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      Sleep and use of electronic devices in adolescence: results from a large population-based study

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          Abstract

          Objectives

          Adolescents spend increasingly more time on electronic devices, and sleep deficiency rising in adolescents constitutes a major public health concern. The aim of the present study was to investigate daytime screen use and use of electronic devices before bedtime in relation to sleep.

          Design

          A large cross-sectional population-based survey study from 2012, the youth@hordaland study, in Hordaland County in Norway.

          Setting

          Cross-sectional general community-based study.

          Participants

          9846 adolescents from three age cohorts aged 16–19. The main independent variables were type and frequency of electronic devices at bedtime and hours of screen-time during leisure time.

          Outcomes

          Sleep variables calculated based on self-report including bedtime, rise time, time in bed, sleep duration, sleep onset latency and wake after sleep onset.

          Results

          Adolescents spent a large amount of time during the day and at bedtime using electronic devices. Daytime and bedtime use of electronic devices were both related to sleep measures, with an increased risk of short sleep duration, long sleep onset latency and increased sleep deficiency. A dose–response relationship emerged between sleep duration and use of electronic devices, exemplified by the association between PC use and risk of less than 5 h of sleep (OR=2.70, 95% CI 2.14 to 3.39), and comparable lower odds for 7–8 h of sleep (OR=1.64, 95% CI 1.38 to 1.96).

          Conclusions

          Use of electronic devices is frequent in adolescence, during the day as well as at bedtime. The results demonstrate a negative relation between use of technology and sleep, suggesting that recommendations on healthy media use could include restrictions on electronic devices.

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          Most cited references32

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          Self-reported and measured sleep duration: how similar are they?

          Recent epidemiologic studies have found that self-reported duration of sleep is associated with obesity, diabetes, hypertension, and mortality. The extent to which self reports of sleep duration are similar to objective measures and whether individual characteristics influence the degree of similarity are not known. Eligible participants at the Chicago site of the Coronary Artery Risk Development in Young Adults Study were invited to participate in a 2003-2005 ancillary sleep study; 82% (n = 669) agreed. Sleep measurements collected in 2 waves included 3 days each of wrist actigraphy, a sleep log, and questions about usual sleep duration. We estimate the average difference and correlation between subjectively and objectively measured sleep by using errors-in-variables regression models. Average measured sleep was 6 hours, whereas the average from subjective reports was 6.8 hours. Subjective reports increased on average by 34 minutes for each additional hour of measured sleep. Overall, the correlation between reported and measured sleep duration was 0.47. Our model suggests that persons sleeping 5 hours over-reported their sleep duration by 1.2 hours, and those sleeping 7 hours over-reported by 0.4 hours. The correlations and average differences between self-reports and measured sleep varied by health, sociodemographic, and sleep characteristics. In a population-based sample of middle-aged adults, subjective reports of habitual sleep are moderately correlated with actigraph-measured sleep, but are biased by systematic over-reporting. The true associations between sleep duration and health may differ from previously reported associations between self-reported sleep and health.
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            The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review.

            Insufficient sleep, poor sleep quality and sleepiness are common problems in children and adolescents being related to learning, memory and school performance. The associations between sleep quality (k=16 studies, N=13,631), sleep duration (k=17 studies, N=15,199), sleepiness (k=17, N=19,530) and school performance were examined in three separate meta-analyses including influential factors (e.g., gender, age, parameter assessment) as moderators. All three sleep variables were significantly but modestly related to school performance. Sleepiness showed the strongest relation to school performance (r=-0.133), followed by sleep quality (r=0.096) and sleep duration (r=0.069). Effect sizes were larger for studies including younger participants which can be explained by dramatic prefrontal cortex changes during (early) adolescence. Concerning the relationship between sleep duration and school performance age effects were even larger in studies that included more boys than in studies that included more girls, demonstrating the importance of differential pubertal development of boys and girls. Longitudinal and experimental studies are recommended in order to gain more insight into the different relationships and to develop programs that can improve school performance by changing individuals' sleep patterns. Copyright 2009 Elsevier Ltd. All rights reserved.
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              Electronic media use and sleep in school-aged children and adolescents: A review.

              Electronic media have often been considered to have a negative impact on the sleep of children and adolescents, but there are no comprehensive reviews of research in this area. The present study identified 36 papers that have investigated the relationship between sleep and electronic media in school-aged children and adolescents, including television viewing, use of computers, electronic gaming, and/or the internet, mobile telephones, and music. Many variables have been investigated across these studies, although delayed bedtime and shorter total sleep time have been found to be most consistently related to media use. A model of the mechanisms by which media use may affect sleep is presented and discussed as a vehicle for future research. Copyright 2010 Elsevier B.V. All rights reserved.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2015
                15 January 2015
                : 5
                : 1
                : e006748
                Affiliations
                [1 ]Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health , Bergen, Norway
                [2 ]Department of Psychosocial Science, University of Bergen , Bergen, Norway
                [3 ]Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital , Bergen, Norway
                [4 ]Department of Biological and Medical Psychology, University of Bergen , Bergen, Norway
                [5 ]Division of Mental Health, Norwegian Institute of Public Health , Bergen, Norway
                [6 ]Uni Research Health , Bergen, Norway
                [7 ]Department of Psychiatry, Helse Fonna HF , Haugesund, Norway
                Author notes
                [Correspondence to ] Dr Mari Hysing; mari.hysing@ 123456uni.no
                Article
                bmjopen-2014-006748
                10.1136/bmjopen-2014-006748
                4316480
                25643702
                f7774f25-9314-48b9-95d6-0914cd55c0ba
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 26 September 2014
                : 28 November 2014
                : 2 December 2014
                Categories
                Epidemiology
                Research
                1506
                1612
                1692
                1712
                1692
                Custom metadata
                press-release

                Medicine
                sleep,media use,epidemiology,adolescents
                Medicine
                sleep, media use, epidemiology, adolescents

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