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Original Investigation |

Hours of Television Viewing and Sleep Duration in Children:  A Multicenter Birth Cohort Study

Marcella Marinelli, MSc, PhD1,2,3; Jordi Sunyer, MD, PhD1,2,3,4; Mar Alvarez-Pedrerol, PhD1,3; Carmen Iñiguez, PhD3,5,6; Maties Torrent, MD, PhD7; Jesús Vioque3,8; Michelle C. Turner, PhD1,3; Jordi Julvez, PhD1,2,3
[+] Author Affiliations
1Center for Research in Environmental Epidemiology, Barcelona, Spain
2Hospital del Mar Research Institute, Barcelona, Spain
3Spanish Consortium for Research on Epidemiology and Public Health, Barcelona, Spain
4Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
5Unit of Environment and Health, Center for Public Health Research, Valencia, Spain
6University of Valencia, Valencia, Spain
7Ib-Salut, Àrea de Salut de Menorca, Menorca, Spain
8Miguel Hernández University, Alicante, Spain
JAMA Pediatr. 2014;168(5):458-464. doi:10.1001/jamapediatrics.2013.3861.
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Importance  This study used longitudinal data to examine potential associations between hours of television viewing and sleep duration in children.

Objective  To examine the association between hours of television viewing and sleep duration in preschool and school-aged children.

Design, Setting, and Participants  Longitudinal, multicenter study among birth cohorts in Menorca, Sabadell, and Valencia from the Spanish Infancia y Medio Ambiente (environment and childhood) project. The study sample included 1713 children (468 from Menorca, 560 from Sabadell, and 685 from Valencia).

Exposure  Parent-reported child television viewing duration measured in hours per day at 2 and 4 years of age in Sabadell and Valencia and at 6 and 9 years of age in Menorca.

Main Outcomes and Measures  Parent-reported child sleep duration measured in hours per day at 2 and 4 years of age in Sabadell and Valencia and at 6 and 9 years of age in Menorca.

Results  In cross-sectional analysis, children with longer periods of television viewing reported at baseline (≥1.5 hours per day) had shorter sleep duration. Longitudinally, children with reported increases in television viewing duration over time (from <1.5 to ≥1.5 hours per day) had a reduction in sleep duration at follow-up visits. Results were similar when examining television viewing duration as a continuous variable, with each 1 hour per day of increased viewing decreasing sleep duration at follow-up visits (β = −0.11; 95% CI, –0.18 to −0.05). Associations were similar when television viewing duration was assessed during weekends and after adjusting for potential intermediate factors (child executive function and attention-deficit/hyperactivity disorder symptoms) and confounders (child physical activity level, parental mental health status, maternal IQ, and maternal marital status).

Conclusions and Relevance  Children spending longer periods watching television had shorter sleep duration. Changes in television viewing duration were inversely associated with changes in sleep duration in longitudinal analysis. Parents should consider avoiding long periods of daily television exposure among preschool and school-aged children.

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