School of Psychological Sciences, Tel-Aviv University, Tel Aviv, Israel.
College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia.
Eur Child Adolesc Psychiatry. 2021 Nov;30(11):1793-1802. doi: 10.1007/s00787-020-01654-w. Epub 2020 Oct 1.
Inadequate sleep and excessive exposure to media screens have both been linked to poorer mental health in youth. However, the ways in which these interact to predict behaviour problems have yet to be examined using objective sleep measurement. The lack of objective evidence for these relationships in young children has recently been defined by the World Health Organization (2019) as a gap in the field. We thus aimed to test the interacting effects of screen exposure and objectively measured sleep on behaviour problems in the preschool age. A total of 145 children aged 3-to-6-years participated in this cross-sectional study. Sleep was assessed objectively using actigraphy for 1-week, and subjectively using parent-reported daily sleep diaries. Parents reported the child's daily duration of screen exposure, and completed the Strengths and Difficulties Questionnaire. Results showed that actigraphic sleep duration, timing and efficiency were associated with screen exposure. The link between screen time and behaviour problems was moderated by sleep duration, as it was significant only for children with sleep duration of 9.88 h or less per night. Sleep duration also moderated the relation between screen time and externalizing-but not internalizing-problems. Hence, the combination of increased screen exposure and decreased sleep duration may be particularly adverse for child mental health. While these key relationships should be further examined in longitudinal and experimental investigations, our findings shed light on their complexity, underscoring the importance of the moderating role of sleep.
睡眠不足和过度暴露于媒体屏幕都与年轻人的心理健康较差有关。然而，使用客观的睡眠测量来检验这些因素如何相互作用来预测行为问题的方法尚未得到检验。世界卫生组织（2019 年）最近将这些关系在幼儿中缺乏客观证据定义为该领域的一个空白。因此，我们旨在检验屏幕暴露和客观测量的睡眠对学龄前儿童行为问题的相互作用影响。共有 145 名 3 至 6 岁的儿童参加了这项横断面研究。使用活动记录仪对睡眠进行了为期一周的客观评估，并使用家长报告的每日睡眠日记进行了主观评估。家长报告了孩子每天的屏幕暴露时间，并完成了《长处和困难问卷》。结果表明，活动记录仪测量的睡眠时间、时间和效率与屏幕暴露有关。屏幕时间与行为问题之间的联系受到睡眠持续时间的调节，因为只有每晚睡眠时间为 9.88 小时或更短的儿童的关联才具有统计学意义。睡眠时间还调节了屏幕时间与外化问题之间的关系，但与内化问题之间的关系则没有调节。因此，增加屏幕暴露和减少睡眠时间的组合可能对儿童心理健康特别不利。虽然这些关键关系应该在纵向和实验研究中进一步检验，但我们的研究结果揭示了它们的复杂性，强调了睡眠的调节作用的重要性。
