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Sleep duration moderates association between screen time and emotional and behavioural problems in young children

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摘要Background Preschoolers and young children are vulnerable to psychosocial and behavioral disorders linked to lifestyle factors such as screen time and sleep disturbances.Our study examines the relationship between screen time and adherence to recommendations with children's behavioral and emotional difficulties,with a focus on the role of sleep duration.Methods Cross-sectional analyses were conducted within the multicenter prospective Childhood Obesity Risk Assessment Longitudinal Study(CORALS),which included 1420 children aged 3-6 years.Screen time(hours/day)and adherence to recommendations(≤ 2 hours/day)were assessed.Behavioral and emotional difficulties were measured via the strengths and difficulties questionnaire.Multivariable linear and logistic regression models were used to estimate associations between screen time(continuous and dichotomous)and strengths and difficulties questionnaire scores,adjusting for potential con-founders.We also tested the moderating effect of sleep and conducted isotemporal substitution analyses replacing screen time with sleep duration.Results Higher screen time was associated with higher total strengths and difficulties questionnaire scores[β 95％confidence interval(CI),0.35(0.10,0.61)],emotional symptoms[0.10(0.01,0.19)],conduct problems[0.10(0.01,0.18)],and greater odds of exceeding the 16-point strengths and difficulties questionnaire cutoff for behavioral and emotional difficulties[odds ratio(OR)(95％CI),1.21(1.04,1.41)].Children who adhered to screen time recommendations had lower strengths and difficulties questionnaire total scores[β(95％CI),-0.64(-1.19,-0.10)]and odds of experiencing behavioral and emotional difficulties[OR(95％CI),0.67(0.47,0.95)].Sleep duration moderated the screen time-strengths and difficulties questionnaire association(P=0.020).The isotemporal substitution of screen time for sleep duration was associated with lower strengths and difficulties questionnaire scores across all subscales,except for prosocial behavior.Conclusions Higher screen time was associated with greater emotional and behavioral difficulties,whereas adherence to screen time recommendations and adequate sleep duration were inversely associated.Managing screen time and promoting sleep are crucial for children's well-being.

作者 Lucía Iglesias-Vázquez ^[1] Tany E.Garcidue?as-Fimbres ^[2] Carlos Gómez-Martínez ^[3] Cristina Castro-Collado ^[4] Rosaura Leis ^[5] María Fernández de la Puente ^[6] Luis A.Moreno ^[7] Santiago Navas-Carretero ^[8] Dolores Corella ^[9] Ana Moreira Echeverria ^[10] José M.Jurado-Castro ^[4] Rosaura Picáns-Leis ^[11] Jiaqi Ni ^[6] Maria L.Miguel-Berges ^[7] J.Alfredo Martínez ^[12] María I.Benedicto-Toboso ^[13] Francisco Llorente-Cantarero ^[4] Rocío Vázquez-Cobela ^[5] Albert Feliu ^[14] Guiomar Masip ^[7] Belén Pastor-Villaescusa ^[15] Mercedes Gil-Campos ^[4] Joaquín Escribano ^[14] Nancy Babio ^[6] 学术成果认领

作者单位 Universitat Rovira I Virgili,Departament de Bioquímica I Biotecnologia,Alimentació,Nutrició,Desenvolupament i Salut Mental(ANUT-DSM),Unitat de Nutrició Humana,Sant Lloren?,21,43201 Reus,Spain;Institut d'Investigació Sanitària Pere Virgili(IISPV),Carrer Dr.Mallafré Guasch,4,43007 Tarragona,Spain ^[1] Universitat Rovira I Virgili,Departament de Bioquímica I Biotecnologia,Alimentació,Nutrició,Desenvolupament i Salut Mental(ANUT-DSM),Unitat de Nutrició Humana,Sant Lloren?,21,43201 Reus,Spain;Institut d'Investigació Sanitària Pere Virgili(IISPV),Carrer Dr.Mallafré Guasch,4,43007 Tarragona,Spain;Consorcio CIBER,M.P.Fisiopatología de la Obesidad y Nutrición(CIBEROBN),Instituto de Salud Carlos Ⅲ (ISCⅢ),Av.Monforte de Lemos,3-5.Pabellón 11.Planta 0,28029 Madrid,Spain;Department of Epidemiology and Public Health,Hospital de la Santa Creu i Sant Pau.Biomedical Research Institute Sant Pau(IIB Sant Pau),Sant Quintí,89,Barcelona,Spain ^[2] Universitat Rovira I Virgili,Departament de Bioquímica I Biotecnologia,Alimentació,Nutrició,Desenvolupament i Salut Mental(ANUT-DSM),Unitat de Nutrició Humana,Sant Lloren?,21,43201 Reus,Spain;Institut d'Investigació Sanitària Pere Virgili(IISPV),Carrer Dr.Mallafré Guasch,4,43007 Tarragona,Spain;Consorcio CIBER,M.P.Fisiopatología de la Obesidad y Nutrición(CIBEROBN),Instituto de Salud Carlos Ⅲ (ISCⅢ),Av.Monforte de Lemos,3-5.Pabellón 11.Planta 0,28029 Madrid,Spain;Division of Psychiatry,Haukeland University Hospital,5021 Bergen,Norway;Department of Biomedicine,University of Bergen,5009 Bergen,Norway ^[3] Consorcio CIBER,M.P.Fisiopatología de la Obesidad y Nutrición(CIBEROBN),Instituto de Salud Carlos Ⅲ (ISCⅢ),Av.Monforte de Lemos,3-5.Pabellón 11.Planta 0,28029 Madrid,Spain;University of Córdoba,Metabolism and Investigation Unit,Reina Sofia University Hospital,Maimónides Institute of Biomedicine Research of Córdoba(IMIBIC),Av.Menéndez Pidal,S/N,14004 Córdoba,Spain ^[4] Consorcio CIBER,M.P.Fisiopatología de la Obesidad y Nutrición(CIBEROBN),Instituto de Salud Carlos Ⅲ (ISCⅢ),Av.Monforte de Lemos,3-5.Pabellón 11.Planta 0,28029 Madrid,Spain;Unit of Pediatric Gastroenterology,Hepatology and Nutrition,Pediatric Service,Hospital Clínico Universitario de Santiago,Rúa da Choupana,S/N,15706 Santiago de Compostela,A Coru?a,Spain;Pediatric Nutrition Research Group,Unit of Investigation in Nutrition,Growth and Human Development of Galicia-USC,Health Research Institute of Santiago de Compostela(IDIS),Rúa da Choupana,S/N,15706 Santiago de Compostela,A Coru?a,Spain ^[5] Universitat Rovira I Virgili,Departament de Bioquímica I Biotecnologia,Alimentació,Nutrició,Desenvolupament i Salut Mental(ANUT-DSM),Unitat de Nutrició Humana,Sant Lloren?,21,43201 Reus,Spain;Institut d'Investigació Sanitària Pere Virgili(IISPV),Carrer Dr.Mallafré Guasch,4,43007 Tarragona,Spain;Consorcio CIBER,M.P.Fisiopatología de la Obesidad y Nutrición(CIBEROBN),Instituto de Salud Carlos Ⅲ (ISCⅢ),Av.Monforte de Lemos,3-5.Pabellón 11.Planta 0,28029 Madrid,Spain ^[6] Consorcio CIBER,M.P.Fisiopatología de la Obesidad y Nutrición(CIBEROBN),Instituto de Salud Carlos Ⅲ (ISCⅢ),Av.Monforte de Lemos,3-5.Pabellón 11.Planta 0,28029 Madrid,Spain;Growth,Exercise,Nutrition and Development(GENUD)Research Group and Instituto Agroalimentario de Aragón(IA2),University of Zaragoza,Pedro Cerbuna,12,50009 Zaragoza,Spain;Instituto de Investigación Sanitaria de Aragón(IIS Aragón),Centro de Investigación Biomédica de Aragón(CIBA).Avda.San Juan Bosco,13,50009 Zaragossa,Spain ^[7] Consorcio CIBER,M.P.Fisiopatología de la Obesidad y Nutrición(CIBEROBN),Instituto de Salud Carlos Ⅲ (ISCⅢ),Av.Monforte de Lemos,3-5.Pabellón 11.Planta 0,28029 Madrid,Spain;Center for Nutrition Research and Fac Pharm & Nutr,Dept Nutr Food Sci & Physiol,University of Navarra,Irunlarrea,1,31008 Pamplona,Spain;IdisNA,Navarra Institute for Health Research,Irunlarrea,3,31008 Pamplona,Spain ^[8] Consorcio CIBER,M.P.Fisiopatología de la Obesidad y Nutrición(CIBEROBN),Instituto de Salud Carlos Ⅲ (ISCⅢ),Av.Monforte de Lemos,3-5.Pabellón 11.Planta 0,28029 Madrid,Spain;Department of Preventive Medicine and Public Health,University of Valencia.Av.de Blasco Ibá?ez,13,El Pla del Real,46010 Valencia,Spain ^[9] Fundació Hospital Sant Joan de Déu de Martorell,Av.Mancomunitats Comarcals,1,3,08760 Martorell,Barcelona,Spain ^[10] Pediatric Nutrition Research Group,Unit of Investigation in Nutrition,Growth and Human Development of Galicia-USC,Health Research Institute of Santiago de Compostela(IDIS),Rúa da Choupana,S/N,15706 Santiago de Compostela,A Coru?a,Spain ^[11] Consorcio CIBER,M.P.Fisiopatología de la Obesidad y Nutrición(CIBEROBN),Instituto de Salud Carlos Ⅲ (ISCⅢ),Av.Monforte de Lemos,3-5.Pabellón 11.Planta 0,28029 Madrid,Spain;Center for Nutrition Research and Fac Pharm & Nutr,Dept Nutr Food Sci & Physiol,University of Navarra,Irunlarrea,1,31008 Pamplona,Spain;Nutrición de Precisión y Programa de Salud Cardio Metabólica,Instituto Madrile?o de Estudios Avanzados(IMDEA),Consejo Superior de Investigaciones Científicas-Campus de Excelencia Internacional(CSIC-CEI),28049 Madrid,Spain ^[12] Growth,Exercise,Nutrition and Development(GENUD)Research Group and Instituto Agroalimentario de Aragón(IA2),University of Zaragoza,Pedro Cerbuna,12,50009 Zaragoza,Spain;Instituto de Investigación Sanitaria de Aragón(IIS Aragón),Centro de Investigación Biomédica de Aragón(CIBA).Avda.San Juan Bosco,13,50009 Zaragossa,Spain ^[13] Institut d'Investigació Sanitària Pere Virgili(IISPV),Carrer Dr.Mallafré Guasch,4,43007 Tarragona,Spain;Hospital Universitari Salut Sant Joan de Reus;and Pediatric Nutrition and Human Development Research Unit,Universitat Rovira I Virgili,Sant Lloren?,21,43201 Reus,Spain ^[14] University of Córdoba,Metabolism and Investigation Unit,Reina Sofia University Hospital,Maimónides Institute of Biomedicine Research of Córdoba(IMIBIC),Av.Menéndez Pidal,S/N,14004 Córdoba,Spain ^[15]

关键词 Child Mental health Screen time Sleep Strengths and difficulties questionnaire

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Original articles

DOI 10.1007/s12519-025-00963-x

发布时间 2025-12-29（万方平台首次上网日期，不代表论文的发表时间）

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