For Teens who Text, Bedtime Doesn't Mean Lights Out

More than half of children and adolescents who use mobile devices at bedtime to send text messages or search the Internet are likely to have problems falling asleep and experience mood, behavior, and cognitive problems during the day, according to research presented at CHEST 2010, the 76th annual meeting of the American College of Chest Physicians, in Vancouver, Canada.

In the study, Peter G. Polos, PhD, and colleagues from the JFK Medical Center, in Edison, NJ, found that on average, adolescents send a total of more than 3,400 electronic messages at bedtime every month, with each child sending an average of 33.5 texts and e-mails per night.

"Children who engage in pre-bedtime use of technology have a high rate of daytime problems, which can include attention deficit hyperactivity disorder, anxiety, depression, and learning difficulties," he said in a statement. "This is in addition to nighttime problems, such as excessive movements, insomnia, and leg pain."

To study the effects of sleep time-related information and communication technology (STRICT) on sleep patterns and daytime functioning in children and adolescents, the researchers analyzed responses from 40 students, aged 8 to 22 years, who completed a modified version of the Children’s Sleep Habits Questionnaire from September 2009 to May 2010.

According to the study, which is published in Chest, more than 77% of the students had persistent problems getting to sleep. The average number of times a student was awakened by communication technology was once per night. Among adolescents, older age correlated with later bedtimes and more time spent using electronic media.

"Sleep is largely habitual in nature," said Polos. "If children begin this type of behavior, they may set themselves up for the need for external stimulation before sleep later in life. The effects of this can include sleep-onset insomnia, insufficient sleep, and daytime sleepiness. More research is needed to determine all of the short- and long-term consequences."

Researchers also found gender differences in the type of technology preferred at bedtime, as boys were more likely to surf the Internet and play online games, whereas girls were more likely to text message and use cell phones. Most sleep-time texts occurred over a range of 10 minutes to 4 hours after bedtime, they noted.

"One of the most surprising findings of our research was the average number of texts and e-mails sent per night. It is significant that these children are engaging in stimulating activity when they should be in an environment to promote sleep," said Polos.

The researchers concluded that use of information and communication technologies at bedtime may have “an adverse impact on sleep hygiene and daytime function which may be significant,” and recommend that health care providers incorporate this questionnaire into routine evaluation of sleep patients.

They also recommend that parents monitor this activity, and attempt to limit use of mobile technology at bedtime.

“Using cell phones or computers, or surfing the Internet, with all the graphics and rapid responses, is more addictive, seductive, and interactive than passively watching television, said Polos. “The sooner parents establish appropriate times for children to use this technology, the better. They may also want to move key items, such as computers, from a child’s bedroom into a common area."

For more information on the texting habits of teens, click here.

Have you addressed this issue with your patients? If so, at what age do you bring up the topic? And do you speak with parents as well about setting limits for technology use?