Night-time screen-based media device use and adolescents' sleep and health-related quality of life

Michael O Mireku; Mary M Barker; Julian Mutz; Iroise Dumontheil; Michael S C Thomas; Martin Röösli; Paul Elliott; Mireille B Toledano

doi:10.1016/j.envint.2018.11.069

Night-time screen-based media device use and adolescents' sleep and health-related quality of life

Environ Int. 2019 Mar:124:66-78. doi: 10.1016/j.envint.2018.11.069. Epub 2019 Jan 10.

Authors

Michael O Mireku¹, Mary M Barker², Julian Mutz³, Iroise Dumontheil⁴, Michael S C Thomas⁴, Martin Röösli⁵, Paul Elliott⁶, Mireille B Toledano⁷

Affiliations

¹ MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK; National Institute for Health Research Health Protection Research Unit in Health Impact of Environmental Hazards at King's College London, a Partnership with Public Health England, and collaboration with Imperial College London, W2 1PG, UK; School of Psychology, University of Lincoln, LN6 7TS, UK.
² MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK; Department of Health Sciences, University of York, YO10 5DD, UK.
³ MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK; National Institute for Health Research Health Protection Research Unit in Health Impact of Environmental Hazards at King's College London, a Partnership with Public Health England, and collaboration with Imperial College London, W2 1PG, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁴ Department of Psychological Sciences, Birkbeck, University of London, UK.
⁵ Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland; University of Basel, Switzerland.
⁶ MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK; National Institute for Health Research Health Protection Research Unit in Health Impact of Environmental Hazards at King's College London, a Partnership with Public Health England, and collaboration with Imperial College London, W2 1PG, UK.
⁷ MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK; National Institute for Health Research Health Protection Research Unit in Health Impact of Environmental Hazards at King's College London, a Partnership with Public Health England, and collaboration with Imperial College London, W2 1PG, UK. Electronic address: m.toledano@imperial.ac.uk.

PMID: 30640131
DOI: 10.1016/j.envint.2018.11.069

Abstract

Objective: The present study investigates the relationship between night-time screen-based media devices (SBMD) use, which refers to use within 1 h before sleep, in both lit and dark rooms, and sleep outcomes and health-related quality of life (HRQoL) among 11 to 12-year-olds.

Methods: We analysed baseline data from a large cohort of 6616 adolescents from 39 schools in and around London, United Kingdom, participating in the Study of Cognition Adolescents and Mobile Phone (SCAMP). Adolescents self-reported their use of any SBMD (mobile phone, tablet, laptop, television etc.). Sleep variables were derived from self-reported weekday and/or weekend bedtime, sleep onset latency (SOL) and wake time. Sleep quality was assessed using four standardised dimensions from the Swiss Health Survey. HRQoL was estimated using the KIDSCREEN-10 questionnaire.

Results: Over two-thirds (71.5%) of adolescents reported using at least one SBMD at night-time, and about a third (32.2%) reported using mobile phones at night-time in darkness. Night-time mobile phone and television use was associated with higher odds of insufficient sleep duration on weekdays (Odds Ratio, OR = 1.82, 95% Confidence Interval, CI [1.59, 2.07] and OR = 1.40, 95% CI [1.23, 1.60], respectively). Adolescents who used mobile phones in a room with light were more likely to have insufficient sleep (OR = 1.32, 95% CI [1.10, 1.60]) and later sleep midpoint (OR = 1.64, 95% CI [1.37, 1.95]) on weekends compared to non-users. The magnitude of these associations was even stronger for those who used mobile phones in darkness for insufficient sleep duration on weekdays (OR = 2.13, 95% CI [1.79, 2.54]) and for later sleep midpoint on weekdays (OR = 3.88, 95% CI [3.25, 4.62]) compared to non-users. Night-time use of mobile phones was associated with lower HRQoL and use in a dark room was associated with even lower KIDSCREEN-10 score (β = -1.18, 95% CI [-1.85, -0.52]) compared to no use.

Conclusions: We found consistent associations between night-time SBMD use and poor sleep outcomes and worse HRQoL in adolescents. The magnitude of these associations was stronger when SBMD use occurred in a dark room versus a lit room.

Keywords: Children; Mobile phone; Quality of life; Screen-based media; Sleep; Television.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Cross-Sectional Studies
Female
Humans
London
Male
Odds Ratio
Quality of Life*
Screen Time*
Sleep*
Surveys and Questionnaires

Grants and funding

MR/L01341X/1/MRC_/Medical Research Council/United Kingdom