title: The association between television viewing and irregular sleep schedules among children less than 3 years of age.
abstract: BACKGROUND
  Regular sleep schedules are an important part of healthy sleep habits. Although television viewing is associated with altered sleep patterns and sleep disorders among children and adolescents, the effect of television viewing on the sleep patterns of infants and toddlers is not known.
  
  
  OBJECTIVE
  To test the hypothesis that television viewing by infants and toddlers is associated with having irregular naptime and bedtime schedules.
  
  
  METHODS
  We used data from the National Survey of Early Childhood Health, a nationally representative, cross-sectional study of the health and health care of children 4 to 35 months of age. Our main outcome measures were whether children had irregular naptime and bedtime schedules. Our main predictor was hours of television watched on a daily basis. We performed multivariate logistic regression analyses, adjusting for a variety of factors including demographic information, measures of maternal mental health, and measures of family interactions, to test the independent association of television viewing and irregular naptime and bedtime schedules.
  
  
  RESULTS
  Data were available for 2068 children. Thirty-four percent of all children had irregular naptime schedules, and 27% had irregular bedtime schedules. Mean hours of television viewing per day were as follows: 0.9 hours/day (95% confidence interval [CI]: 0.8-1.0 hours/day) for children <12 months of age, 1.6 hours/day (95% CI: 1.4-1.8 hours/day) for children 12 to 23 months of age, and 2.3 hours/day (95% CI: 2.1-2.5 hours/day) for children 24 to 35 months of age. In our logistic regression model, the number of hours of television watched per day was associated with both an irregular naptime schedule (odds ratio: 1.09; 95% CI: 1.01-1.18) and an irregular bedtime schedule (odds ratio: 1.13; 95% CI: 1.04-1.24).
  
  
  CONCLUSIONS
  Television viewing among infants and toddlers is associated with irregular sleep schedules. More research is warranted to determine whether this association is causal.
authors.affiliation: Robert Wood Johnson Clinical Scholars Program, University of Washington, Seattle, Washington, USA. darcy3@u.washington.edu
authors.forename: Darcy A
authors.initials: DA
authors.lastname: Thompson
authors.forename: Dimitri A
authors.initials: DA
authors.lastname: Christakis
mesh_terms: D002654:Child Care; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D020920:Dyssomnias / Q000209:etiology*; D005190:Family; D006801:Humans; D007223:Infant; D012959:Socioeconomic Factors; D013690:Television