Prolonged screen time is associated with increased prevalence of sleep disorders in children

PURPOSE: This study aimed to investigate whether sleep disorders are associated with electronic screen use before bedtime and total daily usage time in preschool children. METHODS: A cross-sectional study was conducted with 604 preschool children aged 4-5 years. Sleep disorders were assessed using the Sleep Disturbance Scale for Children (SDSC). Caregivers reported children's daily screen time and use of electronic media at bedtime. Data were analyzed using univariate and multivariate Poisson regression models with robust variance (p<0.05). RESULTS: Most children used electronic media to fall asleep (88.9%), and more than half used it for over one hour per day (66.9%), while 17.3% used it for more than 4 hours daily. Prolonged electronic screen time was independently associated with higher SDSC scores (p = 0.003; adjusted PR = 1.16; 95% CI = 1.05 - 1.28), as well as with the excessive daytime sleepiness (p = 0.015; adjusted PR = 1.16; 95% CI = 1.05 -1.28) and sleep-wake transition disorders (p = 0.026; adjusted PR = 1.12; 95% CI = 1.01 - 1.25). Use of media at bedtime was associated with disorders of initiating and maintaining sleep (p = 0.010; adjusted PR = 1.17; 95% CI = 1.04 - 1.33) and hyperhidrosis (p = 0.046; adjusted PR = 1.12; 95% CI = 1.00 - 1.27). CONCLUSION: Prolonged screen time and screen use before bedtime are associated with sleep disorders in preschool children. WHAT IS KNOWN: • Excessive and problematic screen use has been widely reported among children and adolescents,raising concerns about its potential impact on sleep health and children development. WHAT IS NEW: • Higher screen exposure was independently associated with sleep disturbances in preschool children, emphasizing early childhood as a critical window for interventions aimed at reducing screen-related sleep problems.