Martin KB, Bednarz JM, Aromataris EC. Interventions to
control children's screen use and their effect on sleep: A systematic review
and meta-analysis [published online ahead of print, 2020 Jun 21]. J Sleep Res.
2020;e13130. doi:10.1111/jsr.13130
Abstract
Prolonged viewing of screen-based media is associated with
poor sleep in children. Previous systematic reviews have analysed the
effectiveness of interventions that aim to limit children's screen use;
however, none have evaluated its effect on sleep. The aim of this systematic
review was to evaluate the effect of interventions that incorporate strategies
to control children's screen use on screen use and sleep. The databases Pubmed,
Embase, Eric, Scopus and PsycInfo were searched during October 2017 and updated
in February 2019 for experimental studies with a control that assessed
interventions to control screen use in children aged 2-14 years and reported
both screen use and sleep outcomes. From 3,872 initial records, 11 studies (six
randomized control [RCT], four cluster RCT and one cluster, quasi-experimental)
were eligible for inclusion. A total of 4,656 children aged 2-13 years were
included in the studies. The mean reduction in screen time was 0.56 hr (33
min)/day (95% confidence interval [CI], 0.92, 0.20) and the mean sleep duration
increased by 0.19 hr (11 min)/day (95% CI, 0.05, 0.33). Bedtime was advanced by
0.16 hr (10 min) on weekdays and by 1.0 hr at the weekend. Subgroup analyses
indicated stronger intervention effects for interventions of shorter duration
(<3 months), which specifically targeted screen use or sleep, and those with
direct participant contact. In conclusion, small improvements in screen time
and sleep duration can be achieved in children. It is not possible to determine
if a reduction in screen time directly improves sleep, due to the limited number
of studies, the presence of co-interventions, issues with studies'
methodological quality and heterogeneity.
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