Sleep Duration Does Not Mediates the Association between Screen Time and Adolescent Depression and Anxiety: Findings from the 2018 National Survey of Children’s Health

Abstract Objective/Background Adolescence is a crucial time period in which individuals are at high risk for depression and anxiety. Associations between screen time and adolescent depression and anxiety have been inconclusive. We examined 1) the associations of screen time with adolescent depression and anxiety and 2) whether sleep duration mediates these relationships. Methods This study utilized data from the 2018 U.S. National Survey of Children’s Health, a large cross-sectional population representative dataset with parent/caregiver responses. Multivariable logistic regression was used to estimate the associations between screen time and depression and anxiety in separate models. Path models were used to test the mediating role of sleep duration. Confounders, as sex, age, and sociodemographic variables were included in our adjusted models. Results Data of 10,907 adolescents aged 13 to 17 were included in this study. The average screen time was 3.76 hours daily. Compared to no screen time, adolescents who used over 4 hours of screen time per day had higher odds of depression (OR=2.23, 95% CI:1.27 – 3.91) and anxiety (OR=1.85, 95% CI: 1.26 - 2.72). Sleep duration did not mediate the associations between screen time and depression and anxiety. Conclusions Further research is necessary to examine the associations of screen time content with depression and anxiety, as well as the effects of sleep quality in conjunction with sleep duration on the relationships of screen time and depression and anxiety.