Association Between Portable Screen-Based Media Device Access or Use and Sleep Outcomes: A Systematic Review and Meta-analysis.
Association Between Portable Screen-Based Media Device Access or Use and Sleep Outcomes: A Systematic Review and Meta-analysis.
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DOI：
10.1001/jamapediatrics.2016.2341
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发表时间：
2016-12-01
期刊：
影响因子：
26.1
通讯作者：
Paradkar MS
中科院分区：
文献类型：
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作者：
Carter B;Rees P;Hale L;Bhattacharjee D;Paradkar MS
睡眠对儿童的生物-心理-社会发展至关重要。睡眠数量和质量不足是一个公共卫生问题，具有一系列有害的健康结果。便携式移动的和媒体设备已经成为儿童生活中无处不在的一部分，并且可能影响儿童的睡眠持续时间和质量。本系统综述旨在检查便携式媒体设备（例如移动的手机和平板设备）对睡眠结果的影响。制定了检索策略，并在2011年1月1日至2015年6月15日期间的12个数据库中检索了已发表文献和灰色文献。未应用语言限制。我们纳入了随机对照试验、队列研究和横断面研究设计。在467项确定的研究中，20项横断面研究进行了质量评估。数据提取和质量评估由两名评审员独立进行，分歧由三分之一解决。在随机效应荟萃分析中汇总数据，并在可能时进行个体参与者荟萃分析。主要结局为：睡眠不足;睡眠质量差;和过度的日间嗜睡，按照先验协议进行。纳入20项研究并进行质量评估，涉及125，198名儿童，50.1%为男性。睡前使用媒体设备与以下因素之间存在强烈且一致的相关性：睡眠量不足（OR =2.17; 95%CI 1.42-3.32）;睡眠质量差（OR=1.46; 95%CI 1.14-1.88）;以及白天过度嗜睡（OR=2.72; 95%CI 1.32-5.61）。此外，在夜间使用（但不使用）媒体设备的儿童更可能存在以下不足：睡眠量（OR=1.79; 95%CI 1.39-2.31）;睡眠质量（OR=1.53; 95%CI 1.11-2.10）;和白天嗜睡（OR=2.27; 95%CI 1.54-3.35）。这是第一次对媒体设备的访问和使用对睡眠结果的影响进行荟萃分析。睡前访问和使用媒体设备与睡眠不足、睡眠质量差和白天过度嗜睡显著相关。教师、医疗保健提供者和家长之间需要采取综合方法，以尽量减少睡前使用设备，未来的研究需要评估对睡眠卫生和结果的影响。
Sleep is vital to children’s bio-psycho-social development. Inadequate sleep quantity and quality is a public health concern with an array of detrimental health outcomes. Portable mobile and media device have become a ubiquitous part of children’s lives and may impact children’s sleep duration and quality. This systematic review was conducted to examine the effect of portable media devices (e.g. mobile phones, and tablet devices) on sleep outcomes A search strategy was developed and searches of the published and grey literature were conducted across 12 databases from January 1st 2011 to June 15th, 2015. No language restriction was applied. We included randomized controlled trials; cohort; and cross sectional study designs. Of 467 studies identified, 20 cross-sectional studies were assessed for quality Data extraction and quality assessment was independently carried out by two reviewers and disagreements resolved by a third. Data was pooled in a random-effects meta-analysis, and an individual participant meta-analysis was carried out where possible. The primary outcomes were: inadequate sleep quantity; poor sleep quality; and excessive daytime sleepiness, carried out following an a priori protocol. Twenty studies were included and quality assessed, involving 125,198 children, 50.1% were male. There was a strong and consistent association between bedtime media device use and: inadequate sleep quantity (OR =2.17; 95%CI 1.42-3.32); poor sleep quality (OR=1.46; 95%CI 1.14-1.88); and excessive daytime sleepiness (OR=2.72; 95%CI 1.32-5.61). Additionally, children who had access to (but did not use) media devices at night were more likely to have inadequate: sleep quantity (OR=1.79; 95%CI 1.39-2.31); sleep quality (OR=1.53; 95%CI 1.11-2.10); and daytime sleepiness (OR=2.27; 95%CI 1.54-3.35). This was the first meta-analysis of the effect of access and use of media device on sleep outcomes. Bedtime access and use of media devices was significantly associated with inadequate sleep quantity; poor sleep quality; and excessive daytime sleepiness. An integrated approach between teachers, healthcare providers and parents is needed to minimize device access at bedtime, and future research is needed to evaluate the impact on sleep hygiene and outcomes.