Key Research

Associations Between Portable Screen-Based Media Device Access or Use and Sleep Outcomes: a Systematic Review and Meta-analysis

Key Takeaways:

  • This meta-analysis study shows strong and consistent evidence of an association between access to and/or use of devices and reduced sleep quantity, quality, and  increased daytime sleepiness.
  • Phone and tablets were the only devices considered in this study.
  • Sleep problem among youth is a major public health concern. Given the evolving technological landscape and the replacement of textbooks with media devices in schools, screen-based media device access and use are likely to rise. 
  • An integrated approach among teachers, health care professionals, and parents is needed to improve sleep hygiene.
  • Policy-led, population-wide health promotion is needed not to stigmatize individual children but guide all communities to promote the importance of sleep hygiene.


LiveMore ScreenLess’ Summary

Sleep disturbance in childhood is known to lead to adverse physical and mental health consequences, including poor eating habits, less physical lifestyles, reduced immunity, and mental health issues. In the United States, 75% of those 17 to 18 years old report insufficient sleep, similar to other developed countries. School times, caffeine, and electronic media use are all contributing factors.

The problems with phones are manifold: 72% of all children and 89% of adolescents have at least 1 device in their sleep environment, with most used near bedtime which displaces, delays, or interrupts sleep time; the content can be psychologically stimulating; and the light emitted from devices affects circadian timing. 

Bedtime device use was associated with an increase in the odds of inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness. Media device presence in the bedroom (even without use) was also associated with an increased odds of detrimental sleep outcomes.

Due to the fact that devices have been developed faster than the research can be done, this is the first study of its kind. The limitations of this research include measurement error of self-reported data; difficulty in ascertaining causality; and weaknesses inherent to observational study designs. 

Carter B, Rees P, Hale L, Bhattacharjee D, Paradkar MS. Association Between Portable Screen-Based Media Device Access or Use and Sleep Outcomes: A Systematic Review and Meta-analysis. JAMA Pediatr. 2016;170(12):1202–1208. 

Topics: Sleep

Year: 2016

Participants: analysis included randomized clinical trials, cohort studies, and cross-sectional study designs between 2011 – 2015. Inclusion criteria were studies of school-age children between 6 and 19 years.

Data Collection: 467 studies identified; meta-anaylsis