title: Media use and child sleep: the impact of content, timing, and environment.
abstract: BACKGROUND
  Media use has been shown to negatively affect a child's sleep, especially in the context of evening use or with a television in the child's bedroom. However, little is known about how content choices and adult co-use affect this relationship.
  
  
  OBJECTIVE
  To describe the impact of media content, timing, and use behaviors on child sleep.
  
  
  METHODS
  These data were collected in the baseline survey and media diary of a randomized controlled trial on media use in children aged 3 to 5 years. Sleep measures were derived from the Children's Sleep Habits Questionnaire. Media diaries captured time, content title, and co-use of television, video-game, and computer usage; titles were coded for ratings, violence, scariness, and pacing. Nested linear regression models were built to examine the impact of timing, content, and co-use on the sleep problem score.
  
  
  RESULTS
  On average, children consumed 72.9 minutes of media screen time daily, with 14.1 minutes occurring after 7:00 pm. Eighteen percent of parents reported at least 1 sleep problem; children with a bedroom television consumed more media and were more likely to have a sleep problem. In regression models, each additional hour of evening media use was associated with a significant increase in the sleep problem score (0.743 [95% confidence interval: 0.373-1.114]), as was daytime use with violent content (0.398 [95% confidence interval: 0.121-0.676]). There was a trend toward greater impact of daytime violent use in the context of a bedroom television (P=.098) and in low-income children (P=.07).
  
  
  CONCLUSIONS
  Violent content and evening media use were associated with increased sleep problems. However, no such effects were observed with nonviolent daytime media use.
authors.affiliation: Seattle Children's Research Institute, Center for Child Health, Behavior and Development, PO Box 5371, Seattle, WA 98145, USA. michelle.garrison@seattlechildrens.org
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Garrison
authors.forename: Kimberly
authors.initials: K
authors.lastname: Liekweg
authors.forename: Dimitri A
authors.initials: DA
authors.lastname: Christakis
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012890:Sleep; D013690:Television / Q000706:statistics & numerical data*; D013997:Time Factors; D018910:Video Games / Q000706:statistics & numerical data*; D014754:Violence