EFFECT OF ELECTRONIC USAGE AND SCREEN TIME ON NIGHTTIME SLEEP DURATION AMONG CHILDREN AGED BETWEEN 4-8 YEARS

Abstract

Introduction: Electronic device use has become highly prevalent among children and is increasingly recognized as a significant behavioural factor affecting sleep health. Early primary school years represent a critical period for sleep regulation, and excessive screen exposure—particularly before bedtime—may adversely influence sleep duration and quality. However, limited data are available from rural Indian paediatric populations. Materials and Methods: This school-based cross-sectional observational study included 132 children aged 4–8 years selected using simple random sampling from rural primary schools in Mandya district. Data were collected using structured, validated parent-reported questionnaires assessing screen exposure, sleep duration, and sleep disturbances using the Children’s Sleep Habits Questionnaire (CSHQ). Statistical analysis included descriptive statistics, Chi-square test, and Pearson correlation analysis. A p-value <0.05 was considered statistically significant. Results: Screen exposure was observed in 78.8% of children, with 48.5% exposed to more than 60 minutes per day, exceeding recommended limits. The mean screen duration was 64.82 ± 38.15 minutes. The mean nighttime sleep duration was 9.28 ± 1.14 hours, while mean total sleep duration was 9.57 ± 1.05 hours, indicating marginal sleep insufficiency in a substantial proportion of children. Severe sleep disturbance was identified in 37.9% of children, while 33.3% had moderate disturbance. A statistically significant positive correlation was observed between screen exposure and CSHQ score (r = 0.52, p < 0.001), indicating increased sleep disturbance with greater screen use. Conversely, total sleep duration demonstrated a significant negative correlation with sleep disturbance severity (r = –0.48, p < 0.001), suggesting a protective effect of longer sleep duration. Mean screen exposure increased progressively across sleep disturbance categories, from 18.24 ± 12.52 minutes in the normal/mild group to 76.82 ± 34.18 minutes in the severe group (p < 0.001). Similarly, mean total sleep duration decreased significantly from 10.41 ± 0.74 hours in the normal/mild group to 8.91 ± 1.02 hours in the severe disturbance group (p < 0.001). A strong association was observed, with increasing screen exposure significantly associated with higher prevalence and severity of sleep disturbance (p < 0.001). Conclusion: This study highlights a high prevalence of screen exposure (78.8%) among children aged 4–8 years, with 48.5% exceeding the recommended daily screen-time limits. Sleep disturbances were also common, with 71.2% of children demonstrating moderate to severe sleep disturbance based on the Children’s Sleep Habits Questionnaire, indicating a significant burden of sleep-related problems in this age group. Screen exposure was found to be significantly associated with reduced nighttime and total sleep duration and with greater severity of sleep disturbance. Children with screen exposure had poorer sleep outcomes compared to those without exposure, and higher screen use was linked to higher CSHQ scores, reflecting increased sleep disturbance. Conversely, longer sleep duration was associated with lower severity of sleep disturbance, suggesting a protective effect of adequate sleep. These findings identify screen exposure as a prevalent and modifiable behavioral factor influencing sleep health in early primary school children. The results underscore the importance of parental education, appropriate regulation of screen use, and reinforcement of healthy sleep hygiene practices, particularly during early childhood, to promote optimal sleep, growth, and neurodevelopment.