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已发表论文
幼儿过度使用电子屏幕与情绪及行为问题相关，且睡眠紊乱起中介作用
Authors You Y, Chen Y, Shang J, Tan L, Yu M, Wu Y, Li B, Guo P, Zhang Q
Received 26 June 2025
Accepted for publication 12 October 2025
Published 21 October 2025 Volume 2025:17 Pages 2757—2770
DOI https://doi.org/10.2147/NSS.S549178
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Valentina Alfonsi
Yingbin You,1,* Yuhui Chen,2,* Jianhui Shang,2 Leyun Tan,2 Mingtao Yu,2 Yueyang Wu,2 Boya Li,2 Pi Guo,2 Qingying Zhang2
1Department of Administrative, Affiliated Hospital Group of Guangdong Medical University Shenzhen Baoan Central Hospital (Baoan Central Hospital of Shenzhen), Shenzhen, Guangdong, People’s Republic of China; 2Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Qingying Zhang, Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, People’s Republic of China, Tel +86-754-88900445, Fax +86-754-88566774, Email qyzhang@stu.edu.cn
Objective: We examined whether excessive screen time (ST) is associated with emotional and behavioral problems (EBPs) in young school children mediated by sleep disturbance.
Methods: This was a cross-sectional survey of 3883 children aged 7– 9 years at 18 primary schools in Shenzhen. Data on children’s ST on weekdays and weekends as well as household environment, parental ST, and parental accompaniment time were collected. Sleep disturbance and EBPs were assessed with the Sleep Disturbance Scale for Children and the Strengths and Difficulties Questionnaire (SDQ), respectively. Odds ratios (ORs) and 95% confidence intervals (CIs), the average causal mediation effects and the average direct effects were estimated.
Results: Overall, 15.7% of children had ST in excess of the recommended 2 hr/day, and 24.1% of parents reported that their child had a sleep disturbance. The total SDQ score was higher for children with than without ST ≥ 2 hr/day and sleep disturbance (P< 0.001). After adjustment for potential confounders, children with ST ≥ 2 hours/day had increased odds of sleep disturbances (OR 1.99, 95% CI 1.65– 2.33). The odds of EBPs were increased for children with ST ≥ 2 hr/day (OR 1.34, 95% CI 1.11– 1.64) and sleep disturbance (OR 2.77, 95% CI 2.23– 3.22). Mediation analysis indicated that sleep disturbance partially explained the association between ST and EBPs (all effects statistically significant, P < 0.001).
Conclusion: Excessive ST was significantly associated with EBPs and may be mediated by sleep disturbance. Reducing children’s ST and encouraging good sleep practices may enhance mental health.
Keywords: children, electronic products, sleep, emotional and behavioral problem
1Department of Administrative, Affiliated Hospital Group of Guangdong Medical University Shenzhen Baoan Central Hospital (Baoan Central Hospital of Shenzhen), Shenzhen, Guangdong, People’s Republic of China; 2Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Qingying Zhang, Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, People’s Republic of China, Tel +86-754-88900445, Fax +86-754-88566774, Email qyzhang@stu.edu.cn
Objective: We examined whether excessive screen time (ST) is associated with emotional and behavioral problems (EBPs) in young school children mediated by sleep disturbance.
Methods: This was a cross-sectional survey of 3883 children aged 7– 9 years at 18 primary schools in Shenzhen. Data on children’s ST on weekdays and weekends as well as household environment, parental ST, and parental accompaniment time were collected. Sleep disturbance and EBPs were assessed with the Sleep Disturbance Scale for Children and the Strengths and Difficulties Questionnaire (SDQ), respectively. Odds ratios (ORs) and 95% confidence intervals (CIs), the average causal mediation effects and the average direct effects were estimated.
Results: Overall, 15.7% of children had ST in excess of the recommended 2 hr/day, and 24.1% of parents reported that their child had a sleep disturbance. The total SDQ score was higher for children with than without ST ≥ 2 hr/day and sleep disturbance (P< 0.001). After adjustment for potential confounders, children with ST ≥ 2 hours/day had increased odds of sleep disturbances (OR 1.99, 95% CI 1.65– 2.33). The odds of EBPs were increased for children with ST ≥ 2 hr/day (OR 1.34, 95% CI 1.11– 1.64) and sleep disturbance (OR 2.77, 95% CI 2.23– 3.22). Mediation analysis indicated that sleep disturbance partially explained the association between ST and EBPs (all effects statistically significant, P < 0.001).
Conclusion: Excessive ST was significantly associated with EBPs and may be mediated by sleep disturbance. Reducing children’s ST and encouraging good sleep practices may enhance mental health.
Keywords: children, electronic products, sleep, emotional and behavioral problem