Response to Stellman SD. Book review of Concepts of Epidemiology

Abstract

Excessive screen time in child and adolescent populations is associated with short sleep duration, but the unique effects of portable vs. non-portable electronic devices has received little attention. Moreover, it is unknown whether the effects of these devices change across childhood. To address these gaps, the current study compared the association of portable vs. non-portable electronic devices with sleep duration throughout childhood.Data were from a 2016 national survey of the caregivers of 43,755 children and adolescents ages 0–17 administered by the U.S. Census Bureau.Children and adolescents who spent more time on screens slept fewer hours and were more likely to get insufficient sleep. In multivariate regressions including time spent on TV and video game consoles and portable electronic devices, associations with sleep duration were primarily due to portable electronic devices. These results remained when demographic variables, diagnoses of anxiety or depression, physical activity, and BMI were included in the model. Moreover, time spent using both portable and non-portable devices was important for sleep duration in children under age 10, but the importance of non-portable devices diminished in children over 10.Spending multiple hours a day on electronic devices is associated with shorter sleep duration across all ages. However, portable electronic devices have a stronger association with sleep duration than non-portable electronic screens, with non-portable devices less relevant for sleep duration in children over age 10. The findings suggest that future interventions should uniquely target portable electronic devices while also accounting for the age group of children targeted.