Touchscreen-using toddlers may sleep less

"'Touchscreen-toddlers' sleep less," BBC News report. Results from a survey of UK parents suggest every hour a child spends using a touchscreen device was associated with an hour's less sleep a night.

Reports such as this are likely to cause concern to many parents, as touchscreen devices, such as smartphones and tablets, are now widespread in most UK houses. The devices are often used as an easy form of entertainment for bored toddlers (and bring some much-needed relief for tired parents).

More than 700 parents took part in a survey that found 75% of children use a touchscreen on a daily basis. A link between levels of use and a reduction in daily sleep was found; however this one-off assessment does not prove that one thing has caused the other.

Many other environmental influences may be involved. Also, despite some of the more worrying headlines, such as The Daily Telegraph's "Ipads could hinder babies' sleep and brain development," the researchers did not look at the effect on developmental milestones. This is an area certainly worth researching, given the rise of "touchscreen toddlers".

It is well known that sleep is important for young children as it has a role in development. Any environmental influences found to reduce the quality of sleep should be limited. Read more advice about how much sleep children need as well as helpful tips that can help improve the quantity and quality of your child's sleep.

Where did the story come from?

The study was carried out by researchers from the University of London and was funded by a Philip Leverhulme Prize.

The study was published in the peer-reviewed medical journal Nature Scientific Reports on an open-access basis so it is free to read online.

The media reported on this study accurately, pointing out that it is not possible to prove that screen use is responsible for reducing sleep from this study.

However, the Telegraph and the Mail Online overstepped the mark by saying that reduction in sleep may increase a child's risk of doing badly at school.

What kind of research was this?

This was an online parental survey that aimed to see whether the use of touchscreen devices, such as mobile phones and tablets, is associated with reduced quality of sleep in infants and toddlers aged between 6 and 36 months.

Surveys are not able to prove that one thing causes another. Also, as all data is parent-reported, we can't rule out the possibility of recall bias or differences in how parents measure and interpret their child's sleep patterns and use of media devices.

However, it is possible to find potential links and see how these match with other similar research.

In this case, heavy use of screen media, such as TV and video games, is known to contribute to poor sleep. So it's important to establish if a similar effect can be seen with portable devices, which reports suggest are more widely used these days.

What did the research involve?

Between June 2015 and March 2016, UK-based parents of infants and toddlers aged 6 to 36 months completed an online questionnaire. Parents were invited to join the survey from Birkbeck Babylab database, Goldsmiths Babylab database and study advertisements from various news agencies, magazines, and charities, including the National Childbirth Trust.

The main areas of focus in the questionnaire were:

demographic information – age, sex and mother's level of education
child's media usage – frequency and duration of touchscreen and television use
developmental milestones

Infant sleep was assessed using the Brief Screening Questionnaire for Infant Sleep problems. This tool covered different sleep-related areas and asked parents about the following:

night-time sleep duration (7pm to 7am)
day-time sleep duration (7am to 7pm)
number of night awakenings
how long it takes for the child to go to sleep

The data was analysed using statistical methods to check for associations, adjusting for the possible effect of confounding factors such as socioeconomic status.

What were the basic results?

The researchers asked 715 parents questions about their child's touchscreen use. Around 75% of toddlers used touchscreen devices on a daily basis for an average of 24 minutes per day.

Usage increased with age, from 51% in the youngest category (6 to 11 months) for an average of 8.53 minutes a day, to 93% in toddlers (25 to 36 months) who spent around 45 minutes using touchscreen devices.

There was a significant association between the frequency of touchscreen use and sleep quality, as measured by looking at total sleep duration, duration of night-time sleep and daytime sleep.

Each additional hour of touchscreen use was associated with 15.6 minutes less total sleep. This was 26.4 minutes less night-time sleep, but 10.8 minutes more daytime sleep.

There was no association between touchscreen use and the number of times a night a child wakes up.

How did the researchers interpret the results?

The researchers concluded that, when controlled for the possible confounding effects of age, sex, TV exposure and maternal education, there was a significant association between touchscreen use and night-time sleep, daytime sleep and how quickly infants fell asleep. However there was no effect seen for the number of night awakenings.

They went on to say that future longitudinal studies are needed to clarify the long-term effects of touchscreen use and the underlying reasons for these effects using detailed sleep tracking.

Conclusion

This survey aimed to assess whether touchscreen use in infants and toddlers aged between 6 and 36 months has an impact on the quality of their sleep.

Sleep is very important for young children as it has a role in development, and if environmental influences are identified that reduce the quality of sleep, they should be limited.

This UK study has strengths in its good sample size and its attempts to control for the effects of other confounding variables – however, these weren't all explicitly listed. While a link between levels of touchscreen use and daily sleep was found, this cross-sectional study is not able to prove causation. We don't know that one thing has directly and independently caused the other and there may be many other unmeasured environmental factors involved.

Also, as highlighted above, parents may not have had full knowledge of their child's sleep quality or measured use of media devices accurately. Another point worth noting is that parents chose to take part in this study. There may be differences between the households of those who did and did not respond to advertisements to take part, and the children in this study may not be representative of all children.

There was also no assessment of the effect reduced sleep might have on developmental milestones, despite having asked about this. This would be an area for further research.

Despite limitations of this study, it is well known that sleep is important for young children as it has a role in development. Any issues found to reduce the quality of sleep should be limited to reduce the risk.

At six months of age a child is expected to have three hours of daytime sleep and 11 hours at night. By 36 months the amount of daytime sleep might reduce to as little as 45 minutes, although 11.5 to 12 hours are still needed at night. There is no indication in this study of how much sleep touchscreen users were found to have and whether this was less than the recommended amount.

Recent US guidelines recommend that children aged between 2 to 5 years should be restricted to one hour of any type of "screen time" per day.

If your child is not getting enough sleep there are sleep tips for children, such as relaxation techniques and avoiding screens in the bedroom, which can help.