Association between excessive screen time and falls, with additional risk from insufficient sleep duration in children and adolescents, a large cross-sectional study in China

Abstract

Objective: Falls is a major global public health issue that occur in all age groups. However, the association between screen time, sleep duration and falls in children and adolescents remains unclear.

Methods: This study included children and adolescents who participated in the 2017 Nutrition and Health Surveillance of Children and Lactating Mothers in China. Screen time, sleep duration and falls in the past 12 months were assessed using baseline questionnaires completed by the participants. We utilized a multivariate logistic regression model to estimate the association between screen time, sleep duration, and falls in children and adolescents. Stratified analyses and sensitivity analyses were performed using the same modelling strategies.

Results: A total of 564 participants (5.7%) self-reported falls in the past 12 months. Multivariate logistic regression analysis revealed that high screen time (> 2 h per day) was associated with a higher incidence of falls (cOR:1.46, 95% CI: 1.22-1.74, p < 0.001). The combination of high screen time and low sleep duration was associated with an increased risk of falls compared to the recommended low screen time and high sleep duration group (cOR: 1.62, 95% CI: 1.25-2.09, p < 0.001). After adjusting for relevant covariates, the associations remained significant (aOR: 1.30, 95% CI: 1.08-1.56, p = 0.006; aOR: 1.43, 95% CI: 1.10-1.87, p = 0.008).

Conclusion: Our study demonstrates that both high screen time and the combination of high screen time and low sleep duration were associated with an increased risk of falls. Interventions to promote healthy physical development should commence in early childhood to decrease the incidence of fall injuries in children and adolescents.

Keywords: Nutrition and Health Surveillance of Children and Lactating Mothers; adolescents; children; falls; screen time; sleep duration.

Figure 1

Flow chart of study participant.

Figure 2

Multivariate-adjusted OR and 95%CI for falls associated with screen time in children and adolescents in stratified analysis (comparing high screen time group with low screen time group).

Figure 3

Multivariate-adjusted OR and 95%CI for falls associated with screen time and sleep duration in children and adolescents in stratified analysis (comparing high screen time low sleep duration group with low screen time high sleep duration group).