Original ArticleImpact of television on the quality of sleep in preschool children
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).
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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.
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.
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