Association between screen time exposure, anxiety, and sleep quality in adolescents
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Abstract
Objective. To analyze the association between sedentary screen time and sleep quality, regardless of the symptoms of anxiety in adolescents of both genders.
Method. Cross-sectional study integrating school-based epidemiological research with a representative sample (n = 666) of high school students (14 to 19 years old) in public schools in the municipality of Caruaru-PE. The translated versions into Portuguese of the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale (HAD) were applied to analyze sleep quality and anxiety, respectively. Binary logistic regression was used to analyze the association, considering sleep quality as an outcome.
Results. There was a positive, statistically significant (p < .001) correlation between sleep quality and symptoms of anxiety (r = .393). A significant association regarding the association between screen time and sleep quality was noted only in those adolescents classified as being possible or probable anxiety cases and only in exposure to the computer (OR = 2.337; 95% CI [1.01, 5.43]) and video games (OR = 8.083; 95% CI [2.0, 32.8]) after adjusting for gender, age, and school shift.
Discussion and conclusion. Increased interaction with the screen and higher levels of anxiety can be more harmful to sleep in adolescents. Exposure to screen time, specifically those which have a greater interaction such as video games and computers, can have a negative impact on sleep quality, but only in adolescents with a higher risk of anxiety.
References
Altintas, E., Karaca, Y., Hullaert, T., & Tassi, P. (2019). Sleep quality and video game playing: Effect of intensity of video game playing and mental health. Psychiatry Research, 273, 487-492. doi: 10.1016/j.psychres.2019.01.030
Aros, L. J. L., Germano-Soares, A. H., Silva, C. R. de M., Silva, A. O. da, & Tassitano, R. M. (2017). Trends in television and computer/videogame use and total screen time in high school students from Caruaru city, Pernambuco, Brazil: A repeated panel study between 2007 and 2012. Motriz: Revista de Educação Física, 23(spe2), 1-8. doi: 10.1590/s1980-6574201700si0093
Batista, G. de A., Silva, T. N. da, Oliveira, M. R. de, Diniz, P. R. B., Lopes, S. S., & Oliveira, L. M. F. T. de. (2018). Associação entre a percepção da qualidade do sono e a assimilação do conteúdo abordado em sala de aula. Rev Paul Pediatr, 36(3), 315 321. doi: 10.1590/1984-0462/;2018;36;3;00008
Bauman, A. E., Sallis, J. F., Dzewaltowski, D. A., & Owen, N. (2002). Toward a better understanding of the influences on physical activity. American Journal of Preventive Medicine, 23(2), 5-14. doi: 10.1016/S0749-3797(02)00469-5
Bertolazi, A. N., Fagondes, S. C., Hoff, L. S., Dartora, E. G., da Silva Miozzo, I. C., de Barba, M. E. F., & Menna Barreto, S. S. (2011). Validation of the Brazilian Portuguese version of the Pittsburgh Sleep Quality Index. Sleep Medicine, 12(1), 70-75. doi: 10.1016/j.sleep.2010.04.020
Bjelland, I., Dahl, A. A., Haug, T., & Neckelmann, D. (2002). The validity of the hospital anxiety and depression scale: an updated literature review. J Psychosom Res, 52(2), 69-77. doi: 10.1016/S0022-3999(01)00296-3
Brand, S., Kirov, R., Kalak, N., Gerber, M., Schmidt, N. B., Lemola, S., … Holsboer-Trachsler, E. (2016). Poor Sleep Is Related to Lower Emotional Competence Among Adolescents. Behavioral Sleep Medicine, 14(6), 602-614. doi: 10.1080/15402002.2015.1048450
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193-213. doi: 10.1016/0165-1781(89)90047-4
Cajochen, C., Frey, S., Anders, D., Späti, J., Bues, M., Pross, A., … Stefani, O. (2011). Evening exposure to a light-emitting diodes (LED)-backlit computer screen affects circadian physiology and cognitive performance. Journal of Applied Physiology, 110(5), 1432-1438. doi: 10.1152/japplphysiol.00165.2011
Cao, H., Qian, Q., Weng, T., Yuan, C., Sun, Y., Wang, H., & Tao, F. (2011). Screen time, physical activity and mental health among urban adolescents in China. Preventive Medicine, 53(4-5), 316-320. doi: 10.1016/j.ypmed.2011.09.002
Chellappa, S. L., & Araujo, J. F. (2007). Qualidade subjetiva do sono em pacientes com transtorno depressivo. Estudos de Psicologia (Natal), 12(3), 269-274. doi: 10.1590/S1413-294X2007000300009
Council on Communications and Media. (2013). Children, Adolescents, and the Media. Pediatrics, 132(5), 958-961. doi: 10.1542/peds.2013-2656
Dworak, M., Schierl, T., Bruns, T., & Struder, H. K. (2007). Impact of Singular Excessive Computer Game and Television Exposure on Sleep Patterns and Memory Performance of School-aged Children. Pediatrics, 120(5), 978-985. doi: 10.1542/peds.2007-0476
Eggermont, S., & Bulck, J. (2006). Nodding off or switching off? The use of popular media as a sleep aid in secondary‐school children. Journal of Paediatrics and Child Health, 42(7‐8), 428-433. doi: 10.1111/j.1440-1754.2006.00892.x
Espinoza, G., & Juvonen., J. (2011). The pervasiveness, connectedness, and intrusiveness of social network site use among young adolescents. Cyberpsychology, Behavior, and Social Networking, 14(12), 705-709. doi: 10.1089/cyber.2010.0492
Fabbri, M., Beracci, A., Martoni, M., Meneo, D., Tonetti, L., & Natale, V. (2021). Measuring Subjective Sleep Quality: A Review. International Journal of Environmental Research and Public Health, 18(3), 1082. doi: 10.3390/ijerph18031082
Faro, A., Araújo, L. F. de, Maciel, S. C., Lima, T. J. S. de, & Souza, L. E. C. de. (2021). Structure and invariance of the Hospital Anxiety Depression Scale (HADS) in adolescents. Ciencias Psicológicas, 15(2), 1-14. doi: 10.22235/cp.v15i2.2069
Ghrouz, A. K., Noohu, M. M., Dilshad Manzar, M., Warren Spence, D., BaHammam, A. S., & Pandi-Perumal, S. R. (2019). Physical activity and sleep quality in relation to mental health among college students. Sleep and Breathing, 23(2), 627-634. doi: 10.1007/s11325-019-01780-z
Gomes, G. C., Passos, M. H. P. dos, Silva, H. A., Oliveira, V. M. A. de, Novaes, W. A., Pitangui, A. C. R., & Araújo, R. C. de. (2017). Qualidade de sono e sua associação com sintomas psicológicos em atletas adolescentes. Revista Paulista de Pediatria, 35(3), 316-321. doi: 10.1590/1984-0462/;2017;35;3;00009
Gordon-Larsen, P., Nelson, M. C., & Popkin, B. M. (2004). Longitudinal physical activity and sedentary behavior trends: Adolescence to adulthood. American Journal of Preventive Medicine, 27(4), 277-283. doi: 10.1016/j.amepre.2004.07.006
Guerra, P. H., Farias Júnior, J. C. de, & Florindo, A. A. (2016). Comportamento sedentárioemcrianças e adolescentes brasileiros: revisão sistemática. Revista de Saúde Pública, 50(9), 1-15. doi: 10.1590/S1518-8787.2016050006307
Guerrero, M. D., Barnes, J. D., Chaput, J.-P., & Tremblay, M. S. (2019). Screen time and problem behaviors in children : exploring the mediating role of sleep duration. International Journal of Behavioral Nutrition and Physical Activity, 16(105), 1-10. doi: 10.1186/s12966-019-0862-x
Instituto Brasileiro de Geografia e Estatística. (2013). Pesquisa Nacional por Amostra de Domicílios: Síntese de Indicadores. Retrieved from IBGE website: https://ww2.ibge.gov.br/home/estatistica/populacao/trabalhoerendimento/pnad2013/ on March 6, 2020.
Koepp, M. J., Gunn, R. N., Lawrence, A. D., Cunningham, V. J., Dagher, A., Jones, T., … Grasby, P. M. (1998). Evidence for striatal dopamine release during a video game. Nature, 393(6682), 266-268. doi: 10.1038/30498
Komada, Y., Aoki, K., Gohshi, S., Ichioka, H., & Shibata, S. (2015). Effects of television luminance and wavelength at habitual bedtime on melatonin and cortisol secretion in humans. Sleep and Biological Rhythms, 13(4), 316-322. doi: 10.1111/sbr.12121
Lopes, A. P., & Rezende, M. M. (2013). Anxiety and the use of psychoactive substances among adolescents. Estudos de Psicologia (Campinas), 30(1), 49-56. doi: 10.1590/S0103-166X2013000100006
Maras, D., Flament, M. F., Murray, M., Buchholz, A., Henderson, K. A., Obeid, N., & Goldfield, G. S. (2015). Screen time is associated with depression and anxiety in Canadian youth. Preventive Medicine, 73, 133-138. doi: 10.1016/j.ypmed.2015.01.029
Moge, C. E., & Romano, D. M. (2020). Contextualising video game engagement and addiction in mental health: the mediating roles of coping and social support. Heliyon, 6(11), e05340. doi: 10.1016/j.heliyon.2020.e05340
Neto, J. M. de S., Costa, F. F. da, Barbosa, A. O., Filho, A. P., Santos, E. V. O. dos, & Júnior, J. C. de F. (2021). Physical activity, screen time, nutritional status and sleep in adolescents in Northeast Brazil. Revista Paulista de Pediatria, 39, e2019138. doi: 10.1590/1984-0462/2021/39/2019138
Passos, M. H. P., Silva, H. A., Pitangui, A. C. R., Oliveira, V. M. A., Lima, A. S., & Araújo, R. C. (2017). Reliability and validity of the Brazilian version of the Pittsburgh Sleep Quality Index in adolescents. Jornal de Pediatria, 93(2), 200-206. doi: 10.1016/j.jped.2016.06.006
Peracchia, S., & Curcio, G. (2018). Exposure to video games: effects on sleep and on post-sleep cognitive abilities. A sistematic review of experimental evidences. Sleep Sci, 11(4), 302-314. doi: 10.5935/1984-0063.20180046
Schaan, C. W., Cureau, F. V, Sbaraini, M., Sparrenberger, K., Kohl, H. W., & Schaan, B. D. (2019). Prevalence of excessive screen time and TV viewing among Brazilian adolescents: a systematic review and meta-analysis. Jornal de Pediatria, 95(2), 155-165. doi: 10.1016/j.jpedp.2018.06.016
Schlarb, A., Friedrich, A., & Claßen, M. (2017). Sleep problems in university students – an intervention. Neuropsychiatric Disease and Treatment, 13, 1989-2001. doi: 10.2147/NDT.S142067
Silva, A. O. da, Oliveira, L. M. F. T. de, Santos, M. A. M. dos, & Tassitano, R. M. (2017). Tempodetela, percepdaqualidadedesonoeepisdeparassoniaemadolescentes. Revista Brasileira de Medicina Do Esporte, 23(5), 375-379. doi: 10.1590/1517-869220172305163582
Silva, A. O. da, Soares, A. H. G., Silva, B. R. V. S., & Tassitano, R. M. (2016). Prevalência do tempo de tela como indicador do comportamento sedentário em adolescentes brasileiros: uma revisão sistemática. Motricidade, 12(2), 155-164.
Silva, K. S., da Silva Lopes, A., Dumith, S. C., Garcia, L. M. T., Bezerra, J., & Nahas, M. V. (2014). Changes in television viewing and computers/videogames use among high school students in Southern Brazil between 2001 and 2011. International Journal of Public Health, 59(1), 77-86. doi: 10.1007/s00038-013-0464-3
Teychenne, M., & Hinkley, T. (2016). Associations between Screen-Based Sedentary Behaviour and Anxiety Symptoms in Mothers with Young Children. PLoS One, 11(5), e0155696. doi: 10.1371/journal.pone.0155696
Thomas, G., Bennie, J. A., De Cocker, K., Castro, O., & Biddle, S. J. H. (2020). A Descriptive Epidemiology of Screen-Based Devices by Children and Adolescents: a Scoping Review of 130 Surveillance Studies Since 2000. Child Indicators Research, 13(3), 935-950. doi: 10.1007/s12187-019-09663-1
Thomée, S., Dellve, L., Härenstam, A., & Hagberg, M. (2010). Perceived connections between information and communication technology use and mental symptoms among young adults-a qualitative study. BMC Public Health, 10(1), 66. doi: 10.1186/1471-2458-10-66
Tremblay, M. S., LeBlanc, A. G., Kho, M. E., Saunders, T. J., Larouche, R., Colley, R. C., … Gorber, S. C. (2011). Systematic review of sedentary behaviour and health indicators in school-aged children and youth. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 98. doi: 10.1186/1479-5868-8-98
Uhde, T. W., Cortese, B. M., & Vedeniapin, A. (2009). Anxiety and sleep problems: Emerging concepts and theoretical treatment implications. Current Psychiatry Reports, 11(4), 269-276. doi: 10.1007/s11920-009-0039-4
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2008). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Journal of Clinical Epidemiology, 61(4), 344-349. doi: 10.1016/j.jclinepi.2007.11.008
Wahl, S., Engelhardt, M., Schaupp, P., Lappe, C., & Ivanov, I. V. (2019). The inner clock—Blue light sets the human rhythm. Journal of Biophotonics, 12(12), 1-14. doi: 10.1002/jbio.201900102
White, D., Leach, C., Sims, R., Atkinson, M., & Cottrell, D. (1999). Validation of the Hospital Anxiety and Depression Scale for use with adolescents. British Journal of Psychiatry, 175(5), 452-454. doi: 10.1192/bjp.175.5.452
Woods, H. C., & Scott, H. (2016). #Sleepyteens : Social media use in adolescence is associated with poor sleep quality, anxiety, depression and low. Journal of Adolescence, 51, 41-49. doi: 10.1016/j.adolescence.2016.05.008
Wu, X. Y., Han, L. H., Zhang, J. H., Luo, S., Hu, J. W., & Sun, K. (2017). The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: A systematic review. PloS One, 12(11), e0187668. doi: 10.1371/journal.pone.0187668
Yoshimura, M., Kitazawa, M., Maeda, Y., Mimura, M., Tsubota, K., & Kishimoto, T. (2017). Smartphone viewing distance and sleep: an experimental study utilizing motion capture technology. Nature and Science of Sleep, 9, 59-65. doi: 10.2147/NSS.S123319
Zink, J., Belcher, B. R., Kechter, A., Stone, M. D., & Leventhal, A. M. (2019). Reciprocal associations between screen time and emotional disorder symptoms during adolescence. Preventive Medicine Reports, 13, 281-288. doi: 10.1016/j.pmedr.2019.01.014
