ArticleNature and science of sleep2025
Excessive Screen Time Associated with Emotional and Behavioral Problems Mediated by Sleep Disturbance Among Young Children.
Article in Nature and science of sleep, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: We examined whether excessive screen time (ST) is associated with emotional and behavioral problems (EBPs) in young school children mediated by sleep disturbance. Methods: This was a cross-sectional survey of 3883 children aged 7-9 years at 18 primary schools in Shenzhen. Data on children's ST on weekdays and weekends as well as household environment, parental ST, and parental accompaniment time were collected. Sleep disturbance and EBPs were assessed with the Sleep Disturbance Scale for Children and the Strengths and Difficulties Questionnaire (SDQ), respectively. Odds ratios (ORs) and 95% confidence intervals (CIs), the average causal mediation effects and the average direct effects were estimated. Results: Overall, 15.7% of children had ST in excess of the recommended 2 hr/day, and 24.1% of parents reported that their child had a sleep disturbance. The total SDQ score was higher for children with than without ST ≥ 2 hr/day and sleep disturbance (P<0.001). After adjustment for potential confounders, children with ST ≥ 2 hours/day had increased odds of sleep disturbances (OR 1.99, 95% CI 1.65-2.33). The odds of EBPs were increased for children with ST ≥ 2 hr/day (OR 1.34, 95% CI 1.11-1.64) and sleep disturbance (OR 2.77, 95% CI 2.23-3.22). Mediation analysis indicated that sleep disturbance partially explained the association between ST and EBPs (all effects statistically significant, P < 0.001). Conclusion: Excessive ST was significantly associated with EBPs and may be mediated by sleep disturbance. Reducing children's ST and encouraging good sleep practices may enhance mental health.
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