Association between screen time and sleep duration and the moderating effect of outdoor activity among preschoolers

doi:10.11852/zgetbjzz2021-1587

Abstract

Abstract: Objective To examine the association between electronic screen time and sleep duration among preschoolers in Guangzhou, and to explore the moderate effect of outdoor activity, in order to provide reference for facilitating sleep health of children.Methods Using a random cluster sampling method, a total of 166 preschoolers in 3 kindergartens in Guangzhou were selected into this study from October to December 2020. Data on electronic screen time, outdoor activities, and sleep duration of children were collected by parental questionnaire. General linear regression models were used to analyze the association of electronic screen time and outdoor activities with sleep duration, and the moderating test was used to explore the moderating effect of outdoor activity. Results Totally 138 preschoolers (83.1%) had a sleep duration less than 10 hours per night, and the daily screen time of 86 preschoolers (51.8%) was more than 1 hours. The mobile electronic screen time was prominently associated with sleep duration (β=-0.298,95%CI:-0.603 - -0.021), while the TV screen time has no relation with sleep duration (β＝-0.144, 95%CI :-0.382 - 0.089). The moderating test demonstrated a null moderating effect of outdoor activity on the association between screen time and sleep duration (P>0.05). Conclusion Exposure to mobile electronic screen is adversely associated with the sleep duration among preschoolers, and outdoor activitiesplay no moderating role on this association.

Key words: screen exposure, sleep duration, outdoor activities, preschoolers

摘要： 目的了解学龄前儿童屏幕暴露和睡眠情况,探讨二者的关系,为促进儿童睡眠健康提供参考。方法采用随机整群抽样方法,2020年10—12月选取广州市3所幼儿园的166名在园幼儿为研究对象,利用父母问卷调查学龄前儿童屏幕暴露时间、户外活动时间和睡眠时间等。采用线性回归模型分析学龄前儿童屏幕暴露时间与睡眠时间的关联性,并采用调节效应模型分析户外活动时间的调节作用。结果共调查学龄前儿童166例,其中有138例(83.1%)夜间睡眠持续时间不足10 h,86例(51.8%)每日总视屏时间≥1 h。多元线性回归模型分析显示学龄前儿童移动电子(手机/平板电脑)屏幕暴露时间与睡眠时间显著相关(β=-0.298,95%CI:-0.603~-0.021);而看电视时间与睡眠时间无显著关联(β＝-0.144, 95%CI :-0.382~0.089)。调节效应模型显示户外活动时间对不同类型屏幕暴露时间与睡眠时间的关系均无显著调节效应(P>0.05)。结论学龄前儿童屏幕暴露时间,尤其是移动电子视屏时间可能会影响其睡眠时间,增加户外活动时间可能并不降低屏幕暴露对睡眠时间的影响。

关键词: 屏幕暴露, 睡眠持续时间, 户外活动, 学龄前儿童

CLC Number:

R179

MA Ying, JIAO Ting, HUANG Ya-shen, SHU Guan-yu, SONG Yan-yan, JIANG Lin. Association between screen time and sleep duration and the moderating effect of outdoor activity among preschoolers[J]. Chinese Journal of Child Health Care, 2022, 30(6): 664-668.

马颖, 焦婷, 黄亚深, 舒冠瑜, 宋燕燕, 蒋琳. 学龄前儿童屏幕暴露对睡眠的影响及户外活动的调节作用[J]. 中国儿童保健杂志, 2022, 30(6): 664-668.

References

[1] Baird J, Hill CM, Harvey NC, et al. Duration of sleep at 3 years of age is associated with fat and fat-free mass at 4 years of age: the Southampton Women's Survey [J]. J Sleep Res, 2016, 25(4):412-418.
[2] Schlieber M, Han J. The role of sleep in young children's development: A review[J]. J Genet Psychol, 2021, 182(4):205-217.
[3] Rideout V, Saphir M, Pai S, et al. Zero to eight: Children's media use in America 2013.Common sense media[EB/OL]. https://www.commonsensemedia.org/research/zero-to-eight- childrens-media-use-inamerica-2013.
[4] Friel CP, Duran AT, Shechter A, er al. U.S. Children meeting physical activity, screen time, and sleep guidelines [J]. Am J Prev Med, 2020, 59(4):513-521.
[5] 滕晓雨,杜继鹏,蔡雅君,等.屏幕暴露对学龄前儿童睡眠时间和质量的影响[J].中国妇幼健康研究,2021,32(4):477-483.
[6] Janssen X, Martin A, Hughes AR, et al. Associations of screen time, sedentary time and physical activity with sleep in under 5s: A systematic review and meta-analysis [J]. Sleep Med Rev, 2020,49: 101226.
[7] National Sleep Foundation. Sleep in America poll: Children and sleep[EB/OL]. https://sleepfoundation.org/sleep-polls-data/sleep-in- america-poll/2004-children-and-sleep.
[8] 潘婉,江流,耿梦龙,等.学龄前儿童视屏时间及户外活动对情绪的影响[J].中华流行病学杂志,2019,40(12):1569-1572.
[9] Council on Communications and Media. Media and young minds[J]. Pediatrics, 2016, 138(5):e20162591.
[10] 柴晶鑫,曹远,于彤,等.新型冠状病毒肺炎疫情期间北京市3～6岁儿童视屏时间调查[J].首都公共卫生,2020,14(6):294-297.
[11] Zhao J, Zhang Y, Jiang F, et al. Excessive screen time and psychosocial well-being: The mediating role of body mass index, sleep duration, and parent-child interaction[J]. J Pediatr, 2018, 202: 157-162.e1.
[12] Lan QY, Chan KC, Yu KN, et al. Sleep duration in preschool children and impact of screen time[J]. Sleep Med, 2020,76: 48-54.
[13] Griffiths LJ, Dowda M, Dezateux C, et al. Associations between sport and screen-entertainment with mental health problems in 5-year-old children[J]. Int J Behav Nutr Phys Act, 2010,7: 30.
[14] Tomaz SA, Hinkley T, Jones RA, et al. Screen time and sleep of rural and urban south African preschool children[J]. Int J Environ Res Public Health, 2020, 17(15):5449.
[15] 马颖,邢艳菲,蒋琳,等.就寝时间和睡眠持续时间对广州市学龄前儿童情绪和行为的影响[J].医学与社会,2019,32(4):98-102.
[16] 王广海. 我国学龄前儿童睡眠问题:特点、影响因素及行为干预[D]. 上海:华东师范大学,2015.
[17] Komada Y, Abe T, Okajima I, et al. Short sleep duration and irregular bedtime are associated with increased behavioral problems among Japanese preschool-age children[J].Tohoku J Exp Med, 2011,224(2):127-136.
[18] Scharf RJ, Demmer RT, Silver EJ, et al. Nighttime sleep duration and externalizing behaviors of preschool children[J]. J Dev Behav Pediatr, 2013, 34:384-391.
[19] Hiltunen P, Leppánen MH, Ray C, Mááttá S, et al. Relationship between screen time and sleep among Finnish preschool children:Results from the DAGIS study[J]. Sleep Med, 2021, 77:75-81.
[20] Engberg E, Figueiredo RAO, Rounge TB, et al. Heavy screen users are the heaviest among 10,000 children[J]. Sci Rep, 2019, 9(1):11158.
[21] Cain N, Gradisar M. Electronic media use and sleep in school-aged children and adolescents: A review[J]. Sleep Med, 2010,11(8):735-742.
[22] Roser K, Schoeni A, Bürgi A, et al. Development of an RF-EMF exposure surrogate for epidemiologic research[J]. Int J Environ Res Public Health, 2015,12(5):5634-5356.
[23] Lustenberger C, Murbach M, Tüshaus L, et al. Inter-individual and intra-individual variation of the effects of pulsed RF EMF exposure on the human sleep EEG [J]. Bioelectromagnetics, 2015, 36(3):169-177.