Streaming instead of dreaming: Problems linked to kids' media device use at bedtime

Bedtime use of cellphones or tablets by children — even just having access to them — is consistently linked to excessive daytime sleepiness and poor sleep, researchers say.

Use of mobile devices before sleep provides stimulating material as brain trying to wind down

Excessive daytime sleepiness the next day was one of the measures of poor sleep quality in a pediatric review on use of mobile devices. (Jeffrey Greenberg/UIG/Getty)

Bedtime use of cellphones or tablets by children — even just having access to them — is consistently linked to excessive daytime sleepiness and poor sleep, researchers say.

They called on teachers, health care professionals, parents and children to be educated about the damaging influence of device use on sleep.

The portable media devices have entered the bedroom, giving children unprecedented access to technology and media before researchers have had a chance to explore the positive and negative impacts.

To explore whether there's an association between use of, or access to, media devices and sleep quantity and quality, researchers reviewed 20 sleep studies involving 125,198 children aged six to 19. 

In Monday's issue of JAMA Pediatrics, the reviewers concluded there's strong and consistent evidence of an association between access to or use of devices and reduced sleep quantity (defined as less than 10 hours for children and less than nine hours for adolescents) or quality, as well as increased daytime sleepiness.

The way device use leads to poor sleep is thought to be light emission. But the review looked at examples of holding a device in the bedroom and not using it, which excludes light emission as the sole mechanism, said study author Ben Carter of the Institute of Psychiatry, Psychology and Neuroscience at King's College London.

Teachers will be the first torecognize the signs of day-time sleepiness.They need to know what advice tooffer to parents, and when to do so.- Ben Carter, study author

"We are presenting results that highlight that it looks likely there are also other causes," Carter said in an email.

"One theory I hold is that there may be the effect of continuous mental stimulation and engagement which is keeping children awake."

As our technological landscape evolves and textbooks are increasingly replaced with media devices in schools, access and use to screen-based media devices is likely to rise, the researchers said.

The goal is to guide communities on the importance of sleep hygiene — activities we engage in before going to bed, such as drinking coffee or cola, playing video games and chatting or texting or a phone. 

Stop 90 minutes before bed

On the teaching side, Carter welcomed the widespread introduction of e-readers and computer skills.

If these are used in the evening, however, and have connectivity, they may be providing a vehicle for increased handheld use exposure. Simple interventions such as timing restrictions could help, he suggested.

"However, more widely, teachers will be the first to recognize the signs of day-time sleepiness. They need to know what advice to offer to parents, and when to do so. They also need to educate against the over use of these devices, so that all parents feel empowered to know that everyone in their child's class stop using their devices prior to bedtime and any restriction on their child is not seen as a punitive action."

Difficult to resist

Looking at healthcare professionals, Carter said typically the advice and support offered by family physicians is inconsistent.

"More to the point, health-care professionals need a clear message to parents that children need to stop using their devices 90 minutes prior to bedtime. Parents would benefit from this clear message of empowerment to improve their children's sleep hygiene."

Children who had access to but didn't use media devices at night also were more likely to have all three sleep issues. 

It isn't possible to draw any cause and effect relationships from this type of research. 
"The use of mobile media devices at bedtime provides socially and physiologically stimulating material at a time when the transition to sleep requires the brain to wind down," Dr. Charles Czeisler and Dr. Theresa Shanahan of Harvard Medical School said in a journal editorial. "Interesting content is often difficult to resist, and children frequently have a fear of missing out if they disconnect."

Parents often declare "go to bed" as children get older without teaching or modeling how to transition to sleep, the editorial writers said.

But the studies weren't randomly controlled, and only two of the studies included in the review were judged to be of good quality, which highlights the limitations in data available to guide parents, teachers and doctors.