Sleep and new media usage in toddlers


Several studies over the years have demonstrated the association between lack of sleep in children and certain physical, psychological, and behavioral disorders. The aim of this study was to disentangle the association between new screen-based electronic devices and sleep problems in toddlers, adjusting for other covariates already known to be associated with sleep quality. We conducted a cross-sectional study with the aid of a national sample of 1117 toddlers. Parents reported children’s sleeping habits such as total sleep time and sleep onset latency, recreational activities, bedtime routines, and temperament. An ordered logistic regression was run to assess the associations between new media exposure and two sleep outcomes (total sleep time and sleep onset latency). Everyday use of a tablet or smartphone raised the odds of a shorter total sleep time (OR 1.95 [1.00–3.79], p < 0.05) and a longer sleep onset latency (OR 2.44 [1.26–4.73] p < 0.05) irrespective of other factors, such as temperament (restlessness, sociability), or traditional screen exposure (watching TV or playing videogames).

Conclusion: New media usage is a factor associated in toddlers with sleeping fewer hours and taking longer to fall asleep, irrespective of other confounding factors.

What is known
• Studies have found an association between sleep behavior and the use of computers and video games in early childhood.
• The blue light emitted from TV screens suppresses endogenous melatonin.
What is new
• The study found an association between daily new media (tablet and smartphone) usage and sleep quality in toddlers
• New media usage exposes toddlers to the risk of fewer hours of sleep and taking longer to fall asleep, irrespective of other factors.

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Federazione Italiana Medici Pediatri


  1. 1.

    Acheson A, Richards JB, de Wit H (2007) Effects of sleep deprivation on impulsive behaviors in men and women. Physiol Behav 91(5):579–587

    Article  CAS  PubMed  Google Scholar 

  2. 2.

    Adams GC, Stoops MA, Skomro RP (2014) Sleep tight: exploring the relationship between sleep and attachment style across the life span. Sleep Med Rev 18(6):495–507

    Article  PubMed  Google Scholar 

  3. 3.

    Ahearne C, Dilworth S, Rollings R, Livingstone V, Murray D (2016) Touch-screen technology usage in toddlers. Arch Dis Child 101(2):181–183

    Article  PubMed  Google Scholar 

  4. 4.

    Bathory E, Tomopoulos S (2017) Sleep regulation, physiology and development, sleep duration and patterns, and sleep hygiene in infants, toddlers, and preschool-age children. Curr Probl Pediatr Adolesc Health Care 47(2):29–42

    Article  PubMed  Google Scholar 

  5. 5.

    Blair PS, Humphreys JS, Gringras P, Taheri S, Scott N, Emond A, Henderson J, Fleming PJ (2012) Childhood sleep duration and associated demographic characteristics in an English cohort. Sleep 35(3):353–360

    Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Brambilla P, Giussani M, Pasinato A et al (2017) Sleep habits and pattern in 1-14 years old children and relationship with video devices use and evening and night child activities. Ital J Pediatr 43(1):7

    Article  PubMed  PubMed Central  Google Scholar 

  7. 7.

    Carter B, Rees P, Hale L, Bhattacharjee D, Paradkar MS (2016) Association between portable screen-based media device access or use and sleep outcomes: a systematic review and meta-analysis. JAMA Pediatr 170(12):1202–1208

    Article  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Cespedes EM, Gillman MW, Kleinman K, Rifas-Shiman SL, Redline S, Taveras EM (2014) Television viewing, bedroom television, and sleep duration from infancy to mid-childhood. Pediatrics 133(5):e1163–e1171

    Article  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Cheung CH, Bedford R, Saez De Urabain IR et al (2017) Daily touchscreen use in infants and toddlers is associated with reduced sleep and delayed sleep onset. Sci Rep 7:46104

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. 10.

    Day JJ, Roitman MF, Wightman RM, Carelli RM (2007) Associative learning mediates dynamic shifts in dopamine signaling in the nucleus accumbens. Nat Neurosci 10:1020–1028

    Article  CAS  PubMed  Google Scholar 

  11. 11.

    Falbe J, Davison KK, Franckle RL, Ganter C, Gortmaker SL, Smith L, Land T, Taveras EM (2015) Sleep duration, restfulness, and screens in the sleep environment. Pediatrics 135(2):e367–e375

    Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Garrison MM, Liekweg K, Christakis DA (2011) Media use and child sleep: the impact of content, timing, and environment. Pediatrics 128(1):29–35

    Article  PubMed  PubMed Central  Google Scholar 

  13. 13.

    Gregory AM, Sadeh A (2012) Sleep, emotional and behavioral difficulties in children and adolescents. Sleep Med Rev 16(2):129–136

    Article  PubMed  Google Scholar 

  14. 14.

    Hirshkowitz M, Whiton K, Albert SM et al (2015) National Sleep Foundation's sleep time duration recommendations: Methodology and results summary. Sleep Health 1(1):40–43

    Article  PubMed  Google Scholar 

  15. 15.

    Hiscock H, Canterford L, Ukoumunne OC, Wake M (2007) Adverse associations of sleep problems in Australian preschoolers: national population study. Pediatrics 119(1):86–93

    Article  PubMed  Google Scholar 

  16. 16.

    Huttenlocher PR (2002) Neural plasticity: the effects of the environment on the development of the cerebral cortex. Harvard University Press, London

    Google Scholar 

  17. 17.

    Kabali HK, Irigoyen MM, Nunez-Davis R, Budacki JG, Mohanty SH, Leister KP, Bonner RL (2015) Exposure and use of mobile media devices by young children. Pediatrics 136(6):1044–1050

    Article  PubMed  Google Scholar 

  18. 18.

    Kelly Y, Kelly J, Sacker A (2013) Time for bed: associations with cognitive performance in 7-year-old children: a longitudinal population-based study. J Epidemiol Community Health 67:926–931

    Article  PubMed  PubMed Central  Google Scholar 

  19. 19.

    Magee CA, Lee JK, Vella SA (2014) Bidirectional relationships between sleep duration and screen time in early childhood. JAMA Pediatr 168(5):465–470

    Article  PubMed  Google Scholar 

  20. 20.

    Council on Communications and Media. (2016) Media and Young Minds. Pediatrics. 138(5). pii: e20162591.

  21. 21.

    Mindell JA, Meltzer LJ, Carskadon MA, Chervin RD (2009) Developmental aspects of sleep hygiene: findings from the 2004 National Sleep Foundation sleep in America poll. Sleep Med 10(7):771–779

    Article  PubMed  Google Scholar 

  22. 22.

    Ophoff D, Slaats MA, Boudewyns A, Glazemakers I, Van Hoorenbeeck K, Verhulst SL (2018) Sleep disorders during childhood: a practical review. Eur J Pediatr 177(5):641–648

    Article  CAS  PubMed  Google Scholar 

  23. 23.

    Ottaviano S, Giannotti F, Cortesi F, Bruni O, Ottaviano C (1996) Sleep characteristics in healthy children from birth to 6 years of age in the urban area of Rome. Sleep 19(1):1–3

    CAS  PubMed  Google Scholar 

  24. 24.

    Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS (2016) Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of sleep medicine. J Clin Sleep Med 12(6):785–786

    Article  PubMed  PubMed Central  Google Scholar 

  25. 25.

    Pisch M (2015)A longitudinal study of infant sleep and its effects on cognitive development (Doctoral thesis, Birbeck University of London, UK)

  26. 26.

    Radesky JS, Schumacher J, Zuckerman B (2015) Mobile and interactive media use by young children: the good, the bad, and the unknown. Pediatrics 135:1–3

    Article  PubMed  Google Scholar 

  27. 27.

    Salti R, Tarquini R, Stagi S, Perfetto F, Cornélissen G, Laffi G, Mazzoccoli G, Halberg F (2006) Age-dependent association of exposure to television screen with children's urinary melatonin excretion? Neuro Endocrinol Lett 27(1–2):73–80

    CAS  PubMed  Google Scholar 

  28. 28.

    Schweizer A, Berchtold A, Barrense-Dias Y, Akre C, Suris JC (2017) Adolescents with a smartphone sleep less than their peers. Eur J Pediatr 176(1):131–136

    Article  PubMed  Google Scholar 

  29. 29.

    Thompson DA, Christakis DA (2005) The association between television viewing and irregular sleep schedules among children less than 3 years of age. Pediatrics 116(4):851–856

    Article  PubMed  Google Scholar 

  30. 30.

    Titova OE, Hogenkamp PS, Jacobsson JA, Feldman I, Schiöth HB, Benedict C (2015) Associations of self-reported sleep disturbance and duration with academic failure in community-dwelling Swedish adolescents: sleep and academic performance at school. Sleep Med 16(1):87–93

    Article  PubMed  Google Scholar 

  31. 31.

    Vijakkhana N, Wilaisakditipakorn T, Ruedeekhajorn K, Pruksananonda C, Chonchaiya W (2015) Evening media exposure reduces night-time sleep. Acta Paediatr 104(3):306–312

    Article  PubMed  Google Scholar 

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The authors thank all pediatricians and parents who participated in the study.


Funding for this study was provided by the Italian Federation of Pediatricians (Federazione Italiana dei Medici Pediatri), Genitori Attenti! Association for the promotion of social and health action, and by the Novella Fronda Foundation.

Author information




Dr. Gallimberti conceptualized the study, coordinated all study phases, and approved the final manuscript as submitted. Dr. Buja, Dr. Sperotto and Dr. Buzzetti designed the study, carried out the statistical analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted. Dr. DeBattisti wrote the paper. Dr. Marini, Dr. Marconi and Dr. Terraneo were involved in the design of the study. Dr. Chindamo designed the data collection tools, coordinated and supervised data collection, and approved the final manuscript as submitted. Dr. Doria and Dr Chiamenti coordinated and supervised data collection, critically reviewed and revised the manuscript and approved the final manuscript as submitted. Dr. Ceschin, Dr. Malorgio, and Dr. Tommasi coordinated data collection and approved the final manuscript as submitted. Dr. Gomez Perez interpreted the data, critically reviewed and revised the manuscript, and approved the final manuscript as submitted. Prof Baldo designed the sampling methods, critically reviewed and revised the manuscript, and approved the final manuscript as submitted.

Corresponding author

Correspondence to Alessandra Buja.

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The authors declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Communicated by Mario Bianchetti

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Chindamo, S., Buja, A., DeBattisti, E. et al. Sleep and new media usage in toddlers. Eur J Pediatr 178, 483–490 (2019).

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  • Time
  • Sleep
  • Childhood
  • Toddlers
  • Touch screen device
  • Video games