To examine the independent associations between sleep duration, four technology types (computer use, mobile telephones, TV viewing and video gaming) and body mass index (BMI) z-score. We propose a theoretical path model showing direct effects of four technology types on BMI z-score and sleep duration as well as the indirect effects of each technology on BMI z-score while considering sleep duration as a mediator.
Consenting adolescents (n=632; 63.9% girls, aged 11–18 years) were recruited to the Midlands Adolescent Schools sleep Education Study. The School Sleep Habits Survey (SSHS) and Technology Use Questionnaire (TUQ) were administered. Objective measures of height (cm) and weight (kg) were obtained for BMI z-score calculation.
Weekday use of all technology types was significantly associated with reduced weekday sleep duration after adjustment (β (computer use)=−0.38, P<0.01; β (mobile telephone)=−0.27, P<0.01; β (TV viewing)=−0.35, P<0.01; and β (video gaming)=−0.39, P<0.01). Use of all technology types, with the exception of mobile telephones, was significantly associated with increased BMI z-score after adjustment (β (computer use)=0.26, P<0.01; β (TV viewing)=0.31, P<0.01; and β (video gaming)=0.40, P<0.01). Our path model shows that weekday sleep duration was significantly and negatively associated with BMI z-score (β=−0.40, P<0.01).
Weekday sleep duration potentially mediates the effects of some technologies on BMI z-score. If confirmed, improving sleep through better management of technology use could be an achievable intervention for attenuating obesity.
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We are grateful to all the participating adolescents. All authors are affiliated to the University of Birmingham. The study received funding from Action Medical Research, Aim Higher, the Heart of England Foundation Trust and the University of Birmingham. Drs Taheri, Yao and Hussain received funding from the National Institute for Health Research (NIHR) through the Collaborations for Leadership in Applied Health Research and Care for Birmingham and Black Country (CLAHRC-BBC) programme. The views expressed in this publication are not necessarily those of the NIHR, the Department of Health, NHS Partner Trusts, University of Birmingham or the CLAHRC-BBC Theme 8 Steering Group. We thank Mona Campbell at the Heart of England Foundation Trust for excellent management support for the project. Participating schools were Ashby School, Bishop Vesey’s Grammar School, Hamstead Hall, Highclare School, Repton School and Sutton Coldfield Grammar School for Girls. We thank all teaching staff for their support, in particular Jane Taylor, Trudi Young, William Potter, Claire Horne, Lawrence Sneary, Ken Morris, Suzanne Gray and Dr Dawn Edwards. We also thank all parents who agreed for their children to participate and students who assisted with the project. This was not an industry-supported study.
The authors declare no conflict of interest.
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Arora, T., Hussain, S., Hubert Lam, KB. et al. Exploring the complex pathways among specific types of technology, self-reported sleep duration and body mass index in UK adolescents. Int J Obes 37, 1254–1260 (2013). https://doi.org/10.1038/ijo.2012.209
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