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Future Directions for Screen Time Interventions for Sleep | Sleep Medicine | JAMA Pediatrics | vlog

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Editorial
ٴDz21, 2024

Future Directions for Screen Time Interventions for Sleep

Author Affiliations
  • 1The Ballmer Institute for Children’s Behavioral Health and the Department of Psychology, University of Oregon, Eugene
  • 2Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
JAMA Pediatr. Published online October 21, 2024. doi:10.1001/jamapediatrics.2024.4009

Parents and caregivers of young children are often preoccupied with 2 separate challenges: how to get their kids off screens and how to improve sleep. The recent study by Pickard et al1 indicates that reducing before-bed screen use may help with some sleep outcomes among toddlers. In their UK-based study, Pickard et al1 conducted a randomized clinical trial (RCT) of a 7-week parent-administered screen time intervention (PASTI) in a sample of 105 families with children aged 16 to 30 months. The PASTI intervention was modeled after a related intervention for older children and cocreated with parents and early childhood practitioners, a notable study strength. PASTI involves instructing parents to remove all screen time in the hour before bed by providing a “bedtime box” with alternative activities, in addition to weekly text reminders. The RCT demonstrated surprising PASTI intervention feasibility, with 94% of families adhering to the intervention. They found small to medium effects of the PASTI intervention reducing before-bed screen time and increasing sleep efficiency with marginally significant reductions in nighttime awakenings. Unexpectedly, daytime naps marginally reduced, and there were no significant effects on objectively measured nighttime sleep duration nor attention. The major strengths of this well-executed study include the 3-arm triple-blinded RCT study design, in addition to objective measurement of both sleep (with actigraphy) and attention (with eye tracking). The authors also noted appropriate caution in interpreting the results, including the lack of objective assessment of screen time and being underpowered for an efficacy study.

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