How does television affect sleep?
In adults, it can push back bedtimes and disrupt sleep patterns. In young children, even more can go wrong.
Here's what to look out for, and some evidence-based strategies for protecting your family's sleep health.
Researchers have identified several ways in which television can disrupt or alter sleep patterns:
But how important are these effects, really? Is everyone equally impacted?
Studies suggest otherwise. The effects of television depend on your age, and how you use television.
For example, consider the research on adults.
Binge-viewing (watching multiple episodes of a TV show in one session) has been linked with poor sleep quality and insomnia, possibly because viewers become overly-stimulated before bedtime. Their minds become too active for sleep (Exelmans and Van den Bulck 2017).
There is also evidence connecting television content with dreams. People who view violent or distressing content (from fictional television programs or TV news coverage) are more likely to have violent, disturbing dreams (Van den Bulck et al 2016; Propper et al 2014).
But the same research found no links between insomnia symptoms and watching content on a television screen (Fossum et al 2014).
Why the discrepancy? It might reflect differences in blue light exposure. Researchers have confirmed that the distance of the light source matters (Yoshimura et al 2017). So watching a traditional TV screen that's across the room is less likely to disrupt melatonin production than watching a small computer screen close to your face.
Some adults say they watch television as a sleep aid. Does it help? That’s unclear. But people who use TV in this way are more likely to report poor quality and daytime fatigue (Exelmans and De Bulck 2016).
Leaving the television on during the transition to sleep might help a person cope with nighttime anxiety, and provide distraction from intrusive thoughts. But these benefits are countered by costs. For example, the ongoing background noise may cause sleep disturbances that prevent people from experiencing sustained, deep sleep and REM (Griefan 2002).
Adults who don't have to work the next morning may choose to stay up late watching television. But research suggests they sleep later in the morning to make up for the difference. They don't suffer a net sleep loss (Custers and Van den Bulck 2012).
Beyond the special cases we’ve just mentioned, researchers haven't found any consistent evidence that television affects sleep duration in adults (Mesquita and Reimão 2010; Custers and Van den Bulck 2012; Gradisar et al 2013; Fossum et al 2014; Exelmans and Van den Bulck 2017; Exelmans et al 2018).
Disturbing content might trigger nightmares. And researchers have found that teens, like adults, experience poorer sleep and daytime fatigue when they use television as a sleep aid (Eggermont and Van den Bulck 2006).
In addition, teenagers may experience sleep problems and sleep deficiencies if they expose themselves to blue light or stimulating content immediately before bedtime. In one study of older teens, kids had more trouble falling asleep -- and tended to sleep less -- if they watched television during the last hour before bedtime (Hysing et al 2015).
But once again, outside of these important exceptions, it's not clear that teens suffer sleep problems merely because they watch TV.
For instance, in the study of older teens just mentioned, teenagers didn't experience any heightened risk for television viewing in general. Only bedtime viewing was linked with problems.
And most studies of teenagers don't support the idea that TV viewing time is linked with net sleep loss (Bartel et al 2015).
Studies suggest that children face all the same risk factors that older people do, and more besides.
They are likely more sensitive to the effects of artificial lighting. Studies show that the same doses have a bigger, more negative impact on their ability to sleep.
Children are also more sensitive to television content. They are disturbed by things that don't upset older people.
In addition, bedtime television use in children may contribute to parasomnias -- like sleep terrors (which I discuss here) and sleepwalking.
And research shows that it isn't just nighttime viewing or disturbing content that should concern us. It's also the sheer amount of time spent watching television, and whether or not children sleep in a room with a television.
Children with these risk factors tend to sleep less overall. They are more likely to experience time-shifted sleep habits, and to suffer from sleep problems.
So let's take a closer
look at the evidence. First we'll consider how television affects sleep in children. Then we'll review tips for reducing the impact of television on sleep.
Two recent studies -- both involving approximately 700 children -- provide evidence.
In a study conducted in Singapore on children under the age of two, researchers found that screen time was an important predictor of sleep time (Chen et al 2019).
For every hour each day that babies viewed content on televisions or tablets, they slept about 16 minutes less.
Another study, conducted in the United Kingdom, focused on children between the ages of 6 months and 3 years. Researchers analyzed the distinct effects of watching television content on a TV screen versus watching content on a tablet, and they found evidence that tablets are more disruptive of sleep.
While television viewing was linked with less daytime sleep, tablet use was linked with shorter sleep overall (Cheung et 2017). And the results were particularly stark for sleep duration during the night.
For each additional hour that babies and toddlers engaged in tablet use, they averaged 26 fewer minutes of nighttime sleep.
Is there a minimum acceptable dose? That's not clear. But a British study of approximately 1700 children (14-27 months old) helps put things in perspective.
In this group of babies and toddlers, children who watched more than an hour of evening television were at higher risk of sleeping less than 11 hours a night -- an amount that is unusually low, and possibly insufficient (McDonald et al 2014).
Not every study reports the same results. But most have reported at least some of these links.
For instance, in France, Spain, and the United States, researchers studying sleep among children aged 3-5 have discovered the same pattern: More television, less sleep (Plancoulaine et al 2018; Marinelli et al 2014; Cespedes et al 2014; Helm and Spencer 2019).
How much less? In a recent study, researchers Abigail Helm and Rebecca Spencer tracked 470 preschoolers, and compared kids who watched less than an hour of TV each day with kids who watched more than an hour each day.
The heavier users of television averaged 22 fewer minutes of sleep each night. And they made up some of the difference by sleeping more during the day, they still got less sleep overall. Even after accounting for the extra napping, kids' total sleep duration fell short by 17 minutes (Helm and Spencer 2019).
Helm and Spencer also found that television viewing was linked with poorer sleep quality -- including more disrupted sleep. This is consistent with a study that tracked nearly 1200 French children from the age of two: Kids who watched more TV when they were two years old were more likely to experience frequent night wakings through their 5th birthdays (Reynaud et al 2016).
And in a study of 400 American preschoolers, researchers found no evidence of shorter sleep times, but confirmed links with potentially problematic sleep outcomes. Heavy television users were more likely to have later bedtimes, and to get less of their total sleep during the night (Beyens and Nathanson 2018).
Once again, not every study has reported an effect. But overall, there is a trend.
For example, in a study of more than 700 British kids (11- to 12-year-olds), researchers found that time spent watching television was inversely associated with total sleep duration.
Frequent bedtime television viewers also had nearly 4 times the odds of sleep-walking, and even higher odds of awakening very early in the morning (Arora et al 2014).
Another study of approximately 500 elementary school children in the U.S. found similar links between television use and sleep disturbances, including bedtime resistance, trouble falling asleep, anxiety about sleep, and shorter sleep duration (Owens et al 1999).
And in a survey that included American parents of more than 400 children between the ages of 8 and 17, parents reported more sleep disturbances for kids who spent more time using screens -- including television screens, mobile phones, and tablets (Parent et al 2016).
On balance, how much of the research supports the idea that television is linked with sleep outcomes in school children? Roughly three-quarters of it.
In 2015, Lauren Hale and Stanford Guan identified 42 published studies addressing television viewing and sleep in kids.
Of these studies, 32 (76%) found that television viewing was linked with "adverse sleep outcomes." Among a subset of 30 studies that explicitly measured sleep duration, 21 of them found that kids tended to sleep less as their use of television increased (Hale and Guan et al 2015).
Maybe the link merely reflects the fact that some individuals need less sleep. And since they're awake longer, they tend to spend more time engaging in all sorts of activities-- including watching television.
This is an excellent point, and I don't doubt that it explains part of the effect.
But if this explanation were the only factor, we wouldn't necessarily expect to see links between heavy television use and reduced sleep quality. And as we've already seen, such links have been reported.
Neither would be expect kids to complain of sleep problems. And studies suggest that they do.
In the United States, researchers interviewed more than 2000 children in the 4th and 7th grades. They asked kids about screen time and sleep, and confirmed the link (Falbe et al 2015). The more time children reported watching TV, the more likely they were to say they weren’t getting enough sleep.
A smaller study conducted in the United Kingdom interviewed more than 730 young adolescents (aged 11-13) about technology use at bedtime. Kids who said they "usually" or "always" watched TV reported (1) more trouble falling asleep at night, and (2) more difficulty shutting off their minds when trying to fall asleep (Arora et al 2014).
In a study of more than 20,000 Chinese elementary school children, researchers asked parents about their children's sleep patterns and viewing habits. The results? Kids who watched 2 hours or more were more likely to suffer from sleep anxiety, bedtime resistance, and trouble falling sleep (Li et al 2007).
Yes, that is an important part of the story. Violent content is linked with nightmares and poor quality sleep.
In a study of more than 600 preschool-aged children in the United States, Michelle Garrison and her colleagues asked parents about their children’s regular media use and sleep experiences. And the data revealed clear links:
If kids watched violent content during the day, they were more likely to experience nightmares. They also had more trouble waking up in the morning, and they were more likely to experience daytime tiredness (Garrison et al 2011).
When Michelle Garrison's team examined the effects of nighttime viewing, they found special links with sleep problems (Garrison et al 2011):
The more time kids spent watching TV in the evening, the more difficulty they had falling asleep. They were also more likely to experience nightmares and daytime tiredness.
By contrast, daytime viewing -- of age-appropriate, non-violent content -- was not linked with these problems (Garrison et al 2011).
Other research supports the idea that nighttime viewing is especially disruptive.
For instance, a study of 200 infants in Thailand found that watching television after 7pm reduced total nighttime sleep by 28 minutes (Vijakkhana et al 2015).
And when researchers in the UK interviewed more than 6600 kids between the ages of 11 and 12, they found that kids were more likely to get insufficient sleep if they watched television in the hour before bedtime (Mireku et al 2019).
Is nighttime viewing more problematic for children than it is for adults?
There's reason to think so.
First, children have more difficulty regulating their emotions. So it may be harder for them to calm down after viewing stimulating content.
Second, there is evidence that children are more sensitive than adults to the sleep-busting effects of artificial light, including the light emitted by television screens.
I've written extensively about these factors in my article "Tech at bedtime." So if you want to learn more about the evidence -- and what we can do to protect children's sleep -- be sure to check it out.
Interestingly, researchers haven't found that bedroom televisions affect sleep in adults (Custers and Van De Bulck 2012).
But for kids, it's another matter.
For instance, in Canada, China, the Netherlands, Singapore, Sweden, and the United States, children tend to get less sleep when there is a television in the bedrooms (Chahal et al 2013; Dube et al 2017; Li et al 2007; Gentile et al 2017; Sijtsma et al 2015; Garmy et al 2012; Falbe et al 2015; Owens et al 1999).
How much sleep loss are we talking about?
When researchers in the United States reviewed the sleep habits of more than 1400 kids between the ages of 4 and 7, they found that having a bedroom television was associated with an average of 38 minutes less sleep each night (Cespedes et al 2014).
The effect was smaller for children from higher socioeconomic backgrounds, but even after controlling for this factor, the impact of bedroom TVs remained substantial, with kids averaging 22 fewer minutes of sleep (Cespedes et al 2014).
And in a study of older kids -- more than two thousand 4th graders and 7th graders -- researchers found that possession of a bedroom television was linked with 18 fewer minutes of sleep each night (Falbe et al 2015).
There is also evidence linking bedroom televisions with specific sleep-related problems.
For example, Michelle Garrison and her colleagues (2011) found that preschoolers have more trouble falling asleep at bedtime if there is a TV in the bedroom -- a finding that other researchers have reported (Helm and Spencer 2019; Owens et al 1999).
And studies of toddlers (Brockman et al 2016), elementary school children (Li et al 2007), and young adolescents (11-13) have found links between bedroom televisions and the so-called parasomnias: Kids with bedroom TVs may be more likely to experience problems like night terrors, sleep walking, and sleep talking (Brockman et al 2016; Li et al 2007; Arora et al 2014).
These are good questions. Most studies rely on parental reports, and we know these reports aren't always accurate. In particular, it’s likely that parents underestimate how much time their kids spend watching TV, and overestimate how much time their kids spend sleeping.
But a recent study addresses at least some of the uncertainty.
Abigail Helm and Rebecca Spencer used parental reports to estimate children’s screen time. But they took a more objective, technological approach to estimating sleep time: The researchers fitted 470 preschoolers (between the ages of and 73 months) with wristwatch-style actigraphs.
These actigraphs record movement, and provide data that researchers
can use to distinguish between sleep-related movements and waking ones.
The result is a more accurate measure of sleep duration. What did the
actigraphs reveal in this case?
So this study supports the overall trends reported by studies based on parental reports. Television viewing is linked with shorter sleep duration and sleep-related problems.
Another good question.
Television isn't the only factor linked with worse sleep outcomes.
For instance, research suggests that kids sleep less and experience worse sleep quality when the live in financially-deprived neighborhoods (Bagely et al 2018). This might be caused by many things -- including greater exposure to traffic noise, neighborhood violence, and crowded living conditions.
If kids in such neighborhoods also tend to watch more TV, we'd expect to see a link between television viewing and sleep problems -- even if television itself wasn't to blame. So how can discover the truth?
How much do researchers control for? Not enough, not usually. Studies
make adjustment for a few, basic demographic variables, like age, sex,
race, and socioeconomic status.
But one study, led
by Marcella Marinella, conducted a much more extensive analysis.
In addition to the standard demographic variables, researchers controlled for several parental characteristics (including parental mental health status), as well as characteristics of the children (like how physically active they were, and whether they showed symptoms of attention-deficit/hyperactivity disorder).
making these adjustments, researchers still found the same links.
More television time was associated with shorter sleep duration.
Researchers are constrained in what they can do with experiments. Nobody is keen on randomly assigning a group of children to watch lots of television.
But Michelle Garrison and her colleague, Dimitri Christakis, got around the problem by tweaking the habits of children who were already watching TV on a regular basis.
The researchers recruited hundreds of families with preschool-aged children, and asked parents to report on their kids' current viewing habits. Many kids were watching TV that included violence and content inappropropriate for their developmental level.
So Garrison and Christakis randomly assigned families to one of two groups:
Six months later, the researchers questioned all parents about their children’s sleep experiences, and there was evidence of an effect.
Compared with parents in the nutritional control group, parents in the television intervention were less likely to report that their children had sleep problems (Garrison and Christakis 2012).
Here are some evidence-based tips.
Take a cue from the research of Garrison and Christakis. Monitor what your child watches, and make sure it's appropriate for his or her developmental level. Remember that young children find things disturbing that older people don't, and every child is unique. Tune into the emotions and sensitivities of your child.
Research suggests kids really do sleep more when parents set time limits on media use (Gentile et al 2014).
What limits to experts recommend?
the American Academy of Pediatrics (AAP) advises parents to
all use of screen media by babies under 18 months, with the exception of
online video chatting.
For kids between 2 and 5 years, the AAP advises parents to limit screen use to "one hour or less per day of high-quality programming" (Council on Communications and Media 2016).
As I note in my article, "Tech at bedtime," studies suggest that a one-hour electronic "blackout" before bedtime may help protect kids from sleep-busting effects of artificial light.
It's a big temptation, and one that you can't monitor. Put it somewhere else.
Research confirms that kids don't have to actively watch TV to be affected by it. Merely being around a switched-on TV is enough.
In a study of 5- and 6-year-olds, kids with more than two hours per day of passive exposure had nearly three times the odds of suffering sleep disturbances (Paavonen et al 2006). And kids faced similar elevated risks when they passively consumed content aimed at adults (Paavonen et al 2006).
So take passive viewing into account when you're tallying up total screen time, and watch out for content that is inappropriate for your child.
If we replace violent TV content with non-violent alternatives, won't children be bored or dissatisfied? Experiments suggest otherwise. Kids may actually prefer non-violent programming. Read more about this fascinating research in my article, "Television violence: Do kids (and adults) like it?"
Wondering about the effects of television on a young children's developing language skills? I've written about that too; you can read my analysis here.
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Content of "How television affects sleep" last modified 5/2019
Title image of girl watching TV from sofa cropped from a photo by Alex Pearson / flickr
image of sleeping teen with book by mrehan / flickr
image of boys watching TV together by Paul L Dineen / flickr
image of smiling child with beads by Ashley Campbell / flickr
image of infant with tablet by Steve Paine / flickr
image of moon at night by Tracy O / flickr
image of tv remote by Z Egloff / flickr