Screen exposure and sleep: How the COVID-19 pandemic influenced children and adolescents - A questionnaire-based study

Background: COVID-19 pandemic has drastically increased the exposure to electronic devices in children, influencing their lifestyle and their sleep. This study was conducted to explore the relationship between the augmented screen exposure and sleep habits in children during and after the pandemic.Methods: Using the "Google Forms" tool, we created an online questionnaire addressed to parents of children and adolescents aged 2-18 years. We explored the use of screens before and during/after the lockdown and assessed the presence of sleep disturbances through the Sleep Disturbance Scale for Children (SDSC), referring to the period before and during/after COVID-19 pandemic.Results: We collected 1084 valid questionnaires (median age 8.5 +/- 4.1 years). We observed a significant increase in screens exposure for school (72%) and for leisure (49.7%) during the pandemic. We reported an increased sleep disturbances prevalence from 22.1% before the pandemic to 33.9% during the outbreak (p < 0.001). Even before the pandemic, the highest risks for sleep disorders were related to daily screen time for school reasons (OR 1.65, p < 0.001) and total screen time after 6 p.m. (OR 1.59, p < 0.001). The augmented exposure to screens for any reasons during the pandemic was significantly related to an increase of sleep disorders, especially regarding the increased exposure after 6 p.m. (OR 1.67, p < 0.001).Conclusions: The augmented use of electronic devices was recognized to be a significant predisposing factor in increasing the rate of sleep disorders during and after the pandemic, thus sleep hygiene rec-ommendations should be highlighted to improve sleep habits.(c) 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).