Media use in association to sleep quality in German preschoolers. A mediation analysis based on the Ulm SPATZ Health Study.

Purpose Evidence suggests a relation of digital media use with poor sleep quality and inadequate sleep quantity. However, longitudinal data in preschoolers simultaneously investigating several aspects of adequate sleep and potential mediation are scarce.

Methods We used parent-reported data from self-administered questionnaires in three yearly follow-ups at child ages 4, 5, and 6 years. Sleep quality was measured by the total score of the Children’s Sleep Habits Questionnaire (CSHQ; German version). Average digital media use and book reading were ascertained separately for weekends and work days. Sleep duration and midpoint of sleep were assessed by the Child Chronotype Questionnaire. A mediation analysis was performed in the form of a causal path modelling. Direct and indirect effects were reported as standardized and rescaled regression coefficients.

Results We observed significant effects for total digital media use and TV/DVD watching only, but electronic gaming only and book reading did not affected sleep quality score, sleep duration, or midpoint of sleep. There was little evidence for an indirect effect of media use on sleep quality via sleep duration or midpoint of sleep, indicating that media use acts independently on sleep duration, midpoint of sleep, and sleep quality. Non-statistically significant effects of sleep duration and midpoint of sleep on sleep quality score indicate that sleep quality, sleep quantity, and chronotype are independent aspects of sleep adequacy.

Conclusions Digital media use was associated with impaired sleep quality in German preschoolers. In parallel, we found that media use also affected sleep duration and midpoint of of sleep. However, our analyses just weakly support an indirect effect of digital media use on sleep quality mediated through sleep duration or chronotype.

Publication History

Article published online:
02 September 2021