Screen Use Effects on Children's Sleep

(SCREENS Trial)

Overseen By Insia Raza, MPH

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Baylor College of Medicine

Must not be taking: Sleep medications

Disqualifiers: Blindness, Vision problems, Sleep disorder, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

220 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how different types of screen use before bedtime affect children's sleep and next-day functioning. Researchers aim to determine whether the bright light from screens or the exciting content is more disruptive to sleep patterns. Children will try different combinations, such as bright screens with exciting content or dim screens with calming content, and compare these effects to quiet, non-screen activities. Children who sleep alone most nights and don't have significant sleep or vision issues might be suitable participants, especially if they live in the greater Houston area. As an unphased study, this trial provides a unique opportunity to contribute to understanding how screen time impacts children's sleep and daily life.

Will I have to stop taking my current medications?

The trial excludes children who are taking medications that impact sleep, so if your child is on such medications, they would not be eligible to participate.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that using screens before bed can cause children to go to bed later and sleep less, though no direct evidence of harm exists. Studies have found that screen time often correlates with poorer sleep quality and longer times to fall asleep, especially with bright screens and exciting content.

Blue light from screens can reduce melatonin, the hormone that aids sleep, potentially delaying or disrupting sleep for kids. Exciting content can also keep kids alert, making it harder for them to fall asleep.

Calmer content on dim screens might have a lesser impact on sleep. However, even dim screens can still affect sleep, particularly if used right before bedtime.

Overall, while screens can alter sleep patterns, no evidence suggests they cause harm beyond sleep disruption. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how different types of screen exposure before bed affect children's sleep. Unlike traditional advice that simply suggests reducing screen time, this trial examines the impact of various screen settings and content types, such as bright versus dim screens and calming versus exciting content. By comparing these different conditions, the trial aims to uncover more precise guidelines for parents on how to manage screen use in a way that supports better sleep for children.

What evidence suggests that this trial's treatments could be effective for improving children's sleep?

Research has shown that using screens before bedtime can make it harder for children to fall asleep and can shorten their sleep time. This trial will expose children in different groups to various screen conditions to study these effects. For example, Group 1 will experience bright screens with exciting content, which can lower melatonin levels, a hormone that aids sleep. Group 3 will use a tablet with a dim, filtered screen and exciting content, while Group 4 will use a dim, filtered screen with calming content, which might reduce these effects and lead to better sleep. Calming content is believed to be less stimulating, potentially helping children fall asleep more easily. Although more research is needed, both the type of light and the kind of content on screens play important roles in how screen time affects children's sleep. ^{2 3 6 7 8}

Who Is on the Research Team?

Jennette P Moreno, PhD

Principal Investigator

Baylor College of Medicine

Candice A Alfano, PhD

Principal Investigator

University of Houston

Are You a Good Fit for This Trial?

The SCREENS study is for children aged between 8 and 11.9 years who are in the early stages of physical development, live with a parent or guardian at least half the time, and can communicate in English. It's not for kids with cognitive impairments like ADHD, sleep-affecting medical conditions, recent travelers across time zones, those with significant vision issues or diagnosed sleep/psychiatric disorders.

Inclusion Criteria

My child is between 8 and 11 years old.

My physical development is in the early stages.

I live with my parent(s) or legal guardian more than half the time.

Exclusion Criteria

Developmental or cognitive delays

Diagnosed cognitive or learning impairment affecting executive functioning (e.g., attention deficit hyperactivity disorder)

Travel beyond 2 time zones in the month before starting the study

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

Baseline

Collection of baseline data including demographics and structured interviews

1 day

1 visit (virtual)

Experimental Weekend Protocol

Children participate in experimental and control conditions with screen media exposure and non-screen activities

3 days

In-home visits by research staff

Follow-up

Participants are monitored for changes in sleep, emotion regulation, and executive functioning

1 week

What Are the Treatments Tested in This Trial?

Interventions

• Calming Content
• Exciting content
• Filtered dim tablet screen
• no screen control with dim light and calming activities
• unfiltered Bright tablet screen

Trial Overview

This study tests how using tablets before bed affects children's sleep quality and next-day emotions and thinking skills. Kids will use tablets with different screen settings (dimmed vs bright) and content types (calming vs exciting), compared to no screen use at all.

How Is the Trial Designed?

Group I: Group 4 Experimental Treatment 3 Interventions

Children will participate in 2 exposure conditions in their own homes (i.e., experimental and internal negative control), facilitated by research staff (one week apart, counterbalanced to control for possible order effects). The internal negative control will be the same for all groups, but the experimental exposure will differ. Both exposures will take place for 1 hour before bed in room lighting (40-50 lux). Experimental exposure: children in Group 4 will be exposed to a tablet with filtered dim screen light and calming media content (DL/CC). Internal negative control exposure: children will participate in non-screen-based quiet activities

Group II: Group 3 Experimental Treatment 3 Interventions

Children will participate in 2 exposure conditions in their own homes (i.e., experimental and internal negative control), facilitated by research staff (one week apart, counterbalanced to control for possible order effects). The internal negative control will be the same for all groups, but the experimental exposure will differ. Both exposures will take place for 1 hour before bed in room lighting (40-50 lux). Experimental exposure: children in Group 3 will be exposed to a tablet with filtered dim screen light and exciting media content (DL/EC). Internal negative control exposure: children will participate in non-screen-based quiet activities

Group III: Group 2 Experimental Treatment 3 Interventions

Children will participate in 2 exposure conditions in their own homes (i.e., experimental and internal negative control), facilitated by research staff (one week apart, counterbalanced to control for possible order effects). The internal negative control will be the same for all groups, but the experimental exposure will differ. Both exposures will take place for 1 hour before bed in room lighting (40-50 lux). Experimental exposure: children in Group 2 will be exposed to a tablet with unfiltered bright screen light and calming media content (BL/CC). Internal negative control exposure: children will participate in non-screen-based quiet activities

Group IV: Group 1 Experimental Treatment 3 Interventions

Children will participate in 2 exposure conditions in their own homes (i.e., experimental and internal negative control), facilitated by research staff (one week apart, counterbalanced to control for possible order effects). The internal negative control will be the same for all groups, but the experimental exposure will differ. Both exposures will take place for 1 hour before bed in room lighting (40-50 lux). Experimental exposure: children in Group 1 will be exposed to a tablet with unfiltered bright screen light and exciting media content (BL/EC). Internal negative control exposure: children will participate in non-screen-based quiet activities

Who Is Running the Clinical Trial?

Baylor College of Medicine

Lead Sponsor

Trials

1,044

Recruited

6,031,000+

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Collaborator

Trials

2,103

Recruited

2,760,000+

Published Research Related to This Trial

In a study of 10,280 early adolescents aged 10-14, it was found that having a television or internet-connected device in the bedroom significantly increased the risk of sleep disturbances, with a 27% higher risk of trouble falling asleep.

Engaging in various screen activities before bed, such as streaming movies or using social media, was linked to greater sleep disturbances, suggesting that specific bedtime screen behaviors should be addressed to improve sleep quality in adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bedtime screen use behaviors and sleep outcomes: Findings from the Adolescent Brain Cognitive Development (ABCD) Study. Nagata, JM., Singh, G., Yang, JH., et al.[2023]

The review identified 36 studies examining the impact of electronic media on sleep in school-aged children and adolescents, highlighting that media use is consistently linked to delayed bedtimes and shorter total sleep duration.

A proposed model of how electronic media affects sleep is discussed, suggesting pathways for future research to explore these relationships further.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Electronic media use and sleep in school-aged children and adolescents: A review. Cain, N., Gradisar, M.[2022]

In a study of 3,011 school-age children in Sweden, those who slept less than the median reported significantly lower enjoyment of school, highlighting the importance of adequate sleep for positive school experiences.

Short sleep duration was linked to having a TV in the bedroom and spending over 2 hours daily on screens, which contributed to feelings of tiredness and difficulties in waking up, suggesting that media habits can negatively impact sleep and learning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sleep and television and computer habits of Swedish school-age children. Garmy, P., Nyberg, P., Jakobsson, U.[2022]

In a study of 16 healthy adolescents, using a bright tablet screen before bedtime resulted in slightly faster reaction times and improved accuracy on a task compared to a dim screen, but these differences were minimal and likely not clinically significant.

No significant effects were observed on sleep onset or quality, indicating that short-term exposure to bright screens may not have a major impact on sleep for adolescents, suggesting the need for further research on longer screen usage durations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does one hour of bright or short-wavelength filtered tablet screenlight have a meaningful effect on adolescents' pre-bedtime alertness, sleep, and daytime functioning? Heath, M., Sutherland, C., Bartel, K., et al.[2015]

Interventions aimed at controlling screen use in children aged 2-14 years resulted in a mean reduction of screen time by about 33 minutes per day and an increase in sleep duration by approximately 11 minutes per day, based on a systematic review of 11 studies involving 4,656 children.

While the findings suggest that reducing screen time may lead to small improvements in sleep duration, the evidence is not strong enough to confirm a direct causal relationship due to methodological limitations and variability among the studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Interventions to control children's screen use and their effect on sleep: A systematic review and meta-analysis. Martin, KB., Bednarz, JM., Aromataris, EC.[2021]

Children aged 4-8 who used three or more media devices, excluding TV/DVDs, were more likely to have delayed bedtimes, indicating a link between excessive device use and sleep disruption.

Smartphone use, even for just 0.1-1 hour per day, was associated with delayed bedtimes, particularly when used for gaming, highlighting the need for families to limit screen time to promote better sleep in young children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Association between Media Use and Bedtime Delays in Young Children: An Adjunct Study of the Japan Environment and Children's Study. Yamamoto, M., Mezawa, H., Sakurai, K., et al.[2022]

A literature review revealed that 90% of studies found a link between screen media use and both delayed bedtimes and reduced total sleep time in children and adolescents.

The widespread issue of sleep loss due to screen media has significant health implications, highlighting the need for further research to promote healthy sleep habits among youth and inform parents, teachers, and clinicians.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Youth Screen Media Habits and Sleep: Sleep-Friendly Screen Behavior Recommendations for Clinicians, Educators, and Parents. Hale, L., Kirschen, GW., LeBourgeois, MK., et al.[2019]

In a study of 736 Finnish preschool children, each additional hour of screen time was linked to a bedtime that was 11 minutes later and a sleep duration that was 10 minutes shorter, indicating a negative impact on sleep.

Different types of screen use, including TV, tablets, and computers, were all associated with later bedtimes and shorter sleep durations, highlighting the need for promoting balanced screen time and healthy sleep habits in young children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Relationship between screen time and sleep among Finnish preschool children: results from the DAGIS study. Hiltunen, P., Leppänen, MH., Ray, C., et al.[2021]

In a study of 467 children and adolescents in Hong Kong, those who woke up due to smart device notifications experienced lower sleep efficiency and longer wake times after initially falling asleep, indicating a negative impact on their sleep quality.

Interestingly, these individuals compensated for their disrupted sleep by increasing their total sleeping time, suggesting that while smart device usage can affect sleep patterns, some children may adjust their sleep duration to make up for lost sleep.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Bedtime smart device usage and accelerometer-measured sleep outcomes in children and adolescents. Lee, PH., Tse, ACY., Cheung, T., et al.[2022]

Adolescents aged 12-18 who used technology devices like phones and laptops for 30 minutes before bed experienced delays in their bedtimes, with phone use causing a 9-minute delay and laptops causing a similar delay.

Using devices such as gaming consoles and watching YouTube was linked to a higher likelihood of insufficient sleep (≤7 hours) and increased daytime sleepiness, indicating that these activities may negatively impact sleep quality for adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What's "app"-ning to adolescent sleep? Links between device, app use, and sleep outcomes. Pillion, M., Gradisar, M., Bartel, K., et al.[2023]

Citations

1.

withpower.com

withpower.com/trial/phase-sleep-1-2024-052a2

Screen Use Effects on Children's Sleep (SCREENS Trial)

Research suggests that using screens before bedtime can lead to delayed bedtimes and shorter sleep duration in children, but there is no direct evidence of harm ...

2.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC5839336/

Youth screen media habits and sleep - PubMed Central - NIH

Another study found that children showed significantly greater melatonin suppression compared to adolescents in response to varying degrees of evening light ...

3.

uh-ir.tdl.org

uh-ir.tdl.org/bitstreams/41482ebd-5c4d-4db2-aad2-dd5cf5889fe7/download

The Impact of Screen Brightness and Media Content on ...

➢ Results from the study will provide needed insight into the impact of pre-sleep screen light and media content on children's sleep duration toward ...

4.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC10903530/

The Impact of Screen Time on Sleep Patterns in School ...

Results: The analysis showed that children with low screen time had better sleep efficiency (90% vs. 75%), more frequent dream recall (70% vs. ...

5.

thensf.org

thensf.org/effects-of-screen-use-on-childrens-sleep/

Effects of Screen Use on Children's Sleep

Screen use impairs sleep health for both children and adolescents. In particular, the content of screen use before bed can have a negative effect on sleep.

6.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC11280700/

Screen time and sleep in children - PMC

Screen time was negatively correlated with sleep outcomes such as timing, duration, quality, onset latency, sleepiness, and other effects.

7.

sleepfoundation.org

sleepfoundation.org/children-and-sleep/how-blue-light-affects-kids-sleep

How Blue Light Affects Kids' Sleep

Blue light decreases melatonin levels and may delay or disrupt sleep in children. Learn about how you can reduce blue light exposure before ...

8.

colorado.edu

colorado.edu/today/2024/05/28/light-or-content-what-we-know-about-screens-and-sleep-disruption

The light or the content? What we know about screens and ...

In general, screen use impairs sleep health among children and adolescents. The content of screen use before sleep impairs sleep health of ...