Elsevier

Sleep Medicine

Volume 15, Issue 2, February 2014, Pages 240-247
Sleep Medicine

Original Article
Associations between specific technologies and adolescent sleep quantity, sleep quality, and parasomnias

https://doi.org/10.1016/j.sleep.2013.08.799Get rights and content

Abstract

Objective

We tested the hypothesis that weekday bedtime use of six technologies would be significantly associated with eight sleep parameters studied relating to sleep quantity, sleep quality, and parasomnias.

Methods

In our cross-sectional study, we previously administered validated age-appropriate questionnaires (School Sleep Habits Survey, Technology Use Questionnaire). Participating adolescents (n = 738; 54.5% boys) were aged 11–13 years and were from the Midlands region of the United Kingdom in 2010.

Results

Frequent use of all technology types was significantly inversely associated with weekday sleep duration (hours). Frequent music listeners and video gamers had significantly prolonged sleep onset (β = 7.03 [standard error {SE}, 2.66]; P < .01 and β = 6.17 [SE, 2.42]; P < .05, respectively). Frequent early awakening was significantly associated with frequent use of all technology types. The greatest effect was observed in frequent television viewers (odds ratio [OR], 4.05 [95% confidence interval {CI}, 2.06–7.98]). Difficulty falling asleep was significantly associated with frequent mobile telephone use, video gaming, and social networking, with music listeners demonstrating the greatest effect (OR, 2.85 [95%CI, 1.58–5.13]). Music listeners were at increased risk for frequent nightmares (OR, 2.02 [95%CI, 1.22–3.45]). Frequent use of all technologies except for music and mobile telephones was significantly associated with greater cognitive difficulty in shutting off. Frequent television viewers were almost four times more likely to report higher sleepwalking frequency (OR, 3.70 [95% CI, 1.89–7.27]).

Conclusions

Frequent weekday technology use at bedtime was associated with significant adverse effects on multiple sleep parameters. If confirmed in other samples and longitudinally, improving sleep hygiene through better management of technology could enhance the health and well-being of adolescent populations.

Introduction

The impact of sleep duration and sleep difficulties on health and performance is increasingly recognized [1], [2]. Adolescence is associated with circadian phase alterations, which conflicts with social demands; thus this important developmental period is commonly accompanied by sleep deprivation [3]. Sleep problems also are frequently reported in adolescence and can be categorized into insomnia (difficulties initiating and maintaining sleep) [4], daytime sleepiness [5], parasomnias (sleep terrors, sleepwalking, bruxism, and nightmares) [6], and movement disorders (e.g., restless legs syndrome) [7].

Ownership and use of multiple technology devices is increasing and is prevalent in the adolescent population [8]. Calamaro et al. [9] showed that children ages 6–10 years with three technology types in their bedroom achieved 45 min less sleep than those without. Although there are multiple benefits from modern technology, its use may promote and exacerbate adolescent sleep deprivation. Television viewing [10], video gaming [11], computer use [11], and mobile telephone use [12] have been associated with reduced sleep duration or sleep disturbance. However, little is known about the effects of social networking on sleep, especially in young adolescents who commonly engage in this form of electronic communication with peers. Shorter sleep duration, also associated with daytime sleepiness, has been linked with negative consequences for health and performance such as obesity [13] and lower school grades [2], [14].

The impact of technology use on sleep parameters aside from sleep duration, including sleep-onset latency (SOL), sleep difficulties, nighttime awakenings, and parasomnias also may be important. Munezawa et al. [6] demonstrated that mobile telephone use after lights out was significantly associated with sleep disturbances, including short sleep duration, reduced sleep quality, excessive daytime sleepiness, as well as symptoms of insomnia in a large sample of Japanese adolescents aged 13–18 years. King et al. [15] experimentally showed a decrease in objective sleep efficiency, total sleep time, and rapid eye movement sleep along with an increased subjective SOL in adolescents (mean age, 16 years). To date, no studies have examined the impact of specific technologies on multiple sleep parameters in a young adolescent sample. Therefore, we sought to examine these relationships in a large early adolescent cohort.

Section snippets

Study population

Seven schools were randomly selected and recruited into the Midlands Adolescents Schools Sleep Education Study. Parents of registered students were mailed a letter regarding study participation. Student participants were included if they (1) provided parental consent, (2) provided personal written consent, (3) were not previously diagnosed with a sleep disorder, (4) were not taking sleep medication, or (5) had not traveled to a different time zone 4 weeks prior to data collection. A total of

Results

Of the 959 student volunteers who provided data, 738 (77%) had complete information on all variables of interest. There was a negative correlation between the quantity of bedroom technology and sleep duration (r = 0.15; P < .001). No relationships were observed for quantity of bedroom technology with any other sleep parameters. Although those with an evening circadian preference (n = 459) had a slightly longer mean SOL (28 min) compared to those with a morning circadian preference (26 min), this

Sleep quantity

Although our findings have shown a significant reduction in weekday sleep duration for bedtime use of all technologies assessed, the greatest impact was observed with frequent users of social networking sites who reported almost 1-h less sleep. These findings are consistent with a recent study reporting that 37% of 268 young adolescents lost sleep on ⩾1 occasion due to social networking [19]. Our data also show that computer use for studying had a negative impact on weekday sleep duration,

Conclusions

Engaging in weekday bedtime technology use may adversely effect the sleep of adolescents. Frequent bedtime technology use of any of the devices we investigated was associated with reduced sleep duration. Frequency of use rather than quantity of bedroom technology appears to be more harmful in this age group. Adolescents who listen to music at bedtime may be at greater risk for sleep problems. The link between parasomnias and bedtime technology use provides novel evidence. Future studies should

Funding sources

This study was funded by the Children’s Charity, Action Medical Research.

Conflict of interest

The ICMJE Uniform Disclosure Form for Potential Conflicts of Interest associated with this article can be viewed by clicking on the following link: http://dx.doi.org/10.1016/j.sleep.2013.08.799.

. ICMJE Form for Disclosure of Potential Conflicts of Interest form.

Acknowledgments

This study was funded by the Children’s Charity, Action Medical Research. Dr. Taheri received funding from the National Institute for Health Research (NIHR) through the Collaborations for Leadership in Applied Health Research and Care for Birmingham and Black Country (CLAHRC-BBC) program. The views expressed in this publication are not necessarily those of the NIHR, the Department of Health, NHS Partner Trusts, Weill Cornell Medical College, University of Birmingham or the CLAHRC-BBC Theme 8

References (46)

  • N. Cain et al.

    Electronic media use and sleep in school-aged children and adolescents: a review

    Sleep Med

    (2010)
  • T. Arora et al.

    The complexity of obesity in UK adolescents: relationships with quantity and type of technology, sleep duration and quality, academic performance and aspiration

    Pediatr Obes

    (2013)
  • M.A. Carskadon et al.

    Regulation of adolescent sleep: implications for behavior

    Ann NY Acad Sci

    (2004)
  • M. Hysing et al.

    Sleep patterns and insomnia among adolescents: a population-based study

    J Sleep Res

    (2013)
  • F. Pizza et al.

    Sleep quality and motor vehicle crashes in adolescents

    J Clin Sleep Med

    (2010)
  • National Sleep Foundation. Annual sleep in america poll exploring connections with communications technology use and...
  • F.B. Ortega et al.

    Sleep patterns in Spanish adolescents: associations with TV watching and leisure-time physical activity

    Eur J Appl Physiol

    (2010)
  • T. Munezawa et al.

    The association between use of mobile phones after lights out and sleep disturbances among Japanese adolescents: a nationwide cross-sectional survey

    Sleep

    (2011)
  • F.P. Cappuccio et al.

    Meta-analysis of short sleep duration and obesity in children and adults

    Sleep

    (2008)
  • D.L. King et al.

    The impact of prolonged violent video-gaming on adolescent sleep: an experimental study

    J Sleep Res

    (2013)
  • C. Piovesan et al.

    Can type of school be used as an alternative indicator of socioeconomic status in dental caries studies? a cross-sectional study

    BMC Med Res Methodol

    (2011)
  • A.R. Wolfson et al.

    Evidence for the validity of a sleep habits survey for adolescents

    Sleep

    (2003)
  • T. Arora et al.

    Exploring the complex pathways among specific types of technology, self-reported sleep duration and body mass index in UK adolescents

    Int J Obes (Lond)

    (2013)
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