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Maybe Violent TV Does Give Little Kids Nightmares
Study reveals connection between media consumption and sleep problems for children.
By Nancy Walsh, MedPage Today
Medically Reviewed by Robert Jasmer, MD
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MONDAY, Aug. 6, 2012 (MedPage Today) —Children whose media viewing was healthy and age-appropriate were less likely to have problems with sleep than if they were allowed to watch violent material, a randomized trial suggested.
A yearlong intervention that encouraged educational and child-suitable media viewing was associated with a lower likelihood of children having "any sleep problem", according to Michelle M. Garrison, PhD, and Dimitri A. Christakis, MD, of the University of Seattle in Washington.
The effect size of the intervention was similar through the duration of the study, with differences in sleep scores between the intervention and control groups of −0.16 at 6 months and −0.14 at 1 year, the researchers reported online ahead of print in the September issue ofPediatrics.
"Observational studies have consistently shown an association between media use and child sleep problems," they wrote.
However, because most of the research has been conducted in a cross-sectional fashion, it has been unclear whether media viewing caused the sleep problems or was a result of the child's sleep difficulties.
To address this, Garrison and Christakis enrolled 565 families with children ages 3 to 5, assigning them randomly to the media intervention or a control nutritional program that encouraged healthy eating.
The intervention consisted of a baseline visit to the home by a case manager who collected information and discussed the impact of violent or other inappropriate media viewing, whether on television, DVDs, or computer, on young children.
The case managers also provided handouts and encouraged the use of parental controls and shared viewing with the child, with an emphasis on programs such asSesame StreetandCurious George.
The baseline visit was then followed up with monthly mailings and telephone calls.
Slightly more boys than girls were included, mean age was 4, and the majority were white. Almost half of the parents had completed college, and most were two-parent families. Fewer than 10 percent of the children had a television in the bedroom.
Average daily media viewing was slightly more than one hour, with about 15 minutes in the evening, and about 22 minutes involving violent content.
About 40 percent of the children had some type of sleep difficulty.
The most common problem was in falling asleep, with 26 percent of the children needing more than 20 minutes to fall asleep two to four times each week and 12 percent taking that long to fall asleep five or more nights every week.
Other frequently reported sleep difficulties included waking more than once during the night, having trouble waking up in the morning, and tiredness during the day.
While the intervention showed significant benefits throughout the 12-month study, its effects had begun to diminish 6 months later, when the difference in sleep scores between the two groups had fallen to −0.08, the researchers reported.
"The potential decay at 18 months suggests that families may need supportive maintenance after the active intervention or that the intervention protocol may need to be revised to ensure that families are mastering the skills needed to continue making healthy media choices as their child continues to grow older and media options evolve," they observed.
They also emphasized that the intervention addressed only content and made no effort to limit the time spent in viewing.
This suggested that the benefits on sleep were indeed related to the program content, and possibly through effects on anxiety and fears or hyperactivity.
Limitations of the study included its general, nonobjective assessment of sleep and the study population being from a single city.
In addition, potentially modifying factors such as family income were not examined.
Nonetheless, the study suggests that limiting young children's media viewing according to content can be a useful strategy for avoiding sleep difficulties, according to the authors.
"Given that early childhood sleep problems have been associated with a range of deleterious outcomes, both acute and long-term, including increased injuries, behavioral and emotional problems, difficulties in school, and obesity, the availability of useful, feasible strategies is critical," Garrison and Christakis concluded.
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