Media consumption and sleep quality in early childhood: results from the Ulm SPATZ Health Study.

BACKGROUND: Media use is increasingly becoming common in preschoolers and starting before the age of three years. While several studies have documented the effects of screen time on sleep duration in this age group, investigations including sleep quality are scarce and mainly cross-sectional. Moreover, they are limited by investigating sleep across broader age ranges or in older preschoolers, which may blur early effects and the ideal time for intervention.

METHODS: The current study analyzed data from the Ulm SPATZ Health Study, a birth cohort study in which 1006 live newborns were recruited from the general population shortly after delivery at the University Medical Center Ulm, Southern Germany, from April 2012 to May 2013. Longitudinal data on child sleep were parent reported on the Children's Sleep Habits Questionnaire (CSHQ) at ages two and three years. Child media consumption was assessed at three years of age with different questions on electronic media and books. Statistical analyses included Kruskal-Wallis tests and multivariable linear and logistic regression models.

RESULTS: Electronic media consumption had a moderate prevalence and dose, and prevalence of never using books appeared to be high (39%). The preliminary results indicated strong statistically significant inverse cross-sectional associations between electronic media consumption and overall sleep quality and, using longitudinal data, with worsening indicators of bedtime resistance, sleep anxiety, and daytime sleepiness.

CONCLUSIONS: This was the first larger-scale study to comprehensively investigate the effects of electronic media consumption and book reading on all CSHQ items in three-year-olds. Considering the risk of chronification, preventive efforts (eg, by effective sleep-oriented training programs) already seem necessary in early life.