A Meta-Analysis of Electronic Media Use and Sleep Quality: An Updated Systematic Review.

BACKGROUND: This paper explores the widely discussed relationship between electronic media use and sleep quality, indicating negative effects due to various factors. However, existing meta-analyses on the topic have some limitations.

OBJECTIVE: The study aims to analyze and compare the impacts of different digital media types, such as smartphones, online games, and social media, on sleep quality.

METHODS: Adhering to PRISMA guidelines, the study performed a systematic meta-analysis of literature across multiple databases, including Web of Science, MEDLINE, PsycINFO, PubMed, Science Direct, Scopus, and Google Scholar, from January 2018 to October 2023. Two trained coders coded the study characteristics independently. The effect sizes were calculated using the correlation coefficient as a standardized measure of the relationship between electronic media use and sleep quality across studies. The Comprehensive Meta-Analysis Software 3 (CMA 3.0) was used to perform meta-analysis. Statistical methods such as funnel plots were utilized to assess the presence of asymmetry and p-curve test to test p hacking problem, which can indicate publication bias.

RESULTS: Following a thorough screening process, the study involved 55 articles (56 items) with 41,716 participants from over 20 countries, classifying electronic media use into 'general use' and 'problematic use'. Meta-analysis revealed that electronic media use was significantly linked with decreased sleep quality and increased sleep problems with varying effect sizes across subgroups. A significant cultural difference was also observed in these effects. General use was associated with a significant decrease in sleep quality. The pooled effect size was 0.28 (k=20, 95% CI 0.21 to 0.35). Problematic use was associated with a significant increase in sleep problems. The pooled effect size was 0.33 (k=36, 95% CI 0.28 to 0.38). The subgroup analysis indicated that the effect of general smartphone use and sleep problems was r=0.33 (CI 0.27 to 0.40), which was the highest among the general group. The effect of problematic Internet use and sleep problems was r=0.51 (CI 0.43 to 0.59), which was the highest among the problematic group. There were significant differences among these subgroups (general: Qbetween=14.46, p=.001; problematic: Qbetween=27.37, p<.001). The results of the meta-regression analysis using age, gender, and culture as moderators indicated that only cultural difference in the relationship between eastern and western culture was significant (Qbetween=6.69, p=.01). All funnel plots and p-curve analyses showed no evidence of publication and selection bias.

CONCLUSIONS: Despite some variability, the study overall confirms the correlation between increased electronic media use and poorer sleep outcomes, notably more substantial in Eastern cultures.