During the first year of the pandemic, profound changes in screen use and sleep timing occurred among US adolescents as a result of spending more time using electronic devices, going to bed later, and getting up later compared to before the pandemic, new research indicates.

The excessive screen time negatively affected sleep, said lead investigator Orsolya Kiss, PhD, with the Center for Health Sciences at SRI International, Menlo Park, California.

And what’s “concerning,” she told Medscape Medical News, is that there is no indication of any spontaneous decline in screen use in 2021, when there were fewer restrictions.

Kiss said she is “very much interested to see what future studies will show.”

The findings were presented at SLEEP 2022: 36th Annual Meeting of the Associated Professional Sleep Societies.

Sleep Takes a Pandemic Hit

“Adolescents and families have turned to online activities and social platforms more than ever before to maintain wellbeing, connect with friends and family, and for online schooling,” Kiss said in a conference statement.

She and her colleagues examined longitudinal data from 5027 adolescents aged 11 to 14 years who are participating in the ongoing Adolescent Brain Cognitive Development (ABCD) Study.

As part of the study, participants reported sleep and daily screen time use prior to and at six time points during the first year of the pandemic (May 2020 to March 2021).

During the first year of the pandemic, relative to before the pandemic, recreational screen time was dramatically higher, with adolescents spending about 45 minutes more on social media and 20 minutes more playing video games, Kiss reported.

The jump in screen time was coupled with changes in sleep patterns.

Adolescents’ wake up times were delayed about 1.5 hours during May and August 2020, relative to prepandemic levels. The delay was partly due to summer break; wake-up times returned to earlier times in the fall of 2020.

During all pandemic assessments, bedtimes were delayed by about 1 hour, even when the new school year started. This was particularly the case in older adolescents and girls.

The findings highlight the need to promote “balanced and informed use of social media platforms, video games, and other digital technology to ensure adequate opportunity to sleep and maintain other healthy behaviors during this critical period of developmental change,” the authors wrote in their conference abstract.

Mental Illness Risk

In an interview with Medscape Medical News, Ruth Benca, MD, PhD, co-chair of the Alliance for Sleep, noted that “during adolescence, the tendency to become more of a night owl naturally worsens and when kids have no sleep schedule imposed on them, these patterns become exacerbated.”

Benca, who was not involved in the study, also noted that altered sleep patterns are risk factors for psychiatric illness.

“Adolescence, in particular, is so critical for brain development and it really raises the question of whether sleep disturbances in adolescence or poor sleep patterns are contributing to the increase psychiatric epidemic we’re seeing in adolescents and children these days,” said Benca, with Wake Forest University School of Medicine and Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina.

Also weighing in on the study, journalist and author Lisa Lewis, MS, based in Southern California, said, “It’s not surprising that tech use and social media ― which is such an important part of their social worlds ― went up during the pandemic.”

Lewis, a parent of two teenagers, played a key role in California’s new healthy school start times law, the first of its kind in the nation, and is the author of the newly released book, The Sleep-Deprived Teen (Mango Publishing).

“Far too many adolescents aren’t getting anywhere close to the 8-10 hours of nightly sleep they need,” Lewis told Medscape Medical News.

She noted that the the American Academy of Pediatrics recommends no tech use an hour before bed.

“And there are other house rules parents can implement, such as charging all devices in a central location like the kitchen. Making sleep a priority helps teens, but it helps parents too: no one functions well when they’re sleep-deprived,” Lewis added.

Support for the study was provided by the National Institutes of Health. The authors have disclosed no relevant financial relationships. Benca is a consultant for Idorsia Pharmaceuticals. Lewis has no relevant disclosures.

SLEEP 2022: the 36th Annual Meeting of the Associated Professional Sleep Societies. Abstract 0049. Presented June 6, 2022.

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