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Bedtime smart device usage and accelerometer-measured sleep outcomes in children and adolescents

Bedtime smart device usage and accelerometer-measured sleep outcomes in children and adolescents
Bedtime smart device usage and accelerometer-measured sleep outcomes in children and adolescents

Purpose: we analyzed the association between bedtime smart device usage habits and accelerometer-measured sleep outcomes (total sleeping time, sleep efficiency, and wake after sleep onset) in Hong Kong children and adolescents aged 8–14. 

Methods: a total of 467 students in Hong Kong participated in this study from 2016 to 2017. They self-reported their bedtime smart device usage habits. The primary caregiver of each participant was also invited to complete a self-administered questionnaire about the family’s social-economic status and bedtime smart device usage habits. An ActiGraph GT3X accelerometer was used to assess participants’ 7-day sleep outcomes. 

Results: the mean age of the participants was 10.3 (SD 1.9), and 54% were girls. Among the participants, 27% (n = 139) used a smart device before sleep, and 33% (n = 170) kept the smart device on before sleep. In total, 27% (n = 128) placed the smart device within reach before sleep, 23% (n = 107) would wake up when notifications were received, and 25% (n = 117) immediately checked the device after being awakened by a notification. Multiple regression controlling for age, sex, socio-economic status, and other confounders showed that those who woke up after receiving a notification had a statistically longer sleeping time (19.7 min, 95% CI: 0.3, 39.1, p = 0.046), lower sleep efficiency (− 0.71%, 95% CI − 1.40, − 0.02, p = 0.04), and a longer wake after sleep onset (2.6 min, 95% CI: 0.1, 5.1, p = 0.045) than those who did not. Nonetheless, all primary caregivers’ bedtime smart device habits were insignificantly associated with all sleep outcomes of their children. 

Conclusion: those who woke up after receiving smart device notifications had lower sleep efficiency and longer wake after sleep onset than those who did not, and they compensated for their sleep loss by lengthening their total sleep time.

Actigraphy, Cross-sectional, Hong Kong, Smartphone, Youth
1520-9512
477-487
Lee, Paul H.
02620eab-ae7f-4a1c-bad1-8a50e7e48951
Tse, Andy C.Y.
e0d6b2be-a736-43ac-b03e-d2d58a56e114
Cheung, Teris
230558d0-9254-44ab-a7e5-aab6ad90e205
Do, C. W.
f95a99ca-4db2-40de-a00c-3c9438c9ae8f
Szeto, Grace P.Y.
9e285ec0-522b-4581-bafa-6a6e79101982
So, Billy C.L.
c1241458-cc83-4be9-b36a-c4f441a6f3ef
Lee, Regina L.T.
76f8a357-ae4e-4e60-9583-75e033aa9fe7
Lee, Paul H.
02620eab-ae7f-4a1c-bad1-8a50e7e48951
Tse, Andy C.Y.
e0d6b2be-a736-43ac-b03e-d2d58a56e114
Cheung, Teris
230558d0-9254-44ab-a7e5-aab6ad90e205
Do, C. W.
f95a99ca-4db2-40de-a00c-3c9438c9ae8f
Szeto, Grace P.Y.
9e285ec0-522b-4581-bafa-6a6e79101982
So, Billy C.L.
c1241458-cc83-4be9-b36a-c4f441a6f3ef
Lee, Regina L.T.
76f8a357-ae4e-4e60-9583-75e033aa9fe7

Lee, Paul H., Tse, Andy C.Y., Cheung, Teris, Do, C. W., Szeto, Grace P.Y., So, Billy C.L. and Lee, Regina L.T. (2022) Bedtime smart device usage and accelerometer-measured sleep outcomes in children and adolescents. Sleep and Breathing, 26 (1), 477-487. (doi:10.1007/s11325-021-02377-1).

Record type: Article

Abstract

Purpose: we analyzed the association between bedtime smart device usage habits and accelerometer-measured sleep outcomes (total sleeping time, sleep efficiency, and wake after sleep onset) in Hong Kong children and adolescents aged 8–14. 

Methods: a total of 467 students in Hong Kong participated in this study from 2016 to 2017. They self-reported their bedtime smart device usage habits. The primary caregiver of each participant was also invited to complete a self-administered questionnaire about the family’s social-economic status and bedtime smart device usage habits. An ActiGraph GT3X accelerometer was used to assess participants’ 7-day sleep outcomes. 

Results: the mean age of the participants was 10.3 (SD 1.9), and 54% were girls. Among the participants, 27% (n = 139) used a smart device before sleep, and 33% (n = 170) kept the smart device on before sleep. In total, 27% (n = 128) placed the smart device within reach before sleep, 23% (n = 107) would wake up when notifications were received, and 25% (n = 117) immediately checked the device after being awakened by a notification. Multiple regression controlling for age, sex, socio-economic status, and other confounders showed that those who woke up after receiving a notification had a statistically longer sleeping time (19.7 min, 95% CI: 0.3, 39.1, p = 0.046), lower sleep efficiency (− 0.71%, 95% CI − 1.40, − 0.02, p = 0.04), and a longer wake after sleep onset (2.6 min, 95% CI: 0.1, 5.1, p = 0.045) than those who did not. Nonetheless, all primary caregivers’ bedtime smart device habits were insignificantly associated with all sleep outcomes of their children. 

Conclusion: those who woke up after receiving smart device notifications had lower sleep efficiency and longer wake after sleep onset than those who did not, and they compensated for their sleep loss by lengthening their total sleep time.

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More information

Accepted/In Press date: 9 April 2021
e-pub ahead of print date: 30 April 2022
Additional Information: © 2021. The Author(s).
Keywords: Actigraphy, Cross-sectional, Hong Kong, Smartphone, Youth

Identifiers

Local EPrints ID: 475113
URI: http://eprints.soton.ac.uk/id/eprint/475113
ISSN: 1520-9512
PURE UUID: 46e92931-2799-4588-a212-fe3006ce3180
ORCID for Paul H. Lee: ORCID iD orcid.org/0000-0002-5729-6450

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Date deposited: 10 Mar 2023 17:33
Last modified: 18 Mar 2024 04:09

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Contributors

Author: Paul H. Lee ORCID iD
Author: Andy C.Y. Tse
Author: Teris Cheung
Author: C. W. Do
Author: Grace P.Y. Szeto
Author: Billy C.L. So
Author: Regina L.T. Lee

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