Evidence-Based Practice Blog

For teenagers, does limiting screen time before bedtime compared to not limiting screen time, affect sleep quality and improve school performance?

Sleep, a vital occupational need, influences mood, behaviors, energy levels, and participation. Sleep gives the body and mind rest and time for restoration. Because sleep is important for one’s mental health and well-being, occupational therapists should prioritize sleep during interventions (Tester and Foss, 2018). In 2011, Sleep in America Poll states that about 60% of adolescents in the United States get less than eight hours of sleep on school nights and 77% reported having sleep problems (Hale and Guan, 2015). For teenagers, does limiting screen time before bedtime compared to not limiting screen time, affect sleep quality and improve school performance?

We want to explore this topic because technology use is very prevalent among adolescents and children especially during the COVID-19 pandemic. The use of technology is difficult to avoid because school is currently accessed through technology. Adolescents spend excessive amounts of time on screens such as computers, TVs, video games, and smart phones. Screen time has increased even more because it is being used as a form of leisure, social network, work, and school. The occupation of sleep is greatly influenced by the duration of screen time throughout the day. Excessive screen time has been linked to sleep disturbances, internalizing and externalizing peer problems (Parent et al., 2016).

Almost all United States adolescents (97%) have at least one electronic device in their bedroom. It is said that the presence of at least one of the screens can cause insufficient and low quality sleep. Two hours of bright screens of the electronics also suppress the sleep hormone- melatonin. Excessive screen time affects general health, physical activity, cognitive, and social development. “Computer use (94% of studies), unspecified screen time (91% of studies), video games (86%), and mobile devices (83%) were most consistently observed to be associated with adverse sleep outcomes” (Hale and Guan, 2015).

The effects of excessive screen time within youth has also been linked to amplifying ADHD symptoms. According to Nikkelen and Valkenburg, screen time can hinder the ability for cognitive simulation and long attention span (2014). Content within the screen exhibit is fast paced, graphic, short-term, and highly stimulating which results in the person watching being conditioned to have a short attention span (Christensen, 2017). In relation to sleep, arousal before or during sleep time causes delayed sleep onset or shortened sleep time which results in poor sleep quality (Cheung et al.; Magee et al., 2014). It is a cycle between poor sleep and exacerbation of ADHD symptoms because children with poor sleep quality tend to display hyperactivity and sensory seeking (Lissak, 2018). Along with ADHD symptomatology, excessive screen time also can lead to a sedentary lifestyle. People who have sedentary lifestyles have a hard time falling asleep due to the lack of energy spent throughout the day. With smartphone usage, studies have found that 18% adolescents were woken up by notifications from their phones at least a few times a night (Falbe et al., 2015).

Screen time can impact the school performance of children. Children whose study time was shortened due to screen-time, performed poorly in the General Education test. Lower marks obtained in the assessment correlates with decreased study time while at home because of screen use. (Sinnarajah et. al, 2019). In a study conducted by Sargent and Sharif, results indicate that there is a strong correlation between levels of exposure to media and poor school performance. The study suggests that it is important for parents of adolescents to consider limiting both media content and the amount of time using technology. The data specifically recommends that parents limit weekday television viewing and video games to ≤ 1 hour. It also suggests that parents should restrict exposure to adult media. (Sharif & Sargent, 2006).

In this research study, Morita et al. (2016), found that obesity and screen time affects academic achievement in “cram schools (test preparation centers) in Japan” (p.161). The study included 315 first-year junior high school students which looked at physical fitness, academic achievement, BMI, socioeconomic and lifestyle confounders to find a correlation between the variables. Morita, et al. (2016) “present findings indicate that the sedentary time spent by children and adolescents on video games and mobile phones not only adds to their sedentary lifestyle but could also negatively affect their academic performance” (p. 163). This study exemplifies how screen time on electronic devices should be reduced and encourage adolescents to have more physical activity. Adolescents on smart phones and computer screens can affect school performance such as GPA average, exam scores, and etc. As the world is becoming more technologically advanced, maybe suggest adolescents put phones away 1 to 2 hours before bed time to improve sleep quality and school performance.

My personal experience is that when I was in high school I was on my smart phone and computer a lot at night which affected my sleep and motivation in school. I was constantly tired and affected my weight in high school and college. I learned not to be on my smart phone on social media sites for no more than 1 to 2 hours per day because I will have a hard time focusing on my schoolwork and going to sleep at a reasonable time. I set a downtime on my smart phones to decrease my screen time to only 2 to 3 hours per day. Also, for my computer I print out my readings as an additional way to decrease screen time.

Jenna personally experienced how screen-time has affected children with my three year old cousin. Since the lockdown started, his screen-time with his tablet has increased tremendously. She have noticed that he gravitates towards using his tablet more frequently than playing with his toys. There have been several instances when my family stays up late sometimes past 1:00 in the morning, and my cousin also stays awake. Yet his nap schedule and morning wake up schedule remained the same. After exploring this literature, it has made me consider how screen-time can potentially be affecting his development, engagement in play, and daily routine.

We believe that excessive use of screen time should be something that parents or guardians should carefully consider. From our personal experiences and findings from the literature, screen-time causes fatigue, sleep disturbances, changes in mood, and academic performance. As we mentioned above, due to the pandemic, there has been an increase in the use of technology and screen time. Because we are currently online for school, we have also felt the effects of excessive screen time as we are feeling more fatigue, difficulties with concentrating, taking longer to complete assignments, and an increase to a sedentary lifestyle. Overall, use of screen time should be limited because it can affect sleep as well as school performance.

References

Cheung, C. H. M., Bedford, R., Saez De Urabain, Irati R, Karmiloff-Smith, A., & Smith, T. J. (2017). Daily touchscreen use in infants and toddlers is associated with reduced sleep and delayed sleep onset. Scientific Reports, 7(1), 46104. 10.1038/srep46104

Christensen, J. F. (2017). Pleasure junkies all around! Why it matters and why ‘the arts’ might be the answer: a biopsychological perspective. Proceedings of the Royal Society. B, Biological Sciences, 284(1854), 20162837. 10.1098/rspb.2016.2837

Falbe, J., Davison, K. K., Franckle, R. L., Ganter, C., Gortmaker, S. L., Smith, L., Land, T., & Taveras, E. M. (2015). Sleep Duration, Restfulness, and Screens in the Sleep Environment. Pediatrics (Evanston), 135(2), e367-e375. 10.1542/peds.2014-2306

Hale, L., & Guan, S. (2015). Screen time and sleep among school-aged children and adolescents: A systematic literature review. Sleep Medicine Reviews, 21, 50-58. doi:https://doi.org/10.1016/j.smrv.2014.07.007

Krishnapradeep, S., Kumarendran, B., & Thanusia, T. (2019). Association of screen time with academic performance and behaviour among primary school children of Kandy district Sri Lanka. Open Journal of Pediatrics and Child Health, , 47-52. 10.17352/ojpch.000020

Lissak, G. (2018). Adverse physiological and psychological effects of screen time on children and adolescents: Literature review and case study. Environmental Research, 164, 149-157. 10.1016/j.envres.2018.01.015

Magee, C. A., Lee, J. K., & Vella, S. A. (2014). Bidirectional Relationships Between Sleep Duration and Screen Time in Early Childhood. JAMA Pediatrics, 168(5), 465. 10.1001/jamapediatrics.2013.4183

Morita, N., Nakajima, T., Okita, K., Ishihara, T., Sagawa, M., & Yamatsu, K. (2016). Relationships among fitness, obesity, screen time and academic achievement in Japanese adolescents. Physiology & Behavior, 163, 161-166. 10.1016/j.physbeh.2016.04.055

Nikkelen, S. W. C., Valkenburg, P. M., Huizinga, M., & Bushman, B. J. (2014). Media use and ADHD-related behaviors in children and adolescents: A meta-analysis. Developmental Psychology, 50(9), 2228-2241. 10.1037/a0037318

Parent, J., Sanders, W., & Forehand, R. (2016). Youth Screen Time and Behavioral Health Problems: The Role of Sleep Duration and Disturbances. Journal of Developmental and Behavioral Pediatrics, 37(4), 277-284. 10.1097/DBP.0000000000000272

Sharif, Iman & Sargent, James. (2006). Association between television, movie, and video game

exposure and school performance. Pediatrics. 118. e1061-70. 10.1542/peds.2005-2854.

Tester, N. J., & Foss, J. J. (2018). Sleep as an occupational need. The American Journal of

Occupational Therapy, 72(1), 7201347010p1-4. doi:10.5014/ajot.2018.020651

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