TY  - JOUR
AU  - Varghese, Nirosha Elsem
AU  - Santoro, Eugenio
AU  - Lugo, Alessandra
AU  - Madrid-Valero, Juan J
AU  - Ghislandi, Simone
AU  - Torbica, Aleksandra
AU  - Gallus, Silvano
PY  - 2021
DA  - 2021/1/21
TI  - The Role of Technology and Social Media Use in Sleep-Onset Difficulties Among Italian Adolescents: Cross-sectional Study
JO  - J Med Internet Res
SP  - e20319
VL  - 23
IS  - 1
KW  - sleep-onset difficulties
KW  - adolescents
KW  - social media
KW  - electronic device use
AB  - Background: The use of technology and social media among adolescents is an increasingly prevalent phenomenon. However, there is a paucity of evidence on the relationship between frequency of use of electronic devices and social media and sleep-onset difficulties among the Italian population. Objective: The aim of this study is to investigate the association between the use of technology and social media, including Facebook and YouTube, and sleep-onset difficulties among adolescents from Lombardy, the most populous region in Italy. Methods: The relationship between use of technology and social media and sleep-onset difficulties was investigated. Data came from the 2013-2014 wave of the Health Behavior in School-aged Children survey, a school-based cross-sectional study conducted on 3172 adolescents aged 11 to 15 years in Northern Italy. Information was collected on difficulties in falling asleep over the last 6 months. We estimated the odds ratios (ORs) for sleep-onset difficulties and corresponding 95% CIs using logistic regression models after adjustment for major potential confounders. Results: The percentage of adolescents with sleep-onset difficulties was 34.3% (1081/3151) overall, 29.7% (483/1625) in boys and 39.2% (598/1526) in girls. It was 30.3% (356/1176) in 11-year-olds, 36.2% (389/1074) in 13-year-olds, and 37.3% (336/901) in 15-year-olds. Sleep-onset difficulties were more frequent among adolescents with higher use of electronic devices, for general use (OR 1.50 for highest vs lowest tertile of use; 95% CI 1.21-1.85), use for playing games (OR 1.35; 95% CI 1.11-1.64), use of online social networks (OR 1.40 for always vs never or rarely; 95% CI 1.09-1.81), and YouTube (OR 2.00; 95% CI 1.50-2.66). Conclusions: This study adds novel information about the relationship between sleep-onset difficulties and technology and social media in a representative sample of school-aged children from a geographical location that has not been included in studies of this type previously. Exposure to screen-based devices and online social media is significantly associated with adolescent sleep-onset difficulties. Interventions to create a well-coordinated parent- and school-centered strategy, thereby increasing awareness on the unfavorable effect of evolving technologies on sleep among adolescents, are needed. 
SN  - 1438-8871
UR  - http://www.jmir.org/2021/1/e20319/
UR  - https://doi.org/10.2196/20319
UR  - http://www.ncbi.nlm.nih.gov/pubmed/33475517
DO  - 10.2196/20319
ID  - info:doi/10.2196/20319
ER  -