Beware of the time before sleeping

by drnieman on May 10, 2013

in Monthly

Too much screen-time for kids a problem, but can be part of solution

BY DR. PETER NIEMAN, FOR THE CALGARY HERALD MAY 8, 2013

Q: I was told by a friend recently that poor sleep patterns in my children and an increase in aggression may be due to television watching. Can that be true?

A: Children are increasingly impacted by media in a generation for which screen time has become more and more difficult to control. A Harvard-based pediatrician, Dr. Michael Rich, coined the term “mediatrician” (a pediatrician who is an expert on the impact of media on children’s health).

In the 1980s it was relatively easy to control total screen time. All a parent had to do was to ensure that the TV is not in the bedroom and that total TV watching not exceed more than one hour per day for a preschooler or no more than two hours for an older child. These times are now forever gone due to the ubiquitous use of tablets, mobile phones and video games. Parenting has become harder.

Recently researchers at the Center for Child Health, Behavior and Development in Seattle, Washington chose to study preschool-aged children, particularly to see what happens if media content was intentionally controlled by the parents.

The study, published in the March issue of Pediatrics, is the first of its kind. Preschool-aged children between the ages of three and five were recruited from community pediatric practices. The goal was to alter viewing habits by replacing violence-laden programs with high-quality educational programs, without trying to reduce total screen time.

Surprisingly, few studies have looked at the impact of violent television on preschool children — this is in contrast with older children where we know that reducing the total amount of television watching reduces aggressive behaviour. A New Zealand study also published in Pediatrics showed that excessive viewing during childhood and adolescence was associated with anti-social behaviour in adulthood.

The Seattle study showed that by altering the viewing habits of preschoolers, their overall social and emotional competence was enhanced. Low income boys derived the biggest benefit.
The authors concluded that by using a widely accepted and highly used medium, the results of their study may have a broad public health impact because we have the ability to reduce aggressive behaviour in children. They add that although television is frequently implicated as a cause of many problems, it may also be part of the solution.

In an editorial commenting on the study, Dr. Claire McCarthy, from Harvard observes, “For years many parents have ignored the advice of reducing screen time. If the screens are going to be on, let’s concentrate on the content and how we can make it work for children.”

Another important area where the amount of screen time may influence children’s health is sleep. A New Zealand study — also a first of its kind — was published in Pediatrics, showing that presleep activities have a major impact on the time of sleep onset in children.

The study was conducted with 2,017 children between the ages of five and 18 years. Participants were asked to record their activities during the 90 minutes before sleep. Activities recorded were: homework, reading, sport, extracurricular activities, video games, using tablets, mobile phones and television viewing.

What made this study unique was that participants included a wide geographic area and that it represented the population well in terms of age and ethnicity. It also looked in detail at the entire presleep period of 90 minutes — as opposed to just one single factor such as screen time alone.

The study showed that screen time dominated the presleep period. Nearly half of the sample reported sitting and watching television and screen time accounted for more than 30 minutes of the 90-minute period. Screen time as the major presleep activity was associated with kids falling asleep later. (The study did not look into the impact of screen time before bedtime on the quality of sleep throughout the night)

It is speculated that the blue light emitted by screens interfered with the production of melatonin which induce sleep. Screen time — especially action-oriented electronic games during the 90 minutes prior to going to bed also stimulates wakefulness by inducing fear or excitement.

These two studies confirm common sense — eliminate exposure of preschoolers to violent television shows and video games and replace it with prosocial, educational viewing; pay attention to what kind of activities children engage in during the 90 minutes prior to bedtime to help them more easily fall asleep.

Research shows that the majority of parents still need to be reminded of these important realities. Relaxing after a long day, watching TV or using other electronics, should not be allowed in the 90 minutes prior to bedtime.

For more information on what parents can do to ensure appropriate screen time, visit Media Health Matters (www.cmch.tv)

Dr. Peter Nieman is a community Pediatrican and the host of www.healthykids.ca. He is the co-founder of the Pediatric Weight Clinic in Calgary and the President of the Alberta Chapter of the American Academy of Pediatrics.
© Copyright (c) The Calgary Herald

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