Methods: Data for this study were obtained from the 2017 YRBSS. A sample of 14,603 adolescents aged 14-18 years (51.5% female) was analyzed using binary logistic regression with insufficient sleep as the outcome variable and excessive screen-time behaviors as the main explanatory variable. Missing data were handled using Multiple Imputation using Chained Equations (MICE) given that data were missing at random. Three binary logistic regression models were fitted with demographic variables entered in Model 1. Model 2 consists of demographic variables plus health and mental health factors. The final model consists of variables in Model 2 plus excessive screen-time behaviors.
Results: Of the 14,603 adolescents, almost three out of four (74.8%) had less than 8 hours of sleep on an average school night, and about 43% engaged in excessive screen-time behaviors on an average school day. Controlling for all other predictors, odds were 1.34 times higher for adolescents who engaged in excessive screen-time behaviors to have insufficient sleep when compared to adolescents who did not engage in excessive scree-time behaviors (AOR=1.34, p<.001, 95% CI=1.22-1.48). Physical activity had a protective effect of insufficient sleep such that adolescents who reported meeting the recommended physical activity level had a 17% lower odds of having insufficient sleep when compared to their counterparts not meeting the recommended physical activity level (AOR=0.83, p<.001, 95% CI=0.76-0.92). Other significant factors associated with insufficient sleep include grade level, self-identifying as lesbian, gay, or bisexual, feeling depressed, experiencing suicidal ideation, and being overweight. Excessive screen-time behaviors explained 12% of the variance in insufficient sleep.
Conclusions: The findings of this study underscore the association between excessive screen-time behaviors and insufficient sleep and add to the growing call for limiting the amount of screen-time for adolescents. School counsellors, clinicians, and social work practitioners should consider ways of educating adolescents on how to cut down on excessive screen-time to increase sleep duration.