Adolescents' screen time, sleep and mental health: literature review

Systematic review summarising the published experimental and longitudinal evidence on adolescent screen time, sleep and mental health.

Appendix Table D: Overview of reviewed published literature reviews


Literature review aims

Number of potentially relevant primary studies (based on abstract)

Allen et al 2016 (35)

Recognizing this gap in the literature, the research team developed the ABCs of SLEEPING mnemonic to capture constructs and practices that are commonly targeted by recommendations aimed at promoting healthy sleep. The mnemonic is the ABCs of SLEEPING, which stands for " 1) age appropriate bedtimes and wake-times with consistency, 2) schedules and routines, 3) location, 4) exercise and diet, 5) no electronics in the bedroom or before bed, 6) positivity, 7) independence when falling asleep, and 8) needs of child met during the day, 9) equal great sleep".

This article uses the ABCs of SLEEPING mnemonic as an organizing framework for 1) outlining common paediatric sleep recommendations 2) reviewing and evaluating empirical research that speaks to these recommendations, and 3) identifying areas where further research is needed. The article focuses on children aged 1-12 as this encompasses the time period after most children can be expected to have developed the ability to sleep through the night (i.e. ~9 mo to 1 y), wherein parents play a major role in their children's sleep practices and routines. In organizing the article around the ABCs of SLEEPING mnemonic we hope to facilitate the ease with which non-sleep specialists will be able to readily recall and access the knowledge gained from reading this article, thus enhancing the clinical utility of the review. Ultimately, we hope the ABCs of SLEEPING mnemonic in tandem with this review will help to meet the identified need for comprehensive, accessible, time efficient, evidence-based resources to support non-sleep specialists' ability to provide guidance and recommendations to families around paediatric sleep problems.


Belmon et al 2018 (36)

This systematic review summarizes the current evidence on potential determinants of children's sleep behaviour for the age of 4-12 years based on longitudinal studies, taking into account their methodological quality. It aims to provide an overview of determinants of children's sleep behaviour and stimulate future intervention development of healthy sleep interventions for children.


Costigan et al 2013 (37)

To present a broad overview of various health indicators related to screen time, the primary aim of this systematic review is therefore to investigate the association between time spent engaging in recreational screen based sedentary behaviour (specifically television viewing, computer/internet use, and/or electronic gaming) and the physical, behavioural and psychosocial health indicators in adolescent girls.

Therefore, a secondary objective of our review was to identify studies examining adolescent girls that have specifically adjusted for physical activity participation in order to further understand this relationship.


Elhai et al 2019 (38)

In the present paper, we examine the literature studying relations between problematic smartphone use (PSU) and anxiety symptom severity. We first present background on the health advantages and disadvantages of using a smartphone. Next, we provide caveats in distinguishing healthy smartphone use from unhealthy PSU, and we discuss how PSU is measured. Additionally, we discuss theoretical frameworks explaining how some people develop PSU, including Uses and Gratifications Theory, and Compensatory Internet Use Theory. We present our own theoretical model of how PSU is specifically related to anxiety. We discuss and review mental health constructs associated with PSU severity, based on prior literature. Next, we systematically review the research on PSU severity in relation to anxiety symptoms, given the recent growth of studies on this research question. Finally, we offer implications and recommendations for future research in this area.


Grist et al 2017 (39)

This review aims to provide a contemporary appraisal of the available research evidence for the efficacy and acceptability of mobile apps to support the management of mental health in adolescents. A secondary aim was to collate the feedback from mental health professionals and adolescents involved in these studies. This review will focus on mobile phone apps only (as opposed to broad mHealth and eHealth interventions) and will include a wide remit of publication types.


Hale et al 2018 (40)

In this article, we provide an overview of the current science on screens and sleep, with a focus on recommendations to reduce the potentially excessive influence of screen time on paediatric sleep. We then review how impaired sleep in paediatric populations may lead to a range of adverse behaviours, physical health problems and well-being outcomes. We begin with a summary of the two consensus statements on child and adolescent sleep needs. Then we summarize the range of screen habits among youth, focusing on screen habits at bedtime. Next, we review current literature on evidence of the effects of youth screen habits on sleep, and the mechanisms by which screen habits may impact sleep. We conclude with evidence-based strategies to improve sleep through sleep-friendly screen-behaviour recommendations and other take-home messages for families and practitioners


Harrer et al 2018 (41)

This systematic review aims to assess existing evidence regarding the effectiveness of Internet interventions on symptoms of common mental health disorders, well-being, and functioning outcomes among university students when compared with control groups.


Joshi et al 2019 (42)

This paper will examine these issues, with more breadth than depth, in order to:

1) Provide a snapshot of the technologies used by youth and young adults;

2) Help clinicians differentiate between normal use, problematic overuse, or addictive online behaviour;

3) Provide a basic approach for clinicians to engage, screen, educate/advise, and assess technology issues to move toward the treatment of specific disorders; and

4) Help communities and institutions tackle challenging issues like cyberbullying, sexting, high-risk behaviours, and problematic Internet use (PIU).


Konsta et al 2017 (43)

Recent literature mainly focuses on the use of electronic media and school starting time, since these two factors have a strong impact on adolescent sleep and are modifiable. Aim of this paper is to review recent literature on these parameters.


Lam 2014 (44)

The aim of the study is to systematically review the current literature to elicit epidemiological evidence supporting or refuting the association between Internet gaming addiction and sleep problems, including insomnia and poor sleep quality, as well as to explore the relationship between PIU and sleep problems.


Lissak 2018 (45)

This article reviews screen time effects on sleep, the cardiovascular system, orthopedics, and vision and screen time psychoneurological and social outcomes. A case study of an ADHD diagnosed nine-year-old boy presents an example of screen time in-the-field-effects and will assist to conclude the role of screen time in the formation of the psychophysiological resilience of the young generation.


Mustafao─člu et al 2018 (46)

This study reviews the literature on the clinical problems that digital technology use has on children.


Primack et al 2017 (47)

Despite the relative recency of this phenomenon, there has been a fair amount of initial research exploring how SM interfaces with both psychosocial development and mental health conditions among young adults. We aim in this article to broadly summarize major understandings that have been gleaned to date and to summarize important future directions for research.


Stiglic and Viner 2019 (48)

Our aim was to systematically examine the evidence on the effects of time spent using screens on health and well-being among CYP. Systematic reviews of reviews (RoR or umbrella reviews) are particularly suited to quickly collating the strength of evidence across a very broad area to guide policy. We therefore undertook an RoR of the effects of screentime of any type on CYP health and well-being outcomes.


Stockburger and Omar 2013 (49)

Through the synopsis of articles below, this review investigates the role of media use (including Internet addiction Internet use, mobile phones and computers) on sleep, particularly as a cause of sleep disturbances. It specifically focuses on media use and the subsequent sleep disturbance in children and adolescents.


Thomee 2018 (8)

The purpose of this literature review was to supplement the work of the WHO expert group by carrying out a literature review of quantitative observational studies that consider links between mobile phone use and mental health from a psychological or behavioural perspective.




Duplicates between literature reviews and literature search in electronic database




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