Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Fund for Scientific Research Flanders (FWO), Brussels, Belgium.
Int J Public Health. 2019 May;64(4):487-498. doi: 10.1007/s00038-018-1188-1. Epub 2018 Dec 10.
We examined changes in sleep-onset difficulties over time and associations with physical activity and screen time behavior among adolescents.
We used data from last four survey waves of the Health Behavior in School-Aged Children (HBSC) study (2002-2006-2010-2014). Multilevel logistic regression analyses were conducted to explore associations between regular sleeping difficulties, excessive screen time exposure and being insufficiently physically active (i.e., < 60 min daily) among 33 European and non-European countries.
Findings indicate an increase in the prevalence of sleep-onset difficulties and in excessive screen time exposure and a small but significant increase in physical activity levels. Additionally, adolescents exceeding 2-h daily screen time had 20% higher odds of reporting sleep-onset difficulties, while no association was found for physical activity. The strength of the association between screen time and sleep-onset difficulties increased over time, which may reflect a change in type of screen time use (e.g., the increased use of easy accessible screens such as smartphones and tablets).
Effective strategies to reduce screen time are key to reverse the detrimental trend in sleep-onset difficulties among adolescents.
我们考察了青少年入睡困难随时间的变化情况，并分析了其与身体活动和屏幕时间行为的关联。
我们使用了来自青少年健康行为纵向研究（HBSC）的四个连续调查波次的数据（2002-2006-2010-2014）。采用多水平逻辑回归分析方法，探究了在 33 个欧洲和非欧洲国家中，经常出现入睡困难、过度暴露于屏幕时间以及身体活动不足（即每日<60 分钟）与入睡困难之间的关联。
研究结果表明，入睡困难的发生率、过度暴露于屏幕时间以及身体活动水平均呈上升趋势，尽管后者的增幅较小但具有统计学意义。此外，每日屏幕时间超过 2 小时的青少年出现入睡困难的可能性要高出 20%，而身体活动与入睡困难之间则不存在关联。屏幕时间与入睡困难之间的关联强度随时间推移而增强，这可能反映出屏幕使用类型发生了变化（例如，智能手机和平板电脑等易于获取的屏幕的使用日益增多）。
有效减少屏幕时间的策略是扭转青少年入睡困难这一不良趋势的关键。
