Sleep Problems and Their Associations with Digital Screen Exposure Among 2 to 5 Years Old Children in Chandigarh, a North Indian Union Territory

Abstract

Background: Watching television and other electronic devices can adversely affect children’s sleep. This study aims to ascertain the association of sleep problems with digital screen exposure (DSE) among 2- to 5-year-old children in Chandigarh, India. Methods: A cross-sectional study was conducted among 400 randomly selected families having 2- to 5-year-old children, using a validated DSE questionnaire and the standard child’s sleep habits questionnaire abbreviated, from October 2017 to March 2018. The American and Indian Academy of Pediatrics guidelines were used to define higher DSE as more than 1 h per day. The multivariate binary logistic regression analysis was performed using IBM SPSS Statistics for Macintosh, Version 26.0 (IBM Corp., New York, USA), to identify significant predictors of sleep problems. Results: Boys (51.5%) and girls (48.5%) were equally represented. On average, children (3.5 ± 0.9 years) slept for 10 ± 1.6 h per day. Bedtime sleep resistance (15.1% vs 11%) and sleep behavior problems (11.8% vs 5.6%) were significantly ( P < .05) higher among children with higher DSE than children having DSE of less than 1 h per day. The significant predictors of sleep problems were children living in a nuclear family (adjOR = 2.4, CI [1.1, 5.3]), watching non-educational digital media content (adjOR = 2.6, 2.36, CI [1.1, 6.2]), and absence of digital media rules at home (adjOR = 3.9, CI [1.3, 12]). In the subgroup analysis, children having higher DSE (adjOR = 2.4, CI [1.1, 4.9]) had a significantly greater probability of bedtime resistance, and those living in a nuclear family (adjOR = 1.7, CI [1.1, 2.7]) had a significantly greater probability of morning waking-up problems. Conclusion: Sleep problems were significantly associated with higher DSE among young children in Chandigarh, India.