Researchers assess relationships between screen time, sleep and mental health in American teens

The past decade has seen a dramatic rise in mental health problems and associated risks like suicidal thoughts and actions in American adolescents. Suicide is one of the top three causes of death in this age group. Some studies have found an association between time spent on social media and the internet and poorer mental health in adolescents, while others have found little to no effect. Researchers have also found that sleep duration may have a mediating effect on screen time and mental health, though results have been mixed.

A new study published in the journal Psychological Reports looks into the relationships between sleep, screen time and mental health problems and suicidality in male and female adolescents in the United States. In the study, Shuo Feng, a graduate student in the Texas A&M University School of Public Health and Ping Ma, PhD, an associate professor in the Department of Health Behavior there, along with colleagues from Baylor University and the University of North Carolina, analyzed data on health risk behaviors to find direct and indirect associations among sleep duration, screen time and mental health problems and suicidality in male and female adolescents.

The researchers used responses from the 2021 Youth Risk Behavior Survey, a nationally representative survey by the Centers for Disease Control and Prevention. This survey asks questions about a wide array of health risk behaviors, including mental health, suicidal thoughts and actions, sleep practices and screen time. The researchers analyzed data from more than 9,000 American adolescents between ninth and 12th grade.

The survey asked respondents how often they had mental health problems, including anxiety and depression, and whether they had considered, planned or attempted suicide in the previous 12 months. The analysis also included measures of how many hours adolescents spent in front of a television, computer or other electronic device, not counting school work, and the number of hours of sleep respondents got on a typical school night. The researchers also included factors like sex, race and ethnicity and age, as well as substance use and whether participants had been bullied in their analysis.

“We found that female adolescents had a higher prevalence of suicidality, with more than 35 percent of females and around 18 percent of males reporting suicidal thoughts or actions in the past 12 months,” Ma said. “In addition, female adolescents were more likely to report more than three hours of daily screen time and shorter sleep duration than males.”

Further analysis found a significant association between excessive screen time and shorter sleep duration, especially among female adolescents. The researchers also observed a significant decrease in suicidality with increased sleep duration. These findings indicate that sleep duration likely plays a mediating role between screen time and mental health problems.

The analysis also identified stronger direct and indirect effects of screen time and sleep duration on mental health among female adolescents. One possible reason for this is that sleep duration is more affected by excessive screen time in female adolescents due to differences in circadian rhythms. Female adolescents often tend to go to sleep and wake earlier than males, meaning that excessive screen time is more likely to delay bedtimes for female adolescents. Going to sleep later can lead to poorer sleep quality, which in turn could worsen mental health outcomes.

The researchers noted a few limitations to their study, with the survey’s reliance on self-reported data being the most notable. Additionally, the survey did not provide clear definitions of mental health and terms related to suicidality, which could have led to differences in responses. The analysis also included considering, planning and attempting suicide in a single variable, which could have missed differing patterns in these factors.

“These findings are consistent with other studies in pointing to a relationship between excessive screen time, shorter sleep duration and poorer mental health outcomes,” Ma said.  “They highlight the importance of considering differences between male and female adolescents when considering health behavior risks and also could be helpful for designing interventions for improving adolescent mental health.”