Sleep and sleep hygiene is essential for children and adolescents. It is important to health and function because it has a role in many processes such as memory consolidation, homeostasis, and immunity. In fact, research has shown that learning improves after a good night of sleep, and its disruption impairs some of the mechanisms involved in brain plasticity. For instance, some evidence shows that sleep is important in brain development.
Two broad brain processes generate normal sleep-wake cycle: the homeostatic drive and the circadian system. The former increases our drive to fall asleep the longer we stay awake and is reset by a good night of sleep. The latter regulates our internal physiologic environment, such as body temperature and the secretion of hormones in a 24-hour cycle.
The circadian system receives multiple environmental inputs, with light being critical as it suppresses melatonin, one of the most important hormones involved in sleep. Therefore, it is not surprising that the latest technology—especially TVs, cell phones, and tablets—can have an effect on sleep by decreasing melatonin, even with short exposures prior to sleep.
A Harvard study showed that reading a book on an iPad before bed resulted in longer time to fall asleep, reduced evening sleepiness, melatonin secretion, and next morning alertness when compared to reading a printed book under the same conditions. A survey of more than 3000 adolescents demonstrated that the majority texts, reads, or plays video games in bed. It has also been demonstrated that adolescents who use electronic devices in bed have shorter sleep duration, later bedtimes, increased daytime sleepiness, and worse academic performance.
Considering the importance of sleep, doctors should educate adolescents and parents about the following principles of sleep hygiene to battle the adverse effects of technology. Bedtimes and wake times should be consistent during school nights and not vary by more than 1 hour on weekends. The bedroom should be quiet and comfortable. Video games, television, and exercise should be avoided at least 30 minutes before sleep. TVs, phones, and electronic games should be kept out of the child’s bedroom. Since the blue light present on many electronic devices has the greatest effect on suppressing melatonin secretion and disrupting sleep, several computer and smartphone programs were developed to reduce the amount of blue light emitted by these devices. F.Lux is one such program, which can lower blue light emission of a phone or computer screen during night time. The latest iOS (9.3) includes a function “Night Shift,” which can be found under the “Display & Brightness” settings tab, which is also designed to reduce blue light emission.
There is very active research on the importance of sleep and how modern technology affects it. However, it is already clear that sleep is an essential part of life and that some electronic devices can affect the quality of sleep. Helping our patients understand these concepts can improve their overall health and daytime performance.
References and suggested readings
Chang AM, Aeschbach D, Duffy JF, Czeisler CA. Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. PNAS. 2015;112(4):1232-1237.
Polos PG, Bhat S, Gupta D, et al. The impact of Sleep Time-Related Information and Communication Technology (STRICT) on sleep patterns and daytime functioning in American adolescents. Journal of Adolescence. 2015;44:232-244.