Lin Yumin, Zhang Xueqin, Huang Yinying, Jia Zhiwei, Chen Jing, Hou Wanling, Zhao Lili, Wang Guiyan, Zhu Jiemin
Department of Nursing, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China.
Department of Obstetrics and Gynecology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China.
Front Pediatr. 2022 Oct 10;10:987523. doi: 10.3389/fped.2022.987523. eCollection 2022.
Currently young children have more opportunity to access all kinds of media, while their sleep duration has been steadily decreasing. However, little is known about the relationships between screen viewing and sleep quality, and the reasons of screen viewing for children under three years old in China. This study aimed to describe the relationships between screen viewing and sleep quality of infants and toddlers in mainland China.
A cross-sectional study was conducted. Eight hundred twenty-seven children were recruited at a health care unit from a university affiliated hospital in China, and the questionnaires were completed by their parents. An extended Brief Infant Sleep Questionnaire and a Screen Viewing Questionnaire were used to collect information on children's sleep quality and screen viewing. Multivariate linear regression models were used to assess the relationships between screen viewing and sleep quality among infants and toddlers, adjusted for sociodemographic variables.
Of the 827 children, 26.9% of the infants and 61.4% of the toddlers did not comply with the World Health Organization (WHO) guideline on screen time. Even after adjusting for the sociodemographic covariates for both infants and toddlers, negative relationships between screen time and total sleep time (< 0.001), and screen time and nighttime sleep (< 0.001) existed. TV viewing time was negatively related to infants' total sleep time (=-0.15, < 0.001) and toddlers' nighttime sleep (=-0.1, < 0.05). Smartphone viewing time was negatively related to toddlers' total sleep time (=-0.12, < 0.05) and daytime sleep (=-0.22, < 0.05). Parents who offered screen media for children when they needed to do house chores were more likely to report that their children had less total sleep time (=-0.1, < 0.05) and shorter longest sleep episode (=-0.1, < 0.05).
The majority of toddlers did not meet the WHO guidelines on screen time in China. Screen time was negatively related to total sleep time and nighttime sleep among infants and toddlers. Practical strategies, such as education programs on children's screen viewing, more outdoor exercises and indoor parent-child activities, providing other educational materials instead of screening, early sleep, restricted use of TVs and smartphones, and screen co-viewing, are needed to improve young children's sleep quality and promote their development.
目前幼儿有更多机会接触各种媒体，而他们的睡眠时间却在持续减少。然而，对于屏幕观看与睡眠质量之间的关系，以及中国三岁以下儿童观看屏幕的原因，人们知之甚少。本研究旨在描述中国大陆婴幼儿屏幕观看与睡眠质量之间的关系。
进行了一项横断面研究。在中国一家大学附属医院的保健科招募了827名儿童，问卷由他们的父母填写。使用扩展的简短婴儿睡眠问卷和屏幕观看问卷收集有关儿童睡眠质量和屏幕观看的信息。多元线性回归模型用于评估婴幼儿屏幕观看与睡眠质量之间的关系，并对社会人口统计学变量进行了调整。
在827名儿童中，26.9%的婴儿和61.4%的幼儿未遵守世界卫生组织（WHO）的屏幕时间指南。即使在对婴儿和幼儿的社会人口统计学协变量进行调整之后，屏幕时间与总睡眠时间（<0.001）以及屏幕时间与夜间睡眠（<0.001）之间仍存在负相关关系。看电视时间与婴儿的总睡眠时间（=-0.15，<0.001）和幼儿的夜间睡眠（=-0.1，<0.05）呈负相关。看智能手机时间与幼儿的总睡眠时间（=-0.12，<0.05）和白天睡眠（=-0.22，<0.05）呈负相关。当父母需要做家务时为孩子提供屏幕媒体的，更有可能报告他们的孩子总睡眠时间较少（=-0.1，<0.05）且最长睡眠时长较短（=-0.1，<0.05）。
在中国，大多数幼儿未达到WHO的屏幕时间指南。屏幕时间与婴幼儿的总睡眠时间和夜间睡眠呈负相关。需要采取一些实际策略，如开展关于儿童屏幕观看的教育项目、增加户外活动和室内亲子活动、提供其他教育材料而非播放视频、早睡、限制电视和智能手机的使用以及共同观看屏幕等，以改善幼儿的睡眠质量并促进其发育。
