Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
Department of Pediatric Cardiology and Pulmonology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago de Chile, Chile.
Sleep Med. 2018 May;45:7-10. doi: 10.1016/j.sleep.2017.10.013. Epub 2017 Dec 12.
Media use is increasingly becoming common in preschoolers and starting before the age of three years. While several studies have documented the effects of screen time on sleep duration in this age group, investigations including sleep quality are scarce and mainly cross-sectional. Moreover, they are limited by investigating sleep across broader age ranges or in older preschoolers, which may blur early effects and the ideal time for intervention.
The current study analyzed data from the Ulm SPATZ Health Study, a birth cohort study in which 1006 live newborns were recruited from the general population shortly after delivery at the University Medical Center Ulm, Southern Germany, from April 2012 to May 2013. Longitudinal data on child sleep were parent reported on the Children's Sleep Habits Questionnaire (CSHQ) at ages two and three years. Child media consumption was assessed at three years of age with different questions on electronic media and books. Statistical analyses included Kruskal-Wallis tests and multivariable linear and logistic regression models.
Electronic media consumption had a moderate prevalence and dose, and prevalence of never using books appeared to be high (39%). The preliminary results indicated strong statistically significant inverse cross-sectional associations between electronic media consumption and overall sleep quality and, using longitudinal data, with worsening indicators of bedtime resistance, sleep anxiety, and daytime sleepiness.
This was the first larger-scale study to comprehensively investigate the effects of electronic media consumption and book reading on all CSHQ items in three-year-olds. Considering the risk of chronification, preventive efforts (eg, by effective sleep-oriented training programs) already seem necessary in early life.
媒体的使用在学龄前儿童中越来越普遍，甚至在三岁之前就开始了。虽然有几项研究记录了屏幕时间对该年龄段儿童睡眠时间的影响，但包括睡眠质量在内的调查很少，且主要是横断面研究。此外，它们受到调查范围较广的年龄范围或年龄较大的学龄前儿童睡眠的限制，这可能会模糊早期影响和干预的理想时间。
本研究分析了乌尔姆 SPATZ 健康研究的数据，这是一项出生队列研究，在德国南部乌尔姆大学医学中心，从 2012 年 4 月到 2013 年 5 月，在新生儿出生后不久从一般人群中招募了 1006 名活产儿。在两岁和三岁时，家长通过儿童睡眠习惯问卷（CSHQ）报告了儿童睡眠的纵向数据。在三岁时，使用关于电子媒体和书籍的不同问题评估儿童媒体消费。统计分析包括 Kruskal-Wallis 检验和多变量线性和逻辑回归模型。
电子媒体消费有一个中等的流行率和剂量，而且似乎从未使用过书籍的比例很高（39%）。初步结果表明，电子媒体消费与整体睡眠质量之间存在强烈的、具有统计学意义的横断面负相关，并且使用纵向数据，与入睡抵抗、睡眠焦虑和日间困倦的指标恶化相关。
这是第一项大规模研究，全面调查了三岁儿童电子媒体消费和阅读对 CSHQ 所有项目的影响。考虑到慢性化的风险，在生命早期似乎已经需要进行预防努力（例如，通过有效的以睡眠为导向的培训计划）。
