Elsevier

Sleep Medicine

Volume 20, April 2016, Pages 140-144
Sleep Medicine

Original Article
Impact of television on the quality of sleep in preschool children

https://doi.org/10.1016/j.sleep.2015.06.005Get rights and content

Highlights

  • A television (TV) set in the child's bedroom reduces sleep quality.

  • Exposure to more hours of TV was associated with a reduction in sleep quality.

  • Sleep terrors, nightmares, and sleep talking were affected by the TV exposure.

  • Evening TV viewers had significantly more sleep problems.

Abstract

Objectives

We aimed to investigate the impact of different habits concerning television (TV) use and the time of day in which TV is watched on the sleep quality of young children.

Methods

Parents of 100 healthy children (58% boys, mean age of 2.7 ± 1.5 years) attending a routine health check completed the Sleep Disturbance Scale for Children (SDSC) and a questionnaire concerning TV and electronic media use. Children were divided into those with a normal (SDSC−) or abnormal (SDSC+) questionnaire score. TV viewing habits were compared between groups.

Results

The total sleep time and total TV viewing time were not different between groups. A TV set was inside each child's bedroom in 51% of participants. Children with a TV in their bedroom showed significantly higher scores in the “sleep terrors,” “nightmares,” “sleep talking,” and “tired when waking up” responses of the SDSC (P = 0.02, 0.01, 0.01, and 0.01, respectively). Children with a TV in their room had an odds ratio (95% confidence interval) of 3.29 (1.08–9.99) for having an abnormal SDSC. Evening TV viewers had significantly higher SDSC scores compared with those who watched TV earlier during the day (P = 0.04).

Conclusions

The presence of a TV set in the child's bedroom was associated with significant reductions in the quality of young children's sleep. Evening exposure to TV was associated with significantly worse sleep quality.

Introduction

Television (TV), computers, smartphones, tablets, video game consoles, and other electronic media devices have become increasingly available for children and adolescents. Children and adolescents have also increased their exposure to media, raising the number of hours per day watching TV [1], surfing on the Internet, or playing video games [2]. In recent surveys, almost 100% of all adolescents in the US had at least one electronic device in their bedroom: 57% had a TV set, 28% a computer, 90% music players, and 64% cell phones [2], [3]. Electronic devices have become more lightweight and portable; children can take a small tablet or smartphone everywhere with them, even to bed before going to sleep or during the night. Parental control seems to be far more difficult considering the omnipresence and small size of electronic devices [4].

The extent to which this sharp increase in the use of electronic media and TV may affect children's sleep has been demonstrated by several studies in older children and adolescents [5], [6], [7]. The use of multiple electronic devices and TV may even worsen the effect on the quality of sleep [8]. Furthermore, screen time has been associated with a decrease in the total hours of sleep time [9], [10].

There are several possible mechanisms for linking sleep disruption to the use of TV. The most evident cause is the displacement of sleep initiation due to more and later use of TV viewing [2]. However, the exposure to the light emitted from TV screens or from other electronic devices may affect the natural circadian rhythm in children [2], [11], [12].

In toddlers and preschool children, TV viewing seems to be more consistently associated with emotional and peer relation problems than an e-game or computer use [13], [14]. Despite findings that these young children are apparently spending even more time viewing TV than older children, there have been fewer studies on the impact of media use on sleep for this age group [4].

Considering that early childhood is a phase of progressive neuronal myelination and maturation of their cerebral cortex, the impact of TV on the quality of sleep is especially a concern. As sleep disorders have significant effects on the neurocognitive development of young children [15], the exposure to factors that may affect the normal circadian rhythm or sleep quality is of concern. Despite previously published evidence on the negative effects of TV and electronic media on the sleep quality of schoolchildren [16] and adolescents [2], [17], there is still a lack of information on younger preschool children. In the present study, we aimed to investigate the impact of different habits concerning TV use and the time of the day when it is watched on sleep quality specifically in young children (ie, toddlers and preschoolers).

Section snippets

Subjects

Sampling consisted of healthy children aged 1–6 years who attended a health supervision check in the pediatric outpatient clinic of the Pontificia Universidad Católica de Chile in Santiago, Chile. Subjects were recruited from January 2013 to January 2014. The Chilean health supervision system is designed to provide routine health checks to all children on a regular schedule, that is, every month until the 6th month, then every two months until the first year, and subsequently every 3–4 months.

Results

Of n = 110 initially recruited children, n = 6 had to be excluded from the study as they were using medication. Four of the completed questionnaires had to be excluded as they were not complete, leaving n = 100 finally included subjects. All included children were from Hispanic origin.

Table 1 reports details on demographic characteristics of the study sample. Most questionnaires were answered by children's mothers (76%), only a few by their fathers (3%), with those completed by both parents

Discussion

The present study showed that the presence of a TV set inside the child's bedroom and the exposure to more hours of TV were associated with a significant reduction in young children's sleep quality. Sleep terrors, nightmares, sleep talking, and tiredness when waking up were all issues significantly affected by the exposure to TV. Interestingly, the evening exposure to TV showed a significant worsening of sleep quality; evening TV viewers had significantly more sleep problems.

These findings are

Conclusions

The present study identified that having a TV set in the bedroom in particular seems to affect several sleep-quality domains. Young preschool children's exposure to TV and electronic media is associated with poor quality of sleep. The significant effect of evening TV viewing on sleep quality may be related to a circadian rhythm impact produced by this exposure.

Conflict of interest

The authors declare no 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.2015.06.005.

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

Acknowledgements

We would like to thank all the children and their parents who participated in the study. Furthermore, we thank FONDECYT project 11130573 for supporting the conduction of this study and analysis of data. We thank Mr. Richard Dewhirst and Mr. Alfred Brockmann for helping with the edition of this manuscript.

References (34)

  • T. Nuutinen et al.

    Do computer use, TV viewing, and the presence of the media in the bedroom predict school-aged children's sleep habits in a longitudinal study?

    BMC Public Health

    (2013)
  • T. Nuutinen et al.

    Computer use, sleep duration and health symptoms: a cross-sectional study of 15-year olds in three countries

    Int J Public Health

    (2014)
  • J. Owens

    Insufficient sleep in adolescents and young adults: an update on causes and consequences

    Pediatrics

    (2014)
  • C.A. Magee et al.

    Bidirectional relationships between sleep duration and screen time in early childhood

    JAMA Pediatr

    (2014)
  • M. Marinelli et al.

    Hours of television viewing and sleep duration in children: a multicenter birth cohort study

    JAMA Pediatr

    (2014)
  • S. Higuchi et al.

    Effects of VDT tasks with a bright display at night on melatonin, core temperature, heart rate, and sleepiness

    J Appl Physiol

    (2003)
  • S. Higuchi et al.

    Effects of playing a computer game using a bright display on presleep physiological variables, sleep latency, slow wave sleep and REM sleep

    J Sleep Res

    (2005)
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