LAUSR

BACKGROUND The presence of small screens in the sleep environment has been associated with shorter sleep duration and later bedtimes in children of normal weight, but the role these devices play in the sleep environment of overweight children is unclear. We sought to examine the association of small screen presence in the sleep environment with sleep behaviors among school-age children with obesity. METHODS We surveyed 526 parents of children ages 6 to 12 years old with a body mass index ≥95th percentile who were participating in a randomized trial to treat childhood obesity. Twelve months after enrollment, parents were asked how frequently their child slept with or near a small screen (defined as a cellphone, smartphone, or texting/chat-capable device). We used multivariable linear regression to examine associations of the presence of small screens with sleep duration, waketime, and bedtime. RESULTS Compared with children who rarely/never slept with a small screen in their bedroom, children who did so 1 day or more per week had shorter sleep durations and later bedtimes. After we adjusted for television presence in the bedroom, small screen presence was still associated with shorter sleep duration (-9.9 minutes; P = .02) and later weekday (8.8 minutes; P = .03) and weekend (12.0 minutes; P = .03) bedtimes. CONCLUSIONS Children with obesity and a small screen present in their sleep environment have shorter sleep durations and later bedtimes than children who rarely/never sleep with a small screen. Pediatricians should consider inquiring about small screens in the bedroom when counseling on healthy sleep and weight management habits.