Abstract
BackgroundNo study has comprehensively investigated the association between the usage of typical screen-based electronic media devices and sleep quality in a Chinese population with individuals in a wide range of ages.ObjectiveThis study aimed to understand the characteristics of television (TV) viewing, computer usage, and mobile phone usage in a representative Chinese population in Macau and to examine their roles in predicting the variations in sleep quality.MethodsThis cross-sectional study was an analysis of 1500 Macau residents aged 15 to 90 years based on a community-based health needs assessment study entitled, “Healthy Living, Longer Lives.” Data collection was conducted in 7 districts of Macau from 2017 to 2018 through face-to-face interviews. The durations of daily TV viewing, computer usage, and mobile phone usage were recorded in a self-administered questionnaire. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality.ResultsThe prevalence of TV, computer, and mobile phone usage was 78.4% (1176/1500), 51.6% (769/1490), and 85.5% (1276/1492), respectively. The average daily hours of usage were 1.75 (1.62), 1.53 (2.26), and 2.85 (2.47) hours, respectively. Females spent more time watching TV (P=.03) and using mobile phones (P=.02) and less time on the computer (P=.04) as compared to males. Older adults were more likely to watch TV while young people spent more time using the computer and mobile phones (P for all trends<.001). The mean PSQI global score was 4.79 (2.80) among the participants. Females exhibited significantly higher PSQI scores than males (5.04 vs 4.49, respectively; P<.001). No linear association was observed between the PSQI score and the amount of time spent on the 3 electronic devices (P=.58 for PSQI-TV, P=.05 for PSQI-computer, and P=.52 for PSQI-mobile phone). Curve estimation showed significant quadratic curvilinear associations in PSQI-TV (P=.003) and PSQI-computer (P<.001) among all the participants and in PSQI-mobile phone among youths (age, 15-24 years; P=.04). After adjustment of the gender, age, body mass index, demographics, and lifestyle factors, more than 3 hours of TV viewing and 4 hours of computer usage or mobile phone usage was associated with 85% (95% CI 1.04-1.87; P=.008), 72% (95% CI 1.01-2.92; P=.045), and 53% (95% CI 1.06-2.22; P=.03) greater odds of having poor sleep quality (PSQI score>5), respectively.ConclusionsThe mobile phone was the most popular screen-based electronic device used in the Macau population, especially among young people. “J” shape associations were observed between sleep quality and the duration of TV viewing, computer usage, and mobile phone usage, indicating that the extreme use of screen-based electronic devices predicted poorer sleep status, whereas moderate use would be acceptable.
Highlights
The use of screen-based electronic media devices such as computers, televisions (TVs), mobile phones, video games, and other screen-based products have become an integral part of our lives and has continued to increase sharply in the past decade [1,2]
“J” shape associations were observed between sleep quality and the duration of TV viewing, computer https://www.jmir.org/2020/7/e18095
Another typical finding was that, unlike most previous studies, we found a quadratic curvilinear association between sleep quality and electronic device usage time; this J-shape occurred among all the participants for TV viewing and computer usage and among the youths for mobile phone usage
Summary
The use of screen-based electronic media devices such as computers, televisions (TVs), mobile phones, video games, and other screen-based products have become an integral part of our lives and has continued to increase sharply in the past decade [1,2]. A recent systematic review showed that in over 90% of the studies, increased screen-based media consumption by children and adolescents (age, 5-17 years) was associated with a reduction in total sleep duration [3]. Regarding the Chinese population, a cross-sectional study on adolescents in Hong Kong showed that prolonged mobile phone use was significantly related to daytime sleepiness, decreased sleep duration, and poor sleep quality [7]. Similar sleep problems were reported among the residents of Macau, which is another special administrative region of China. No study has comprehensively investigated the association between the usage of typical screen-based electronic media devices and sleep quality in a Chinese population with individuals in a wide range of ages
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