Okul Öncesi Çocuklarda Ekran Maruziyeti ile Uyku Kalitesi ve Öz-Düzenleme Becerileri Arasındaki İlişki

Abstract

Amaç: Bu çalışmanın amacı okul öncesi çocuklarda ekran maruziyeti ile uyku kalitesi ve öz-düzenleme becerileri arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler: Çalışma Mart-Mayıs 2022 tarihleri arasında aile hekimliği polikliniğe başvuran 4-6 yaşında çocuğu olan 140 anne ile gerçekleştirildi. Çocukların yaş, cinsiyet, mevcut kronik hastalıkları, en çok kullanılan teknolojik ürün, kullanım amacı, zamanı ve süreleri sorgulandı. Çocukların uyku alışkanlıkları “Çocukların Uyku Alışkanlıkları Ölçeği (CSHQ)” ile, öz-düzenleme becerileri ise 4-6 Yaş Çocuklarına Yönelik Öz-Düzenleme Becerileri Ölçeği (Anne Formu) ile değerlendirildi. Bulgular: Çalışmamızda çocukların median yaşı 60 (48-72) aydı. Katılımcıların 75/140’ı kadındı. Evde en çok kullanılan teknolojik ürün telefondu (% 48.2). Ekran süresi %64’ünün 2 saat altında; %21.6’sının 2-4 saat arasında; %14.4’ünün 4 saat üzerindeydi. Ekran maruziyeti çok olanların anne (p=0.003) ve babalarının (p<0.001) eğitim durumu daha düşüktü. CSHQ alt ölçeklerinden uykuya dalmada gecikme skoru ekran maruziyeti 4 saat üzerinde olanlarda daha yüksekti (p<0.001). Öz-düzenleme becerileri ölçeği total skor (p=0.001), dikkat (p=0.014), engelleyici kontrol-duygu (p=0.004) ve engelleyici kontrol-davranış (p=0.029) alt-ölçek skorları ekran süresi fazla olan çocuklarda daha düşüktü. Sonuç: Okul öncesi çocuklarda aşırı ekran maruziyeti uykuya dalmada gecikme ve düşük öz düzenleme becerileri ile ilişkilidir.

Keywords

• Okul öncesi çocuklar
• Ekran maruziyeti
• Öz-düzenleme becerileri
• Uyku

The Relationship of Screen Exposure with Sleep Quality and Self-Regulation Skills in Preschool Children

Abstract

Objective: We aimed to investigate possible links between screen time, self-regulation skills and sleep quality in preschool children. Material and Methods: The study was carried out with 140 mothers with 4-6 years old children who visited the family medicine outpatient clinic between March and May 2022. Children’s age, gender, existing chronic diseases, the most used technological product, purpose of use, time and duration were recorded. Children’s sleep habits were evaluated with the “Children’s Sleep Habits Questionnaire (CSHQ)”, and their self-regulation skills were evaluated with the “Self-Regulation Skills Scale for 4-6 Years-Old Children(Mother Form)(SrSS)”. Results: The median age of the children in our study was 60 (48-72) months. 75/140 of the participants were girls. The most used technological product at home was the smartphone (48.2%). 64% of the participants reported less than 2 hours screen time, 21.6% of them reported between 2-4 hours and 14.4% of them reported over 4 hours. Educational status of mothers (p=0.003) and fathers (p<0.001) of those with a lot of screen exposure was lower. Delay in falling asleep score, one of the CSHQ subscales, was higher in those with screen exposure over 4 hours (p<0.001). Self-regulation skills scale total score (p=0.001), attention (p=0.014), inhibitory control-emotion (p=0.004), and inhibitory control-behavior (p=0.029) sub-scale scores were lower in children with longer screen time. Conclusion: Excessive screen exposure in preschool children is associated with delay in falling asleep and low self-regulation skills.

Keywords

• Preschool children
• Screen exposure
• Self-regulation skills
• Sleep

References

1. Stiglic N, Viner RM. Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews. BMJ Open 2019 ;9:e023191. doi: 10.1136/bmjopen-2018-023191
2. Marsh S, Ni Mhurchu C, Maddison R. The non-advertising effects of screen-based sedentary activities on acute eating behaviors in children, adolescents, and young adults. A systematic review. Appetite 2013;71:259-73.
3. Jahangiry L, Aune D, Farhang MA. Screen time and the risk of metabolic syndrome among children and adolescents: A systematic review and dose-response meta-analysis. Nutr Metab Cardiovasc Dis 2022;32:2483-92.
4. Iannotti RJ, Janssen I, Haug E, Kololo H, Annaheim B, Borraccino A; HBSC Physical Activity Focus Group. Interrelationships of adolescent physical activity, screen-based sedentary behavior, and social and psychological health. Int J Public Health 2009;54 Suppl 2(Suppl 2):191 8.
5. Domingues-Montanari S. Clinical and psychological effects of excessive screen time on children. J Paediatr Child Health 2017;53:333-8.
6. Trott M, Driscoll R, Irlado E, Pardhan S. Changes and correlates of screen time in adults and children during the COVID-19 pandemic: A systematic review and meta-analysis. Ecclinical Medicine 2022;48:101452.
7. American Academy of Pediatrics. (2016, 01 November). Access: https://pediatrics.aappublications.org/content/138/5/e20162591/tab-article-info. Access date: 06.10.2022.
8. Twenge JM, Hisler GC, Krizan Z. Associations between screen time and sleep duration are primarily driven by portable electronic devices: evidence from a population-based study of US children ages 0-17. SleepMed 2019;56:211-8.

9. Kahn M, Schnabel O, Gradisar M, Rozen GS, Slone M, Atzaba-Poria N, et al. Sleep, screen time and behavior problems in preschool children: an actigraphy study. Eur Child Adolesc Psychiatry 2021;30:1793-802.
10. Zhu R, Fang H, Chen M, Hu X, Cao Y, Yang F, et al. Screen time and sleep disorder in preschool children: identifying the safe threshold in a digital world. Public Health 2020;186:204-10.
11. Short MA, Blunden S, Rigney G, Matricciani L, Coussens S, M Reynolds C, et al. Cognition and objectively measured sleep duration in children: a systematic review and meta-analysis. SleepHealth 2018;4:292-300.
12. Goodlin-Jones B, Tang K, Liu J, Anders TF. Sleep problems, sleepiness and daytime behavior in preschool‐age children. Journal of Child Psychology Psychiatry 2009;50:1532-40.
13. Munzer TG, Miller AL, Peterson KE, Brophy-Herb HE, Horodynski MA, Contreras D, et al. Media Exposure in Low-Income Preschool-Aged Children Is Associated with Multiple Measures of Self-Regulatory behavior. J Dev Behav Pediatr 2018;39:303-9.
14. Cliff DP, Howard SJ, Radesky JS, McNeill J, Vella SA. Early Childhood Media Exposure and Self-Regulation: Bidirectional Longitudinal Associations. Acad Pediatr 2018;18:813-9.
15. Eisenberg N, Sulik MJ. Emotion-Related Self-Regulation in Children. Teach Psychol 2012;39:77-83.
16. Cuartas J, Hanno E, Lesaux NK, Jones SM. Executive function, self-regulation skills, behaviors, and socioeconomic status in early childhood. PLoS One 2022;17:e0277013.
17. Raver CC, Carter JS, McCoy DC, Roy A, Ursache A, Friedman A. Testing models of children’s self-regulation within educational contexts: implications for measurement. Adv Child Dev Behav 2012;42:245-70.
18. Owens JA, Spirito A, McGuinn M. The Children’s Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep 2000;23:1043-51.
19. Fiş NP, Arman A, Ay P, Topuzoğlu A, Güler AS, İmren SG, et al. The validity and the reliability of Turkish Version of Children’s Sleep Habits Questionnaire. Anatolian Journal of Psychiatry 2010; 11: 151-60.
20. Erol A, Ivrendi A. Developing an Instrument for Measuring Self-Regulation Skills of 4-6 Year -Old Children (Mother Form). PUJE 2018: 44; 178-95.
21. Varadarajan S, Venguidesvarane AG, Ramaswamy KN, Rajamohan M, Krupa M, Christadoss SBW. Prevalence of excessive screen time and its association with developmental delay in children aged <5 years: A population-based cross-sectional study in India. PLoS ONE 2021;16:e0254102.
22. Hosokawa R, Katsura T. Association between mobile technology use and child adjustment in early elementary school age. PLoS ONE 2018;13:e0199959.
23. Raj D, Mohd Zulkefli N, Mohd Shariff Z, Ahmad N. Determinants of Excessive Screen Time among Children under Five Years Old in Selangor, Malaysia: A Cross-Sectional Study. Int J Environ Res Public Health 2022;19:3560.
24. Tezol O, Yildiz D, Yalcin S, Oflu A, Erat Nergiz M, Caylan N, et al. Excessive screen time and lower psychosocial well-being among preschool children. Arch Pediatr 2022;29:61-6.
25. Oflu A, Tezol O, Yalcin S, Yildiz D, Caylan N, Ozdemir DF, et al. Excessive screen time is associated with emotional lability in preschool children. Arch Argent Pediatr 2021;119:106-13.
26. Felix E, Silva V, Caetano M, Ribeiro MVV, Fidalgo TM, Rosa Neto F, et al. Excessive Screen Media Use in Preschoolers Is Associated with Poor Motor Skills. Cyberpsychol Behav Soc Netw 2020;23:418-25.
27. Linebarger DL, Barr R, Lapierre MA, Piotrowski JT. Associations between parenting, media use, cumulative risk, and children›s executive functioning. Journal of developmental and behavioral pediatrics: JDBP 2014;35:367–77.
28. Lan QY, Chan KC, Yu KN, Chan NY, Wing YK, Li AM, et al. Sleep duration in preschool children and impact of screen time. SleepMed 2020;76:48-54.
29. Lin YY, Lee WT, Yang HL, Weng WC, Lee CC, Jeng SF, et al. Screen Time Exposure and Altered Sleep in Young Children With Epilepsy. J Nurs Scholarsh 2020;52:352-9.
30. Hiltunen P, Leppänen MH, Ray C, Määttä S, Vepsäläinen H, Koivusilta L, et al. Relationship between screen time and sleep among Finnish children: results from the DAGIS study. SleepMed. 2021;77:75-81.
31. Foley LS, Maddison R, Jiang Y, Marsh S, Olds T, Ridley K. Presleep activities and time of sleep onset in children. Pediatrics. 2013;131:276-82.
32. American Academy of Child & Adolescent Psychiatry. Media Habits During COVID-19: Children & Teens on Screens in Quarantine. AACAP. 2020. [Accessed on: Dec 4, 2022]. Available in: https://www.aacap.org/App_ Themes/AACAP/Docs/resource libraries/covid-19/ Screen-Time-During-COVID.pdf.
33. McArthur BA, Tough S, Madigan S. Screen time and developmental and behavioral outcomes for preschool children. Pediatric Res. 2022;91:1616-1621.
34. Cameron AJ, Spence AC, Laws R, Hesketh KD, Lioret S, Campbell KJ. A review of the relationship between socioeconomic position and the early-life predictors of obesity. Curr Obes Rep 2015;4:350–62.