No of studies | Design | Quality Assessment | No of participants | Absolute effect | Quality | ||||
---|---|---|---|---|---|---|---|---|---|
Risk of bias | Inconsistency | Indirectness | Imprecision | Other | |||||
Mean age ranged between 6 months and 4.5 years. Data were collected cross-sectionally and up to 4 years. Sleep duration was assessed by parent report. Sedentary behaviors (screen time) were assessed using time-use diaries or questionnaires. | |||||||||
1 | Longitudinal studya | Serious risk of biasb | No serious inconsistency | No serious indirectness | No serious imprecision | None | 2984 | Sleep duration at 4 years of age was inversely associated with television viewing (β = −0.07, p = 0.003) and computer use (β = −0.04, p = 0.001) at 6 years of age [22]. | VERY LOW |
4 | Cross-sectional studyc | Serious risk of biasd | No serious inconsistency | No serious indirectness | No serious imprecision | None | 42,751 | Short sleep duration was associated with time spent watching TV (OR: 1.65, 95% CI 1.23–2.21 per additional hour/24 h) in boys. In girls, the association was not significant (p = 0.75) [31]. Infants who were exposed to screen media in the evening at 12 months of age had a 28-min lower nighttime sleep duration on weekdays. Moreover, infants who were exposed to screen media in the evening at age 6 months and 12 months had shorter 12-month nighttime sleep duration compared with those who were not exposed to screen media after 7 pm at both ages [78]. Watching more than an hour of TV in the evening was associated with short sleep duration (OR = 1.89, 95% CI 1.26–2.84). However, the association was not significant with watching more than an hour of TV in the morning (OR = 1.13, 95% CI 0.80–1.58) [79]. Short sleep duration was associated with longer hours spent watching television (OR = 1.91, 95% CI 1.26–2.90 for ≥4 h/day) and playing computer games (OR = 1.62, 95% CI 1.18–2.23 for ≥2 h/day) compared to not watching/playing [80]. | VERY LOW |