心理科学进展, 2019, 27(1): 70-82 doi: 10.3724/SP.J.1042.2019.00070

研究前沿

电子媒体使用对睡眠的影响,机制及其干预

陈庆伟1,2, 汝涛涛,1,3, 罗雪2,1, 董巧玲2,1, 翟迪国1,3, 熊晓4, 周国富,1,3,5

1 华南师范大学, 国家绿色光电子国际联合研究中心, 广州 510006

2 华南师范大学心理学院, 光与身心健康研究中心, 广州 510631

3 华南师范大学, 华南先进光电子研究院, 广东省光信息材料与技术重点实验室&彩色动态电子纸显示技术研究所, 广州 510006;

4 北京益普索市场咨询有限公司, 北京 100029

5 深圳市国华光电科技有限公司, 深圳 518110

The effects of digital media usage on sleep: Mechanisms and interventions

CHEN Qingwei1,2, RU Taotao,1,3, LUO Xue2,1, DONG Qiaoling2,1, ZHAI Diguo1,3, XIONG Xiao4, ZHOU Guofu,1,3,5

1 National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou 510006, China

2 Research Center of Light and Physio-psychological Health, School of Psychology, South China Normal University, Guangzhou 510631, China

3 Guangdong Provincial Key Laboratory of Optical Information Materials and Technology & Institute of Electronic Paper Displays, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou 510006, China;

4 Beijing Ipsos Market Consulting Co., Ltd, Beijing 100029, China

5 Shenzhen Guohua Optoelectronics Tech. Co. Ltd., Shenzhen 518110, China

通讯作者: 汝涛涛, E-mail:taotao.ru@m.scnu.edu.cn;周国富, E-mail: guofu.zhou@m.scnu.edu.cn汝涛涛, E-mail:taotao.ru@m.scnu.edu.cn;周国富, E-mail: guofu.zhou@m.scnu.edu.cn

收稿日期: 2018-03-19   网络出版日期: 2019-01-15

基金资助: * 国家重点研发计划项目.  2016YFB0401202
广东省创新科研团队.  2013C102
教育部“长江学者和创新团队发展计划”项目滚动支持.  No. IRT_17R40
广东省光信息材料与技术重点实验室.  2017B030301007
广州市类纸显示材料与器件重点实验室.  201705030007
教育部光信息国际合作联合实验室, 国家高等学校学科创新引智计划111引智基地项目资助.  

Received: 2018-03-19   Online: 2019-01-15

摘要

电子媒体设备日益流行的同时, 睡眠问题也日趋加重, 主客观研究均发现电子媒体使用会对睡眠产生消极影响.背后的加工机制涉及睡眠置换,唤醒,屏幕光和电磁辐射.可以通过睡眠卫生教育,限制电子媒体使用,屏蔽屏幕蓝光等方式进行干预.未来研究需要从理论机制的整合,因果关系的确定,测量方式的客观化和标准化,使用情况细化和本土化研究方面做努力.

关键词: 电子媒体 ; 睡眠 ; 睡眠置换 ; 屏幕光 ; 唤醒 ; 电磁辐射

Abstract

Sleep problems are more common with the prevalence of digital media devices. Subjective and objective research has shown evidence of negative sleep impacts of digital media usages. The underlying mechanisms involve sleep displacement, hyperarousal and effects of screen light and electromagnetic radiation. Sleep education, restriction of digital media usage and blocking blue light from screen can be promising options to alleviate the undesirable effects of digital media on sleep. More effort should be devoted to the integration of theoretical models, causality establishment between digital media and sleep, objectivization and standardization of measurements, refined classification of digital media user behaviors and local research.

Keywords: digital media ; sleep ; sleep displacement ; arousal ; screen light ; electromagnetic radiation

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本文引用格式

陈庆伟, 汝涛涛, 罗雪, 董巧玲, 翟迪国, 熊晓, 周国富. (2019). 电子媒体使用对睡眠的影响,机制及其干预 . 心理科学进展, 27(1), 70-82

CHEN Qingwei, RU Taotao, LUO Xue, DONG Qiaoling, ZHAI Diguo, XIONG Xiao, ZHOU Guofu. (2019). The effects of digital media usage on sleep: Mechanisms and interventions. Advances in Psychological Science, 27(1), 70-82

随着科技的发展, 电子媒体设备(如手机,电脑,电子阅读器,游戏主机等)在生活中随处可见, 人们花费大量时间使用该类设备进行工作,社交,娱乐和学习.伴随数字技术和电子媒体内容的渗透, 新生儿从出生开始就受其影响, 成为数字原住民(李宜霖, 周宗奎, 牛更枫, 2017).据统计, 超过三分之二的未成年人每天使用电子媒体两个小时以上(Atkin, Sharp, Corder, & van Sluijs, 2014).在美国的一项全国性调查中, 90%被访者在上床前一小时内都会使用某种电子媒体(Gradisar et al., 2013).

电子媒体是一把双刃剑, 在给人们生活带来巨大便利的同时, 也可能对身心健康造成一系列不良影响, 如过度和不良的电子媒体使用方式可能会导致肥胖,抑郁,学习成绩下降,社交障碍等一系列问题(Robinson et al., 2017).其中, 电子媒体使用对睡眠的影响不容小觑, 近年来, 学界对该领域的研究颇为关注, 并提醒大众对电子媒体的过度泛滥要提高警惕, 倡导理性使用.

随着电子媒体的日益流行, 睡眠问题也呈现日趋严重的态势.如流行病学的调查发现, 所有国家的儿童和青少年都没有得到足够的睡眠.上个世纪以来, 儿童和青少年的睡眠时长至少减少一个小时(Matricciani, Olds, & Petkov, 2012).而最近的一项元分析表明, 睡眠障碍在我国大学生中非常普遍, 发生率为25.7% (Li et al., 2018).此外, 我国老年人的睡眠状况也不容乐观(Lu et al., 2017).不良的睡眠模式和一系列身心健康问题均有密切联系, 如抑郁(Riemann, Berger, & Voderholzer, 2001),肥胖(Liu, Zhang, & Li, 2012),心脑血管疾病(Cappuccio, Cooper, D'Elia, Strazzullo, & Miller, 2011),癌症(Qin, Zhou, Zhang, Wei, & He, 2014)等, 甚至会增加死亡风险(Gallicchio & Kalesan, 2009).

之前国内学者从生态科技亚系统理论和数字原住民假说出发, 从宏观和微观的视角系统阐释了数字技术对个体社会性与人格,认知以及大脑的结构和功能等方面的影响(李宜霖 等, 2017), 而关于电子媒体使用对于睡眠的影响却并未涉及, 本文试图从这个视角切入, 系统综述电子媒体使用对睡眠的影响,机制及其预防措施.

1 电子媒体使用对睡眠的影响

大量研究表明, 电子媒体使用不仅会对睡眠的主观参数(如睡眠质量,睡眠时长等)产生影响, 而且也会对睡眠的客观参数(如睡眠结构等)产生不同程度的影响.目前, 该领域的研究主要采用横断研究的方式探讨二者之间的相关关系, 也有少量研究使用实验室研究和纵向研究的方法试图探明二者之间更加明确的因果关系.下面我们将从这两方面的研究系统阐述电子媒体使用对睡眠的影响.

1.1 电子媒体使用对睡眠的影响:主观测量的证据

主观睡眠参数的测量主要采用自陈问卷的 方式进行, 总的来说, 可以分为两类:自我报告量表和父母报告量表(Ji & Liu, 2016).其中自我报 告量表中使用最广泛的是匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index) (Buysse, Reynolds, Monk, Berman, & Kupfer, 1989), 该问卷具有良好的信效度, 是睡眠领域的经典问卷, 经国内学者的翻译修订(刘贤臣 等, 1996), 可用于对失眠患者睡眠质量的综合评价(路桃影, 李艳, 夏萍, 张广清, 吴大嵘, 2014).父母报告量表中的儿童睡眠习惯量表(Children’s Sleep Habits Questionnaire, CSHQ)也在该领域研究中得到广泛应用(Owens, Spirito, & Mcguinn, 2000), 修订后的版本适用于中国学龄儿童(Li et al., 2007)和学龄前儿童(Liu, Wang, Tang, Wen, & Li, 2014).除了标准化的问卷量表之外, 睡眠日志在睡眠研究中是应用最广的,可靠的睡眠参数记录方法(任志洪 等, 2016).

国外有专家针对学龄儿童和青少年群体的电子媒体使用和睡眠之间的关系进行了综述和元分析, 结果发现, 电子媒体使用与睡眠质量,睡眠数量和日间睡意均有十分显著的相关关系(Cain & Gradisar, 2010; Carter, Rees, Hale, Bhattacharjee, & Paradkar, 2016; Hale & Guan, 2015).例如, Carter等人(2016)对带有屏幕的便携移动设备(如手机,平板电脑等)和睡眠各变量之间的关系进行元分析发现, 床上电子媒体的使用与不良睡眠质量,较短的睡眠时长以及过多的日间睡意均存在十分显著的相关关系, 且这种关系十分稳定.Hale和Guan (2015)对学龄儿童和青少年的视屏时间(screen time)与睡眠之间关系的研究进行系统性综述, 他们将视屏时间分为电视,电脑,电子游戏,移动设备和未分类五种类型, 分别总结它们和睡眠主要参数之间的关系, 结果发现, 90%的研究均发现视屏时间和睡眠质量(主要是睡眠时长和入睡时间)之间存在负相关关系.更早的一项综述也发现了类似的结果(Cain & Gradisar, 2010).学龄前的婴幼儿群体也显示出相似的结果模式(Cheung, Bedford, Saez De Urabain, Karmiloff-Smith, & Smith, 2017; Nathanson & Beyens, 2018; Tso et al., 2016).而成人群体的研究结果则相对没那么一致.如有研究发现了电子媒体使用对睡眠的消极作用(Exelmans & van den Bulck, 2015), 而有的研究却并未发现电子媒体使用对睡眠的显著影响(Exelmans & van den Bulck, 2016;Leech, 2017).

1.2 电子媒体使用对睡眠的影响:客观测量的证据

客观睡眠参数主要利用体动记录仪和睡眠多导记录仪(polysomnograph, PSG)采集.PSG是测量睡眠参数的“金标准”, 它可以记录个体睡眠时的体动,呼吸,血氧,心跳,脑电等活动, 并且通过视频记录下个体睡眠时的状态, 此外, 它还能客观测量主要的睡眠参数:如入睡潜伏期(sleep onset latency), 睡眠总时间(total sleep time), 睡眠效率(sleep efficiency), 入睡后醒来时长(wake after sleep onset), 在床总时间(time in bed)等(Blood, Sack, Percy, & Pen, 1997).经过专业培训和指导之后, 研究人员还可以根据PSG记录到的相关数据和信号对睡眠进行分期, 以更加全面地了解个体睡眠的情况和动态变化过程.体动记录仪所记录到的睡眠参数虽然没有PSG丰富和全面, 但是由于其便捷性和经济性, 在实际研究中也得到广泛使用, 它得出的睡眠数据和PSG也有一定的可比性, 在一定程度上可以代替PSG进行睡眠参数的客观测量(van de Water, Holmes, & Hurley, 2011).

目前关于电子媒体使用和睡眠之间的实验研究较少.2015年, 有学者对比了夜间睡前阅读4个小时纸质书和电子书对睡眠的影响, 结果发现相对于纸质书来说, 使用电子书会显著抑制褪黑素分泌, 从而导致入睡时间延迟, 快速眼动睡眠减少, 次日醒来之后也感觉更累, 更难完全清醒过来(Chang, Aeschbach, Duffy, & Czeisler, 2015).后续研究发现阅读时间减少到两小时也能得到类似的结果(Rångtell et al., 2016).随后的一项随机对照实验发现, 相对于纸质书来说, 在床上阅读电子书会显著减少慢波活动(Grønli et al., 2016), 慢波活动对内稳态睡眠压力十分敏感(Borbély, Daan, Wirz-Justice, & Deboer, 2016), 这也就意味着, 电子书阅读会减少内稳态睡眠压力, 从而让被试更难进入睡眠.然而, 最近有一项针对顶尖运动员的研究却发现, 睡前使用两个小时平板电脑并不会影响睡眠(Jones et al., 2018).这一方面可能是因为顶尖运动员本身就具有良好的睡眠习惯, 另一方面, 也可能是因为该研究样本量较小(只有8个)所致.

2 电子媒体使用对睡眠的影响机制

前人的研究中提出了四种理论假设来解释 电子媒体使用对睡眠影响的作用机制(Cain & Gradisar, 2010), 这四种机制如下:

2.1 睡眠置换(sleep displacement)理论

该理论认为电子媒体使用作为一种非组织化的休闲活动(van den Bulck, 2000), 没有明确的 起止时间和时间限制(Kubey, 1986), 容易导致睡眠时间的置换, 从而影响睡眠时间和睡眠质量(Kubiszewski, Fontaine, Rusch, & Hazouard, 2014; Twenge, Krizan, & Hisler, 2017; van den Bulck, 2000, 2004; Westerik, Renckstorf, Wester, & Lammers, 2005) (如图1所示).这种现象在儿童和青少年群体中尤为普遍(Adam, Snell, & Pendry, 2007; Hysing et al., 2015; Reynolds et al., 2015).最近, Exelmans和van den Bulck (2017)将闭眼时间纳入, 对上床时间(bedtime)和睡眠起始时间之间的阶段进一步细分, 将上床时间之前的阶段称为睡眠置换阶段一, 而将上床时间到闭眼时间的这段闭眼潜伏期(shuteye onset)称之为睡眠置换阶段二, 在传统的睡眠置换理论的基础上, 提出睡眠置换双阶段理论(如图2所示), 从而对传统的睡眠置换理论进行了扩展和延伸.

2.2 唤醒理论

唤醒理论认为电子媒体内容中可能包含大量的暴力和色情信息(Brown et al., 2006;Dill & Dill, 1999), 容易导致个体的生理唤醒和心理唤醒水平明显升高, 产生恐惧,焦虑和压力反应(Anderson et al., 2010;Harrison & Cantor, 1999;van der Molen & Bushman, 2008), 从而使人难以入睡, 睡眠质量下降(如图3所示).然而, 近期一个研究却发现睡前玩视频游戏对心率和入睡时间没有显著影响(King et al., 2013), 这也意味着, 唤醒作为解释电子媒体对睡眠影响的机制还需要进一步探讨.

图1

图1   睡眠置换理论(Exelmans & van den Bulck, in press)


图2

图2   睡眠置换双阶段理论(Exelmans & van den Bulck, in press)


图3

图3   唤醒理论


2.3 屏幕光理论

屏幕光理论认为电子设备屏幕发出的光会干扰褪黑素分泌和生理节律, 从而延迟入睡时间, 影响睡眠(Cajochen et al., 2011; Chang et al., 2015; Chellappa et al., 2013; Green, Cohen-Zion, Haim, & Dagan, 2017, 2018; Grønli et al., 2016; Wood, Rea, Plitnick, & Figueiro, 2013) (如图4所示).而新一代的电子媒体设备普遍使用发光二极管(light- emitting diodes, LED)作为屏幕材质, 该材质的屏幕通常会发出褪黑素敏感的短波长蓝光, 这会显著抑制褪黑素的分泌(Berson, Dunn, & Takao, 2002; Chellappa et al., 2013), 从而影响睡眠质量.

图4

图4   屏幕光理论


需要注意的是, 屏幕光对褪黑素分泌和生物节律的影响具有一定的时间累积效应, 因此, 使用时间是需要考虑的重要变量之一.最近一项研究使用平板电脑分别对比了三种屏幕光条件(亮,暗屏幕光和过滤了短波成分的屏幕光)在一个小时使用之后, 对青少年睡前警觉性,睡眠和日间功能的影响进行了研究, 结果发现, 三种条件之间的差异微乎其微(Heath et al., 2014).另一项研究也发现类似结果(Wood et al., 2013), 然而, 在使用时间延长到两小时之后, 电子媒体使用对睡眠的影响就开始显现出来(Orzech, Grandner, Roane, & Carskadon, 2016), 屏幕光会显著抑制褪黑素的分泌, 从而推迟入睡时间.

此外, 一系列研究表明, 通过屏蔽或者过滤屏幕光中的蓝光成分, 就可以显著改善睡眠质量(Ayaki et al., 2016;van der Lely et al., 2015; Wood et al., 2013), 这也为该机制的合理性提供了进一步证据.另外, 一项最新研究发现, 除了传统的电话之外, 带屏幕的电子设备均对醒后的日间绩效表现有不良影响(Johansson, Petrisko, & Chasens, 2016), 这也为该理论提供了间接佐证.

2.4 电磁辐射理论

该理论认为电子设备发射的电磁辐射会改变睡眠结构(Hamblin & Wood, 2002; Loughran et al., 2005), 推迟褪黑素的分泌时间(Wood, Loughran, & Stough, 2006), 从而影响睡眠质量(如图5所示).然而, 近期的一项研究却表明, 电磁辐射并不会影响7岁儿童的睡眠质量(Huss et al., 2015).最新的一篇综述系统回顾了电磁辐射对人体睡眠,生理节律和认知的影响, 结果发现电磁辐射对睡眠的影响结论并不一致(Singh & Pati, 2016), 因此还需要更多研究来进一步对该机制进行探索.

图5

图5   电磁辐射理论


综上所述, 四种机制分别从不同角度对电子媒体对睡眠的影响进行解释, 如睡眠置换理论从使用时间, 唤醒理论从使用内容, 屏幕光理论从屏幕光的非视觉效应, 电磁辐射理论从电磁辐射对褪黑素抑制的角度对该议题进行不同角度的剖析.其中, 睡眠置换理论对睡眠时长的减少解释较好, 然而, 电子媒体使用不仅对睡眠时长有消极影响, 它还对睡眠的其他指标, 如入睡潜伏期,睡眠效率等有影响, 而对于这些指标的影响, 睡眠置换理论不能做出理想的解释.此外, 该机制对于这种现象的解释也过于简单, 不够深入.虽然最近有学者对该理论进行了一定的细化和扩展, 提出了睡眠置换的双阶段理论(Exelmans & van den Bulck, 2017), 然而, 双阶段理论本质上跟经典的睡眠置换理论是一脉相承的, 以上这些问题依然没有得到很好解决.最后, 该理论在对现象进行解释的时候也存在一定的群体适用性, 它在青少年和儿童群体中的解释力较强, 而成人的相关研究似乎并不支持该理论.成人群体的研究发现, 虽然电子媒体的使用会推迟入睡起始时间, 但它同时也会推迟起床时间, 因此, 睡眠总时 长很少受影响(Custers & van den Bulck, 2012; Exelmans & van den Bulck, 2015, 2016).最近一项加拿大的研究甚至发现了和青少年群体相反的结果, 该研究发现1998年到2010年屏幕使用时长和睡眠时长均有所增加, 且两者存在显著的正相关关系(Leech, 2017).这表明屏幕使用时间的增加并不一定会导致睡眠时长的减少.这有可能是因为成人比青少年更有能力调控自己的日常作息, 从而能够根据电子媒体的使用情况来灵活调整自己的入睡和起床时间.

而对于唤醒理论和电磁辐射理论, 这两个理论虽然有部分实证研究支持, 但是其得出的结果还很不一致, 需要未来研究进一步探索.目前研究结论较为一致的就是屏幕光理论.该理论根植于光照的非视觉效应(陈庆伟 等, 2018; 毛天欣 等, 2018; 朱莹莹, 汝涛涛, 周国富, 2015), 从生理机制层面对这种现象进行了有力解释, 并且有干预研究作为佐证, 对于人们的日常生活来说具有重要的实践指导意义.但是前人研究发现, 没有屏幕光参与的电子媒体使用活动也会对睡眠有所影响, 对于这类现象, 屏幕光理论并不能给予理想的解释.

3 电子媒体使用对睡眠影响的预防和干预措施

首先要对公众进行睡眠卫生教育, 使他们了解有关睡眠的科学知识, 特别是电子媒体使用对睡眠的影响, 提高大众健康睡眠的意识.比如通过在学校进行睡眠教育课程能够有效改善青少年主客观睡眠(Barber & Cucalon, 2017; Kira, Maddison, Hull, Blunden, & Olds, 2014).另外, 美国儿科协会每隔一段时间就会发布一个政策声明(Policy Statement)来系统总结电子媒体使用对儿童和青少年各方面的影响, 并据此提出一些应对措施, 来提高公众对于电子媒体使用情况及其影响的全面认识, 如2011年的政策声明就建议两岁以下儿童不要使用电子媒体, 而两岁以上儿童的使用时间每天最多不要超过两个小时(Council On Media Communications & Brown, 2011).这种公众教育活动也能够有效减少电子媒体使用不当所引起的消极后果.

从睡眠置换的角度来说, 主要可以通过减少或限制电子媒体的使用时间来干预.尽管许多研究已经在儿童群体上探讨减少视屏时间对睡眠的改善效果(Wahi, Parkin, Beyene, Uleryk, & Birken, 2011), 而且一些研究也把限制视屏时间作为改善公众睡眠卫生情况的一个推荐措施(Blunden & Rigney, 2015), 但是近期一个研究却发现, 连续4周22:00以后禁止使用电子媒体对于那些已经形成良好睡眠习惯的运动员的睡眠情况并无显著改善(Harris et al., 2015).因此, 单纯限制使用时间可能并不能起到很好的效果.

从唤醒理论的角度来说, 睡前使用电子媒体的话, 可以适当观看,浏览一些有助于放松的内容, 而不要接触一些比较激烈,血腥,暴力,色情的内容.从电磁辐射理论的角度来说, 则最好把电子媒体设备放在卧室之外, 从而使该类设备发出的电磁辐射对睡眠的消极影响减到最小.

鉴于目前结论较为一致的是屏幕光理论, 因此, 现有干预研究中, 主要针对的是削弱屏幕光对睡眠的消极影响.目前研究主要从三个方面进行:

第一, 从屏幕本身材质入手, 预防思路是改进目前的LED屏幕显示技术或者发明一种新型的显示介质使得屏幕光发出的蓝光成分减少.目前已有研究在手机屏幕(Oh, Yoo, Park, & Do, 2015)和灯光设备(Brainard et al., 2013; Jou et al., 2013; Žukauskas, Vaicekauskas, & Vitta, 2012)上进行了一系列尝试并取得良好效果.近期很多商家生产和推广的低蓝光屏幕产品也体现出这个方面的趋势.值得注意的是, 目前国内已有研究团队致力于开发彩色电子纸显示技术(Shui et al., 2014; Yi et al., 2015)来减轻屏幕光对睡眠的消极影响.与LED屏幕不同的是, 电子纸屏幕主要是通过反射环境光从而达到显示彩色内容的目的, 这就彻底避免了LED屏幕自发光所带来的问题.对屏幕材质的改进虽然需要长期的资金和技术投入, 但它能从根本上减轻甚至消除电子媒体使用对睡眠的消极影响, 因此是值得深入探索的一个方向.

第二, 使用过滤膜或者防护眼镜来过滤屏幕蓝光.使用过滤膜或者防护眼镜可以选择性地过滤到特定的光谱成分(如蓝光), 从而达到保护睡眠的功用(Ayaki et al., 2016; Burkhart & Phelps, 2009; Escofet & Bara, 2017; Gringras, Middleton, Skene, & Revell, 2015; Sasseville, Paquet, Sévigny, Hébert, 2006; van der Lely et al., 2015).过滤膜或者防护眼镜具有经济,易于获取的优点, 在过滤蓝光方面也体现出较好的功效性, 但是二者也存在一些固有的缺陷.首先, 过滤膜必须贴在屏幕上, 而防护眼镜必须戴在用户头上, 这可能在某些场合下造成一定程度的不便.其次, 过滤膜和防护眼镜的透射率是固定不变的, 因此不能根据特定要求进行动态调节.

第三, 使用软件应用来过滤屏幕蓝光.该方法原理在于控制单个像素二极管发出光谱的相对权重, 从而达到动态调节屏幕光光谱的效用.软件应用能够在满足基本视觉要求的基础上, 尽量减少屏幕光对睡眠的消极影响.此外, 它没有实体存在, 节能环保, 用户可以根据自己的需求进行动态调节.目前该类软件应用主要有f.lux (Escofet & Bara, 2017; Heath et al., 2014), Twilight (Bossi & Hopker, 2017), sleep-aware (Gringras et al., 2015)和苹果公司产品的“Night Shift”模式(Nagare, Plitnick, & Figueiro, in press)等.

以上介绍的干预方式在一定程度上使用的参数均比较粗糙, 未来研究还需要进一步细化相关参数, 为将来的干预研究提供更精确的指标体系.此外, 在已有研究的基础上, 其他潜在的干预方式也值得继续探索.比如光照干预, 最近一项研究发现, 白天14:30~21:00六个半小时的亮光(约569 lx)照射能够有效抵消夜间两小时的平板电脑阅读对睡眠的消极影响(Rångtell et al., 2016).此外, 睡眠的认知行为疗法, 特别是其中的自助式认知行为治疗也有望能够改善电子媒体使用导致的睡眠问题.该疗法着眼于良好睡眠习惯的养成以及不良睡眠相关认知的调整(Montgomery & Dennis, 2004; Murawski et al., 2018).而其中的自助式认知行为治疗能够借助迷你掌上设备(Riley et al., 2010)和计算机(van Straten et al., 2014)等载体来传递认知行为疗法, 该疗法对失眠具有较好的疗效(任志洪 等, 2016), 借助它可以改变人们对电子媒体使用的认知和看法, 减弱电子媒体和睡眠二者之间的内在关联, 从而帮助人们改善睡眠问题.

4 未来研究展望

4.1 因果关系的进一步厘清

电子媒体使用和睡眠之间的因果关系目前并不十分明朗, 现有的实验室研究和纵向研究的结果并不一致.虽然前述的大部分实验研究均支持电子媒体使用会导致睡眠问题, 一些追踪电子媒体使用长期效果的纵向研究也支持该结论, 如有研究表明青少年时期每天超过3个小时的电视观看时间和成年早期的较高的睡眠问题发生率显著相关(Johnson, Cohen, Kasen, First, & Brook, 2004).Nuutinen等人(2013)的纵向研究表明, 电脑使用,观看电视和卧室里电子媒体设备的存在均会减少儿童的睡眠时长.但是也有一些实验室研究发现了相反的结论.如有学者通过人为操纵睡眠时长发现, 睡眠时长减少能够显著增加观看电视的时间(Hart et al., 2017).另外一些研究也发现, 人们很可能将电子媒体作为睡眠问题的一种应对手段, 即电子媒体使用是睡眠问题的结果而非原因.一项为期三年的纵向研究表明, 大学生的睡眠问题导致了电子媒体的使用(Tavernier & Willoughby, 2014), 甚至可能导致短信依赖和iPod依赖(Ferraro, Holfeld, Frankl, Frye, & Halvorson, 2015).日本最近一项持续6年的研究也支持该结论, 他们发现, 6岁时的入睡时间延迟和12岁时的电子媒体的过度使用具有显著的正相关关系(Kato, Yorifuji, Yamakawa, & Inoue, 2018).研究者们认为之所以出现这种结果可能是因为电子媒体使用和睡眠之间的关系会随着年龄的变化而变化.而Johnson等人(2004)的研究也支持该假设.他们发现, 14岁时电子媒体使用时间的减少和16岁时睡眠问题的减少呈显著的正相关关系, 而16岁时电子媒体使用时间的减少却和22岁时睡眠问题的减少没有显著关联.

还有学者基于以上这些矛盾的结果, 提出两者之间可能是一种双向相关关系(Magee, Lee, & Vella, 2014).未来需要设计更加严谨的纵向研究和反向的实验室研究(即探讨睡眠时长或者质量的改变对电子媒体使用情况的影响)来进一步确定二者之间的因果关系以及可能存在的调节变量和中介变量, 如孤独感(Cacioppo et al., 2002; Carter, 2018; Carter et al., 2016)等.

4.2 测量方式的客观化和多样化

目前对于睡眠的客观测量已经有体动记录仪和“金标准”PSG, 现有的实验研究也开始逐渐采用这些方法进行实验数据的采集.对于纵向研究和某些特殊群体被试(如婴幼儿,癫痫患者)来说, 使用这两种方法测量睡眠可能不太现实, 目前有专家致力于开发无觉察式的睡眠监测系统, 该类系统能够通过视频和无线传感的方式监测睡眠, 目前的监测质量和睡眠分期结果跟PSG具有一定的可比性(Werth et al., 2017).并且该类系统可以长时间工作, 对被试本身的要求较少, 数据采集的便利性和经济性均可以满足纵向研究, 正常和特殊被试群体的研究需求, 是未来研究值得考虑的记录手段之一.

就主观测量而言, Ji和Liu (2016)的综述发现, 大部分的问卷虽然对信度进行了验证, 但是效度和反应倾向(responsiveness)却并未进行检验, 此外, 大部分问卷均采用频次作为测量指标, 严重程度也应该纳入到量表中进行测量.父母倾向于乐观估计子女的睡眠情况, 从而报告的睡眠时长更长, 上床时间更早(Short, Gradisar, Lack, Wright, & Chatburn, 2013), Liu等人(2018)发现, 在睡眠呼吸障碍,日间睡意和嗜睡三方面父母报告和自我报告之间相关较小, 这提示我们综合使用自我报告和父母报告的重要性.采用睡眠日志的研究也要注意睡眠日志的记录至少需要5天以上(Short, Arora, Gradisar, Taheri, & Carskadon, 2017).

至于电子媒体使用情况的测量则更多采用主观问卷报告的方法, 且各研究使用的主观问卷调查的维度和题目大相径庭, 导致研究结果之间很难进行直接对比.未来研究需要开发出测量电子媒体使用情况的调查量表, 进行严格的心理测量学评估, 以增加后来研究的一致性和可对比性.此外, 开发电子媒体使用情况的客观测量方法也有利于未来研究的开展, 如一些软件和应用程序可以自动记录手机和电脑的使用情况, 未来研究可以考虑使用该类软件或者应用程序来记录电子媒体使用情况.

4.3 理论机制的整合以及本土化研究

从以上对于四种理论的对比分析可以看出, 四种理论各有优缺点, 解释和适用范围均存在一定局限.事实上, 四种理论并非完全对立, 而是存在一定的重合和交叠之处.未来研究可以在现有研究的基础上, 使用更加精巧的实验设计分离出使用内容,使用时长,屏幕光和电磁辐射各方面的独立影响和它们之间的交互影响, 以探明二者之间深层的加工机制, 建构电子媒体使用对睡眠影响的动态模型.另外, 也可以将现有的四个理论进行一定的整合, 以更综合的逻辑框架对该议题进行重新审视, 如图6所示.以睡眠置换双阶段理论为基础, 分别考察屏幕光,电磁辐射和唤醒对睡眠置换阶段一和阶段二的不同影响, 从而勾勒出电子媒体使用对睡眠影响更加完整的图景.

图6

图6   电子媒体使用对睡眠影响的综合理论框架


前文综述的研究大部分是从电子媒体的正常使用状况来看待电子媒体使用对睡眠的影响, 而近年来, 研究也开始渐渐转向电子媒体的病理性使用对睡眠的影响, 如手机成瘾(刘庆奇, 周宗奎, 牛更枫, 范翠英, 2017),网络成瘾(Chen & Gau, 2016)等.也有研究只关注某种特定内容的电子媒体使用情况, 如社交网站使用(Sampasa-Kanyinga, Hamilton, & Chaput, 2018).此外, 不同电子媒体可能对睡眠具有不同的影响, 如Arora等人(2014)的研究表明, 所有种类的电子媒体使用都和工作日的睡眠时长负相关, 手机使用,社交网站使用,玩电子游戏和听音乐与入睡困难显著相关, 其中, 听音乐影响最大.而Twenge等人(2017)区分了传统电子媒体和新媒体, 发现睡眠时长的减少和新媒体而非传统媒体的使用密切相关.此外, 使用目的也会对结果有所影响, 例如, 相对于为了工作目的, 为了休闲目的而每周使用电脑超过30个小时更可能发生睡眠问题(Andersen & Garde, 2015).鉴于目前电子媒体使用越来越复杂和多元化, 人们往往会同时使用多种电子媒体(Calamaro, Mason, & Ratcliffe, 2009), 将来研究要对这种现象多加关注.未来研究需要在这些方面对电子媒体的具体使用情况进行细化, 以更加细致地探讨电子媒体使用的不同情况对睡眠的不同影响.

相对于国外研究百花齐放的研究现状, 目前国内对于该领域的研究相对较少且研究视角单一, 但是随着电子媒体的日益流行和睡眠问题的日趋加重, 国内学者对该议题也开始逐渐重视起来, 研究数量也逐年递增.如Li等人(2007)使用了CSHQ调查了电视和电脑使用情况与学龄儿童睡眠之间的关系, 发现电视和电脑使用是睡眠时长减少的主要风险因素之一(Li et al., 2010).Zhou等人(2012)也发现了类似的结果.对大学生(Wu, Tao, Zhang, Zhang, & Tao, 2015; Xu, Zhu, Sharma, & Zhao, 2015)和学龄前儿童(Tso et al., 2016)的调查研究也发现二者之间相似的关联模式.国内研究大多还是采取传统的问卷调查, 虽然得出的结论具有一定的现实意义, 但是想要解决理论机制和干预方式方面的争议, 还需要更多实验室研究,纵向研究和干预研究的开展.如借鉴国外的睡眠卫生教育, 开发适合国情的睡眠卫生科普活动, 普及睡眠相关知识以及电子媒体使用对睡眠的消极影响及其应对措施, 以帮助公众了解问题的严重性以及可能的解决方案.

致谢:衷心感谢台北市立联合医院Ching-Sui Hung医生对英文摘要的修改.

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心理科学进展, 25(10), 1799-1810.

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数字原住民的相关论述为解释数字技术对个体的影响提供了切入点,数字原住民是指在数字化环境中成长的个体,他们在成长过程中与数字技术互动的经历,不仅会使其表现出相应的行为特质,也会对他们的认知和生理结构产生广泛的影响.生态科技亚系统理论和数字原住民假说从宏观和微观的视角为这些论述提供了理论支持,认知心理学和认知神经领域的研究则对其内容进行了实证检验.在相关研究成果的基础上,未来研究需要进一步扩展研究的方向、广度和深度.

刘庆奇, 周宗奎, 牛更枫, 范翠英 . (2017).

手机成瘾与青少年睡眠质量: 中介与调节作用分析.

心理学报, 49(12), 1524-1536.

URL     [本文引用: 1]

为探讨手机成瘾对青少年睡眠质量的影响及其作用机制,采用问卷法对1258名青少年进行调查。结果表明:(1)手机成瘾不仅对青少年睡眠质量有显著的直接预测作用,还能通过情绪平衡的中介作用间接预测睡眠质量;(2)手机成瘾对青少年睡眠质量的直接作用以及情绪平衡的中介作用都受到反刍的调节,相对于反刍水平低的个体,直接效应和间接效应都在反刍水平高的个体中更强;(3)手机成瘾对青少年睡眠质量的直接作用以及情绪平衡的中介作用还都受到正念的调节,相对于正念水平低的个体,直接效应和间接效应都在正念水平高的个体中更弱。本研究结果有利于揭示手机成瘾是如何影响青少年睡眠质量的,以及手机成瘾在何种条件下对青少年睡眠质量的影响更强/更弱,对移动互联网时代维护与促进青少年身心健康有一定启示意义。

刘贤臣, 唐茂芹, 胡蕾, 王爱祯, 吴宏新, 赵贵芳 , .. 李万顺. (1996).

匹兹堡睡眠质量指数的信度和效度研究.

中华精神科杂志, 29(2), 103-107.

URL     [本文引用: 1]

为了验证匹兹堡睡眠质量指数(PSQI)的测试信度和效度,以112名正常成人、560名大学生和符合中国精神疾病分类方案与论断标准第二版诊断标准的45例失眠症、39例抑郁症和37例神经症病人为测试对象,应用心理测量与统计分析技术进行了验证。结果显示,PSAI有较好的内部一致性、再测信度、构想效度和实证效度。以PSAI〉7为界值,判断病例与正常人的灵敏度和特异度分别为98.3%和90.2%(Kqppa=

路桃影, 李艳, 夏萍, 张广清, 吴大嵘 . (2014).

匹兹堡睡眠质量指数的信度及效度分析.

重庆医学,43(3), 260-263.

[本文引用: 1]

毛天欣, 熊晓, 李静华, 姚颖, 杨健, 李笑然, 周国富 . (2018).

光照的警觉性作用.

心理科学进展, 26(7), 1213-1222.

URL     [本文引用: 1]

光照除了传统的视觉作用外,还具有一定的非视觉效应,包括调节昼夜节律、褪黑素分泌和警觉性等生理功能和行为表现。随着光照对生理节律影响研究的不断深入,近来很多学者开始关注光照的警觉性作用。我们根据最新研究进展总结了:(1)警觉性的测量工具;(2)光照强度、时长、时间点、波长、色温等对光照警觉性作用的影响;(3)光照在治疗情绪障碍、调节生理节律、完善办公照明方面的应用;(4)提出了继续探讨光照警觉性作用的神经机制、优化参数特征和探讨混淆变量的研究方向。

任志洪, 谢菲, 余香莲, 苏文亮, 陈丽君, 赵陵波 . (2016).

失眠的自助式认知行为治疗元分析: 疗效,影响因素及证据评价.

心理科学进展, 24(2), 173-195.

URL     [本文引用: 2]

This meta-analysis evaluated the efficacy of Self-Help Cognitive Behavioral Therapy for Insomnia (SH-CBTI), explored potential moderators of treatment outcome and evaluated the quality of evidence. Thirty five studies were included, and results showed: (a) The immediate efficacies of SH-CBTI for SE, SOL, WASO, TST, SQ, depression and anxiety were 0.66, 610.52, 610.47, 0.20, 0.34, 610.32 and 610.33 respectively; (b) SH-CBTI and face-to-face CBTI showed an equal efficacy at post-treatment while both minimal treatment and pharmacotherapy showed significantly smaller effects; (c) Comorbidities and support formats had a significant impact on the outcome. Evaluation on the quality of evidence showed that qualities of SE, WASO, TST, depression and anxiety are moderate, which means that the true effect is likely to be close to the estimated one. Low-level evidence supports SOL and SQ qualities, which indicates that the true effect may be substantially different from the estimated one.

朱莹莹, 汝涛涛, 周国富 . (2015).

照明的非视觉作用及其脑神经机制.

心理科学进展, 23(8), 1348-1360.

URL     [本文引用: 1]

Lighting is playing a crucial role in people’s daily life. It not only provides us with the basic visual effects such as perceiving the objects’ color and size, distinguishing directions, but also has a significant impact on psycho-physiological activities. A growing number of studies have found that lighting, especially the bright light or light with high correlated color temperature, could significantly decrease sleepiness and enhance subjective alertness by suppressing melatonin secretion. Otherwise, lighting plays a positive role in regulating circadian rhythms so as to keep individuals’ normal activities. Additionally, previous findings indicated that exposure to bright light could improve cognitive performance, relieve seasonal affective disorders (SAD) and even to some extent had a beneficial influence on some social behaviors like altruistic behavior. Both these direct and indirect influences of lighting on physiological and psychological activities mentioned above were all regarded as nonvisual effect of lighting. In recent years, the nonvisual effect of lighting and its brain mechanisms has been attracting much more attention and yielded plenty of valuable results. Future research should focus on the construction of structural equation modeling and the utilization of dynamic lighting to further explore the nonvisual effect of lighting.

Adam E. K., Snell E. K., & Pendry P . (2007).

Sleep timing and quantity in ecological and family context: A nationally representative time-diary study.

Journal of Family Psychology, 21(1), 4-19.

URL     PMID:17371105      [本文引用: 1]

J Fam Psychol. 2007 Mar;21(1):4-19.

Andersen L.L., &Garde A.H . (2015).

Sleep problems and computer use during work and leisure: Cross-sectional study among 7800 adults.

Chronobiology International, 32(10), 1367-1372.

URL     PMID:26539689      [本文引用: 1]

(2015). Sleep problems and computer use during work and leisure: Cross-sectional study among 7800 adults. Chronobiology International: Vol. 32, No. 10, pp. 1367-1372. doi: 10.3109/07420528.2015.1095202

Anderson C. A., Shibuya A., Ihori N., Swing E. L., Bushman B. J., Sakamoto A., .. Saleem M . (2010).

Violent video game effects on aggression, empathy, and prosocial behavior in eastern and western countries: A meta-analytic review.

Psychological Bulletin, 136(2), 151-173.

[本文引用: 1]

Arora T., Broglia E., Thomas G. N., & Taheri S . (2014).

Associations between specific technologies and adolescent sleep quantity, sleep quality, and parasomnias.

Sleep Medicine, 15(2), 240-247.

URL     PMID:24394730     

We tested the hypothesis that weekday bedtime use of six technologies would be significantly associated with eight sleep parameters studied relating to sleep quantity, sleep quality, and parasomnias. In our cross-sectional study, we previously administered validated age-appropriate questionnaires (School Sleep Habits Survey, Technology Use Questionnaire). Participating adolescents (n=738; 54.5% boys) were aged 11–13years and were from the Midlands region of the United Kingdom in 2010. Frequent use of all technology types was significantly inversely associated with weekday sleep duration (hours). Frequent music listeners and video gamers had significantly prolonged sleep onset (β=7.03 [standard error {SE}, 2.66]; P<.01 and β=6.17 [SE, 2.42]; P<.05, respectively). Frequent early awakening was significantly associated with frequent use of all technology types. The greatest effect was observed in frequent television viewers (odds ratio [OR], 4.05 [95% confidence interval {CI}, 2.06–7.98]). Difficulty falling asleep was significantly associated with frequent mobile telephone use, video gaming, and social networking, with music listeners demonstrating the greatest effect (OR, 2.85 [95%CI, 1.58–5.13]). Music listeners were at increased risk for frequent nightmares (OR, 2.02 [95%CI, 1.22–3.45]). Frequent use of all technologies except for music and mobile telephones was significantly associated with greater cognitive difficulty in shutting off. Frequent television viewers were almost four times more likely to report higher sleepwalking frequency (OR, 3.70 [95% CI, 1.89–7.27]). Frequent weekday technology use at bedtime was associated with significant adverse effects on multiple sleep parameters. If confirmed in other samples and longitudinally, improving sleep hygiene through better management of technology could enhance the health and well-being of adolescent populations.

Atkin A. J., Sharp S. J., Corder K ., & van Sluijs, E. M. F. (2014).

Prevalence and correlates of screen time in youth: An international perspective.

American Journal of Preventive Medicine, 47(6), 803-807.

URL     PMID:25241193      [本文引用: 1]

Screen time (including TV viewing/computer use) may be adversely associated with metabolic and mental health in children. To describe the prevalence and sociodemographic correlates of screen time in an international sample of children aged 4–17 years. Data from the International Children’s Accelerometry Database were collected between 1997–2009 and analyzed in 2013. Participants were 11,434 children (48.9% boys; mean [SD] age at first assessment, 11.7 [3.2] years). Exposures were sex, age, weight status, maternal education, and ethnicity. The outcome was self- or proxy-reported screen time <2 or >2 hours/day. Analyses were conducted initially at study level and then combined using random-effects meta-analysis. Within each contributing study, at least two thirds of participants exceeded 2 hours/day of screen time. In meta-analytic models, overweight or obese children were more likely to exceed 2 hours/day of screen time than those who were non-overweight (OR=1.58, 95% CI=1.33,1.88). Girls (vs boys: 0.65; 0.54, 0.78) and participants with more highly educated mothers (vs <university level: 0.53; 0.42, 0.68) were less likely to exceed 2 hours/day of screen time. Associations of age and ethnicity with screen time were inconsistent at study level and non-significant in pooled analyses. Screen time in excess of public health guidelines was highly prevalent, particularly among boys, those who were overweight or obese, and those with mothers of lower educational attainment. The population-attributable risk associated with this exposure is potentially high; further efforts to understand the determinants of within- and between-country variation in these behaviors and inform the development of effective behavior change intervention programs is warranted.

Ayaki M., Hattori A., Maruyama Y., Nakano M., Yoshimura M., Kitazawa M., .. Tsubota K . (2016).

Protective effect of blue-light shield eyewear for adults against light pollution from self-luminous devices used at night.

Chronobiology International, 33(1), 134-139.

URL     PMID:26730983      [本文引用: 2]

Abstract We investigated sleep quality and melatonin in 12 adults who wore blue-light shield or control eyewear 2 hours before sleep while using a self-luminous portable device, and assessed visual quality for the two eyewear types. Overnight melatonin secretion was significantly higher after using the blue-light shield (P < 0.05) than with the control eyewear. Sleep efficacy and sleep latency were significantly superior for wearers of the blue-light shield (P < 0.05 for both), and this group reported greater sleepiness during portable device use compared to those using the control eyewear. Participants rated the blue-light shield as providing acceptable visual quality.

Barber L.K., &Cucalon M.S . (2017).

Modifying the Sleep Treatment Education Program for Students to include technology use (STEPS-TECH): Intervention effects on objective and subjective sleep outcomes.

Stress & Health, 33(5), 684-690.

URL     PMID:28156049      [本文引用: 1]

Abstract University students often have sleep issues that arise from poor sleep hygiene practices and technology use patterns. Yet, technology-related behaviors are often neglected in sleep hygiene education. This study examined whether the Sleep Treatment Education Program for Students-modified to include information regarding managing technology use (STEPS-TECH)-helps improve both subjective and objective sleep outcomes among university students. Results of an experimental study among 78 university students showed improvements in objective indicators of sleep quantity (total sleep time) and sleep quality (less awakenings) during the subsequent week for students in the STEPS-TECH intervention group compared to a control group. Exploratory analyses indicated that effects were driven by improvements in weekend days immediately following the intervention. There were also no intervention effects on subjective sleep quality or quantity outcomes. In terms of self-reported behavioral responses to educational content in the intervention, there were no group differences in sleep hygiene practices or technology use before bedtime. However, the intervention group reported less technology use during sleep periods than the control group. These preliminary findings suggest that STEPS-TECH may be a useful educational tool to help improve objective sleep and reduce technology use during sleep periods among university students.

Berson D. M., Dunn F. A., & Takao M . (2002).

Phototransduction by retinal ganglion cells that set the circadian clock.

Science, 295(5557), 1070-1073.

[本文引用: 1]

Blood M. L., Sack R. L., Percy D. C., & Pen J. C . (1997).

A comparison of sleep detection by wrist actigraphy, behavioral response, and polysomnography.

Sleep, 20(6), 388-395.

URL     PMID:9302721      [本文引用: 1]

Two alternative methods for detecting sleep, wrist actigraphy (ACT) and behavioral response monitoring (BRM), were compared to polysomnography (PSG). In the BRM paradigm, a threshold intensity visual or auditory stimulus generated by a palm-top computer was presented about once per minute, and subjects pressed a microswitch if the stimulus was detected. A response within 5 seconds of the stimulus was scored as "wake" and a failure to respond as "sleep." Four males and four females underwent two nights of simultaneous in-home PSG, BRM, and ACT. Each night, subjects underwent a protocol designed to generate five sleep latency trials. Subjects were awakened by alarm clocks at approximately 1-hour intervals and remained awake for 10 minutes before returning to bed for another sleep onset latency (SOL) trial. Minute-by-minute comparisons were made for PSG versus ACT and BRM. All measures were fairly sensitive in detecting sleep, but BRM was more accurate in determining SOL and subsequent wakefulness. Behavioral response monitoring using a tone resulted in more responses and arousals prior to and during light stages of sleep than BRM using a light. It is concluded that BRM has some important advantages as a simple, minimally invasive method for monitoring sleep.

Blunden S., & Rigney G. (2015).

Lessons learned from sleep education in schools: A review of dos and don'ts.

Journal of Clinical Sleep Medicine, 11(6), 671-680.

URL     PMID:25766709      [本文引用: 1]

Sleep duration and quality are associated with negative neuropsychological and psychosocial outcomes in children and adolescents. However, community awareness of this is low and sleep education programs in schools are attempting to address this issue. Several studies now exist assessing the efficacy of these sleep education programs for improving sleep knowledge, sleep hygiene and sleep patterns. This paper presents these sleep education programs, most particularly, it presents the strengths and weaknesses of the current available studies in the hope that this can identify areas where future sleep education programs can improve.A systematic search of all school-based sleep education studies in adolescents was undertaken. Studies were scrutinized for author, teacher and participant comment regarding strengths and limitations of each study, which were then extracted and summarized.Two specific types of sleep education programs emerged from the review, those that sought to change sleep behavior and those that sought simply to disseminate information. Issues that dictated the strength or weakness of a particular study including who delivers the program, the theoretical basis, the tools utilized to measure sleep patterns, the content, and their capacity to engage students were assessed. Sleep education was considered important by teachers, students and parents alike.Future sleep education programs need to take into account lessons learned from previous sleep education efforts in order to maximize the potential for sleep education programs to improve the sleep health of our young people.A commentary on this article appears in this issue on page 595.

Borbély A. A., Daan S., Wirz-Justice A., & Deboer T . (2016).

The two-process model of sleep regulation: A reappraisal.

Journal of Sleep Research, 25(2), 131-143.

URL     PMID:26762182      [本文引用: 1]

Summary In the last three decades the two-process model of sleep regulation has served as a major conceptual framework in sleep research. It has been applied widely in studies on fatigue and performance and to dissect individual differences in sleep regulation. The model posits that a homeostatic process (Process S) interacts with a process controlled by the circadian pacemaker (Process C), with time-courses derived from physiological and behavioural variables. The model simulates successfully the timing and intensity of sleep in diverse experimental protocols. Electrophysiological recordings from the suprachiasmatic nuclei (SCN) suggest that S and C interact continuously. Oscillators outside the SCN that are linked to energy metabolism are evident in SCN-lesioned arrhythmic animals subjected to restricted feeding or methamphetamine administration, as well as in human subjects during internal desynchronization. In intact animals these peripheral oscillators may dissociate from the central pacemaker rhythm. A sleep/fast and wake/feed phase segregate antagonistic anabolic and catabolic metabolic processes in peripheral tissues. A deficiency of Process S was proposed to account for both depressive sleep disturbances and the antidepressant effect of sleep deprivation. The model supported the development of novel non-pharmacological treatment paradigms in psychiatry, based on manipulating circadian phase, sleep and light exposure. In conclusion, the model remains conceptually useful for promoting the integration of sleep and circadian rhythm research. Sleep appears to have not only a short-term, use-dependent function; it also serves to enforce rest and fasting, thereby supporting the optimization of metabolic processes at the appropriate phase of the 24-h cycle.

Bossi A.H., & Hopker J. (2017).

Twilight: Filter the blue light of your device and sleep better.

British Journal of Sports Medicine, 51(14), 1103-1104.

URL     PMID:27208069      [本文引用: 1]

Abstract Twilight Health and fitness. Android (V2.2 or above). Free; ‘Pro’ version available for 1.99/051.99/US$1.99. The Twilight app was created to help people mitigate sleep perturbations arising from the usage of self-illuminating electronic devices (eg, mobile phones and tablets) prior to sleeping.1 Blue light in the range of wavelengths 446–477 nm has been identified as the most potent light stimulus that suppresses melatonin production,2 a hormone that plays a major role in the regulation of sleep and wake cycles.3 Accordingly, Twilight filters the blue light emitted from mobile devices and protects the eyes with a soft red pellicle, potentially helping the user to fall asleep earlier and sleep better.1 ,4 ,5 On the basis of the user's local geographic coordinates, which are taken by …

Brainard G. C., Coyle W., Ayers M., Kemp J., Warfield B., Maida J., .. Hanifin J. P . (2013).

Solid-state lighting for the International Space Station: Tests of visual performance and melatonin regulation.

Acta Astronautica, 92(1), 21-28.

URL     [本文引用: 1]

78 Research was done inside a high-fidelity replica of the ISS Crew Quarters (CQ). 78 A Solid-State Lighting Assembly (SSLA) for the ISS was used to illuminate the CQ. 78 High levels of SSLA light significantly suppressed plasma melatonin inside the CQ. 78 SSLA light allows for contrast and color vision similar to room light and daylight.

Brown J. D., L'Engle K. L., Pardun C. J., Guo G., Kenneavy K., Jackson C . (2006).

Sexy media matter: Exposure to sexual content in music, movies, television, and magazines predicts black and white adolescents' sexual behavior.

Pediatrics, 117(4), 1018-1027.

URL     PMID:16585295      [本文引用: 1]

Abstract OBJECTIVE: To assess over time whether exposure to sexual content in 4 mass media (television, movies, music, and magazines) used by early adolescents predicts sexual behavior in middle adolescence. METHODS: An in-home longitudinal survey of 1017 black and white adolescents from 14 middle schools in central North Carolina was conducted. Each teen was interviewed at baseline when he or she was 12 to 14 years old and again 2 years later using a computer-assisted self interview (audio computer-assisted self-interview) to ensure confidentiality. A new measure of each teen's sexual media diet (SMD) was constructed by weighting the frequency of use of 4 media by the frequency of sexual content in each television show, movie, music album, and magazine the teen used regularly. RESULTS: White adolescents in the top quintile of sexual media diet when 12 to 14 years old were 2.2 times more likely to have had sexual intercourse when 14 to 16 years old than those who were in the lowest SMD quintile, even after a number of other relevant factors, including baseline sexual behavior, were introduced. The relationship was not statistically significant for black adolescents after controlling for other factors that were more predictive, including parental disapproval of teen sex and perceived permissive peer sexual norms. CONCLUSIONS: Exposure to sexual content in music, movies, television, and magazines accelerates white adolescents' sexual activity and increases their risk of engaging in early sexual intercourse. Black teens appear more influenced by perceptions of their parents' expectations and their friends' sexual behavior than by what they see and hear in the media.

Burkhart K., &Phelps J.R . (2009).

Amber lenses to block blue light and improve sleep: A randomized trial.

Chronobiology International, 26(8), 1602-1612.

URL     PMID:20030543      [本文引用: 1]

All light is not equal: blue wavelengths are the most potent portion of the visible electromagnetic spectrum for circadian regulation. Therefore, blocking blue light could create a form of physiologic darkness. Because the timing and quantity of light and darkness both affect sleep, evening use of amber lenses to block blue light might affect sleep quality. Mood is also affected by light and sleep; therefore, mood might be affected by blue light blockade. In this study, 20 adult volunteers were randomized to wear either blue-blocking (amber) or yellow-tinted (blocking ultraviolet only) safety glasses for 3 h prior to sleep. Participants completed sleep diaries during a one-week baseline assessment and two weeks' use of glasses. Outcome measures were subjective: change in overall sleep quality and positive/negative affect. Results demonstrated that sleep quality at study outset was poorer in the amber lens than the control group. Two- by three-way ANOVA revealed significant (p < .001) interaction between quality of sleep over the three weeks and experimental condition. At the end of the study, the amber lens group experienced significant (p < .001) improvement in sleep quality relative to the control group and positive affect (p = .005). Mood also improved significantly relative to controls. A replication with more detailed data on the subjects' circadian baseline and objective outcome measures is warranted.

Buysse D. J., Reynolds C. F., Monk T. H., Berman S. R., & Kupfer D. J . (1989).

The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research.

Psychiatry Research, 28(2), 193-213.

URL     PMID:2748771      [本文引用: 1]

Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven “component” scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with “good” sleepers (healthy subjects, = 52) and “poor” sleepers (depressed patients, = 54; sleep-disorder patients, = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score > 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, 81 0.001) in distinguishing good and poor sleepers. The clinemetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.

Cacioppo J. T., Hawkley L. C., Berntson G. G., Ernst J. M., Gibbs A. C., Stickgold R., Hobson J. A . (2002).

Do lonely days invade the nights? Potential social modulation of sleep efficiency.

Psychological Science, 13(4), 384-387.

URL     PMID:12137144      [本文引用: 1]

Loneliness predicts morbidity and mortality from broad-based causes, but the reasons for this effect remain unclear. Few differences in traditional health behaviors (e.g., smoking, exercise, nutrition) have been found to differentiate lonely and nonlonely individuals. We present evidence that a prototypic restorative behavior090000sleep090000does make such a differentiation, not through differences in time in bed or in sleep duration, but through differences in efficacy: In the study we report here, lonely individuals evinced poorer sleep efficiency and more time awake after sleep onset than nonlonely individuals. These results, which were observed in controlled laboratory conditions and were found to generalize to the home, suggest that lonely individuals may be less resilient than nonlonely individuals in part because they sleep more poorly. These results also raise the possibility that social factors such as loneliness not only may influence the selection of health behaviors but also may modulate the salubrity of restorative behaviors.

Cain N., & Gradisar M. (2010).

Electronic media use and sleep in school-aged children and adolescents: A review.

Sleep Medicine, 11(8), 735-742.

URL     PMID:20673649      [本文引用: 3]

Electronic media have often been considered to have a negative impact on the sleep of children and adolescents, but there are no comprehensive reviews of research in this area. The present study identified 36 papers that have investigated the relationship between sleep and electronic media in school-aged children and adolescents, including television viewing, use of computers, electronic gaming, and/or the internet, mobile telephones, and music. Many variables have been investigated across these studies, although delayed bedtime and shorter total sleep time have been found to be most consistently related to media use. A model of the mechanisms by which media use may affect sleep is presented and discussed as a vehicle for future research.

Cajochen C., Frey S., Anders D., Späti J., Bues M., Pross A., .. Stefani O . (2011).

Evening exposure to a light- emitting diodes (LED)-backlit computer screen affects circadian physiology and cognitive performance.

Journal of Applied Physiology, 110(5), 1432-1438.

URL     PMID:8980132210002221415172      [本文引用: 1]

Abstract Many people spend an increasing amount of time in front of computer screens equipped with light-emitting diodes (LED) with a short wavelength (blue range). Thus we investigated the repercussions on melatonin (a marker of the circadian clock), alertness, and cognitive performance levels in 13 young male volunteers under controlled laboratory conditions in a balanced crossover design. A 5-h evening exposure to a white LED-backlit screen with more than twice as much 464 nm light emission {irradiance of 0,241 Watt/(steradian 0103 m(2)) [W/(sr 0103 m(2))], 2.1 0103 10(13) photons/(cm(2) 0103 s), in the wavelength range of 454 and 474 nm} than a white non-LED-backlit screen [irradiance of 0,099 W/(sr 0103 m(2)), 0.7 0103 10(13) photons/(cm(2) 0103 s), in the wavelength range of 454 and 474 nm] elicited a significant suppression of the evening rise in endogenous melatonin and subjective as well as objective sleepiness, as indexed by a reduced incidence of slow eye movements and EEG low-frequency activity (1-7 Hz) in frontal brain regions. Concomitantly, sustained attention, as determined by the GO/NOGO task; working memory/attention, as assessed by "explicit timing"; and declarative memory performance in a word-learning paradigm were significantly enhanced in the LED-backlit screen compared with the non-LED condition. Screen quality and visual comfort were rated the same in both screen conditions, whereas the non-LED screen tended to be considered brighter. Our data indicate that the spectral profile of light emitted by computer screens impacts on circadian physiology, alertness, and cognitive performance levels. The challenge will be to design a computer screen with a spectral profile that can be individually programmed to add timed, essential light information to the circadian system in humans.

Calamaro C. J., Mason T. B. A., & Ratcliffe S. J . (2009).

Adolescents living the 24/7 lifestyle: Effects of caffeine and technology on sleep duration and daytime functioning.

Pediatrics, 123(6), e1005-e1010.

URL     PMID:1948273212      [本文引用: 1]

Abstract OBJECTIVE: Adolescents may not receive the sleep they need. New media technology and new, popular energy drinks may be implicated in sleep deficits. In this pilot study we quantified nighttime technology use and caffeine consumption to determine effects on sleep duration and daytime behaviors in adolescents. We hypothesized that with increased technology use, adolescents increase caffeine consumption, resulting in insufficient sleep duration. PATIENTS AND METHODS: Subjects were recruited from a pediatric office in a proximal suburb of Philadelphia, Pennsylvania. Inclusion criteria for this study were middle and high school subjects aged 12 to 18 years old. The questionnaire, Adolescent Sleep, Caffeine Intake, and Technology Use, was developed by the investigators to measure adolescents' intake of caffeinated drinks, use of nighttime media-related technology, and sleep behaviors. Descriptive statistics characterized the subjects, their caffeine and technology use, and sleep variables. Regression models assessed the relationships between caffeine, technology use, and sleep variables, having adjusted for age, race, gender, and BMI. RESULTS: Sleep was significantly related to the multitasking index. Teenagers getting 8 to 10 hours of sleep on school nights tended to have 1.5- to 2-fold lower multitasking indices compared with those getting less sleep. Thirty-three percent of the teenagers reported falling asleep during school. Caffeine consumption tended to be 76% higher by those who fell asleep. The log-transformed multitasking index was significantly related to falling asleep during school and with difficulties falling asleep on weeknights. CONCLUSIONS: Many adolescents used multiple forms of technology late into the night and concurrently consumed caffeinated beverages. Subsequently, their ability to stay alert and fully functional throughout the day was impaired by excessive daytime sleepiness. Future studies should measure more than television hours when evaluating the impact of nighttime activities on sleep patterns in adolescents.

Cappuccio F. P., Cooper D., D'Elia L., Strazzullo P., & Miller M. A . (2011).

Sleep duration predicts cardiovascular outcomes: A systematic review and meta-analysis of prospective studies.

European Heart Journal, 32(12), 1484-1492.

URL     PMID:21300732      [本文引用: 1]

Abstract Aims To assess the relationship between duration of sleep and morbidity and mortality from coronary heart disease (CHD), stroke, and total cardiovascular disease (CVD). Methods and results We performed a systematic search of publications using MEDLINE (1966-2009), EMBASE (from 1980), the Cochrane Library, and manual searches without language restrictions. Studies were included if they were prospective, follow-up >3 years, had duration of sleep at baseline, and incident cases of CHD, stroke, or CVD. Relative risks (RR) and 95% confidence interval (CI) were pooled using a random-effect model. Overall, 15 studies (24 cohort samples) included 474 684 male and female participants (follow-up 6.9-25 years), and 16 067 events (4169 for CHD, 3478 for stroke, and 8420 for total CVD). Sleep duration was assessed by questionnaire and incident cases through certification and event registers. Short duration of sleep was associated with a greater risk of developing or dying of CHD (RR 1.48, 95% CI 1.22-1.80, P < 0.0001), stroke (1.15, 1.00-1.31, P = 0.047), but not total CVD (1.03, 0.93-1.15, P = 0.52) with no evidence of publication bias (P = 0.95, P = 0.30, and P = 0.46, respectively). Long duration of sleep was also associated with a greater risk of CHD (1.38, 1.15-1.66, P = 0.0005), stroke (1.65, 1.45-1.87, P < 0.0001), and total CVD (1.41, 1.19-1.68, P < 0.0001) with no evidence of publication bias (P = 0.92, P = 0.96, and P = 0.79, respectively). Conclusion Both short and long duration of sleep are predictors, or markers, of cardiovascular outcomes.

Carter B. . (2018).

Letter to the editor: Is poor sleep, and loneliness linked by increased use of technology?

Psychological Medicine, 48(5), 876-877.

URL     [本文引用: 1]

react-text: 367 We are updating a systematic review on the above topic, we need the full text of all the included trials to add and analyse in the review /react-text react-text: 368 /react-text

Carter B., Rees P., Hale L., Bhattacharjee D., & Paradkar M. S . (2016).

Association between portable screen-based media device access or use and sleep outcomes: A systematic review and meta-analysis.

JAMA Pediatrics, 170(12), 1202-1208.

URL     PMID:27802500      [本文引用: 2]

Sleep is vital to children's biopsychosocial development. Inadequate sleep quantity and quality is a public health concern with an array of detrimental health outcomes. Portable mobile and media devices have become a ubiquitous part of children's lives and may affect their sleep duration and quality. To conduct a systematic review and meta-analysis to examine whether there is an association between portable screen-based media device (eg, cell phones and tablet devices) access or use in the sleep environment and sleep outcomes. A search strategy consisting of gray literature and 24 Medical Subject Headings was developed in Ovid MEDLINE and adapted for other databases between January 1, 2011, and June 15, 2015. Searches of the published literature were conducted across 12 databases. No language restriction was applied. The analysis included randomized clinical trials, cohort studies, and cross-sectional study designs. Inclusion criteria were studies of school-age children between 6 and 19 years. Exclusion criteria were studies of stationary exposures, such as televisions or desktop or personal computers, or studies investigating electromagnetic radiation. Of 467 studies identified, 20 cross-sectional studies were assessed for methodological quality. Two reviewers independently extracted data. The primary outcomes were inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness, studied according to an a priori protocol. Twenty studies were included, and their quality was assessed. The studies involved 12562198 children (mean [SD] age, 14.5 [2.2] years; 50.1% male). There was a strong and consistent association between bedtime media device use and inadequate sleep quantity (odds ratio [OR], 2.17; 95% CI, 1.42-3.32) (P65<65.001, I265=6590%), poor sleep quality (OR, 1.46; 95% CI, 1.14-1.88) (P65=65.003, I265=6576%), and excessive daytime sleepiness (OR, 2.72; 95% CI, 1.32-5.61) (P65=65.007, I265=6550%). In addition, children who had access to (but did not use) media devices at night were more likely to have inadequate sleep quantity (OR, 1.79; 95% CI, 1.39-2.31) (P65<65.001, I265=6564%), poor sleep quality (OR, 1.53; 95% CI, 1.11-2.10) (P65=65.009, I265=6574%), and excessive daytime sleepiness (OR, 2.27; 95% CI, 1.54-3.35) (P65<65.001, I265=6524%). To date, this study is the first systematic review and meta-analysis of the association of access to and the use of media devices with sleep outcomes. Bedtime access to and use of a media device were significantly associated with the following: inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness. An integrated approach among teachers, health care professionals, and parents is required to minimize device access at bedtime, and future research is needed to evaluate the influence of the devices on sleep hygiene and outcomes.

Chang A. M., Aeschbach D., Duffy J. F., & Czeisler C. A . (2015).

Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness.

Proceedings of the National Academy of Sciences, 112(4), 1232-1237.

[本文引用: 2]

Chellappa S. L., Steiner R., Oelhafen P., Lang D., Götz T., Krebs J., Cajochen C . (2013).

Acute exposure to evening blue-enriched light impacts on human sleep.

Journal of Sleep Research, 22(5), 573-580.

URL     PMID:23509952      [本文引用: 2]

SummaryLight in the short wavelength range (blue light: 446–48302nm) elicits direct effects on human melatonin secretion, alertness and cognitive performance via non-image-forming photoreceptors. However, the impact of blue-enriched polychromatic light on human sleep architecture and sleep electroencephalographic activity remains fairly unknown. In this study we investigated sleep structure and sleep electroencephalographic characteristics of 30 healthy young participants (16 men, 14 women; age range 20–3102years) following 202h of evening light exposure to polychromatic light at 650002K, 250002K and 300002K. Sleep structure across the first three non-rapid eye movement non-rapid eye movement – rapid eye movement sleep cycles did not differ significantly with respect to the light conditions. All-night non-rapid eye movement sleep electroencephalographic power density indicated that exposure to light at 650002K resulted in a tendency for less frontal non-rapid eye movement electroencephalographic power density, compared to light at 250002K and 300002K. The dynamics of non-rapid eye movement electroencephalographic slow wave activity (2.0–4.002Hz), a functional index of homeostatic sleep pressure, were such that slow wave activity was reduced significantly during the first sleep cycle after light at 650002K compared to light at 250002K and 300002K, particularly in the frontal derivation. Our data suggest that exposure to blue-enriched polychromatic light at relatively low room light levels impacts upon homeostatic sleep regulation, as indexed by reduction in frontal slow wave activity during the first non-rapid eye movement episode.

Chen Y.L., &Gau S. S.F . (2016).

Sleep problems and internet addiction among children and adolescents: A longitudinal study.

Journal of Sleep Research, 25(4), 458-465.

URL     PMID:26854132      [本文引用: 1]

Summary Although the literature has documented associations between sleep problems and internet addiction, the temporal direction of these relationships has not been established. The purpose of this study is to evaluate the bidirectional relationships between sleep problems and internet addiction among children and adolescents longitudinally. A four-wave longitudinal study was conducted with 1253 children and adolescents in grades 3, 5 and 8 from March 2013 to January 2014. The sleep problems of the student participants were measured by parental reports on the Sleep Habit Questionnaire, which catalogues early insomnia, middle insomnia, disturbed circadian rhythm, periodic leg movements, sleep terrors, sleepwalking, sleep talking, nightmares, bruxism, snoring and sleep apnoea. The severity of internet addiction was measured by students’ self-reports on the Chen Internet Addiction Scale. Based on the results of time-lag models, dyssomnias (odds ratio02=021.31), especially early and middle insomnias (odds ratio02=021.74 and 2.24), sequentially predicted internet addiction, and internet addiction sequentially predicted disturbed circadian rhythm (odds ratio02=022.40), regardless of adjustment for gender and age. This is the first study to demonstrate the temporal relationship of early and middle insomnia predicting internet addiction, which subsequently predicts disturbed circadian rhythm. These findings imply that treatment strategies for sleep problems and internet addiction should vary according to the order of their occurrence.

Cheung C. H. M., Bedford R., Saez De Urabain, I. R. S., Karmiloff-Smith A., & Smith T. J . (2017).

Daily touchscreen use in infants and toddlers is associated with reduced sleep and delayed sleep onset.

Scientific Reports, 7, 46104.

URL     PMID:28406474      [本文引用: 1]

Abstract Traditional screen time (e.g. TV and videogaming) has been linked to sleep problems and poorer developmental outcomes in children. With the advent of portable touchscreen devices, this association may be extending down in age to disrupt the sleep of infants and toddlers, an age when sleep is essential for cognitive development. However, this association has not been demonstrated empirically. This study aims to examine whether frequency of touchscreen use is associated with sleep in infants and toddlers between 6 and 36 months of age. An online survey was administered to 715 parents reporting on child media use (daily exposure to TV and use of touchscreens), sleep patterns (night-time and daytime sleep duration, sleep onset - time to fall asleep, and frequencies of night awakenings). Structural equation models controlling for age, sex, TV exposure and maternal education indicated a significant association between touchscreen use and night-time sleep, daytime sleep and sleep onset. No significant effect was observed for the number of night awakenings. To our knowledge, this is the first report linking the use of touchscreen with sleep problems in infants and toddlers. Future longitudinal studies are needed to clarify the direction of effects and the mechanisms underlying these associations using detailed sleep tracking.

Council On Media Communications., & Brown A. (2011).

Media use by children younger than 2 years.

Pediatrics, 128(5), 1040-1045.

URL     PMID:22007002      [本文引用: 1]

In 1999, the American Academy of Pediatrics (AAP) issued a policy statement addressing media use in children. The purpose of that statement was to educate parents about the effects that media--both the amount and the content--may have on children. In one part of that statement, the AAP recommended that "pediatricians should urge parents to avoid television viewing for children under the age of two years." The wording of the policy specifically discouraged media use in this age group, although it is frequently misquoted by media outlets as no media exposure in this age group. The AAP believed that there were significantly more potential negative effects of media than positive ones for this age group and, thus, advised families to thoughtfully consider media use for infants. This policy statement reaffirms the 1999 statement with respect to media use in infants and children younger than 2 years and provides updated research findings to support it. This statement addresses (1) the lack of evidence supporting educational or developmental benefits for media use by children younger than 2 years, (2) the potential adverse health and developmental effects of media use by children younger than 2 years, and (3) adverse effects of parental media use (background media) on children younger than 2 years.

Custers K., & van den Bulck J. (2012).

Television viewing, internet use, and self-reported bedtime and rise time in adults: Implications for sleep hygiene recommendations from an exploratory cross-sectional study.

Behavioral Sleep Medicine, 10(2), 96-105.

URL     PMID:22468928      [本文引用: 1]

This study examined whether the availability of the Internet and TV in the bedroom and overall Internet use and TV viewing were related to sleep variables in a sample of 711 residents of Flanders, Belgium. Although the relations were small, there was some evidence of time shifting: Internet access in the bedroom predicted later bedtime (0205 = .12, p < .05) and later rise time (0205 = .11, p < .05) on weekdays and later bedtime (0205 = .10, p < .001) on weekends. Internet use volume predicted later bedtime (0205 = .10, p < .001) and rise time (0205 = .07, p < .05) on weekends, and TV viewing predicted later bedtime (0205 = .10, p < .05) on weekends. However, neither the availability of the Internet or TV in the bedroom, nor the volume of Internet use or TV viewing, was a significant predictor of reduced sleep window or tiredness. Reducing media use might not be important for sleep hygiene advice to adults.

Dill K.E., &Dill J.C . (1999).

Video game violence: A review of the empirical literature.

Aggression and Violent Behavior, 3(4), 407-428.

URL     [本文引用: 1]

The popularity of video games, especially violent video games, has reached phenomenal proportions. The theoretical line of reasoning that hypothesizes a causal relationship between violent video-game play and aggression draws on the very large literature on media violence effects. Additionally, there are theoretical reasons to believe that video game effects should be stronger than movie or television violence effects. This paper outlines what is known about the relationship between violent video-game playing and aggression. The available literature on virtual reality effects on aggression is discussed as well. The preponderance of the evidence from the existing literature suggests that exposure to video-game violence increases aggressive behavior and other aggression-related phenomena. However, the paucity of empirical data, coupled with a variety of methodological problems and inconsistencies in these data, clearly demonstrate the need for additional research.

Escofet J., & Bará S. (2017).

Reducing the circadian input from self-luminous devices using hardware filters and software applications.

Lighting Research and Technology, 49(4), 481-496.

Exelmans L., & van den Bulck J. (2015).

Sleep quality is negatively related to video gaming volume in adults.

Journal of Sleep Research, 24(2), 189-196.

URL     PMID:25358428      [本文引用: 2]

Summary <p>Most literature on the relationship between video gaming and sleep disturbances has looked at children and adolescents. There is little research on such a relationship in adult samples. The aim of the current study was to investigate the association of video game volume with sleep quality in adults via face-to-face interviews using standardized questionnaires. Adults ( n 02=02844, 56.2% women), aged 18–9402years old, participated in the study. Sleep quality was measured using the Pittsburgh Sleep Quality Index, and gaming volume was assessed by asking the hours of gaming on a regular weekday (Mon–Thurs), Friday and weekend day (Sat–Sun). Adjusting for gender, age, educational level, exercise and perceived stress, results of hierarchical regression analyses indicated that video gaming volume was a significant predictor of sleep quality ( β02 =020.145), fatigue ( β02 =020.109), insomnia ( β02 =020.120), bedtime ( β02 =020.100) and rise time ( β02 =020.168). Each additional hour of video gaming per day delayed bedtime by 6.902min (95% confidence interval 2.0–11.902min) and rise time by 13.802min (95% confidence interval 7.8–19.702min). Attributable risk for having poor sleep quality (Pittsburgh Sleep Quality Index02>025) due to gaming >102h02day was 30%. When examining the components of the Pittsburgh Sleep Quality Index using multinomial regression analysis (odds ratios with 95% confidence intervals), gaming volume significantly predicted sleep latency, sleep efficiency and use of sleep medication. In general, findings support the conclusion that gaming volume is negatively related to the overall sleep quality of adults, which might be due to underlying mechanisms of screen exposure and arousal.</p>

Exelmans L., & van den Bulck J. (2016).

Bedtime mobile phone use and sleep in adults.

Social Science & Medicine, 148, 93-101.

URL     PMID:26688552      [本文引用: 2]

The few studies that have investigated the relationship between mobile phone use and sleep have mainly been conducted among children and adolescents. In adults, very little is known about mobile phone usage in bed our after lights out. This cross-sectional study set out to examine the association between bedtime mobile phone use and sleep among adults. A sample of 844 Flemish adults (18-94 years old) participated in a survey about electronic media use and sleep habits. Self-reported sleep quality, daytime fatigue and insomnia were measured using the Pittsburgh Sleep Quality Index (PSQI), the Fatigue Assessment Scale (FAS) and the Bergen Insomnia Scale (BIS), respectively. Data were analyzed using hierarchical and multinomial regression analyses. Half of the respondents owned a smartphone, and six out of ten took their mobile phone with them to the bedroom. Sending/receiving text messages and/or phone calls after lights out significantly predicted respondents’ scores on the PSQI, particularly longer sleep latency, worse sleep efficiency, more sleep disturbance and more daytime dysfunction. Bedtime mobile phone use predicted respondents’ later self-reported rise time, higher insomnia score and increased fatigue. Age significantly moderated the relationship between bedtime mobile phone use and fatigue, rise time, and sleep duration. An increase in bedtime mobile phone use was associated with more fatigue and later rise times among younger respondents (≤41.5 years old and ≤ 40.8 years old respectively); but it was related to an earlier rise time and shorter sleep duration among older respondents (≥60.15 years old and ≥ 66.4 years old respectively). Findings suggest that bedtime mobile phone use is negatively related to sleep outcomes in adults, too. It warrants continued scholarly attention as the functionalities of mobile phones evolve rapidly and exponentially.

Exelmans L., & van den Bulck J. (2017).

Bedtime, shuteye time and electronic media: Sleep displacement is a two- step process.

Journal of Sleep Research, 26(3), 364-370.

URL     PMID:28271575      [本文引用: 3]

Abstract This study argues that going to bed may not be synonymous with going to sleep, and that this fragmentation of bedtime results in a two-step sleep displacement. We separated bedtime (i.e. going to bed) from shuteye time (i.e. attempting to go to sleep once in bed) and assessed the prevalence of electronic media use in both time slots. A convenience sample of 338 adults (aged 18-250002years, 67.6% women) participated in an online survey. Results indicated a gap of 390002min between bedtime and shuteye time, referred to as 'shuteye latency'. Respondents with a shuteye latency of, respectively, 0909¤300002min, 0909¤1 or >10002h, were 3.3, 6.1 and 9.3 times more likely to be rated as poor sleepers compared to those who went to sleep immediately after going to bed. Before bedtime, volume of electronic media use (170002h0002550002min per week) was higher than non-media activities (140002h per week), whereas the opposite was true after bedtime (media0002=000230002h0002410002min, non-media0002=000270002h0002460002min). Shuteye latency was related exclusively to prebedtime media use. Findings confirmed the proposed fragmentation of bedtime. Sleep displacement should therefore be redefined as a two-step process, as respondents not only engage in the delay of bedtime, but also in the delay of shuteye time once in bed. Theoretical, methodological and practical implications are discussed. 0008 2017 European Sleep Research Society.

Exelmans L ., & van den Bulck, J.

(in press). Sleep research: A primer for media scholars.Health Communication.

Ferraro F. R., Holfeld B., Frankl S. N., Frye N., & Halvorson N. J . (2015).

Texting/iPod dependence, executive function and sleep quality in college students.

Computers in Human Behavior, 49, 44-49.

URL     [本文引用: 1]

Participants were classified as “good” sleepers (n=70) or “poor” sleepers (n=66) based on the Pittsburgh Sleep Quality Index (PSQI; Buysee, Reynolds, Monk, Berman, & Kupfer, 1989). Differences between good and poor sleepers were examined on executive function, texting and iPod dependence, depression, and anxiety. Poor sleepers reported higher levels of depression, higher levels of state and trait anxiety, greater texting dependence and iPod dependence, and poorer executive function performance, as compared to good sleepers. Poor sleep quality among college students may contribute to a range of negative psychological, neuropsychological, and social consequences.

Gallicchio L., & Kalesan B. (2009).

Sleep duration and mortality: A systematic review and meta-analysis.

Journal of Sleep Research, 18(2), 148-158.

URL     PMID:19645960      [本文引用: 1]

Epidemiologic studies have shown that sleep duration is associated with overall mortality. We conducted a systematic review of the associations between sleep duration and all-cause and cause-specific mortality. PubMed was systematically searched up to January, 2008 to identify studies examining the association between sleep duration and mortality (both all-cause and cause-specific) among adults. Data were abstracted serially in a standardized manner by two reviewers and analyzed using random-effects meta-analysis. Twenty-three studies assessing the associations between sleep duration and mortality were identified. All examined sleep duration measured using participant self-report. Among the 16 studies which had similar reference categories and reported sufficient data on short sleep and mortality for meta-analyses, the pooled relative risk (RR) for all-cause mortality for short sleep duration was 1.10 [95% confidence interval (CI): 1.06, 1.15]. For cardiovascular-related and cancer-related mortality, the RRs associated with short sleep were 1.06 (95% CI: 0.94, 1.18) and 0.99 (95% CI: 0.88, 1.13), respectively. Similarly, among the 17 studies reporting data on long sleep duration and mortality, the pooled RRs comparing the long sleepers with medium sleepers were 1.23 (95% CI: 1.17, 1.30) for all-cause mortality, 1.38 (95% CI: 1.13, 1.69) for cardiovascular-related mortality, and 1.21 (95% CI: 1.11, 1.32) for cancer-related mortality. Our findings indicate that both short sleepers and long sleepers are at increased risk of all-cause mortality. Further research using objective measures of sleep duration is needed to fully characterize these associations.

Gradisar M., Wolfson A. R., Harvey A. G., Hale L., Rosenberg R., Czeisler C. A . (2013).

The sleep and technology use of Americans: Findings from the National Sleep Foundation's 2011 sleep in America poll.

Journal of Clinical Sleep Medicine, 9(12), 1291-1299.

URL     PMID:24340291      [本文引用: 1]

Study Objectives: To describe the technology use and sleep quality of Americans, and the unique association between technology use and sleep disturbances.Methods: Interviews were conducted via random digit dialing (N = 750) or the Internet (N = 758). 1,508 Americans (13-64 years old, 50% males) matched to 2009 U. S. Census data provided complete interviews. The sample was further divided into adolescents (13-18 years, N = 171), young adults (19-29 years, N = 293), middle-aged adults (30-45 years, N = 469), and older adults (46-64 years, N = 565) to contrast different generations' technology use. Participants answered a 47-item semi-structured survey, including questions about their sleep habits, and the presence and use of technology in the hour before bed in the past 2 weeks.Results: Nine of 10 Americans reported using a technological device in the hour before bed (e. g., TVs the most popular; 60%). However, those under 30 years of age were more likely to use cell phones (72% of adolescents, 67% of young adults) than those over 30 years (36% of middle-aged, and 16% of older adults). Young adults' sleep patterns were significantly later than other age groups on both weekdays and weekend nights. Unlike passive technological devices (e. g., TV, mp3 music players), the more interactive technological devices (i.e., computers/laptops, cell phones, video game consoles) used in the hour before bed, the more likely difficulties falling asleep (beta = 9.4, p Conclusions: Technology use near bedtime is extremely prevalent in the United States. Among a range of technologies, interactive technological devices are most strongly associated with sleep complaints.

Green A., Cohen-Zion M., Haim A., & Dagan Y . (2017).

Evening light exposure to computer screens disrupts human sleep, biological rhythms, and attention abilities.

Chronobiology International, 34(7), 855-865.

URL     PMID:28548897      [本文引用: 1]

Abstract The use of electronic devices with light-emitting screens has increased exponentially in the last decade. As a result, humans are almost continuously exposed to unintentional artificial light. We explored the independent and combined effects of two aspects of screen illumination, light wavelength, and intensity, on sleep, its biological regulation, and related functional outcomes. The 2 2 repeated-measure design included two independent variables: screen light intensity (low ([LI] versus high [HI]) and wavelength (short [SWL] versus long [LWL]). Nineteen participants (11F, 8M; mean age 24.3 [卤2.8] years) underwent four light conditions, LI/SWL, HI/SWL, LI/LWL, and HI/LWL, in counterbalanced order. Each light exposure lasted for two hours (21:00-23:00), following which participants underwent an overnight polysomnography. On each experimental night, oral temperature and urine samples (for melatonin analysis) were collected at multiple time points. Each morning, participants filled out questionnaires and conducted a computerized attention task. Irrespective of light intensity, SWL illumination significantly disrupted sleep continuity and architecture and led to greater self-reported daytime sleepiness. SWL light also altered biological rhythms, subduing the normal nocturnal decline in body temperature and dampening nocturnal melatonin secretion. Light intensity seemed to independently affect sleep as well, but to a lesser degree. Both light intensity and wavelength negatively affected morning attention. In sum, light wavelength seems to have a greater influence than light intensity on sleep and a wide-range of biological and behavioral functions. Given the widespread use of electronic devices today, our findings suggest that screen light exposure at evening may have detrimental effects on human health and performance.

Green A., Cohen-Zion M., Haim A., & Dagan Y . (2018).

Comparing the response to acute and chronic exposure to short wavelength lighting emitted from computer screens.

Chronobiology International, 35(1), 90-100.

URL     PMID:29111816      [本文引用: 1]

react-text: 412 Melatonin is a versatile physiological agent that relating to the control of numerous physiologic processes owing to the multiplicity of sites of formation and the presence of melatonin receptors in various places of a human body. The melatonin metabolite 6-sulphatoxymelatonin (alias aMT6s or 6-SMT) infiltrates in urine. Therefore, there is a sense to find the sensitive and selective... /react-text react-text: 413 /react-text [Show full abstract]

Gringras P., Middleton B., Skene D. J., & Revell V. L . (2015).

Bigger, Brighter, Bluer-Better? Current light-emitting devices——Adverse sleep properties and preventative strategies.

Frontiers in Public Health, 3, 233.

URL     PMID:4602096      [本文引用: 2]

In an effort to enhance the efficiency, brightness, and contrast of light-emitting (LE) devices during the day, displays often generate substantial short-wavelength (blue-enriched) light emissions that can adversely affect sleep. We set out to verify the extent of such short-wavelength emissions, produced by a tablet (iPad Air), e-reader (Kindle Paperwhite 1st generation), and smartphone (iPhone 5s) and to determine the impact of strategies designed to reduce these light emissions. University of Surrey dedicated chronobiology facility. First, the spectral power of all the LE devices was assessed when displaying identical text. Second, we compared the text output with that of “Angry Birds” – a popular top 100 “App Store” game. Finally, we measured the impact of two strategies that attempt to reduce the output of short-wavelength light emissions. The first strategy employed an inexpensive commercially available pair of orange-tinted “blue-blocking” glasses. The second strategy tested an app designed to be “sleep-aware” whose designers deliberately attempted to reduce short-wavelength light emissions. All the LE devices shared very similar enhanced short-wavelength peaks when displaying text. This included the output from the backlit Kindle Paperwhite device. The spectra when comparing text to the Angry Birds game were also very similar, although the text emissions were higher intensity. Both the orange-tinted glasses and the “sleep-aware” app significantly reduced short-wavelength emissions. The LE devices tested were all bright and characterized by short-wavelength enriched emissions. Since this type of light is likely to cause the most disruption to sleep as it most effectively suppresses melatonin and increases alertness, there needs to be the recognition that at night-time “brighter and bluer” is not synonymous with “better.” Ideally future software design could be better optimized when night-time use is anticipated, and hardware should allow an automatic “bedtime mode” that shifts blue and green light emissions to yellow and red as well as reduce backlight/light intensity.

Grønli J., Byrkjedal K. I., Bjorvatn B., Nødtvedt Ø., Hamre B., Pallesen S . (2016).

Reading from an iPad or from a book in bed: The impact on human sleep. A randomized controlled crossover trial.

Sleep Medicine, 21, 86-92.

URL     PMID:27448477      [本文引用: 2]

To objectively and subjectively compare whether reading a story for 3065min from an iPad or from a book in bed prior to sleep will differentially affect sleep. Sixteen students (12 females, mean age 25.165±652.9 years) underwent ambulatory (sleeping in their own beds at home) polysomnographic (PSG) recordings in a counterbalanced crossover design consisting of three PSG nights (one adaptation night, two test nights) and two different reading materials: read from an iPad or from a book. Illumination was measured during reading and Karolinska Sleepiness Scale was completed prior to turning the light off. Sleep diaries were kept to assess subjective sleep parameters from day to day. Illumination was higher in the iPad condition compared to the book condition (58.365±656.9 vs 26.765±658.065lux,p<0.001). Reading a story from an iPad decreased subjective sleepiness, delayed the EEG dynamics of slow wave activity by approximately 3065min, and reduced slow wave activity after sleep onset compared to reading from a book. No parameters of sleep state timing and sleep onset latency differed between the two reading conditions. Although there was no direct effect on time spent in different sleep states and self-reported sleep onset latency, the use of an iPad which emits blue enriched light impinges acutely on sleepiness and EEG characteristics of sleep pressure. Hence, the use of commercially available tablets may have consequences in terms of alertness, circadian physiology, and sleep.

Hale L., & Guan S. (2015).

Screen time and sleep among school-aged children and adolescents: A systematic literature review.

Sleep Medicine Reviews, 21, 50-58.

URL     PMID:25193149      [本文引用: 1]

We systematically examined and updated the scientific literature on the association between screen time (e.g., television, computers, video games, and mobile devices) and sleep outcomes among school-aged children and adolescents. We reviewed 67 studies published from 1999 to early 2014. We found that screen time is adversely associated with sleep outcomes (primarily shortened duration and delayed timing) in 90% of studies. Some of the results varied by type of screen exposure, age of participant, gender, and day of the week. While the evidence regarding the association between screen time and sleep is consistent, we discuss limitations of the current studies: 1) causal association not confirmed; 2) measurement error (of both screen time exposure and sleep measures); 3) limited data on simultaneous use of multiple screens, characteristics and content of screens used. Youth should be advised to limit or reduce screen time exposure, especially before or during bedtime hours to minimize any harmful effects of screen time on sleep and well-being. Future research should better account for the methodological limitations of the extant studies, and seek to better understand the magnitude and mechanisms of the association. These steps will help the development and implementation of policies or interventions related to screen time among youth.

Hamblin D.L., &Wood A.W . (2002).

Effects of mobile phone emissions on human brain activity and sleep variables.

International Journal of Radiation Biology, 78(8), 659-669.

URL     PMID:12194749      [本文引用: 1]

Purpose : To compare the findings of the main studies that have examined the effects of GSM mobile phone radiofrequency emissions on human brain activity and sleep variables. Materials and methods : Fourteen published studies reporting on human brain electrical activity measurements during and/or after such radiofrequency emissions were identified and compared. Conclusions : Although, in general, outcomes have been inconsistent and comparison between individual studies is difficult, enhanced electroencephalogram alpha-band power has been noted in several of the studies, a phenomenon also observed in some animal studies. Performance decrements observed in some recent extremely low frequency studies are consistent with enhanced alpha-band power, highlighting the possible role of extremely low frequency fields associated with battery current in mobile phone handsets. However, more complex cognitive tasks appear to show improved performance in relation to mobile phone exposure. Significant cognitive effects have been reported using both modulated and unmodulated radiofrequency carriers. The possibility of putative effects being due to extremely low frequency demodulation is therefore unlikely. There are no obvious associations between the site of exposure and regions of the brain from which effects are reported or implied. Lastly, radiofrequency effects have been reported to occur both during exposure and up to 1 h or so after cessation of exposure.

Harris A., Gundersen H., Mørk-Andreassen P., Thun E., Bjorvatn B., .. Pallesen S . (2015).

Restricted use of electronic media, sleep, performance, and mood in high school athletes——A randomized trial.

Sleep Health, 1(4), 314-321.

URL     PMID:29073407      [本文引用: 1]

The study aims to evaluate whether 4 weeks with restricted use of electronic media after 22:00 affects sleep, athletic performance, cognitive performance, and mood in high school athletes. Eighty-five athletes were randomized to either an intervention group (n = 44), who was instructed to not use any electronic media after 22:00, or a control condition (n = 41), where they could act as they preferred in terms of media use. Primary outcomes were sleep habits measured with a sleep diary. Secondary outcomes were (a) physical performance measured with a set of standardized tests (beep test, 20-m linear sprint, chin-up test, hanging sit-ups test, counter movement jump and sit-n-reach test); (b) cognitive performance (response time and response accuracy); and (c) positive and negative affect. Differences between groups were tested with mixed between-within subject analyses of variance. Thirty-five and 40 of the athletes in the intervention and control group, respectively, completed the study. Results showed that restricted use of electronic media after 22:00 did not improve sleep habits, athletic performance, cognitive performance, or mood in a group of high school top athletes with already good sleep habits. However, these findings give us knowledge about sleep habits and performance in this population that is of importance when designing future studies.

Harrison K., & Cantor J. (1999).

Tales from the screen: Enduring fright reactions to scary media.

Media Psychology, 1(2), 97-116.

URL     [本文引用: 1]

This study was conducted to examine enduring fright reactions to mass media via recollective self-reports of a sample of undergraduates (average age 20.6 years) from two universities. Ninety percent (138 of 153) of the participants reported such a reaction. Most experiences occurred in childhood or adolescence, with 26.1% of the participants still experiencing residual anxiety at the time of measurement. More than half of the sample reported subsequent disturbances in sleeping or eating patterns, and a substantial proportion reported avoiding or dreading the situation depicted in the program or movie and mental preoccupation with the stimulus. Stimulus types were coded according to the jive categories of stimuli related to phobic reactions nimal, environmental, situational, blood/injection/injury, and "other" (disturbing sounds and distorted images) escribed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994). Almost all of the films or movies reported contained stimuli from at least one of these categories. Developmental differences were observed in both the types of stimuli that provoked fright responses and the coping strategies used by viewers.

Hart C. N., Hawley N., Davey A., Carskadon M., Raynor H., Jelalian E., .. Wing R. R . (2017).

Effect of experimental change in children's sleep duration on television viewing and physical activity.

Pediatric Obesity, 12(6), 462-467.

URL     PMID:27417142      [本文引用: 1]

Summary Background Paediatric observational studies demonstrate associations between sleep, television viewing and potential changes in daytime activity levels. Objective(s) To determine whether experimental changes in sleep lead to changes in children's sedentary and physical activities. Methods Using a within-subject counterbalanced design, 37 children 8–1165years old completed a 3-week study. Children slept their typical amount during a baseline week and were then randomized to increase or decrease mean time in bed by 1.565h/night for 165week; the alternate schedule was completed the final week. Children wore actigraphs on their non-dominant wrist and completed 3-d physical activity recalls each week. Results Children reported watching more television ( p 65<650.001) and demonstrated lower daytime actigraph-measured activity counts per epoch ( p 65=650.03) when sleep was decreased (compared with increased). However, total actigraph-measured activity counts accrued throughout the entire waking period were higher when sleep was decreased (and children were awake for longer) than when it was increased ( p 65<650.001). Conclusion(s) Short sleep during childhood may lead to increased television viewing and decreased mean activity levels. Although additional time awake may help to counteract negative effects of short sleep, increases in reported sedentary activities could contribute to weight gain over time.

Heath M., Sutherland C., Bartel K., Gradisar M., Williamson P., Lovato N., Micic G . (2014).

Does one hour of bright or short-wavelength filtered tablet screenlight have a meaningful effect on adolescents’ pre-bedtime alertness, sleep, and daytime functioning?

Chronobiology International, 31(4), 496-505.

URL     PMID:24397302      [本文引用: 2]

Electronic media use is prevalent among adolescent populations, as is the frequency of sleeplessness. One mechanism proposed for technology affecting adolescents' is the alerting effects from bright screens. Two explanations are provided. First, screens emit significant amounts of short-wavelength light (i.e. blue), which produces acute alertness and alters timing. Second, later chronotypes are hypothesised to be hypersensitive to evening light. This study analysed the pre-alertness (GO/task speed, accuracy; subjective sleepiness), (diary, polysomnography), and morning functioning of 16 healthy adolescents (M65=6517.465±651.965yrs, 56% f) who used a bright tablet screen (8065lux), dim screen (165lux) and a filtered short-wavelength screen (f.lux; 5065lux) for 165hr before their usual bedtime in a within-subjects protocol. Chronotype was analysed as a continuous between-subjects factor; however, no significant interactions occurred. Significant effects occurred between bright and dim screens for GO/speed and accuracy. However, the magnitude of these differences was small (e.g. GO/speed171717=652365ms, accuracy65=6513%), suggesting minimal clinical significance. No significant effects were found for onset latency, slow-rolling eye movements, or the number of SWS and REM minutes in the first two cycles. Future independent studies are needed to test short (165hr) vs longer (>265) screen usage to provide evidence for safe-to-harmful levels of screenlight exposure before adolescents' usual bedtime.

Huss A., van Eijsden M., Guxens M., Beekhuizen J., van Strien R., Kromhout H., .. Vermeulen R . (2015).

Environmental radiofrequency electromagnetic fields exposure at home, mobile and cordless phone use, and sleep problems in 7-year-old children.

PLoS ONE, 10(10), e139869.

URL     PMID:4625083      [本文引用: 1]

We evaluated if exposure to RF-EMF was associated with reported quality of sleep in 2,361 children, aged 7 years. This study was embedded in the Amsterdam Born Children and their Development (ABCD) birth cohort study. When children were about five years old, school and residential exposure to RF-EMF from base stations was assessed with a geospatial model (NISMap) and from indoor sources (cordless phone/WiFi) using parental self-reports. Parents also reported their children use of mobile or cordless phones. When children were seven years old, we evaluated sleep quality as measured with the Child Sleep Habits Questionnaire (CSHQ) filled in by parents. Of eight CSHQ subscales, we evaluated sleep onset delay, sleep duration, night wakenings, parasomnias and daytime sleepiness with logistic or negative binomial regression models, adjusting for child age and sex and indicators of socio-economic position of the parents. We evaluated the remaining three subscales (bedtime resistance, sleep anxiety, sleep disordered breathing) as unrelated outcomes (negative control) because these werea priorihypothesised not to be associated with RF-EMF. Sleep onset delay, night wakenings, parasomnias and daytime sleepiness were not associated with residential exposure to RF-EMF from base stations. Sleep duration scores were associated with RF-EMF levels from base stations. Higher use mobile phones was associated with less favourable sleep duration, night wakenings and parasomnias, and also with bedtime resistance. Cordless phone use was not related to any of the sleeping scores. Given the different results across the evaluated RF-EMF exposure sources and the observed association between mobile phone use and the negative control sleep scale, our study does not support the hypothesis that it is the exposure to RF-EMF that is detrimental to sleep quality in 7-year old children, but potentially other factors that are related to mobile phone usage.

Hysing M., Pallesen S., Stormark K. M., Jakobsen R., Lundervold A. J., .. Sivertsen B . (2015).

Sleep and use of electronic devices in adolescence: Results from a large population-based study.

BMJ Open, 5(1), e6748.

URL     PMID:25643702      [本文引用: 1]

ObjectivesAdolescents spend increasingly more time on electronic devices, and sleep deficiency rising in adolescents constitutes a major public health concern. The aim of the present study was to investigate daytime screen use and use of electronic devices before bedtime in relation to sleep.DesignA large cross-sectional population-based survey study from 2012, the youth@hordaland study, in Hordaland County in Norway.SettingCross-sectional general community-based study.Participants9846 adolescents from three age cohorts aged 16–19. The main independent variables were type and frequency of electronic devices at bedtime and hours of screen-time during leisure time.OutcomesSleep variables calculated based on self-report including bedtime, rise time, time in bed, sleep duration, sleep onset latency and wake after sleep onset.ResultsAdolescents spent a large amount of time during the day and at bedtime using electronic devices. Daytime and bedtime use of electronic devices were both related to sleep measures, with an increased risk of short sleep duration, long sleep onset latency and increased sleep deficiency. A dose–response relationship emerged between sleep duration and use of electronic devices, exemplified by the association between PC use and risk of less than 561h of sleep (OR=2.70, 95% CI 2.14 to 3.39), and comparable lower odds for 7–861h of sleep (OR=1.64, 95% CI 1.38 to 1.96).ConclusionsUse of electronic devices is frequent in adolescence, during the day as well as at bedtime. The results demonstrate a negative relation between use of technology and sleep, suggesting that recommendations on healthy media use could include restrictions on electronic devices.

Ji X., & Liu J. (2016).

Subjective sleep measures for adolescents: A systematic review.

Child: Care, Health and Development, 42(6), 825-839.

URL     PMID:27495828      [本文引用: 1]

Abstract BackgroundSleep disturbances in adolescents have received significant attention because of their high prevalence and the negative health outcomes. Relative to objective measures, subjective sleep instruments have been the most practical tools used to identify sleep problems and assess responses to interventions in research and clinical settings. This systematic review aims to examine the psychometric properties of subjective measures that are used to assess sleep quality and disturbances among adolescents, identify the strength and limitation of each measurement and inform recommendations for practice. MethodsPubMed, Embase and PsycInfo were searched from 2000 through May 2016. The reference lists of important articles were included if they met the inclusion criteria. The available measures were evaluated and classified as positive, intermediate or poor according to the quality criteria for health status questionnaires. ResultsThirteen self-reported or parent-reported sleep measures met the inclusion criteria. Of the measurements reviewed, six were generic instruments assessing overall sleep quality and disturbances; five were dimension-specific instruments measuring daytime sleepiness, sleep insufficiency and sleep hygiene; and two were condition-specific instruments for insomnia. None of the subjective sleep measures for adolescents has a psychometric profile with all essential measurement properties. Specifically, the generic sleep measurements capture multiple dimensions but face issues of participant burden and compatibility. Among the domain-specific tools, the Cleveland Adolescent Sleepiness Questionnaire and the Chronic Sleep Reduction Questionnaire have achieved good psychometric merits but need further evaluation for responsiveness. Likewise, essential measurement properties of condition-specific tools for insomnia have yet to be established. ConclusionsBecause of the limited evidence, no definite recommendations can be made at this point. However, each available measurement has its own uniqueness and strength despite the limitations. Future research on measurement development and evaluation for adolescent sleep is needed to ensure the relevance and suitability to different stages of adolescence and social contexts.

Johansson A. E. E., Petrisko M. A., & Chasens E. R . (2016).

Adolescent sleep and the impact of technology use before sleep on daytime function.

Journal of Pediatric Nursing, 31(5), 498-504.

URL     PMID:27184356      [本文引用: 1]

61Adolescents get less sleep than recommended by medical experts.61Technology use before sleep is associated with daytime consequences.61Nurses need to provide education and community advocacy regarding adolescent sleep.

Johnson J. G., Cohen P., Kasen S., First M. B., & Brook J. S . (2004).

Association between television viewing and sleep problems during adolescence and early adulthood.

Archives of Pediatrics & Adolescent Medicine, 158(6), 562-568.

URL     PMID:15184220      [本文引用: 1]

Abstract BACKGROUND: Although research has suggested that extensive television viewing may be associated with sleep problems, the direction of this association has not yet been determined. OBJECTIVE: To investigate directional hypotheses regarding the association between television viewing and sleep problems during adolescence and early adulthood. DESIGN: The Children in the Community Study, a prospective longitudinal investigation. PARTICIPANTS AND SETTING: A community-based sample of 759 mothers from upstate New York and their offspring were interviewed during the early adolescence (mean age, 14 years), middle adolescence (mean age, 16 years), and early adulthood of the offspring (mean age, 22 years). MAIN OUTCOME MEASURES: Television viewing and sleep problems during adolescence and early adulthood measured using the Disorganizing Poverty Interview and the age-appropriate versions of the Diagnostic Interview Schedule for Children. RESULTS: Adolescents who watched 3 or more hours of television per day during adolescence were at a significantly elevated risk for frequent sleep problems by early adulthood. This elevation in risk remained significant after offspring age, sex, previous sleep problems, offspring psychiatric disorders, offspring neglect, parental educational level, parental annual income, and parental psychiatric symptoms were controlled statistically. Adolescents who reduced their television viewing from 1 hour or longer to less than 1 hour per day experienced a significant reduction in risk for subsequent sleep problems. Sleep problems during adolescence were not independently associated with subsequent television viewing when prior television viewing was controlled. CONCLUSION: Extensive television viewing during adolescence may contribute to the development of sleep problems by early adulthood.

Jones M. J., Peeling P., Dawson B., Halson S., Miller J., Dunican I., .. Eastwood P . (2018).

Evening electronic device use: The effects on alertness, sleep and next-day physical performance in athletes.

Journal of Sports Sciences, 36(2), 162-170.

URL     PMID:28282750      [本文引用: 1]

Abstract The aim of the present study was to investigate the influence of different types of tasks performed with or without an electronic device (tablet) on pre-sleep alertness, subsequent sleep quality and next-day athletic performance. Eight highly trained netball players attended a sleep laboratory for pre-sleep testing, polysomnographic sleep monitoring and next-day physical performance testing on 5 separate occasions (1 familiarisation and 4 experimental sessions). For 2 h prior to bedtime, athletes completed cognitively stimulating tasks (puzzles) or passive tasks (reading) with or without a tablet. Sleepiness tended to be greater after reading compared to completing puzzles without a tablet (d = 0.80), but not with a tablet. Melatonin concentration increased more so after reading compared to completing puzzles on a tablet (P = 0.02). There were no significant differences in sleep quality or quantity or next-day athletic performance between any of the conditions. These data suggest that using a tablet for 2 h prior to sleep does not negatively affect subsequent sleep or next-day performance in athletes.

Jou J. H., Hsieh C. Y., Tseng J. R., Peng S. H., Jou Y. C., Hong J. H., .. Lin C. H . (2013).

Candle Light-Style Organic Light-Emitting Diodes.

Advanced Functional Materials, 23(21), 2750-2757.

URL     [本文引用: 1]

In response to the call for a physiologically-friendly light at night that shows low color temperature, a candle light-style organic light emitting diode (OLED) is developed with a color temperature as low as 1900 K, a color rendering index (CRI) as high as 93, and an efficacy at least two times that of incandescent bulbs. In addition, the device has a 80% resemblance in luminance spectrum to that of a candle. Most importantly, the sensationally warm candle light-style emission is driven by electricity in lieu of the energy-wasting and greenhouse gas emitting hydrocarbon-burning candles invented 5000 years ago. This candle light-style OLED may serve as a safe measure for illumination at night. Moreover, it has a high color rendering index with a decent efficiency.

Kato T., Yorifuji T., Yamakawa M., & Inoue S . (2018).

National data showed that delayed sleep in six-year-old children was associated with excessive use of electronic devices at 12 years.

Acta Paediatrica, 107(8), 1439-1448.

URL     [本文引用: 1]

Objectives We investigated the association between breastfeeding duration during the first half year of life and the risk of early childhood caries from the age of 30 to 66 months in Japan. Design Observational study of a longitudinal survey. Setting A secondary data analysis of the Japanese Longitudinal Survey of Babies in the 21st Century. Participants 43 383 infants at the age of 6... [Show full abstract]

King D. L., Gradisar M., Drummond A., Lovato N., Wessel J., Micic G., .. Delfabbro P . (2013).

The impact of prolonged violent video-gaming on adolescent sleep: An experimental study.

Journal of Sleep Research, 22(2), 137-143.

URL     PMID:23137332      [本文引用: 1]

Video-gaming is an increasingly prevalent activity among children and adolescents that is known to influence several areas of emotional, cognitive and behavioural functioning. Currently there is insufficient experimental evidence about how extended video-game play may affect adolescents' sleep. The aim of this study was to investigate the short-term impact of adolescents' prolonged exposure to violent video-gaming on sleep. Seventeen male adolescents (mean age=16 +/- 1years) with no current sleep difficulties played a novel, fast-paced, violent video-game (50 or 150min) before their usual bedtime on two different testing nights in a sleep laboratory. Objective (polysomnography-measured sleep and heart rate) and subjective (single-night sleep diary) measures were obtained to assess the arousing effects of prolonged gaming. Compared with regular gaming, prolonged gaming produced decreases in objective sleep efficiency (by 7 +/- 2%, falling below 85%) and total sleep time (by 27 +/- 12min) that was contributed by a near-moderate reduction in rapid eye movement sleep (Cohen's d=0.48). Subjective sleep-onset latency significantly increased by 17 +/- 8min, and there was a moderate reduction in self-reported sleep quality after prolonged gaming (Cohen's d=0.53). Heart rate did not differ significantly between video-gaming conditions during pre-sleep game-play or the sleep-onset phase. Results provide evidence that prolonged video-gaming may cause clinically significant disruption to adolescent sleep, even when sleep after video-gaming is initiated at normal bedtime. However, physiological arousal may not necessarily be the mechanism by which technology use affects sleep.

Kira G., Maddison R., Hull M., Blunden S., & Olds T . (2014).

Sleep education improves the sleep duration of adolescents: A randomized controlled pilot study.

Journal of Clinical Sleep Medicine, 10(7), 787-792.

URL     PMID:25024657      [本文引用: 1]

To determine the feasibility and pilot a sleep education program in New Zealand high school students.A parallel, two-arm randomized controlled pilot trial was conducted. High school students (13 to 16 years) were randomly allocated to either a classroom-based sleep education program intervention (n = 15) or to a usual curriculum control group (n = 14). The sleep education program involved four 50-minute classroom-based education sessions with interactive groups. Students completed a 7-day sleep diary, a sleep questionnaire (including sleep hygiene, knowledge and problems) at baseline, post-intervention (4 weeks) and 10 weeks follow-up.An overall treatment effect was observed for weekend sleep duration (F 1,24 = 5.21, p = 0.03). Participants in the intervention group slept longer during weekend nights at 5 weeks (1:37 h:min, p = 0.01) and 10 weeks: (1:32 h:min, p = 0.03) compared to those in the control group. No differences were found between groups for sleep duration on weekday nights. No significant differences were observed between groups for any of the secondary outcomes (sleep hygiene, sleep problems, or sleep knowledge).A sleep education program appears to increase weekend sleep duration in the short term. Although this program was feasible, most schools are under time and resource pressure, thus alternative methods of delivery should be assessed for feasibility and efficacy. Larger trials of longer duration are needed to confirm these findings and determine the sustained effect of sleep education on sleep behavior and its impact on health and psychosocial outcomes.A commentary on this article appears in this issue on page 793.

Kubey R.W . (1986).

Television use in everyday life: Coping with unstructured time.

Journal of Communication, 36(3), 108-123.

URL     [本文引用: 1]

Indicates that (1) less affluent, less educated, and divorced and separated respondents are more inclined than others to watch television to avoid the negative moods that often coincide with solitude and unstructured time; and (2) personality dispositions and internal states are more likely to dictate media use than vice versa. (JD)

Kubiszewski V., Fontaine R., Rusch E., & Hazouard E . (2014).

Association between electronic media use and sleep habits: An eight-day follow-up study.

International Journal of Adolescence and Youth, 19(3), 395-407.

URL     [本文引用: 1]

To describe the use of media as a sleep aid in adolescents and relate this to their sleep routines and feelings of tiredness. A questionnaire about using media as a sleep aid, media presence in bedrooms, time to bed and time out of bed on average weekdays and average weekend days, and questions regarding level of tiredness in the morning, at school, after a day at school and after the weekend... [Show full abstract]

Leech J.A . (2017).

Changes in sleep duration and recreational screen time among Canadians, 1998-2010.

Journal of Sleep Research, 26(2), 202-209.

URL     PMID:27995665      [本文引用: 2]

Abstract It is commonly claimed that sleep duration has declined in recent years - over a period coinciding with a marked increase in personal electronics and communications use. The aim of this study was to assess change in sleep duration among Canadians from 1998 to 2010, and examine any associations with non-work-related screen time. The analysis uses population-representative data from Statistics Canada's General Social Survey cycles of 1998 and 2010; the respective samples numbered 1002749 and 1502390 individuals. Response rates were 80% in 1998 and 55% in 2010. Respondents were aged 1502years and older, residing in private households in the 10 Canadian provinces. The General Social Survey is administered by computer-assisted telephone interviewing. Data on sleep duration (excluding naps outside essential sleep time) and recreational screen time were obtained using a 24-h time-use diary. Survey weights were applied to adjust for non-response and non-landline households. Frequencies (respondent characteristics) and averages (time-use variables) were estimated by age group and sex. Sleep duration was examined by weighted quartile of screen time. Confidence intervals (95%) were calculated around estimates. Average sleep duration increased from 8.161h in 1998 to 8.302h in 2010. Average screen time increased from 14002min in 1998 to 15461min in 2010. Sleep duration and screen time were positively related in both years. The percentage of people averaging less than 602h sleep decreased from 9.6% in 1998 to 8.6% in 2010. Between 1998 and 2010, increases in screen time did not occur at the expense of sleep duration. 08 2016 European Sleep Research Society.

Li L., Wang Y. Y., Wang S. B., Zhang L., Li L., Xu D. D., .. Xiang Y. T . (2018).

Prevalence of sleep disturbances in Chinese university students: A comprehensive meta- analysis.

Journal of Sleep Research, 27(3), e12648.

URL     PMID:29383787      [本文引用: 1]

Abstract This is a meta-analysis of the pooled prevalence of sleep disturbances and its associated factors in Chinese university students. English (PubMed, PsycINFO, Embase) and Chinese (SinoMed, Wan Fang Database and Chinese National Knowledge Infrastructure) databases were systematically and independently searched from inception until 16 August 2016. The prevalence of sleep disturbances was pooled using random-effects model. Altogether 76 studies involving 112 939 university students were included. The overall pooled prevalence of sleep disturbances was 25.7% (95% CI: 22.5-28.9%). When using the screening scales Pittsburgh Sleep Quality Index, Athens Insomnia Scale and Self-Rating Sleeping State Scale, and the diagnostic criteria of the Chinese Classification of Mental Disorders (Second Edition), the pooled prevalence of sleep disturbances was 24.1% (95% CI: 21.0-27.5%) and 18.1% (95% CI: 16.4-20.0%), respectively. The percentages of students dissatisfied with sleep quality and those suffering from insomnia symptoms were 20.3% (95% CI: 13.0-30.3%) and 23.6% (95% CI: 18.9-29.0%), respectively. Subgroup analyses revealed that medical students were more vulnerable to sleep disturbances than other student groups. There was no significant difference between males and females, and across geographic locations. Sleep disturbances are common in Chinese university students. Appropriate strategies for prevention and treatment of sleep disturbances in this population need greater attention.

Li S. H., Jin X. M., Wu S. G., Jiang F., Yan C. H., Shen X. M . (2007).

The impact of media use on sleep patterns and sleep disorders among school-aged children in China.

Sleep, 30(3), 361-367.

URL     PMID:17425233      [本文引用: 1]

STUDY OBJECTIVES: To determine the amount of television viewing and computer use in urban school-aged Chinese children, and to examine their associations with sleep/wake patterns, duration of sleep, and sleep disorders. DESIGN AND SETTING: Students representing 8 Chinese cities were studied during November and December 2005. PARTICIPANTS: A total of 19,299 elementary-school children, 49.7% boys and 50.3% girls, with a mean age of 9.00 years, participated in the survey. MEASUREMENTS: A parent-administered questionnaire and the Chinese version of the Children's Sleep Habits Questionnaire were completed to quantify media use and to characterize sleep patterns and sleep disturbances. RESULTS: A television or computer was present in the bedroom of 18.5% and 18.3% of Chinese school-aged children, respectively. Media presence in the bedroom and media use were positively correlated with later bedtimes, later awakening times, and a shorter duration of sleep during weekdays and weekends. They were also significantly associated with at least 2 types of sleep disturbances. Overall, the most affected sleep behaviors were bedtime and awakening time on the weekends, the duration of sleep during the weekdays, and sleep disorders of bedtime resistance and sleep anxiety. Television viewing > or = 2 hours/day on weekends, with a prevalence of 48.8%, was the predominant risk factor for all sleep disorders with the exception of the sleep duration disorder. Computer use, however, had no correlation with any sleep disorder. CONCLUSION: The presence of media in a child's bedroom and media use had a negative effect on children's sleep/wake patterns, duration of sleep, and sleep disorders.

Li S. H., Zhu S. K., Jin X. M., Yan C. H., Wu S. H., Jiang F., .. Shen X. M . (2010).

Risk factors associated with short sleep duration among Chinese school-aged children.

Sleep Medicine, 11(9), 907-916.

URL     PMID:20817554      [本文引用: 1]

To examine risk factors regarding short sleep duration among Chinese school-aged children. A random sample of 20,778 children aged around 5–11 years participated in a cross-sectional survey, which was conducted in eight cities of China in 2005. A parent-administered questionnaire was used to collect information on children’s sleep duration and possible related factors from eight domains. Short sleep duration was defined as total sleep duration <9 h per day. In all, 28.3% of the sampled children slept <9 h per day. The multivariate logistic regression identified, after adjusting for demographic and socioeconomic variables, factors associated with short sleep duration: more television viewing during weekdays (OR = 1.21, p = 0.004), more frequent computer/internet using (OR = 1.17, p = 0.006), earlier school starting time (OR = 1.10, p = 0.020), more time on homework during weekdays (OR = 1.66, p < 0.001) and weekends (OR = 1.14, p = 0.001), poor bedtime hygiene (e.g., having drinks with caffeine after 6:00PM [OR = 1.22, p < 0.001], doing exciting activities during bedtime [OR = 1.16, p < 0.001], and irregular bedtime [OR = 1.55, p < 0.001]), and shorter sleep duration of parents (mother: OR = 1.31, p < 0.001 for sleep duration <6 h and OR = 1.24, p = 0.006 for 6–8 h; father: OR = 1.52, p < 0.001 for <6 h and OR = 1.19, p < 0.001 for 6–8 h). Factors associated with sleep duration covered multidimensional domains among school-aged children. Compared to sleep environments and chronic health problems, school schedules, lifestyle patterns, and parents’ sleep habits had greater impact on children’s sleep duration, indicating the existing chronic sleep loss in school children could be, at least partly, intervened by reducing the use of visual technologies, by changing the school schedules, by improving the sleep hygiene routine, and by regulating parents’ sleep habits.

Liu J. H., Wang G. H., Ji X. P., Cui N. X., & Liu X. C . (2018).

Agreement between parent-reports and child self-reports of sleep problems in Chinese children.

Sleep & Biological Rhythms, 16(3), 283-291.

URL    

Sleep problems are major concerns for parents, health professionals, and children and youths themselves. For assessing sleep problems, both parent and child reports are important, with each having its unique features. However, little is known about the correlates of the agreement between parent and child self-reports. This study evaluated the agreement between the youth self-report sleep questionnaire (YSRSQ) and the parent-reported children’s sleep habits questionnaire (CSHQ) and assessed the associated sociodemographic factors, as well as the underlying discrepancies. The participants included 3143 pairs of Chinese preadolescents (mean age65=6511.03, SD65=650.98) and parents. Sleep-disordered breathing (SDB), daytime sleepiness, and parasomnia were assessed by both the YSRSQ and CSHQ. Significant but low correlations were present between parent report and preadolescent self-report items on SDB problems, daytime sleepiness, and parasomnias. Although the agreement between SDB symptoms and parasomnias was stronger for girls than for boys, the degree of concordance between SDB symptoms and parasomnia increased with preadolescent age, with the highest agreement achieved among preadolescents aged 1202years or older for SDB problems and 1102years or older for parasomnias. Findings underscore the importance of utilizing both parental and preadolescent self-reports in accurately assessing and diagnosing sleep impairment in pediatric samples.

Liu J. Z., Zhang A. L., & Li L. D . (2012).

Sleep duration and overweight/obesity in children: Review and implications for pediatric nursing.

Journal for Specialists in Pediatric Nursing, 17(3), 193-204.

URL     PMID:22734873      [本文引用: 1]

Purpose. The purpose of this study was to review evidence from the last 5 years (20060900092011) regarding a relationship between sleep duration and childhood overweight/obesity.Conclusions. Among the 25 studies selected from PubMed and Web of Knowledge databases, all indicated significant associations between short sleep duration and childhood overweight/obesity. Studies explored a range of pediatric populations, methodologies, and potential contributing factors.Practice Implications. Childhood sleep duration may be a modifiable risk factor in preventing obesity. In addition to identifying and assessing patients' sleep habits, nurses play important roles as educators regarding the importance of adequate sleep and promoting it in children.

Liu Z. J., Wang G. H., Tang H., Wen F. M., & Li N. X . (2014).

Reliability and validity of the Children’s Sleep Habits Questionnaire in preschool-aged Chinese children.

Sleep & Biological Rhythms, 12(3), 187-193.

URL     [本文引用: 1]

Abstract The Children's Sleep Habits Questionnaire (CSHQ) has been used globally as a sound screening tool for sleep problems in children, and it has been increasingly adopted in China. However, its psychometrical properties have not been examined among preschool-aged Chinese children. This study examined the reliability and validity of the CSHQ in urban, preschool-aged Chinese children. Questionnaires were distributed to 3850 kindergarteners and completed by their parents or other guardians. Another 113 CSHQ questionnaires were distributed to examine the test–retest reliability, which was determined by the intraclass correlation coefficient. Internal consistency was evaluated by Cronbach's α. The construct validity was explored by both exploratory and confirmatory factor analysis. Of the 3850 distributed questionnaires, 3324 (86.3%) were returned, and for test–retest questionnaires, 106 of 113 (93.8%) were returned. Cronbach's α ranged from 0.44 (Night-time awakenings) to 0.63 (Daytime sleepiness); test–retest reliability ranged from 0.54 (Night-time awakenings) to 0.76 (Sleep anxiety), with an exceptionally low subscale of 0.38 (Sleep duration). Confirmatory factor analysis showed that the original eight-domain structure was not well suited for preschool-aged Chinese children, and exploratory factor analysis revealed an acceptable eight-factor structure after certain items were deleted and some items were loaded on two factors. Although the results were not optimum, the CSHQ demonstrated basically acceptable reliability, except for Night-time awakenings and Sleep duration subscales, in urban, preschool-aged Chinese children. However, because of factors such as culture and age difference, the CSHQ's structure must be modified to adapt the preschool-aged Chinese children.

Loughran S. P., Wood A. W., Barton J. M., Croft R. J., Thompson B., Stough C . (2005).

The effect of electromagnetic fields emitted by mobile phones on human sleep.

Neuroreport, 16(17), 1973-1976.

[本文引用: 1]

Lu L., Wang S. B., Rao W. W., Ungvari G. S., Ng C. H., Chiu H. F. K., .. Xiang Y. T . (2017).

Sleep duration and patterns in Chinese older adults: A comprehensive meta- analysis.

International Journal of Biological Sciences, 13(6), 682-689.

URL     PMID:5485624      [本文引用: 1]

This meta-analysis examined the mean sleep duration and patterns in Chinese older adult population. A literature search was systematically conducted covering major English (PubMed, Embase and PsycINFO) and Chinese (Chinese National Knowledge Infrastructure (CNKI), WanFang and SinoMed) databases. Data in studies with the mean and standard deviation of sleep duration and/or the proportion of short and long sleep durations in Chinese older adults were extracted and pooled using random-effects models. Subgroup analyses were conducted according to gender, region, area, survey time and sample size. A total of 36 studies with 150,616 subjects were included for analyses. The pooled mean sleep duration of 21 studies with available data was 6.82 hours/day (95% CI: 6.59-7.05 hours/day). The estimated proportions of sleep duration <5 hours/day, <6 hours/day, <7 hours/day were 18.8% (95% CI: 1.7%-35.9%), 26.7% (95% CI: 19.7%-33.7%) and 42.3% (95% CI: 34.8%-49.8%), respectively. The pooled proportions for long sleepers were 22.6% (95% CI: 13.9%-31.4%) (>8 hours/day) and 17.6% (95% CI: 12.4%-22.9%) (>9 hours/day). Given the adverse effects of unhealthy sleep patterns, health professionals should pay more attention to sleep patterns in this population in China.

Magee C. A., Lee J. K., & Vella S. A . (2014).

Bidirectional relationships between sleep duration and screen time in early childhood.

JAMA Pediatrics, 168(5), 465-470.

URL     PMID:24589672      [本文引用: 1]

IMPORTANCE: duration and media use (ie, computer use and television viewing) have important implications for the health and well-being of children. Population data suggest that shorter duration and excessive screen time are growing problems among children and could be interacting issues.: To examine whether bidirectional relationships exist between duration and media use among children, and whether these associations are moderated by child- and household-related factors. DESIGN, SETTING,: Cohort study of a representative sample of 3427 Australian children (4-5 years of age at baseline [51.2%male children]), obtained from the Longitudinal Study of Australian Children. Data were available from 3 waves (2004, 2006, and 2008) when children were 4, 6, and 8 years of age, respectively. MAIN OUTCOMES AND MEASURES: duration and media use. RESULTS Bidirectional relationships were observed between duration and media use; for instance, total media use at 4 years of age was significantly associated with duration at 6 years of age (芒 =.0.06 [95%CI,.0.10 to.0.02]), with media use at 6 years of age predicting duration at 8 years of age (芒 =.0.06 [95%CI,.0.11 to.0.02]). duration at 4 years of age was associated with media use at 6 years of age (芒 =.0.10 [95%CI,.0.14 to.0.05]), with duration at 6 years of age predicting media use at 8 years of age (芒 =.0.08 [95%CI,.0.13 to.0.03]). Several of these bidirectional relationships varied by socioeconomic status.: The results supported the hypotheses that bidirectional relationships exist between duration and media use among children. These findings are important given recent population trends for increased media use and shorter durations among children.

Matricciani L., Olds T., & Petkov J . (2012).

In search of lost sleep: Secular trends in the sleep time of school-aged children and adolescents.

Sleep Medicine Reviews, 16(3), 203-211.

URL     PMID:21612957      [本文引用: 1]

Sleep deficits are associated with a wide range of detrimental physical and mental health outcomes. There is concern that children are not getting enough sleep, and that sleep duration has been declining. However, evidence is sparse. A systematic review of world literature was conducted to locate studies reporting the sleep duration of children aged 5–18 years. Monte Carlo simulation was used to generate pseudodata from summary data, which were combined with raw data and analysed by linear regression of sleep duration on year of measurement at the age02×02sex02×02day type02×02country level. Data were available on 690,747 children from 20 countries, dating from 1905 to 2008. From these data, 641 regressions were derived. The sample-weighted median rate of change was02610.7502min nightly per year, indicating a decrease of more than 102h per night over the study period. Rates of change were negative across age, sex and day type categories, but varied according to region, with Europe, the USA, Canada and Asia showing decreases and Australia, the UK and Scandinavia showing increases. Over the last 103 years, there have been consistent rapid declines in the sleep duration of children and adolescents.

Montgomery P., & Dennis J. (2004).

A systematic review of non-pharmacological therapies for sleep problems in later life.

Sleep Medicine Reviews, 8(1), 47-62.

URL     PMID:15062210      [本文引用: 1]

Sleep problems become more common with age, affect quality of life for individuals and their families, and can increase healthcare costs. Older people are often prescribed a range of drugs for their health problems, many of which have side effects. Side effects are just one reason why there is an argument to be made for clinical use of non-pharmacological treatments. This review considers the effectiveness of three interventions, cognitive behavioural therapy (CBT), bright light, and physical exercise. It considers sleep quality, duration and efficiency as primary outcome measures. Randomised controlled trials were selected where 80% or more of participants were over 60 and had a diagnosis of primary insomnia and where investigators had taken care to screen participants for dementia and/or depression. The data suggest a mild effect of CBT for sleep problems in older adults, best demonstrated for sleep maintenance insomnia. It may be that the provisions of ‘top-up’ or ‘refresher’ sessions of CBT training to improve durability of effect are worthy of investigation. Evidence of the efficacy of bright light and exercise were so limited that no conclusions about them can be reached as yet; however, in view of the promising results of bright light therapy in other populations with problems of sleep timing, further research into its effectiveness with older adults would seem justifiable. Exercise, though not appropriate for all in this population, may enhance sleep. Research involving exercise programmes designed with the elderly in mind is needed.

Murawski B., Wade L., Plotnikoff R. C., Lubans D. R., & Duncan M. J . (2018).

A systematic review and meta-analysis of cognitive and behavioral interventions to improve sleep health in adults without sleep disorders.

Sleep Medicine Reviews, 40, 160-169.

[本文引用: 1]

Nagare R., Plitnick B ., & Figueiro, M. G.

(in press).

Does the iPad Night Shift mode reduce melatonin suppression?

Lighting Research and Technology.

Nathanson A.I., & Beyens I. (2018).

The relation between use of mobile electronic devices and bedtime resistance, sleep duration, and daytime sleepiness among preschoolers.

Behavioral Sleep Medicine, 16(2), 202-219.

[本文引用: 1]

Nuutinen T., Ray C., & Roos E . (2013).

Do computer use, TV viewing, and the presence of the media in the bedroom predict school-aged children's sleep habits in a longitudinal study?

BMC Public Health, 13, 684.

Oh J. H., Yoo H., Park H. K., & Do Y. R . (2015).

Analysis of circadian properties and healthy levels of blue light from smartphones at night.

Scientific Reports, 5, 11325.

URL     PMID:26085126      [本文引用: 1]

This study proposes representative figures of merit for circadian and vision performance for healthy and efficient use of smartphone displays. The recently developed figures of merit for circadian luminous efficacy of radiation (CER) and circadian illuminance (CIL) related to human health and circadian rhythm were measured to compare three kinds of commercial smartphone displays. The CIL values for social network service (SNS) messenger screens from all three displays were higher than 41.3 biolux (blx) in a dark room at night, and the highest CIL value reached 50.9 blx. These CIL values corresponded to melatonin suppression values (MSVs) of 7.3% and 11.4%, respectively. Moreover, smartphone use in a bright room at night had much higher CIL and MSV values (58.765~65105.2 blx and 15.465~6536.1%, respectively). This study also analyzed the nonvisual and visual optical properties of the three smartphone displays while varying the distance between the screen and eye and controlling the brightness setting. Finally, a method to possibly attenuate the unhealthy effects of smartphone displays was proposed and investigated by decreasing the emitting wavelength of blue LEDs in a smartphone LCD backlight and subsequently reducing the circadian effect of the display.

Orzech K. M., Grandner M. A., Roane B. M., & Carskadon M. A . (2016).

Digital media use in the 2 h before bedtime is associated with sleep variables in university students.

Computers in Human Behavior, 55, 43-50.

URL     PMID:28163362      [本文引用: 1]

Digital media use is widespread in University students, and use of digital media near bedtime has a broadly negative effect on sleep outcomes. Adequate and good quality sleep is important for physical and mental health, but few studies have rigorously measured both sleep and digital media use. In this study, we investigated whether self-reported sleep patterns were associated with digital media use in a first- year University student (N 1 4 254, 48% male) population. Students tracked their sleep through daily online diaries and provided digital media use data in 15-min blocks for 2 h prior to bedtime on nine occasions. A longer duration of digital media use was associated with reduced total sleep time and later bedtime, while greater diversity of digital media use was associated with increased total sleep time and earlier bedtime. Analysis of activities in the last hour before bedtime indicated that activity type plays a role in digital media's effect on sleep, with computer work, surfing the Internet, and listening to music showing the strongest relationship to multiple sleep variables. These findings have implications for physical and mental health of University students and can inform design of devices to minimize negative effects of digital media on sleep.

Owens J. A., Spirito A., & Mcguinn M . (2000).

The Children's Sleep Habits Questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children.

Sleep, 23(8), 1043-1051.

[本文引用: 1]

Qin Y. Y., Zhou Y. H., Zhang X., Wei X., & He J . (2014).

Sleep duration and breast cancer risk: A meta-analysis of observational studies.

International Journal of Cancer, 134(5), 1166-1173.

URL     PMID:24037973      [本文引用: 1]

Studies on the association of short or long sleep duration with breast cancer risk have reported inconsistent results. We quantitatively assessed this association by conducting a meta-analysis based on the evidence from observational studies. In April 2013, we performed electronic searches in PubMed, EmBase and the Cochrane Library to identify studies examining the effect of sleep duration on breast cancer incidence. The odds ratio (OR) was used to measure any such association in a random-effects model. The analysis was further stratified by confounding factors that could bias the results. A total of six studies (two case–control and four cohort studies) involving 159,837 individuals were included in our meta-analysis. Our study did not show an association between either short or long sleep duration and breast cancer risk (short sleep duration data: pooled OR = 1.01, 95% confidence interval (CI) = 0.90–1.14, p = 0.853; long sleep duration data: pooled OR = 0.95, 95% CI = 0.86–1.04, p = 0.251). Moreover, we did not identify any statistically significant association between sleep duration and breast cancer risk in all the subgroup analyses. In conclusion, our findings indicate that sleep duration has no effect on breast cancer risk.

Rångtell F. H., Ekstrand E., Rapp L., Lagermalm A., Liethof L., Búcaro M. O., .. Benedict C . (2016).

Two hours of evening reading on a self-luminous tablet vs. reading a physical book does not alter sleep after daytime bright light exposure.

Sleep Medicine, 23, 111-118.

URL     PMID:27539026      [本文引用: 2]

The use of electronic devices emitting blue light during evening hours has been associated with sleep disturbances in humans, possibly due to the blue light-mediated suppression of the sleep-promoting hormone melatonin. However, experimental results have been mixed. The present study therefore sought to investigate if reading on a self-luminous tablet during evening hours would alter sleepiness, melatonin secretion, nocturnal sleep, as well as electroencephalographic power spectral density during early slow-wave sleep. Following a constant bright light exposure over 6.5 hours (~569 lux), 14 participants (six females) read a novel either on a tablet or as physical book for two hours (21:00–23:00). Evening concentrations of saliva melatonin were repeatedly measured. Sleep (23:15–07:15) was recorded by polysomnography. Sleepiness was assessed before and after nocturnal sleep. About one week later, experiments were repeated; participants who had read the novel on a tablet in the first experimental session continued reading the same novel in the physical book, andvice versa. There were no differences in sleep parameters and pre-sleep saliva melatonin levels between the tablet reading and physical book reading conditions. Bright light exposure during daytime has previously been shown to abolish the inhibitory effects of evening light stimulus on melatonin secretion. Our results could therefore suggest that exposure to bright light during the day – as in the present study – may help combat sleep disturbances associated with the evening use of electronic devices emitting blue light. However, this needs to be validated by future studies with larger sample populations.

Reynolds C. M., Gradisar M., Kar K., Perry A., Wolfe J., Short M. A . (2015).

Adolescents who perceive fewer consequences of risk-taking choose to switch off games later at night.

Acta Paediatrica, 104(5), e222-e227.

URL     PMID:25603718      [本文引用: 1]

http://doi.wiley.com/10.1111/apa.12935

Riemann D., Berger M., & Voderholzer U . (2001).

Sleep and depression — Results from psychobiological studies: An overview.

Biological Psychology, 57(1-3), 67-103.

URL     PMID:11454435      [本文引用: 1]

Disturbances of sleep are typical for most depressed patients and belong to the core symptoms of the disorder. Polysomnographic sleep research has demonstrated that besides disturbances of sleep continuity, in depression sleep is characterized by a reduction of slow wave sleep and a disinhibition of REM sleep, with a shortening of REM latency, a prolongation of the first REM period and increased REM density. These findings have stimulated many sleep studies in depressive patients and patients with other psychiatric disorders. In the meantime, several theoretical models, originating from basic research, have been developed to explain sleep abnormalities of depression, like the two-process-model of sleep and sleep regulation, the GRF/CRF imbalance model and the reciprocal interaction model of non-REM and REM sleep regulation. Interestingly, most of the effective antidepressant agents suppress REM sleep. Furthermore, manipulations of the sleep ake cycle, like sleep deprivation or a phase advance of the sleep period, alleviate depressive symptoms. These data indicate a strong bi-directional relationship between sleep, sleep alterations and depression.

Riley W. T., Mihm P., Behar A., & Morin C. M . (2010).

A computer device to deliver behavioral interventions for insomnia.

Behavioral Sleep Medicine, 8(1), 2-15.

URL     PMID:20043245      [本文引用: 1]

An automated program for delivering stimulus control and sleep restriction strategies was developed and implemented on a handheld computer and compared to a self-help manual program in 90 chronic primary insomnia participants at 6 and 12 weeks. The computerized program was generally well accepted and utilized. No significant differences between conditions were found on questionnaire and sleep diary measures, but subsequent exploratory analyses revealed greater percentages of participants in the computer condition compared to the self-help condition who were classified as without clinically significant insomnia at 6 weeks based on Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) criteria. Further research is needed on the efficacy of computerized behavioral approaches for insomnia, but the results of this study indicate that computerized delivery of stimulus control and sleep restriction is feasible and sufficiently promising to warrant further study.

Robinson T. N., Banda J. A., Hale L., Lu A. S., Fleming-Milici F., Calvert S. L., .. Wartella E . (2017).

Screen media exposure and obesity in children and adolescents.

Pediatrics, 140, S97-S101.

URL     PMID:5769928      [本文引用: 1]

react-text: 379 Introduction: the epidemic of diabesity The prevalence of obesity is increasing worldwide, particularly in the US. Obesity is a major risk factor for type 2 diabetes mellitus (T2DM), and it is estimated that more than 20 million Americans are currently diabetic and that one third of them remains undiagnosed (Diabetes statistics from the American Diabetes Association available at:... /react-text react-text: 380 /react-text [Show full abstract]

Sampasa-Kanyinga H., Hamilton H. A., & Chaput J. P . (2018).

Use of social media is associated with short sleep duration in a dose-response manner in students aged 11 to 20 years.

Acta Paediatrica, 107(4), 694-700.

URL     PMID:29363166      [本文引用: 1]

Abstract Aim This study examined the association between social media and sleep duration among Canadian students aged 11–20. Methods Data from 5242 students were obtained from the 2015 Ontario Student Drug Use and Health Survey, a province-wide, school-based survey that has been conducted every two years since 1977. We measured the respondents’ sleep duration against the recommended ranges of 9–11h per night at 11–13years of age, 8–10h at 14–17 and 7–9h per night for those aged 18years or more. Results Overall, 36.4% of students met or exceeded the recommended sleep duration and 63.6% slept less than recommended, with 73.4% of students reporting that they used social media for at least one hour per day. After adjusting for various covariates, the use of social media was associated with greater odds of short sleep duration in a dose–response manner (p for linear trend <0.001). Odds ratios ranged from 1.82 for social media use of at least one hour per day to 2.98 for at least five hours per day. Conclusion Greater use of social media was associated with shorter sleep duration in a dose–response fashion among Canadian students aged 11–20.

Sasseville A., Paquet N., Sévigny J., & Hébert M . (2006).

Blue blocker glasses impede the capacity of bright light to suppress melatonin production.

Journal of Pineal Research, 41(1), 73-78.

URL     PMID:16842544      [本文引用: 1]

Abstract: Blocking morning light exposure with dark goggles can contribute to the adjustment to night work but these glasses are incompatible with driving. Recently, it was discovered that the biological clock is most sensitive to short wavelengths (blue light). Therefore, we tested the hypothesis that cutting the blue portion of the light spectrum with orange lens glasses (blue blockers) would prevent the light-induced melatonin suppression, a test broadly used as an indirect assessment of the circadian clock sensitivity. Fourteen normal subjects were exposed at night to a 60 min bright light pulse (1300 lx behind filters) between 01:00 and 02:00 hr while wearing orange lens glasses (experimental condition) or grey lens glasses (control condition). The amount of salivary melatonin change observed during the light pulse was compared with a melatonin baseline obtained the night before. Although both glasses transmitted the same illuminance (1300 lx) but at an irradiance 25% higher for the orange lens (408 0204 W/cm 2 ) compared with the grey lens (327 0204 W/cm 2 ), a non-significant increase of 6% (95% CI, 09080820% to 9%) was observed with the orange lens whereas a significant ( P < 0.05) reduction of 46% (95% CI, 3509000957%) was observed with the grey lens. Blue blockers represent an elegant means to prevent the light-induced melatonin suppression. Further studies are needed to show that these glasses, which are suitable for driving, could facilitate adaptation to night work.

Short M. A., Arora T., Gradisar M., Taheri S., & Carskadon M. A . (2017).

How many sleep diary entries are needed to reliably estimate adolescent sleep? Sleep, 40(3), zsx006.

URL     PMID:28199718      [本文引用: 1]

Abstract Study Objectives To investigate (i) how many nights of sleep diary entries are required for reliable estimates of five sleep-related outcomes (bedtime, wake time, sleep onset latency, sleep duration and wake after sleep onset) and (ii) the test-retest reliability of sleep diary estimates of school night sleep across 12 weeks. Methods Data were drawn from four adolescent samples (Australia [n=385], Qatar [n=245], United Kingdom [UK; n=770] and United States [US; n=366]), who provided 1,766 eligible sleep diary weeks for reliability analyses. We performed reliability analyses for each cohort using complete data (7 days), 1 5 school nights, and 1 2 weekend nights. We also performed test-retest reliability analyses on 12-week sleep diary data available from a subgroup of 55 US adolescents. Results ICCs for bedtime, sleep onset latency, and sleep duration indicated good to excellent reliability from five weekday nights of sleep diary entries across all adolescent cohorts. Four school nights was sufficient for wake times in the Australian and UK samples, but not the US or Qatari samples. Only Australian adolescents showed good reliability for two weekend nights of bedtime reports; estimates of sleep onset latency were adequate for UK adolescents based on two weekend nights. Wake after sleep onset was not reliably estimated using one week of sleep diaries. We observed excellent test-rest reliability across 12 weeks of sleep diary data in a subsample of US adolescents. Conclusion We recommend at least five weekday nights of sleep dairy entries to be made when studying adolescent bedtimes, sleep onset latency and sleep duration. Adolescent sleep patterns were stable across 12 consecutive school weeks.

Short M. A., Gradisar M., Lack L. C., Wright H. R., & Chatburn A . (2013).

Estimating adolescent sleep patterns: Parent reports versus adolescent self-report surveys, sleep diaries, and actigraphy.

Nature and Science of Sleep, 5, 23-26.

URL     PMID:3630985      [本文引用: 1]

timating adolescent sleep patterns: parent reports versus adolescent self-report surveys, sleep diaries, and actigraphy Original Research (654) Total Article Views Authors: Short MA, Gradisar M, Lack LC, Wright HR, Chatburn A Published Date February 2013 Volume 2013:5 Pages 23 - 26 DOI: http://dx.doi.org/10.2147/NSS.S38369 Received: 21 September 2012 Accepted: 22 October 2012 Published: 12 February 2013 Michelle A Short,1,2 Michael Gradisar,1 Leon C Lack,1 Helen R Wright,1 Alex Chatburn2 1School of Psychology, Flinders University, 2Centre for Sleep Research, University of South Australia, Adelaide, South Australia, Australia Background: In research and clinical contexts, parent reports are often used to gain information about the sleep patterns of their adolescents; however, the degree of concordance between parent reports and adolescent-derived measures is unclear. The present study compares parent estimates of adolescent sleep patterns with adolescent self-reports from surveys and sleep diaries, together with actigraphy. Methods: A total of 308 adolescents (59% male) aged 13 17 years completed a school sleep habits survey during class time at school, followed by a 7-day sleep diary and wrist actigraphy. Parents completed the Sleep, Medical, Education and Family History Survey. Results: Parents reported an idealized version of their adolescent's sleep, estimating significantly earlier bedtimes on both school nights and weekends, significantly later wake times on weekends, and significantly more sleep than either the adolescent self-reported survey, sleep diary, or actigraphic estimates. Conclusion: Parent reports indicate that the adolescent averages a near-optimal amount of sleep on school nights and a more than optimal amount of sleep on weekends. However, adolescent-derived averages indicate patterns of greater sleep restriction. These results illustrate the importance of using adolescent-derived estimates of sleep patterns in this age group and the importance of sleep education for both adolescents and their parents.

Shui L. L., Hayes R. A., Jin M. L., Zhang X., Bai P. F., van den Berg A., .. Zhou G. F . (2014).

Microfluidics for electronic paper-like displays.

Lab on a Chip, 14, 2374-2384.

URL     PMID:24872144      [本文引用: 1]

Displays are ubiquitous in modern life, and there is a growing need to develop active, full color, video-rate reflective displays that perform well in high-light conditions. The core of display technology is to generate or manipulate light in the visible wavelength. Colored fluids or fluids with particles can be used to tune the light intensity (greyscale) or wavelength (colors) of reflective displays by different actuation methods. Microfluidic technology plays an increasing role in fluidic manipulation in microscale devices used in display areas. In this article, we will review microfluidic technologies based on different actuation methods used for display applications: pressure-driven flow, electrophoresis, electroosmosis, electrowetting, magnetic-driven flow, and cell-actuation principles.

Singh M.M., &Pati A.K . (2016).

Effects of radiation emanating from base transceiver station and mobile phone on sleep, circadian rhythm and cognition in humans-A review.

Biological Rhythm Research, 47(3), 353-388.

URL     [本文引用: 1]

The electromagnetic fields (EMF) are ubiquitous. The base transceiver station (BTS) and mobile phones (MPs) contribute to the generation of EMF around their locations and are regarded as important sources of non-ionizing radiations. The use of mobile phone has increased dramatically in recent years so also the skepticism regarding its effects. In this review, we have made an attempt to scan the key research papers those aimed at elucidating the effects of EMF starting from extreme low frequency (ELF) to radio frequency (RF) through low frequency (LF). We have selected papers that dealt with the effects of radiations emanating from the BTS and MPs on human sleep, circadian rhythm, and cognition. Mostly, we have concentrated on papers published in the last 15 years. We came across conflicting reports. The findings reported in many papers suggest that the exposure to EMF has potentiality to compromise parameters related to sleep quality; in contrast, there are several reports those have given a clean sheet to the EMF exposure. The effects of EMF on circadian rhythms also remain inconclusive. The EMF exposure while did not produce any effect on circadian rhythm of heart rate and blood chemistry, it modulated the rhythms in cortisol and melatonin characterized by a decline in their 24-h circulating levels. The effects of exposure to EMF on cognitive parameters, like performance and memory, are also equivocal. The existing contradictory findings could be attributed to inter-individual variability in tolerance, gender-, and age-dependent differences in response, latitudinal differences in efficacy, variability among employed methodologies and differences in specific absorption rate, frequency of the mobile phone usage, and interaction of EMF with other physiological and environmental factors, among others. The future research should be carried out with added focus on elucidating the modulatory effects of these factors to put an end to the existing controversies on the biological effects of low/RF EMF radiations.

Tavernier R., & Willoughby T. (2014).

Sleep problems: Predictor or outcome of media use among emerging adults at university?

Journal of Sleep Research, 23(4), 389-396.

URL     PMID:24552437      [本文引用: 1]

SummaryThe pervasiveness of media use in our society has raised concerns about its potential impact on important lifestyle behaviours, including sleep. Although a number of studies have modelled poor sleep as a negative outcome of media use, a critical assessment of the literature indicates two important gaps: (i) studies have almost exclusively relied on concurrent data, and thus have not been able to assess the direction of effects; and (ii) studies have largely been conducted with children and adolescents. The purpose of the present 3-year longitudinal study, therefore, was to examine whether both sleep duration and sleep problems would be predictors or outcomes of two forms of media use (i.e. television and online social networking) among a sample of emerging adults. Participants were 942 (71.5% female) university students (M = 19.01 years, SD = 0.90) at Time 1. Survey measures, which were assessed for three consecutive years starting in the first year of university, included demographics, sleep duration, sleep problems, television and online social networking use. Results of a cross-lagged model indicated that the association between sleep problems and media use was statistically significant: sleep problems predicted longer time spent watching television and on social networking websites, but not vice versa. Contrary to our hypotheses, sleep duration was not associated with media use. Our findings indicate no negative effects of media use on sleep among emerging adults, but instead suggest that emerging adults appear to seek out media as a means of coping with their sleep problems.

Tso W., Rao N., Jiang F., Li A. M., Lee S. L., Ho F. K., .. Ip P . (2016).

Sleep duration and school readiness of Chinese preschool children.

Journal of Pediatrics, 169, 266-271.

URL     PMID:26608085      [本文引用: 2]

To examine the average sleep duration in Chinese preschoolers and to investigate the association between sleep duration and school readiness. This is a cross-sectional study that included 553 Chinese children (mean age02=025.4602years) from 20 preschools in 2 districts of Hong Kong. Average daily sleep duration in the last week was reported by parents and school readiness as measured by the teacher-rated Chinese Early Development Instrument (CEDI). Most Chinese preschoolers had 9-1002hours of sleep per day. Only 11% of preschoolers had the recommended 11-1202hours of sleep per day. This group was associated with more “very ready” CEDI domains. Sleep deprivation (≤702hours per day) was associated with a lower CEDI total score, lower scores in the emotional maturity and language/cognitive domain, and prosocial behaviors subdomain but a greater score in the hyperactivity/inattention subdomain. Children with a lower family socioeconomic index, lower maternal education level, infrequent parent-child interactions, and who used electronic devices for more than 302hours per day had shortened sleep durations. Optimal sleep duration was associated with better school readiness in preschool children, whereas sleep deprivation was associated with lower school readiness, more hyperactivity and inattention, and less prosocial behavior.

Twenge J. M., Krizan Z., & Hisler G . (2017).

Decreases in self-reported sleep duration among U.S. adolescents 2009-2015 and association with new media screen time.

Sleep Medicine, 39, 47-53.

URL     PMID:29157587      [本文引用: 1]

Abstract STUDY OBJECTIVES: Insufficient sleep among adolescents carries significant health risks, making it important to determine social factors that change sleep duration. We sought to determine whether the self-reported sleep duration of U.S. adolescents changed between 2009 and 2015 and examine whether new media screen time (relative to other factors) might be responsible for changes in sleep. METHODS: We drew from yearly, nationally representative surveys of sleep duration and time use among adolescents conducted since 1991 (Monitoring the Future) and 2007 (Youth Risk Behavior Surveillance System of the Centers for Disease Control; total N0002=0002369,595). RESULTS: Compared to 2009, adolescents in 2015 were 16%-17% more likely to report sleeping less than 70002h a night on most nights, with an increase in short sleep duration after 2011-2013. New media screen time (electronic device use, social media, and reading news online) increased over this time period and was associated with increased odds of short sleep duration, with a clear exposure-response relationship for electronic devices after 2 or more hours of use per day. Other activities associated with short sleep duration, such as homework time, working for pay, and TV watching, were relatively stable or reduced over this time period, making it unlikely that these activities caused the sudden increase in short sleep duration. CONCLUSIONS: Increased new media screen time may be involved in the recent increases (from 35% to 41% and from 37% to 43%) in short sleep among adolescents. Public health interventions should consider electronic device use as a target of intervention to improve adolescent health. Copyright 0008 2017 Elsevier B.V. All rights reserved.

van den Bulck J. (2000).

Is television bad for your health? Behavior and body image of the adolescent “couch potato”.

Journal of Youth and Adolescence, 29(3), 273-288.

URL     [本文引用: 2]

This article examines the potential health effects of television. A survey of 1035 Flemish 17- and 18-year-olds shows that eating snacks and drinking regularly accompany viewing. Television was also shown to influence sleeping and family meals. Heavy viewers did not, however, appear to be more passive than lighter viewers. Their indulgence in sports did not differ, but content-specific relationships with going out appear to exist. In this group no link between viewing and obesity was found, but viewing was significantly related to various aspects of people's self assessments regarding their weight, their ideal weight and their looks. Particular attention was given to those television programs that portray “idealized bodies.” Generally, a distinction was made between men and women because many body-, weight-, and health-related factors may be culture and gender specific.

van den Bulck J. (2004).

Television viewing, computer game playing, and Internet use and self-reported time to bed and time out of bed in secondary-school children.

Sleep, 27(1), 101-104.

URL     PMID:14998244      [本文引用: 1]

Abstract OBJECTIVE: To investigate the relationship between the presence of a television set, a gaming computer, and/or an Internet connection in the room of adolescents and television viewing, computer game playing, and Internet use on the one hand, and time to bed, time up, time spent in bed, and overall tiredness in first- and fourth-year secondary-school children on the other hand. METHODS: A random sample of students from 15 schools in Flanders, Belgium, yielded 2546 children who completed a questionnaire with questions about media presence in bedrooms; volume of television viewing, computer game playing, and Internet use; time to bed and time up on average weekdays and average weekend days; and questions regarding the level of tiredness in the morning, at school, after a day at school, and after the weekend. RESULTS: Children with a television set in their rooms went to bed significantly later on weekdays and weekend days and got up significantly later on weekend days. Overall, they spent less time in bed on weekdays. Children with a gaming computer in their rooms went to bed significantly later on weekdays. On weekdays, they spent significantly less time in bed. Children who watched more television went to bed later on weekdays and weekend days and got up later on weekend days. They spent less time in bed on weekdays. They reported higher overall levels of being tired. Children who spent more time playing computer games went to bed later on weekdays and weekend days and got up later on weekend days. On weekdays, they actually got up significantly earlier. They spent less time in bed on weekdays and reported higher levels of tiredness. Children who spent more time using the Internet went to bed significantly later during the week and during the weekend. They got up later on weekend days. They spent less time in bed during the week and reported higher levels of tiredness. Going out was also significantly related to sleeping later and less. CONCLUSION: Concerns about media use should not be limited to television. Computer game playing and Internet use are related to sleep behavior as well. Leisure activities that are unstructured seem to be negatively related to good sleep patterns. Imposing more structure (eg, end times) might reduce impact.

van der Lely S., Frey S., Garbazza C., Wirz-Justice A., Jenni O. G., Steiner R., .. Schmidt C . (2015).

Blue blocker glasses as a countermeasure for alerting effects of evening light-emitting diode screen exposure in male teenagers.

Journal of Adolescent Health, 56(1), 113-119.

URL     PMID:25287985      [本文引用: 3]

Adolescents prefer sleep and wake times that are considerably delayed compared with younger children or adults. Concomitantly, multimedia use in the evening is prevalent among teenagers and involves light exposure, particularly in the blue-wavelength range to which the biological clock and its associated arousal promotion system is the most sensitive. We investigated whether the use of blue light–blocking glasses (BB) during the evening, while sitting in front of a light-emitting diode (LED) computer screen, favors sleep initiating mechanisms at the subjective, cognitive, and physiological level. The ambulatory part of the study comprised 2 weeks during which the sleep–wake cycle, evening light exposure, and multimedia screen use were monitored in thirteen 15- to 17-year-old healthy male volunteers. BB or clear lenses as control glasses were worn in a counterbalanced crossover design for 1 week each, during the evening hours while using LED screens. Afterward, participants entered the laboratory and underwent an evening blue light–enriched LED screen exposure during which they wore the same glasses as during the preceding week. Salivary melatonin, subjective sleepiness, and vigilant attention were regularly assayed, and subsequent sleep was recorded by polysomnography. Compared with clear lenses, BB significantly attenuated LED-induced melatonin suppression02in the evening and decreased vigilant attention and subjective alertness before bedtime. Visually scored sleep stages and behavioral measures collected the morning after were not modified. BB glasses may be useful in adolescents as a countermeasure for alerting effects induced by light exposure through LED screens and therefore potentially impede the negative effects modern lighting imposes on circadian physiology in the evening.

van derMolen J. H.W., &Bushman B.J . (2008).

Children's direct fright and worry reactions to violence in fiction and news television programs.

The Journal of Pediatrics, 153(3), 420-424.

URL     PMID:18534207      [本文引用: 1]

To examine whether violence in fictional and news television content frightens and worries children. Mixed factorial. Type of reaction (fright, worry) and television programming (violent news, violent fiction) were within-subjects factors, whereas age, sex, and television viewing frequency were between-subjects factors. Participants included 572 children (47% boys), aged 8 to 12 years, from 9 urban and rural primary schools in the Netherlands. The main exposure was to descriptions of 8 threats frequently depicted in fictional and news programs (eg, murder, war, house fires). Children reported whether they were frightened or worried by these threats. Violent threats increased both fright and worry. These 2 reactions could be distinguished from one another in a factor analysis. When violent content was described as news, it produced more fear reactions than when it was described as fiction. Fright and worry were greater in girls than in boys, in younger children than in older children, and in light television viewers than in heavy television viewers. Pediatricians should inform parents, educators, policy makers, and broadcasters about the potentially harmful effect of violent programming on children's emotions, especially in the case of news programming.

van de Water, A. T. M. HolmesA., & Hurley D. A . (2011).

Objective measurements of sleep for non-laboratory settings as alternatives to polysomnography-A systematic review.

Journal of Sleep Research, 20(1), 183-200.

[本文引用: 1]

van Straten A., Emmelkamp J., de Wit J., Lancee J., Andersson G., van Someren, E. J. W., Cuijpers P . (2014).

Guided Internet-delivered cognitive behavioural treatment for insomnia: A randomized trial.

Psychological Medicine, 44(7), 1521-1532.

URL     PMID:24001364      [本文引用: 1]

Insomnia is a prevalent problem with a high burden of disease (e.g. reduced quality of life, reduced work capacity) and a high co-morbidity with other mental and somatic disorders. Cognitive behavioural therapy (CBT) is effective in the treatment of insomnia but is seldom offered. CBT delivered through the Internet might be a more accessible alternative. In this study we examined the effectiveness of a guided Internet-delivered CBT for adults with insomnia using a randomized controlled trial (RCT). A total of 118 patients, recruited from the general population, were randomized to the 6-week guided Internet intervention (n= 59) or to a wait-list control group (n= 59). Patients filled out an online questionnaire and a 7-day sleep diary before (T0) and after (T1) the 6-week period. The intervention group received a follow-up questionnaire 3 months after baseline (T2). Almost three-quarters (72.9%) of the patients completed the whole intervention. Intention-to-treat (ITT) analysis showed that the treatment had statistically significant medium to large effects (p< 0.05; Cohen'sdbetween 0.40 and 1.06), and resulted more often in clinically relevant changes, on all sleep and secondary outcomes with the exception of sleep onset latency (SOL) and number of awakenings (NA). There was a non-significant difference in the reduction in sleep medication between the intervention (a decrease of 6.8%) and control (an increase of 1.8%) groups (p= 0.20). Data on longer-term effects were inconclusive. This study adds to the growing body of literature that indicates that guided CBT for insomnia can be delivered through the Internet. Patients accept the format and their sleep improves.

Wahi G., Parkin P. C., Beyene J., Uleryk E. M., & Birken C. S . (2011).

Effectiveness of interventions aimed at reducing screen time in children: A systematic review and meta-analysis of randomized controlled trials.

Archives of Pediatrics and Adolescent Medicine, 165(11), 979-986.

[本文引用: 1]

Werth J., Atallah L., Andriessen P., Long X., Zwartkruis- Pelgrim E., Aarts R. M . (2017).

Unobtrusive sleep state measurements in preterm infants - A review.

Sleep Medicine Reviews, 32, 109-122.

URL     PMID:27318520      [本文引用: 1]

Sleep is important for the development of preterm infants. During sleep, neural connections are formed and the development of brain regions is triggered. In general, various rudimentary sleep states can be identified in the preterm infant, namely active sleep (AS), quiet sleep (QS) and intermediate sleep (IS). As the infant develops, sleep states change in length and organization, with these changes as important indicators of brain development. As a result, several methods have been deployed to distinguish between the different preterm infant sleep states, among which polysomnography (PSG) is the most frequently used. However, this method is limited by the use of adhesive electrodes or patches that are attached to the body by numerous cables that can disturb sleep. Given the importance of sleep, this review explores more unobtrusive methods that can identify sleep states without disturbing the infant. To this end, after a brief introduction to preterm sleep states, an analysis of the physiological characteristics associated with the different sleep states is provided and various methods of measuring these physiological characteristics are explored. Finally, the advantages and disadvantages of each of these methods are evaluated and recommendations for neonatal sleep monitoring proposed.

Westerik H., Renckstorf K., Wester F., & Lammers J . (2005).

The situational and time-varying context of routines in television viewing: An event history analysis.

Communications, 30(2), 155-182.

[本文引用: 1]

Wood A. W., Loughran S. P., & Stough C . (2006).

Does evening exposure to mobile phone radiation affect subsequent melatonin production?

International Journal of Radiation Biology, 82(2), 69-76.

URL     PMID:16546905      [本文引用: 1]

Abstract PURPOSE: To test whether exposure to the emissions from a digital mobile phone handset prior to sleep alters the secretion of melatonin. MATERIALS AND METHODS: In a double-blind cross-over design, 55 adult volunteers were both actively exposed or sham-exposed (in random order on successive Sunday nights) to mobile phone emissions for 30 min (0.25 W average power). Urine collection occurred immediately prior to retiring to bed and on rising the next morning. Melatonin output was estimated from principal metabolite concentrations (6-sulphatoxymelatonin (aMT6s) via radioimmunoassay), urine volumes and creatinine concentrations. RESULTS: Total melatonin metabolite output (concentration x urine volume) was unchanged between the two exposure conditions (active 14.1+/-1.1 microg; sham 14.6+/-1.3 microg). The pre- and post-bedtime outputs considered separately were also not significantly different, although the pre-bedtime value was less for active versus sham exposure. When melatonin metabolite output was estimated from the ratio of aMT6s to creatinine concentrations, the pre-bedtime value was significantly less (p = 0.037) for active compared to sham. Examination of individual responses is suggestive of a small group of 'responders'. CONCLUSIONS: Total nighttime melatonin output is unchanged by mobile phone handset emissions, but there could be an effect on melatonin onset time.

Wood B., Rea M. S., Plitnick B., & Figueiro M. G . (2013).

Light level and duration of exposure determine the impact of self-luminous tablets on melatonin suppression.

Applied Ergonomics, 44(2), 237-240.

URL     PMID:22850476      [本文引用: 3]

Exposure to light from self-luminous displays may be linked to increased risk for sleep disorders because these devices emit optical radiation at short wavelengths, close to the peak sensitivity of melatonin suppression. Thirteen participants experienced three experimental conditions in a within-subjects design to investigate the impact of self-luminous tablet displays on nocturnal melatonin suppression: 1) tablets-only set to the highest brightness, 2) tablets viewed through clear-lens goggles equipped with blue light-emitting diodes that provided 40 lux of 470-nm light at the cornea, and 3) tablets viewed through orange-tinted glasses (dark control; optical radiation <525 nm approximate to 0). Melatonin suppressions after 1-h and 2-h exposures to tablets viewed with the blue light were significantly greater than zero. Suppression levels after 1-h exposure to the tablets-only were not statistically different than zero: however, this difference reached significance after 2 h. Based on these results, display manufacturers can determine how their products will affect melatonin levels and, use model predictions to tune the spectral power distribution of self-luminous devices to increase or to decrease stimulation to the circadian system. (C) 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Wu X. Y., Tao S. M., Zhang Y. K., Zhang S. C., & Tao F. B . (2015).

Low physical activity and high screen time can increase the risks of mental health problems and poor sleep quality among Chinese college students.

PLoS ONE, 10(3), e119607.

URL     PMID:4364939      [本文引用: 1]

Abstract OBJECTIVE: To test the independent and interactive associations of physical activity (PA) and screen time (ST) with self-reported mental health and sleep quality among Chinese college students. METHOD: Data were collected in October, 2013. The gender, age, residential background, body mass index (BMI), perceived family economy and perceived study burden were obtained from a total of 4747 college students (41.6% males and 58.4% females). The outcomes were self-reported PA status, ST, anxiety, depression, psychopathological symptoms and sleep quality. Analyses were conducted with logistic regression models. RESULTS: Overall, 16.3%, 15.9% and 17.3% of the students had psychological problems, such as anxiety, depression and psychopathological symptoms, respectively. The prevalence of poor sleep quality was 9.8%. High ST was significantly positively associated with anxiety (OR=1.38, 95%CI: 1.15-1.65), depression (OR=1.76, 95%CI: 1.47-2.09), psychopathological symptoms (OR=1.69, 95%CI: 1.43-2.01) and poor sleep quality (OR=1.32, 95%CI: 1.06-1.65). High PA was insignificantly negatively associated with anxiety, depression, psychopathological symptoms and poor sleep. Low PA and high ST were independently and interactively associated with increased risks of mental health problems and poor sleep quality (p<0.05 for all). CONCLUSION: Interventions are needed to reduce ST and increase PA in the lifestyles of young people. Future research should develop and measure the impacts of interventions and their potential consequences on sleep, health, and well being.

Xu X. L., Zhu R. Z., Sharma M., & Zhao Y . (2015).

The influence of social media on sleep quality: A study of undergraduate students in Chongqing, China.

Journal of Nursing & Care, 4(3), 253.

[本文引用: 1]

Yi Z. C., Shui L. L., Wang L., Jin M. L., Hayes R. A., Zhou G . (2015).

A novel driver for active matrix electrowetting displays.

Displays, 37, 86-93.

URL     [本文引用: 1]

Electrowetting display (EWD) is a reflective display technology in which fluidic pixels can response and switch quickly by electronic control, showing the capability for video-speed reflective display applications. In this paper, a new driver system is proposed and realized for video playing function of active matrix electrowetting display (AM-EWD). The hardware system is designed based on Field-Programmable-Gate-Array (FPGA) and the existing electrophoretic display (EPD) driving integrated chips (IC). A driving logic circuit and FPGA software is introduced for providing the EWD system with driving and timing control. And a set of specific driving waveforms, which is loaded to a lookup table of the FPGA in advance, is designed to display grayscale on EWDs. 4-level gray scale videos have been successfully performed by applying the driving waveforms. To our knowledge, such work has not been reported before.

Zhou H. Q., Shi W. B., Wang X. F., Yao M., Cheng G. Y., Chen P. Y., Li D. G . (2012).

An epidemiological study of sleep quality in adolescents in South China: A school- based study.

Child: Care, Health and Development, 38(4), 581-587.

Žukauskas A., Vaicekauskas R., & Vitta P . (2012).

Optimization of solid-state lamps for photobiologically friendly mesopic lighting.

Applied Optics, 51(35), 8423-8432.

URL     PMID:23262538     

The circadian and visual-performance-based mesopic systems of photometry were applied for the optimization of the spectral power distributions (SPDs) of the solid-state sources of light for low-illuminance lighting applications. At mesopic adaptation luminances typical of outdoor lighting (0.1-2 cd/m(2)), the optimal SPDs were obtained through the minimization of the mesopic circadian action factor, which is the ratio of the circadian efficacy of radiation to mesopic luminous efficacy of radiation. For correlated color temperatures below ~3000 K, the optimized dichromatic light-emitting diodes (LEDs) are shown to pose a lower circadian hazard than high-pressure sodium lamps and common warm white LEDs; also they are potentially more efficacious and have acceptable color rendition properties under mesopic conditions.

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