Relationship between screen use, physical activity, sleep duration and bladder and bowel dysfunction in Thai children

Lower urinary tract dysfunction (LUTD) is prevalent among children and can cause chronic kidney disease. Multiple factors linked to LUTD, including genetic, physical, and behavioral characteristics, have been identified. However, research on the links among time spent on screens (television, computer, smart phones and tablets), physical activity, sleep duration and LUTD is limited. The aim of this study was to investigate the relationships among screen use, physical activity, sleep duration and LUTD among Thai children. In this cross-sectional study the parents or guardians of children aged 3–6 years in Thailand anonymously answered the online questionnaires (Dysfunctional Voiding Symptom Score and the surveillance of digital media habits in early childhood questionnaire®). Multivariable analysis was used to identify associated factors. Participants were 1,891 adult parents or guardians. The median age of the children was 4.9 years, and 53.8% were boys. Bladder and bowel dysfunction (BBD) was highly prevalent among girls and young children. Female sex and high average screen use were associated with BBD, with odds ratios of 3.74 (95% CI: 2.96–4.74; P < 0.001) and 1.10 (95% CI: 1.03–1.16; P = 0.002), respectively. In subgroup analysis based on gender and age, the analysis revealed that prolonged screen use was significantly associated with BBD only in girls (Adjusted OR = 1.12; 95% CI: 1.04–1.21; P = 0.002) and only in children aged 3 to < 5 years (Adjusted OR = 1.13; 95% CI: 1.05–1.22; P = 0.001), with no significant association found in their counterparts. However, increased amount of moderate-to-vigorous physical activity and short sleep duration were not associated to BBD. Higher screen use was associated with early lower urinary tract symptoms and bowel symptoms in preschool-kindergarten aged 3–<5 years and in girls. Parents and clinicians should be aware of the links between BBD and children’s prolonged screen use.