Zhao Jia, Cui Naixue, Li Yan, Wang Guanghai, Hu Shunpeng, Hao Yinjun, Liu Jianghong
School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China.
Kindergarten of Huaiyin District, Jinan, Shandong Province, China.
Pediatr Res. 2025 Feb 22. doi: 10.1038/s41390-025-03944-y.
Circadian disruption has been proposed as an etiological mechanism for psychopathology, yet its role in the relationship between screen use and emotional and behavioral problems remains under-investigated. This study aimed to examine the mediating effect of circadian rhythm in this relationship among young children.
This cross-sectional study analyzed data from 1111 children aged 2 to 7 years recruited from six kindergartens between March 2022 and June 2024. Parents reported children's screen time and use before sleep. Parents and teachers assessed internalizing and externalizing problems using the Strengths and Difficulties Questionnaire. Circadian rhythm, including chronotype and midsleep on free days corrected for sleep debt (MSF), was measured using the Children's ChronoType Questionnaire. In a subsample, MSF was also measured using actigraphy and sleep diaries.
Screen use was significantly associated with parent-reported internalizing and externalizing problems. Chronotype significantly mediated the relationships between screen use and parent-reported outcomes, whereas the results were not reproducible using MSF derived from survey, actigraphy and sleep diaries.
The mediation of delayed circadian phase in the relationship between screen use and internalizing and externalizing problems in young children may be negligible. Future research should explore the role of other circadian parameters in this relationship.
Circadian disruption has been suggested as a potential mechanism linking screen-based media exposure to psychopathology. Using a triangulation approach that combined multiple data sources-survey, actigraphy, and sleep diaries-we found that the mediating effects of delayed circadian phase in the relationships between screen use and internalizing and externalizing problems were minimal in children aged 2 to 7 years. Future research should explore alternative circadian pathways and examine the long-term developmental effects of screen use during early childhood.
昼夜节律紊乱已被提出作为精神病理学的一种病因机制，但其在屏幕使用与情绪和行为问题之间关系中的作用仍未得到充分研究。本研究旨在探讨昼夜节律在幼儿这种关系中的中介作用。
这项横断面研究分析了2022年3月至2024年6月期间从六所幼儿园招募的1111名2至7岁儿童的数据。家长报告了孩子的屏幕使用时间和睡前使用情况。家长和教师使用优势与困难问卷评估内化和外化问题。使用儿童昼夜类型问卷测量昼夜节律，包括昼夜类型和校正睡眠债后的休息日中午睡眠时间（MSF）。在一个子样本中，还使用活动记录仪和睡眠日记测量MSF。
屏幕使用与家长报告的内化和外化问题显著相关。昼夜类型显著中介了屏幕使用与家长报告结果之间的关系，而使用来自调查、活动记录仪和睡眠日记的MSF得出的结果不可重复。
昼夜节律相位延迟在幼儿屏幕使用与内化和外化问题之间关系中的中介作用可能微不足道。未来的研究应探讨其他昼夜节律参数在这种关系中的作用。
昼夜节律紊乱已被认为是将基于屏幕的媒体暴露与精神病理学联系起来的潜在机制。我们采用了一种结合多种数据来源（调查、活动记录仪和睡眠日记）的三角测量方法，发现昼夜节律相位延迟在2至7岁儿童屏幕使用与内化和外化问题之间关系中的中介作用最小。未来的研究应探索替代的昼夜节律途径，并研究幼儿期屏幕使用的长期发育影响。
