# Associations between different types of screen-based sedentary behavior and sleep among Chinese children and adolescents

## TL;DR

This study examines how different screen-based activities affect sleep in Chinese children and adolescents, finding that some activities may help or harm sleep depending on the type and subgroup.

## Contribution

The study identifies novel associations between specific screen-based behaviors and sleep outcomes in Chinese children, highlighting subgroup differences.

## Key findings

- Daily short-video watching and online gaming were linked to a lower risk of insufficient sleep.
- Daily online shopping was associated with a higher risk of insufficient sleep, especially in younger students.
- WeChat usage and online learning showed no significant link to sleep problems.

## Abstract

Previous studies on the relationship between screen-based sedentary behaviors (SSB) and sleep among children and adolescents have yielded inconsistent findings, particularly concerning novel screen use. Limited research has explored whether associations differ across demographic subgroups. Therefore, this study aimed to explore associations between novel SSB and sleep among Chinese children and adolescents, as well as to assess the consistency of these associations across genders, educational levels, and urban-rural residence.

Data were drawn from the China Family Panel Studies (CFPS) 2020–2022, involving 3,309 children and adolescents aged 10–18 years, 1,526 females. Sleep was measured by a self-reported average daily sleep duration, with < 8 h defined as insufficient sleep. SSB frequencies, covering five activities including online gaming and WeChat usage, were categorized into three levels by frequency (1 = No, 2 = Occasional, 3 = Daily). Generalized linear logistic regression models were used to analyze associations between various SSB and sleep, and subgroup analyses were conducted to examine heterogeneous effects.

Compared with participants who never watched short videos, those who watched short videos daily showed a 36% lower likelihood of insufficient sleep (OR = 0.64, 95% CI: 0.49–0.84). Compared with participants who never used online shopping, those who used online shopping daily showed a 24% higher likelihood of insufficient sleep (OR = 1.24, 95% CI: 1.03–1.49). Compared with participants who never used online gaming, those who used online gaming daily showed a 19% lower likelihood of insufficient sleep (OR = 0.81, 95% CI: 0.67–0.99). No significant associations were found between insufficient sleep and WeChat usage or online learning.

Short-video watching and online gaming may be protective factors against insufficient sleep among Chinese children and adolescents, particularly in specific subgroups (e.g., males, rural residents, and junior high school students), while daily online shopping might be a risk factor for sleep insufficiency, especially among elementary and junior high school students. WeChat usage and online learning showed no significant associations with sleep. Future policies and research should prioritize monitoring of rapidly evolving screen-based sedentary behaviors (SSB), while implementing targeted, subgroup-specific interventions to mitigate their health impacts.