Public research record
Toddler Screen Use Before Bed and Its Effect on Sleep and Attention: A Randomized Clinical Trial.
JAMA pediatrics · 2024
- DOI 10.1001/jamapediatrics.2024.3997
- PMID 39432278
- PMCID PMC11581737
Study snapshot
What this research can tell you
- What is this?
- An indexed scholarly work. The study design is not available in this public record.
- Who did it?
- Pickard H, Chu P, Essex C, et al.
- What did they study?
- Population details are not available in this public record.
- How should I read it?
- FamilyPhD does not assign a strength rating without enough structured study detail.
What was found
The structured finding summary is not available. The study abstract is shown below.
Limitations
Structured limitations are not available in this public record. Absence here does not mean the study has no limitations.
Where FamilyPhD has used it
FamilyPhD may cite this work when it supports a specific answer. A public history of individual answer use is not currently available, so no contribution relationship is implied on this page.
From the publication record
Study abstract
The abstract is publication text, not a FamilyPhD recommendation.
Objective
To test (1) the feasibility of the 7-week parent-administered screen time intervention (PASTI) in toddlers (aged 16-30 months) who have screen time in the hour before bed and (2) the impact of PASTI on toddlers' sleep and attention. Design, setting, and participants This assessor-blinded, UK-based randomized clinical trial was conducted between July 2022 and July 2023. This was a single-site study that enrolled families with a toddler aged between 16 and 30 months, living within 75 miles of the Babylab, and with 10 minutes or more of screen time in the hour before bed on 3 or more days a week. Exclusion criteria were (1) a genetic or neurological condition, (2) premature birth (<37 weeks), and (3) current participation in another study. Interventions Families were randomized (1:1:1) to (1) PASTI: caregivers removed toddler screen time in the hour before bed and used activities from a bedtime box instead (eg, reading, puzzles); (2) bedtime box (BB only): used matched before-bed activities, with no mention of screen time; or (3) no intervention (NI): continued as usual. Main outcomes and measures Feasibility outcomes: participation rate, intervention adherence, retention, family experiences, and assessment acceptability. Efficacy outcomes: screen use, actigraphy-measured sleep, and eye-tracking attention measures.
Results
A total of 427 families were screened, 164 were eligible (38.4%), and 105 families were randomized (mean [SD] age, 23.7 [4.6] months; 60 male [57%]). The trial was feasible, with 99% participant (104 of 105) retention and 94% of families (33 of 35) adhering to PASTI. PASTI showed reductions in parent-reported screen time (vs NI: Cohen d = -0.96; 95% CI, -1.32 to -0.60; vs BB only: Cohen d = -0.65; 95% CI, -1.03 to -0.27). PASTI showed small to medium improvements in objectively measured sleep efficiency (vs NI: Cohen d = 0.27; 95% CI, -0.11 to 0.66; vs BB only: Cohen d = 0.56; 95% CI, 0.17-0.96), night awakenings (vs NI: Cohen d = -0.28; 95% CI, -0.67 to 0.12; vs BB only: Cohen d = -0.31; 95% CI, -0.71 to 0.10), and reduced daytime sleep (vs NI: Cohen d = -0.30; 95% CI, -0.74 to 0.13) but no difference compared with BB only. There was no observable effect of PASTI on objective measures of attention. Compared with BB only, PASTI showed a difference on parent-reported effortful control (Cohen d = -0.40; 95% CI, -0.75 to -0.05) and inhibitory control (Cohen d = -0.48; 95% CI, -0.77 to -0.19), due to an increase in BB-only scores.
Conclusions
and relevance
Results
of this randomized clinical trial show that, supporting pediatric recommendations, removing screen time before toddler bedtime was feasible and showed modest preliminary beneficial effects on sleep. A future full confirmatory trial is needed before PASTI's adoption by parents and pediatricians. Trial registration ISRCTN.org Identifier: ISRCTN58249751.
