| Munezawa et al. 2121. Munezawa T, Kaneita Y, Osaki Y, Kanda H, Minowa M, Suzuki K, et al. The association between use of mobile phones after lights out and sleep disturbances among Japanese adolescents: a nationwide cross-sectional survey. Sleep 2011; 34:1013-20. (2011) |
Japan |
Cross-sectional study |
94,777 adolescents aged 13 to 19 years |
Use of mobile phone after switching off lights (> 2h per night) |
Insufficient (between 6h and 7h per day) |
Associated with poor sleep quality with screen time (p < 0.01) |
Insomnia, daytime sleepiness, and short sleep duration |
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| Falbe et al. 3232. Falbe J, Davison KK, Franckle RL, Ganter C, Gortmaker SL, Smith L, et al. Sleep duration, restfulness, and screens in the sleep environment. Pediatrics 2015; 135:e367-75. (2014) |
United States |
Cross-sectional study |
2,048 adolescents with an average age of 10.6±1.5 years |
TV or DVD (2.4±1.9/day); computer or video games (1.8±1.8/day) |
Sufficient (> 8h a day) |
Sleeping near small screens and sleeping with TVs in their bedrooms were associated with 37.0 minutes (95%CI: 20.1-53.9; p < 0.001) and 31.1 minutes (95%CI: 19.1-43.1; p < 0.001) of late bedtime, respectively |
Later sleep and perception of rest or insufficient sleep |
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| Mak et al. 33. Mak YW, Wu CST, Hui DWS, Lam SP, Tse HY, Yu WY, et al. Association between screen viewing duration and sleep duration, sleep quality, and excessive daytime sleepiness among adolescents in Hong Kong. Int J Environ Res Public Health 2014; 11:11201-19. (2014) |
China |
Cross-sectional study |
762 adolescents with an average age of 15.27±1.70 years |
Computers (3h26min/day); TV (2h50min/day); mobile phone (2h18min/day); portable video devices (1h3min/day). Total: 5h54min/day when using screens |
Insufficient (< 8h per day) |
Length of cell phone use increases the risk of poor sleep quality (95%CI: 0.033-0.170; p < 0.01) |
Daytime sleepiness and musculoskeletal pain |
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| Aguilar et al. 2222. Aguilar MM, Vergara FA, Velásquez EJ, García-Hermoso A. Physical activity, screen time and sleep patterns in Chilean girls. An Pediatr 2015; 83:304-10. (2015) |
Chile |
Cross-sectional study |
196 girls with an average age of 12.2 years |
TV (1h56min/day); video games (27min/day); computer (1h79min/day). Total: 2h43min/day |
Sufficient (9h25min per night) |
The longer the screen time (≥ 2h/day) the lower the quality of sleep (95%CI: 3.05-3.93; p < 0.001) |
Overweight and obesity |
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| Wu et al. 1010. Wu X, Tao S, Zhang Y, Zhang S, Tao F. Low physical activity and high screen time can increase the risks of mental health problems and poor sleep quality among Chinese college students. PLoS One 2015; 10:e0119607. (2015) |
China |
Cross-sectional study |
4,747 adolescents with an average age of 19.22 years |
Screen usage greater than 2h/day |
Poor quality of sleep reported in 9.8% of its sample |
Association between high screen time and poor sleep quality (OR = 1.32, 95%CI: 1.06-1.65; p < 0.001) |
Symptoms of anxiety, depression, and psychopathology |
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| Amra et al. 1111. Amra B, Shahsavari A, Shayan-Moghadam R, Mirheli O, Moradi-Khaniabadi B, Bazukar M, et al. The association of sleep and late-night cell phone use among adolescents. J Pediatr (Rio J.) 2017; 93:560-7. (2017) |
Iran |
Cross-sectional study |
2,257 adolescents with average age of 15.44±1.55 years |
Phone usage after 21h for more than 2h |
Insufficient (7h34min per day) |
Regression model shows that adolescents who used mobile phones at night were 1.39 times more likely to have poor quality of sleep than those who did not (p < 0.001) |
Increased sleep latency |
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| Chung et al. 99. Chung JE, Choi SA, Kim KT, Yee J, Kim JH, Seong JW, et al. Smartphone addiction risk and daytime sleepiness in Korean adolescents. J Paediatr Child Health 2017; 54:800-6. (2017) |
South Korea |
Cross-sectional study |
1,796 adolescents with an average age of 14.9±1.8 years |
Use of smartphones (between 3h and 5h/day) |
Insufficient (6.4±1.7h) |
It showed that girls tend to use social media (SMS) and messaging services more often than boys (41.2 vs. 26.5% and 23.6 vs. 12.8%, respectively, p < 0.0001 for both) |
Daytime drowsiness for both genders and females |
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| Hawi et al. 88. Hawi NS, Samaha M, Griffiths MD. Internet gaming disorder in Lebanon: relationships with age, sleep habits, and academic achievement. J Behav Addict 2017; 7:70-8. (2017) |
Lebanon |
Cross- sectional study |
524 adolescents with an average age of 16.2 years |
Average playing time was 2.2h/day |
Insufficient (6.9±1.7h) |
Hierarchical multiple regression showed that excessive use of online games (> 2h a day) is associated with lower age (-3.032; p < 0.001) and shorter sleep duration (-2.766; p < 0.001) |
Lower academic performance |
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| Husarova et al. 2929. Foerster M, Henneke A, Chetty-Mhlanga S, Röösli M. Impact of adolescents screen time and nocturnal mobile phone-related awakenings on sleep and general health symptoms: a prospective cohort study. Int J Environ Res Public Health 2019; 16:518. (2017) |
Slovakia |
Cross-sectional study |
7,595 adolescents aged 11 to 15.9 years |
Internet usage (> 2h/day) and playing video games (> 2h/day) |
Insufficient (< 8h per day) |
Time spent on digital screens was associated with shorter sleep duration (95%CI: 0.15-0.28; p < 0.01), and higher prevalence of sleep problems (95%CI: 0.12-0.31; p < 0.01) |
Reduction of sleep hours and school problems |
✬✬✬✬✬✬ |
| Jun et al. 2727. Jun N, Lee A, Baik I. Associations of caffeinated beverage consumption and screen time with excessive daytime sleepiness in Korean high school students. Clin Nutr Res 2017; 6:55-60. (2017) |
South Korea |
Cross-sectional study |
249 adolescents aged 17 to 19 years |
Computer (1.3h±0.7/day); TV (0.7h±0.7/day); mobile cell phones (1.5h±0.7/day); games (0.5h±0.7/day) |
Insufficient (6.9h per day) |
Association between the use of mobile phones before sleeping and poor quality of sleep (95%CI: 1.83-2.52; p < 0.05) |
Reduction of hours of sleep and daytime sleepiness |
✬✬✬✬ |
| Royant-Parola et al. 3030. Royant-Parola S, Londe V, Tréhout S, Hartley S. Nouveaux médias sociaux, nouveaux comportements de sommeil chez les adolescents. Encephale 2018; 44:321-8. (2017) |
France |
Cross-sectional study |
776 adolescents with a mean age of 12.4±1.2 years |
Tablet, cell phones, and computers (use between 1h to 2h/day) |
Insufficient (< 6h) |
Shorter sleep with the use of computers (67% vs. 33%; p < 0.0001), mobile phones, (99% vs. 80%; p = 0.0001) and smartphones (85% vs. 66%; p = 0.0001) in their rooms |
Negative effect on mood; difficulty waking; irritability; night awakening; feelings of sadness, and sleep deprivation |
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| Silva et al. 2323. Silva AO, Oliveira LMFT, Tassitano RM. Screen time, perception of sleep quality and episodes of parasomnia in adolescents. Rev Bras Med Esporte 2017; 23:375-9. (2017) |
Brazil |
Cross-sectional study |
481 adolescents aged 14 to 19 years |
Cell phone and TV usage greater than 2h/day |
Insufficient (< 8h per day) |
Quality of sleep was associated with insufficient sleep time (PR = 2.69; 95%CI: 1.53-4.69; p < 0.001) and excessive TV time (PR = 1.49; 95%CI: 1.03-2.16; p < 0.001) |
Bruxism; sleep walking; sleep talking; nightmares one or more times a week; frightened and/or terrified awakenings |
✬✬✬✬✬ |
| Akçay et al. 3131. Akçay D, Akçay BD. The influence of media on the sleep quality in adolescents. Turk J Pediatr 2018; 60:255-63. (2018) |
Turkey |
Cross-sectional study |
392 adolescents with an average age of 16.04±0.86 years |
6.78±5.10 hours per day (TV, mobile phones, and games) |
Insufficient (7h05min±1.51) |
The greater the use of digital screen, the greater the awakening time of adolescents’ sleep |
Does not report |
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| Cabré-Riera et al. 1212. Cabré-Riera A, Torrent M, Donaire-Gonzalez D, Vrijheid M, Cardis E, Guxens M. Telecommunication devices use, screen time and sleep in adolescents. Environ Res 2019; 10:341-7. (2018) |
Spain |
Cross-sectional study |
258 adolescents aged 17 to 18 years |
Use of mobile phones, tablets, laptops, video games, and TVs for a total time of 3h04min (1h37min-4h38min) |
Insufficient (6:18-7:11) |
Cell phone use was associated with lower quality of sleep (PR = 1.55; 95%CI: 1.03-2.33; p < 0.001) |
Increased standby time |
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| Adelantado-Renau et al. 3333. Adelantado-Renau M, Diez-Fernandez A, Beltran-Valls MR, Soriano-Maldonado A, Moliner-Urdiales D. The effect of sleep quality on academic performance is mediated by Internet use time: DADOS study. J Pediatr (Rio J.) 2019; 95:410-8. (2019) |
Spain |
Cross-sectional study |
269 adolescents with an average age of 13.9±0.3 years |
Evaluation in minutes/day: Internet (53.3±58.5), cell phones (111.0±84.3), TV (90.9±52.9), and video game usage (34.5±44.0) |
Sufficient (> 8h per day) |
The quality of sleep was negatively associated with the use of video games (-0.150), time of Internet use (-0.179) and mobile phones (-0.131) |
Decreased thinking ability and lower overall cognitive performance |
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| Caumo et al. 77. Caumo GH, Spritzer D, Carissimi A, Tonon AC. Exposure to electronic devices and sleep quality in adolescents: a matter of type, duration, and timing. Sleep Health 2020; 6:172-8. (2019) |
Brazil |
Cross-sectional study |
177 adolescents with an average age of 13.69±1.78 |
TV (2.25h/day); tablet (2h/day); mobile phone (4h/day) |
Insufficient (7.76±1.72) |
Statistically significant association between the use of cell phones at night and worse quality of sleep during the week (95%CI, 0.22-0.29; p < 0.001) and weekends (95%CI: 0.19-0.22; p < 0.001) |
Reduction of sleep hours |
✬✬✬✬ |
| Foerster et al. 2929. Foerster M, Henneke A, Chetty-Mhlanga S, Röösli M. Impact of adolescents screen time and nocturnal mobile phone-related awakenings on sleep and general health symptoms: a prospective cohort study. Int J Environ Res Public Health 2019; 16:518. (2019) |
Switzerland |
Cohort |
843 adolescents aged 13 to 15 years |
TV, computer, laptop, tablet and mobile phone use totaled an average screen time of > 2h/day |
Insufficient (< 8h/day) |
The longer the screen time, the lower the quality of sleep [OR = 2.11 (95%CI: 1.11-4.02); adjusted OR = 2.64 (95%CI: 1.33-5.26)] |
Night awakenings |
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| Hisler et al. 2525. Hisler G, Twenge JM, Krizan Z. Associations between screen time and short sleep duration among adolescents varies by media type: evidence from a cohort study. Sleep Med 2019; 66:92-102. (2019) |
United Kingdom |
Cohort |
11,361 adolescents with an average age of 13,777 |
Access to social media (between 1h and 2h/day); Internet (3h to 5h/day); games (between 1h and 2h/day); TV (between 2h and 3h/day) |
Insufficient (< 8h/day) |
Excessive use of digital screens is related to negative sleep results, mainly in the use of Internet for more than 2h/day (OR = 3.55; 95%CI: 2.74-4.61; p < 0.001). |
Reduction of sleep hours; night awakenings; and long sleep latency |
✬✬✬✬ |
| Mireku et al. 55. Mireku MO, Barker MM, Mutz M, Dumontheil I, Thomas MSC, Roosli M, et al. Night-time screen-based media device use and adolescents' sleep and health-related quality of life. Environ Int 2019; 12:66-78. (2019) |
United Kingdom |
Cross-sectional study |
6,816 adolescents with an average age of 12.1 years for boys and 12.0 years for girls |
Mobile phone usage after dark. Article does not describe the duration |
Sufficient (8.8h per night) |
Night-time use of mobile phones and television was associated with higher chances of insufficient sleep on weekdays (OR = 1.82; 95%CI: 1.59-2.07 and OR = 1.40; 95%CI: 1.23-1.60) |
Difficulty falling asleep, sleeping poorly, and waking up frequently during the night |
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| Scott et al. 1313. Scott H, Biello SM, Woods HC. Social media use and adolescent sleep patterns: cross-sectional findings from the UK millennium cohort study. BMJ Open 2019; 9:e031161. (2019) |
United Kingdom |
Cross-sectional study |
11,872 adolescents aged 13 to 15 years |
Social media usage (> 5h/day) |
Insufficient (less than 8h/day) |
Intense use of social media was associated with late (OR = 2.75; 95%CI: 2.38-3.18; p < 0.001) and poor sleep (OR = 2.11; 95%CI: 1.75-2.55; p < 0.001) |
Night awakening |
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| Hrafnkelsdottir et al. 1414. Hrafnkelsdottir SM, Brychta RJ, Rognvaldsdottir V, Chen KY, Johannsson E, Gudmundsdottir SL, et al. Less screen time and more physical activity is associated with more stable sleep patterns among Icelandic adolescents. Sleep Health 2020; 2:8-17. (2020) |
Iceland |
Cross-sectional study |
247 adolescents with an average age of 15.8 years |
Video games (1.0h±1.3h/day); Internet (2.2h±1.3h/day); TV (1.7h±0.9h/day) |
Insufficient (7.5±0.7) |
Screen time, especially for playing, was associated with poor quality of sleep (b = 3.813; SE = 1.010 p < 0.001) |
Night awakening and reduction of hours of sleep and rest |
✬✬✬✬ |
| McManus et al. 2424. McManus B, Underhill A, Mrug S, Anthony T, Stavrinos D. Gender moderates the relationship between media use and sleep quality. J Sleep Res 2021; 30:e13243. (2020) |
United States |
Cohort |
98 adolescents with an average age of 16.2 years |
Use of screen-based media with little or no interaction (videos, TV, computer and web browsing): 13h per week. Media interaction screen (video game, instant message, e-mail): 16h per week. Total: 33.5h per week |
Insufficient (7.15h of sleep) |
Association of interactive screen time with lower sleep quality at a 3-month follow-up (β = -0.25, p = 0.06). Three-month assessment: simple tilt analyses showed that longer interactive screen time was associated with better sleep quality for men (β = -0.48, p < 0.01), but not for women (β = 0.24 , p = 0.27) |
Depressive symptomatology and worse sleep quality |
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| Smith et al. 2626. Smith C, de Wilde T, Taylor RW, Galland BC. Prebedtime screen use in adolescents: a survey of habits, barriers, and perceived acceptability of potential interventions. J Adolesc Health 2020; 66:725-32. (2020) |
New Zealand |
Cross-sectional study |
4,811 adolescents from 13 to 17 years old |
Use of digital screens for more than 2h a day (p < 0.001) |
Insufficient (< 8h in 39% of participants) |
The most common screen activities before bedtime were social media (88%) and texting/instant messaging (77%). Most participants reported using phones in bed (86%) and “agreed” they spend a lot of time on screens (70%), a perception that increased with age (p = 0.008) |
Use of screens harms health, socialization, and schoolwork |
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