The dangers of too much screen time for children and how to fix it

Screen time before bedtime has been linked to higher BMIs and poor sleep quality among children

Seven years old boy siting in a sofa while he is playing video games on tv.
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Dinner time for mother-of-three Rhea Mehra is often a tricky process. Not only does she have to ensure that her children are back from the park or their various extra-curricular classes in time to shower and change into their nightclothes, but she also needs them to eat their food and get to bed by 9pm at the latest, to wake them up a little before 6am to get ready for school. It doesn't help matters that "one is a fussy eater, another a slow chewer and the third a chatterbox".

Mehra admits that the only way she can get them all to chomp through whatever is put in front of them, in good time, is by allowing them to eat while they browse on their tablets. "And once dinner is over, they are always wheedling for a few extra minutes, to finish that last game, cartoon or song. The next level or video starts automatically, which my husband and I often miss or sometimes overlook, especially if it's just before or during the weekend," she says.

Such is the case around many a dinner table, with hapless parents allowing their children screen time to get them to eat without creating a fuss, as a bribe for good behaviour or just to pass the time before bed. Whatever the reasons, experts believe that the use of electronic devices before bedtime can negatively impact the sleep cycle and increase the chances of childhood obesity.

The study

Last month, researchers from Penn State identified potential sleep and nutrition problems in children who used digital devices before going to bed. The study, published in the Global Paediatric Health journal, reported that using technology after-hours could result in less sleep, poor sleep quality, tiredness during the day and a higher body mass index (BMI). From the sample group of 234 children between the ages of 8 and 17, those who reported watching TV or playing video games before bed got an average of 30 minutes less sleep than those who did not. Also, those who used their phones or a computer before bed averaged an hour less sleep than those who did not. Medical student Caitlyn Fuller said the results may be indicative of a vicious cycle of technology use, poor sleep and weight gain. "We saw technology before bed being associated with less sleep and higher BMIs. And we also saw this technology use being associated with more fatigue in the morning, which circling back, is another risk factor for higher BMIs. So we're seeing a loop pattern forming."

The triggers

It goes without saying that sleep is one of the most important contributors to optimal functionality, and it impacts both health and behaviour. Numerous studies have established that poor sleep is associated with physical and emotional problems in childhood and adolescence. Dr Amani Osman, a consultant paediatric diabetologist at Al Ain's Imperial College London Diabetes Centre, further analyses the Penn State study for us. "The research highlights two factors as predictors of the moderate and high BMI groups. These are skipping breakfast and non-regular bedtimes. Disrupted bedtimes could affect weight because of an increased appetite, which in turn could lead to consumption of high-calorie foods.

“A short sleep duration ups the production of the hunger hormone, ghrelin, which causes increases in food intake and fat storage. Fewer hours of sleep also lead to a decreased leptin level. This is the energy-expenditure hormone, which stimulates the appetite and leads to further weight gain.

“Other generic studies have suggested that the use of electronic devices might impact the sleep cycle, because there is no set time for the use of electronics. Another point that research has focused on is the increased physiological, emotional and mental stimulation that media use can create. And finally, studies have suggested that the light emission from electronic screens may also affect sleep.” All these outcomes are magnified when it comes to children.

How well children sleep also impacts their day-to-day functioning. According to Dr Valeria Risoli, a clinical psychologist at Dubai Physiotherapy & Family Medicine Clinic, this plays out in two ways when combined with the unchecked use of gadgets. "First, if kids spend too much time interacting with screens during the day, it doesn't allow them to move enough and be physically active. This prevents the brain from producing the neuro chemicals that are essential for the functioning of our body.

Not moving enough during the day also leads kids to not feel tired in the evening. This results in difficulty in falling asleep and maintaining a good quality of sleep through the night,” she says. “And second, using electronics before bed leads to poor sleep quality. As a result, their ability to cope, move, think and perform during the day will be affected, especially in the mornings, and this can have an impact on their physical and psychological well-being.”

The solutions

The American Academy of Pediatrics recently released a recommendation advising families on media use. Osman explains: “Its suggestion is that media is ‘just another environment’ that children are exposed to. One recommendation that parallels this is to create tech-free zones by preserving family meal time.”

If children eat while glued to phones, tablets or the telly, it is likely to affect their ability to gauge when they are full, because they are more focused on the activity rather than the physical sensation of hunger or satiation. This may lead to eating too fast or too slow, or over- or under-eating, none of which is healthy for youngsters.

“Instead, make eating a social moment, an opportunity to interact with your children, to enquire about their day and tell them about your time. Treat it as a chance to ask and answer questions, and as a context to develop social and emotional abilities,” Risoli says. “Eliminating external interferences and constant distractions promotes mindfulness, and this can influence the amount of food we intake. Besides, engaging them in interesting and useful conversation can enrich their mind, stimulate their curiosity and improve their emotional and spatial awareness. It’s our responsibility to make them more interested in people and in the social aspects of life.”

Conditioning plays an important role, too. Good habits start from an early age, so limiting the use of electronic devices should be enforced among toddlers, many of whom are disturbingly adept at manoeuvring smartphones and tablets. This is in part because of our own tech-heavy habits, which are then picked up by our children. That anxiety you feel when you can't find your phone? Your children catch on to it. "We seem to need to have a device in our hands constantly: as soon as we wake up, when we drink our coffee, while working, when watching TV," Risoli explains.

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"We check email while we eat, while we cook, just before getting on the yoga mat or in the gym, when we are out for dinner, at the cinema, and just before we go to bed. If we don't change this, how can we teach our children to act differently? They learn mainly through vicarious processes. They observe us, they copy us. So we really need to improve our habits and provide them with a better model and example."

“Let’s be clear. There are many positive aspects in letting kids use technology: cognitive and educational stimulation, enhanced imagination, problem-solving skills, etc. However, everything has to be used in the right way, with the right dose. I would suggest limiting the screen time to one hour a day, during the day, and never before bedtime,” she adds.

And finally, a sure-fire trick is to ensure your children are engaged and entertained during the day, to the point that the adrenaline they experience earlier on makes them more relaxed closer to bedtime. “Being indoors all day, during holidays or weekends, leads to the temptation to use electronic devices to avoid boredom. Conversely, being outdoors encourages activity, which in turn lowers the chances of being overweight,” Osman says. She also recommends recharging devices outside the bedroom to promote healthier sleep.

Risoli adds: “Implementing a routine that involves sport, group or physical activities allows kids to be more active during the day and so more relaxed at night, limiting their need and, most importantly, their interest for screens in that moment.”