Bedtime Screen Use Behaviors and Sleep Outcomes in Early Adolescents: A Prospective Cohort Study

Purpose: To determine prospective associations between bedtime screen use behaviors and sleep outcomes one year later in a national study of early adolescents in the United States.

Methods: We analyzed prospective cohort data from 9,398 early adolescents aged 11-12 years (48.4% female, 45% racial/ethnic minority) in the Adolescent Brain Cognitive Development Study (Years 2-3, 2018-2021). Regression analyses examined the associations between self-reported bedtime screen use (Year 2) and sleep variables (Year 3; self-reported sleep duration; caregiver-reported sleep disturbance), adjusting for sociodemographic covariates and sleep variables (Year 2).

Results: Having a television or Internet-connected electronic device in the bedroom was prospectively associated with shorter sleep duration one year later. Adolescents who left their phone ringer activated overnight had greater odds of experiencing sleep disturbance and experienced shorter sleep duration one year later, compared to those who turned off their phones at bedtime. Talking/texting on the phone, listening to music, and using social media were all prospectively associated with shorter sleep duration, greater overall sleep disturbance, and a higher factor score for disorders of initiating and maintaining sleep one year later.

Discussion: In early adolescents, several bedtime screen use behaviors are associated with adverse sleep outcomes one year later, including sleep disturbance and shorter weekly sleep duration. Screening for and providing anticipatory guidance on specific bedtime screen behaviors in early adolescents may be warranted.