching television, electronic gaming, and computer use. RESULTS Of the 195,668 participants (Mage 13.59 [1.62] years; 51 % girls), about 25 % of girls reported sleep-onset difficulties, while the rate was 18 % in boys. Adolescents who played electronic games >4 h/day (≤1 h/day as reference) had 30 % higher odds in boys (OR 1.30; 95 % CI: 1.23-1.38) and 38 % higher odds in girls (OR 1.38; 95 % CI: 1.31-1.45) of reporting sleep difficulties. High computer use (>4 h/day) increased the odds of sleep difficulties by 41 % in boys (OR 1.41, 95 % CI: 1.33-1.49) and 61 % in girls (OR 1.61, 95 % CI: 1.53-1.69). Similarly, high television time (>4 h/day) had increased the odds of sleep difficulties by 15 % in boys (OR 1.15, 95 % CI: 1.08-1.22) and 19 % in girls (OR 1.19, 95 % CI: 1.12-1.25). LIMITATIONS Cross-sectional analyses cannot establish causality of the associations. CONCLUSIONS Higher levels of recreational screen use of any type were associated with sleep-onset difficulties among adolescents with adverse effects being more prevalent in active than passive screen time. Prospective research with objective measures is warranted to understand causality of these relationships.
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Affiliation(s)
- Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia; Active Healthy Kids Bangladesh (AHKBD), Bangladesh.
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Brautsch LA, Lund L, Andersen MM, Jennum PJ, Folker AP, Andersen S. Digital media use and sleep in late adolescence and young adulthood: A systematic review. Sleep Med Rev 2022; 68:101742. [PMID: 36638702 DOI: 10.1016/j.smrv.2022.101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 12/08/2022] [Accepted: 12/22/2022] [Indexed: 01/01/2023]
Abstract
Despite much attention on digital media use and young peoples' sleep, the literature on digital media and its impact on sleep in older adolescents and young adults remains to be synthesized. We conducted a systematic review of studies including young people aged 16-25 years. We searched Medline, Web of Science, and CINAHL for observational studies, identifying 60 studies. These studies were assessed for methodological quality. Only studies rated as moderate or high-quality studies were included (n = 42). A narrative synthesis summarized the impact of digital media use on eight sleep outcomes: Bedtime; Sleep onset latency or problems falling asleep; Sleep duration; Early awakening; Sleep disturbance; Daytime tiredness and function; Sleep deficits; Sleep quality. In summary, digital media use was associated to shorter sleep duration and poorer sleep quality. These associations were found for general screen use and use of mobile phone, computer, internet, and social media, but not for television, game console, and tablet use. Most studies investigating bedtime or nighttime use found associations to poor sleep outcomes. Later bedtime and daytime tiredness were associated with mobile phone use at night. Additional research is warranted to draw solid conclusions about the causal direction and to understand the underlying mechanisms.
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Silva SSD, Silveira MACD, Almeida HCRD, Nascimento MCPD, Santos MAMD, Heimer MV. Use of digital screens by adolescents and association on sleep quality: a systematic review. CAD SAUDE PUBLICA 2022; 38:e00300721. [DOI: 10.1590/0102-311xen300721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 08/19/2022] [Indexed: 11/22/2022] Open
Abstract
This study aimed to analyze the influence of digital screen use on adolescents’ quality of sleep. This systematic review was recorded on PROSPERO (CRD42020203403) and conducted according to PRISMA guidelines. Studies covering adolescents from 10 to 19 years were included without language or publication restrictions which answered the following guiding question: “Does the use of digital screen influence adolescents’ quality sleep?”. Article search included the following databases: (MEDLINE/PubMed), LILACS, SciELO, Scopus, EMBASE, Web of Science, IBECS, Cochrane Library, ClinicalTrials.gov, and Open Gray. The following descriptors were used: “Sleep Quality”, “Screen Time”, and “Adolescent”. The Newcastle-Ottawa Scale (NOS) assessed the methodological quality of the cohort studies, and a modified NOS was used to assess the cross-sectional ones. In total, 2,268 articles were retrieved, of which 2,059 were selected for title and abstract reading, after duplicates were deleted. After this stage, 47 articles were selected for full reading, resulting in the 23 articles which compose this review. Excessive use of digital screens was associated with worse and shorter sleep, showing, as its main consequences, night awakenings, long sleep latency, and daytime sleepiness. The use of mobile phones before bedtime was associated with poor quality of sleep among adolescents. Our evaluation of the methodological quality of the chosen studies found seven to be poor and 16, moderate.
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Zahedi S, Jaffer R, Iyer A. A systematic review of screen-time literature to inform educational policy and practice during COVID-19. Int J Educ Res Open 2021; 2:100094. [PMID: 35059672 PMCID: PMC8592820 DOI: 10.1016/j.ijedro.2021.100094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 05/04/2023]
Abstract
There is an urgent need for consensus around the matter of screen time (ST) during the COVID-19 pandemic. Some governments announced restrictions for online schooling time per day to protect students from perceived risks of prolonged screen-use, but critics and an emerging body of research question such regulations. Our review of 52 empirical studies found (a) an overwhelming majority of literature shows effect sizes too small to be of practical or clinical significance, and (b) findings more specifically on educational ST are inconclusive and critically underrepresented. These facts, along with the undeniable benefits of online learning in the absence of brick-and-mortar schooling and the ominous forecasts of learning loss caused by prolonged school closure, inform our recommendations for a more moderate policy and practical stance on restrictions - one that is focused on responsibly leveraging the educational and social benefits of ST in a world still recovering from the COVID-19 pandemic.
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Affiliation(s)
| | - Rhea Jaffer
- Manager of Research and Outreach, The Acres Foundation, Mumbai, India
| | - Anuj Iyer
- Head of Learning & Innovation, The Acres Foundation, Mumbai, India
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