Electronic Media Use and Sleep in Children and Adolescents: A Systematic Review

Abstract Background In recent years, there has been an increasing interest in whether the use of electronic media affects children and young adolescents' sleep. We performed a systematic review of the association between electronic media use and sleep outcomes among 0-15-year-olds.Methods Searches were carried out in four databases (CINAHL, Web of Science, EMBASE, and Medline). Additional studies were identified by hand-searching reference lists of retrieved systematic reviews and meta-analyses. Inclusion criteria were age range from 0 to 15.9 years, in English, and intervention studies, cohort studies, and cross-sectional studies from western countries. Qualitative studies were excluded due to a low number of identified studies. Exclusion criteria were study populations with psychiatric diagnoses, obesity, or any sleep disorder. Results The search identified 10,719 unique studies, of which 108 fulfilled the inclusion and exclusion criteria and were assessed for methodological quality. In total, 49 studies were included in the review. The study designs were randomized controlled trials (n=3), quasi-experimental studies (n=two), prospective cohort studies (n=15), and cross-sectional studies (n=29). Evidence for an association between electronic media use and sleep duration was identified; particularly excessive electronic media use and bedtime use. The evidence was stronger for 6-15-years-olds than 0-5-year-olds. The relationship between electronic media use and other sleep outcomes was more inconclusive. Conclusions Overall, electronic media use was generally associated with shorter sleep duration in children and adolescents aged 0-15. Studies with stronger research design and of higher quality are needed to draw solid conclusions about electronic media’s impact on sleep outcomes and gain better understands of the mechanisms behind the associations. Public awareness and interventions could be promoted about the potential negative impact on children's sleep duration of electronic media devices that are used excessively and close to bedtime.