MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK; National Institute for Health Research Health Protection Research Unit in Health Impact of Environmental Hazards at King's College London, a Partnership with Public Health England, and collaboration with Imperial College London, W2 1PG, UK; School of Psychology, University of Lincoln, LN6 7TS, UK.
MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK; Department of Health Sciences, University of York, YO10 5DD, UK.
Environ Int. 2019 Mar;124:66-78. doi: 10.1016/j.envint.2018.11.069. Epub 2019 Jan 10.
The present study investigates the relationship between night-time screen-based media devices (SBMD) use, which refers to use within 1 h before sleep, in both lit and dark rooms, and sleep outcomes and health-related quality of life (HRQoL) among 11 to 12-year-olds.
We analysed baseline data from a large cohort of 6616 adolescents from 39 schools in and around London, United Kingdom, participating in the Study of Cognition Adolescents and Mobile Phone (SCAMP). Adolescents self-reported their use of any SBMD (mobile phone, tablet, laptop, television etc.). Sleep variables were derived from self-reported weekday and/or weekend bedtime, sleep onset latency (SOL) and wake time. Sleep quality was assessed using four standardised dimensions from the Swiss Health Survey. HRQoL was estimated using the KIDSCREEN-10 questionnaire.
Over two-thirds (71.5%) of adolescents reported using at least one SBMD at night-time, and about a third (32.2%) reported using mobile phones at night-time in darkness. Night-time mobile phone and television use was associated with higher odds of insufficient sleep duration on weekdays (Odds Ratio, OR = 1.82, 95% Confidence Interval, CI [1.59, 2.07] and OR = 1.40, 95% CI [1.23, 1.60], respectively). Adolescents who used mobile phones in a room with light were more likely to have insufficient sleep (OR = 1.32, 95% CI [1.10, 1.60]) and later sleep midpoint (OR = 1.64, 95% CI [1.37, 1.95]) on weekends compared to non-users. The magnitude of these associations was even stronger for those who used mobile phones in darkness for insufficient sleep duration on weekdays (OR = 2.13, 95% CI [1.79, 2.54]) and for later sleep midpoint on weekdays (OR = 3.88, 95% CI [3.25, 4.62]) compared to non-users. Night-time use of mobile phones was associated with lower HRQoL and use in a dark room was associated with even lower KIDSCREEN-10 score (β = -1.18, 95% CI [-1.85, -0.52]) compared to no use.
We found consistent associations between night-time SBMD use and poor sleep outcomes and worse HRQoL in adolescents. The magnitude of these associations was stronger when SBMD use occurred in a dark room versus a lit room.
本研究旨在探讨 11 至 12 岁儿童夜间使用屏幕类媒体设备（SBMD）与睡眠结果和健康相关生活质量（HRQoL）之间的关系。SBMD 是指在睡前 1 小时内在亮灯和黑暗房间内使用任何 SBMD（手机、平板电脑、笔记本电脑、电视等）。
我们分析了来自英国伦敦及其周边 39 所学校的 6616 名青少年的一项大型队列研究的基线数据，这些青少年参与了认知青少年和手机研究（SCAMP）。青少年自我报告他们使用任何 SBMD 的情况（手机、平板电脑、笔记本电脑、电视等）。睡眠变量来自自我报告的工作日和/或周末就寝时间、入睡潜伏期（SOL）和醒来时间。睡眠质量使用瑞士健康调查的四个标准化维度进行评估。HRQoL 使用 KIDSCREEN-10 问卷进行估计。
超过三分之二（71.5%）的青少年报告在夜间至少使用一种 SBMD，约三分之一（32.2%）报告在夜间黑暗中使用手机。夜间使用手机和电视与工作日睡眠时间不足的几率较高相关（优势比，OR=1.82，95%置信区间，CI[1.59,2.07]和 OR=1.40，95%CI[1.23,1.60]）。与非使用者相比，在有灯光的房间内使用手机的青少年更有可能睡眠不足（OR=1.32，95%CI[1.10,1.60]）和周末睡眠中点较晚（OR=1.64，95%CI[1.37,1.95]）。对于那些在工作日因睡眠不足而使用手机的人，这些关联的幅度更大（OR=2.13，95%CI[1.79,2.54]），对于那些在工作日睡眠中点较晚的人（OR=3.88，95%CI[3.25,4.62]），与非使用者相比。夜间使用手机与较低的 HRQoL 相关，而在黑暗房间中使用手机与更低的 KIDSCREEN-10 评分（β=-1.18，95%CI[-1.85，-0.52]）相关，与不使用相比。
我们发现夜间 SBMD 使用与青少年睡眠结果不佳和 HRQoL 较差之间存在一致的关联。当 SBMD 使用发生在黑暗房间而不是亮灯房间时，这些关联的幅度更大。
