Research Article| Volume 6, ISSUE 6, P731-742, December 2020

Screen media use and sleep disturbance symptom severity in children

Published:August 27, 2020DOI:



      Few studies have sought to evaluate how screen media use relates to symptoms of sleep-wake disturbances. To extend these prior studies in a large sample of children, this study examined associations of different types of screen media with symptom severity of different classes of sleep-wake disturbances. This study was preregistered here.


      This study utilized the baseline cross-sectional survey administered within the Adolescent Brain Cognitive Development Study (ABCD; Release 2.0).


      ABCD recruited over 11,000 U.S. children age 9–10 across 21 study sites using an epidemiologically-informed school-based recruitment strategy.


      Children reported typical weekend and weekday use of TV, video, video game, social media, texting, and video chat, and parents completed reports of the child's symptom severity of sleep-wake disturbances via the Sleep Disturbance Scale for Children.


      Greater screen media use, TV, video, and video game use, was associated with decreased sleep duration, increased sleep onset latency as well as greater excessive sleepiness, insomnia, and overall sleep disturbance symptom severity. Use of these screen medias were also associated with clinically relevant sleep problems. Ethnoracial differences emerged in screen use and sleep, but did not moderate the association between screen use and sleep.


      Greater use of screen medias was not just associated with longer sleep onset latency and shorter sleep duration, but also increased severity of multiple types of sleep-wake disturbances. Future research should use longitudinal designs to determine the direction of these associations in adolescent populations.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Sleep Health: Journal of the National Sleep Foundation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Cain N.
        • Gradisar M.
        Electronic media use and sleep in school-aged children and adolescents: a review.
        Sleep Med. 2010; 11: 735-742
        • Fossum I.N.
        • Nordnes L.T.
        • Storemark S.S.
        • Bjorvatn B.
        • Pallesen S
        The association between use of electronic media in bed before going to sleep and insomnia symptoms, daytime sleepiness, morningness, and chronotype.
        Behav Sleep Med. 2014; 12: 343-357
        • Li S.
        • Jin X.
        • Wu S.
        • Jiang F.
        • Yan C.
        • Shen X
        The impact of media use on sleep patterns and sleep disorders among school-aged children in China.
        Sleep. 2007; 30: 361-367
        • Hale L.
        • Kirschen G.W.
        • LeBourgeois M.K.
        • et al.
        Youth screen media habits and sleep: sleep-friendly screen behavior recommendations for clinicians, educators, and parents.
        Child Adolesc Psychiatric Clin. 2018; 27: 229-245
        • Zimmerman F.J.
        Children’s media use and sleep problems: Issues and unanswered questions. Kaiser Family Foundation, 2008
        • American Academy of Pediatrics
        Children, adolescents, and television.
        Pediatrics. 2001; 107: 423-426
        • Brockmann P.E.
        • Diaz B.
        • Damiani F.
        • Villarroel L.
        • Núñez F.
        • Bruni O
        Impact of television on the quality of sleep in preschool children.
        Sleep Med. 2016; 20: 140-144
        • Johnson J.G.
        • Cohen P.
        • Kasen S.
        • First M.B.
        • Brook J.S
        Association between television viewing and sleep problems during adolescence and early adulthood.
        Arch Pediatr Adolesc Med. 2004; 158: 562-568
        • Owens J.
        • Maxim R.
        • McGuinn M.
        • Nobile C.
        • Msall M.
        • Alario A
        Television-viewing habits and sleep disturbance in school children.
        Pediatrics. 1999; 104: e27
        • Paavonen E.J.
        • Pennonen M.
        • Roine M.
        • Valkonen S.
        • Lahikainen A.R
        TV exposure associated with sleep disturbances in 5- to 6-year-old children.
        J Sleep Res. 2006; 15: 154-161
        • Barnes C.M.
        • Drake C.L
        Prioritizing sleep health:public health policy recommendations.
        Perspect Psychol Sci. 2015; 10: 733-737
        • Funder D.C.
        • Ozer D.J.
        Evaluating effect size in psychological research: sense and nonsense.
        Adv Methods Pract Psychol Sci. 2019; 2: 156-168
        • Crowley S.J.
        • Wolfson A.R.
        • Tarokh L.
        • Carskadon M.A
        An update on adolescent sleep: new evidence informing the perfect storm model.
        J Adolesc. 2018; 67: 55-65
        • Reid Chassiakos Y.
        • Radesky J.
        • Christakis D.
        • Moreno M.A.
        • Cross C
        Children and Adolescents and Digital Media.
        Pediatrics. 2016; 138e20162593
        • Arora T.
        • Hussain S.
        • Hubert Lam K.B.
        • Lily Yao G.
        • Neil Thomas G.
        • Taheri S
        Exploring the complex pathways among specific types of technology, self-reported sleep duration and body mass index in UK adolescents.
        Int J Obes. 2013; 37: 1254-1260
        • Twenge J.M.
        • Hisler G.C.
        • Krizan Z
        Associations between screen time and sleep duration are primarily driven by portable electronic devices: evidence from a population-based study of U.S. children ages 0–17.
        Sleep Med. 2019; 56: 211-218
        • Peña M.-.M.
        • Rifas-Shiman S.L.
        • Gillman M.W.
        • Redline S.
        • Taveras E.M
        Racial/ethnic and socio-contextual correlates of chronic sleep curtailment in childhood.
        Sleep. 2016; 39: 1653-1661
        • James S.
        • Chang A.-.M.
        • Buxton O.M.
        • Hale L
        Disparities in adolescent sleep health by sex and ethnoracial group.
        SSM - Popul Health. 2020; 100581
        • Taveras E.M.
        • Hohman K.H.
        • Price S.
        • Gortmaker S.L.
        • Sonneville K
        Televisions in the bedrooms of racial/ethnic minority children: how did they get there and how do we get them out?.
        Clin Pediatr. 2009; 48: 715-719
        • Volkow N.D.
        • Koob G.F.
        • Croyle R.T.
        • et al.
        The conception of the ABCD study: from substance use to a broad NIH collaboration.
        Dev Cogn Neurosci. 2018; 32: 4-7
        • Compton W.M.
        • Dowling G.J.
        • Garavan H
        Ensuring the best use of data: the adolescent brain cognitive development study.
        JAMA Pediatr. 2019; 173: 809-810
        • Auchter A.M.
        • Hernandez Mejia M.
        • Heyser C.J.
        • et al.
        A description of the ABCD organizational structure and communication framework.
        Dev Cogn Neurosci. 2018; 32: 8-15
        • Sharif I.
        • Wills T.A.
        • Sargent J.D
        Effect of visual media use on school performance: a prospective study.
        J Adolesc Health. 2010; 46: 52-61
        • Bruni O.
        • Ottaviano S.
        • Guidetti V.
        • et al.
        The Sleep Disturbance Scale for Children (SDSC) Construct ion and validation of an instrument to evaluate sleep disturbances in childhood and adolescence.
        J Sleep Res. 1996; 5: 251-261
        • Barch D.M.
        • Albaugh M.D.
        • Avenevoli S.
        • et al.
        Demographic, physical and mental health assessments in the adolescent brain and cognitive development study: rationale and description.
        Dev Cogn Neurosci. 2018; 32: 55-66
        • Lewandowski A.S.
        • Toliver-Sokol M.
        • Palermo T.M
        Evidence-based review of subjective pediatric sleep measures.
        J Pediatr Psychol. 2011; 36: 780-793
        • Hirshkowitz M.
        • Whiton K.
        • Albert S.M.
        • et al.
        National Sleep Foundation's sleep time duration recommendations: methodology and results summary.
        Sleep Health. 2015; 1: 40-43
        • Lemola S.
        • Perkinson-Gloor N.
        • Brand S.
        • Dewald-Kaufmann J.F.
        • Grob A
        Adolescents’ electronic media use at night, sleep disturbance, and depressive symptoms in the smartphone age.
        J Youth Adolesc. 2015; 44: 405-418
        • Oka Y.
        • Suzuki S.
        • Inoue Y
        Bedtime activities, sleep environment, and sleep/wake patterns of japanese elementary school children.
        Behav Sleep Med. 2008; 6: 220-233
        • Hisler G.
        • Twenge J.M.
        • Krizan Z
        Associations between screen time and short sleep duration among adolescents varies by media type: evidence from a cohort study.
        Sleep Med. 2020; 66: 92-102
        • Buxton O.M.
        • Chang A.-.M.
        • Spilsbury J.C.
        • Bos T.
        • Emsellem H.
        • Knutson K.L
        Sleep in the modern family: protective family routines for child and adolescent sleep.
        Sleep Health. 2015; 1: 15-27
        • Ruiz J.M.
        • Hamann H.A.
        • Mehl M.R.
        • O'Connor M.-.F
        The Hispanic health paradox: from epidemiological phenomenon to contribution opportunities for psychological science.
        Group Processes Intergroup Rel. 2016; 19: 462-476
        • Garrison M.M.
        • Liekweg K.
        • Christakis D.A
        Media use and child sleep: the impact of content, timing, and environment.
        Pediatrics. 2011; 128: 29-35