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Original Investigation |

Bidirectional Relationships Between Sleep Duration and Screen Time in Early Childhood

Christopher A. Magee, PhD1; Jeong Kyu Lee, PhD1; Stewart A. Vella, PhD2
[+] Author Affiliations
1Centre for Health Initiatives, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
2Interdisciplinary Educational Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
JAMA Pediatr. 2014;168(5):465-470. doi:10.1001/jamapediatrics.2013.4183.
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Importance  Sleep duration and media use (ie, computer use and television viewing) have important implications for the health and well-being of children. Population data suggest that shorter sleep duration and excessive screen time are growing problems among children and could be interacting issues.

Objective  To examine whether bidirectional relationships exist between sleep duration and media use among children, and whether these associations are moderated by child- and household-related factors.

Design, Setting, and Participants  Cohort study of a representative sample of 3427 Australian children (4-5 years of age at baseline [51.2% male children]), obtained from the Longitudinal Study of Australian Children. Data were available from 3 waves (2004, 2006, and 2008) when children were 4, 6, and 8 years of age, respectively.

Main Outcomes and Measures  Sleep duration and media use.

Results  Bidirectional relationships were observed between sleep duration and media use; for instance, total media use at 4 years of age was significantly associated with sleep duration at 6 years of age (β = −0.06 [95% CI, −0.10 to −0.02]), with media use at 6 years of age predicting sleep duration at 8 years of age (β = −0.06 [95% CI, −0.11 to −0.02]). Sleep duration at 4 years of age was associated with media use at 6 years of age (β = −0.10 [95% CI, −0.14 to −0.05]), with sleep duration at 6 years of age predicting media use at 8 years of age (β = −0.08 [95% CI, −0.13 to −0.03]). Several of these bidirectional relationships varied by socioeconomic status.

Conclusions and Relevance  The results supported the hypotheses that bidirectional relationships exist between sleep duration and media use among children. These findings are important given recent population trends for increased media use and shorter sleep durations among children.

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Figure.
Cross-Lagged Model Examining Relationships Between Sleep Duration and Total Media Use Between 4 and 8 Years of Age

Unstandardized coefficients are presented in these models. The subscript numbers indicate the age of the children (4, 6, or 8 years). aP < .05.

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