Social Media Use, Sleep and Obesity in Children
Sleep is vital to the biopsychosocial development of a child, and the American Academy of Sleep Medicine recommends the following amounts per 24 hours [Paruthi et al., 2016]:
- Infants 4-12 months: 12 – 16 hrs (including naps)
- Children 1-2 years: 11 – 14 hours (including naps)
- Children 3 – 5 years: 10 – 13 hours
- Children 6 – 12 years: 9 – 12 hours
- Teenagers 13 – 18 years: 8 – 10 hours
Sleeping the number of recommended hours is associated with better health outcomes, including improved attention, behaviour, learning, memory, emotional regulation, quality of life, and mental and physical health.
However, a large systematic review of the literature covering 20 countries has shown that sleep duration has been consistently declining with children losing on average 1 hour of sleep per night over the last century. [Matricciani et al., 2012]
Read more about the neurobiology, pathophysiology, assessment and management of insomnia
- Insufficient sleep duration in children has consistently been shown to be negatively associated with cardiometabolic factors such as dietary habits, overweight status, and aerobic fitness. [Hitze et al., 2009], [Garaulet et al, 2011], [Tambalis et al, 2018].
- The association between insufficient sleep and behavioural problems in children is a mediator for attentional problems, conduct disorder [Holley et al., 2011], emotional lability [Nixon et al., 2008], and depressive symptoms. [Smaldone et al., 2007]
- Insufficient sleep in teenagers is associated with an increased risk of self-harm, suicidal thoughts, and suicide attempts. [Paruthi et al., 2016]
This trend in reduced sleep durations is partly explained by the increase in screen time and social media activities. [Matricciani et al., 2012], [De Jong et al., 2013], [Hale and Guan, 2015]
Although screen-based media devices are reliable predictors of reduced sleep duration, up to 72% of children, have been reported to have a mobile media device (smartphones and tablets) in their sleeping environment. [Gradisar et al., 2011]
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SOCIAL MEDIA EXPOSURE
The bedtime usage of media devices, or even just their presence in the bedroom, has detrimental sleep outcomes on sleep latency, inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness.
This is because media devices are psychologically (social media and social networking sites [SNS]) and physically stimulating (flashing LEDs).
Media devices impact circadian rhythm and sleep physiology and thus directly displace sleep by delaying and interrupting sleeping.
This unrelenting media device access then correlates with adverse events such as poor diet, sedative behaviour, obesity, reduced immunity, stunted growth, and mental health issues [Calamaro et al., 2009], [Gruber et al., 2014], [Carter et al., 2016].
SOCIAL MEDIA AND CHILDHOOD OBESITY
Studies have shown that the increased prevalence of childhood obesity is associated with chronic partial sleep deprivation. For instance, shorter sleep durations in children is associated with a 20% increase in the risk of overweight/obesity. [Wu et al., 2017], [Miller et al., 2018]
- Sedentary activities such as TV viewing and computer/smartphone use directly compete with physical activity [De Jong et al., 2013]. This displacement of physical activity for extended screen time is detrimental to health and cognitive development.
- Sleep deprivation causes irregularities in the secretion of hormones such as cortisol, insulin, ghrelin, and leptin, which together influence a child’s appetite and satiety. [St-Onge and Schechter, 2013]
- Extended screen time and the overbearing presence of unrealistic body ideals on social media as well as an individual’s physical or body dissatisfaction can reduce self-esteem and increase stress levels (both of which are proposed to be antecedents to obesity) [Hawkins et al., 2004].
Therefore, the rise in childhood obesity may be explained by a combination of sleep deprivation, time-competing activities, and unhealthy eating behaviours.
SOCIAL MEDIA, SELF ESTEEM AND NARCISSISM
Another concern with increased screen time on mobile media devices with broader capabilities is that they expose children to the possibility of real-time and continuous interactions through Social networking sites (SNSs) on the Internet. [Cain and Gradisar, 2010], [Hale and Guan, 2015]
Aboujaoude described the creation of the social avatar that facilitates the shifting personal identity between the e-world and real-world. [Aboujaoude E, 2011]
It has been reported that up to 18% of children and adolescents have been shown to exhibit some form of digital dependency or problematic Internet use. [Cheng and Li, 2014], [Kuss et al, 2014]
Internet addiction is described in the DSM-V and has been shown to have a deleterious impact on mood as well as executive functioning, behaviour, and personality issues related to narcissism. Excessive internet use can be associated with the following.
- Dysthymic mood – Symptoms of anxiety and low self-esteem are a consistent correlation with all types of Internet addictions.
- Executive functioning – deficits in attention span as well as inhibition of memory skills and impulse control can significantly affect school performance in children.
- Narcissistic behaviours – Self-importance, arrogance, egoistic behaviours, and an absence of empathy (grandiose narcissism) is frequent however there can also be oscillations in self-esteem due to the distorted perceptions of others (vulnerable narcissism).
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INTERVENTIONS
Up to 42% of children aged 9 to 12 years old have a Facebook profile even though SNS policies prohibit children under the age of 13 from having an SNS profile. [Barbovschi et al., 2015]
Many of these children also have explicit permission from parents, which appears to be under the principle that SNSs offer children an expanded social circle as well as playing a formative role in a child’s digital literacy development.
Therefore, parents require guidance on their anxieties about how to develop a child’s social circle as well as how to monitor their child’s daily Internet use and any personality changes (e.g. online disinhibition) that the Internet may nurture.
Interventions should ideally include age-specific guidance, as well as parent and teacher-led initiatives to reduce media device access and use. For instance:
- The incorporation of time-sensitive switches near a child’s bedtime is one possible method of restriction.
- Another is that SNSs are provided with a strict time-limit and only when a parent is present (i.e. co-use).
- Clinicians are encouraged to talk to parents and children during routine clinical visits to identify any signs of sleep deprivation and to explore media device access and use.
Finally, it is interesting to note that the increase in screen-based learning at school may also impact sleep hygiene in children.
However, technology use enhances learning and brain plasticity, and therefore, restrictions to a child’s interaction with technology should not discriminate against the relevant parts of technology that foster learning and brain plasticity. [Bavelier et al, 2010]
CONCLUSION
Short sleep duration is a risk factor for adverse behavioural, cardiometabolic, and social development outcomes in children.
Screen-based devices with access to social media and SNSs are prevalent in the paediatric population and are associated with a detrimental impact to children’s sleep duration and quality.
Parents require guidance on how to approach reducing the influence that social media and SNSs have on their children’s physical and mental development.
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