Social epidemiology of bedtime screen use behaviors and sleep outcomes in early adolescence

Objectives: The current study aimed to determine sociodemographic associations of bedtime screen use behaviors and the sociodemographic differences in the associations between bedtime screen use and sleep outcomes in a national (US) study of early adolescents. Methods: We analyzed cross-sectional data from 10,305 early adolescents (12-13 years, 48.4% female) in the Adolescent Brain Cognitive Development (ABCD) Study (Year 3, 2019-2021). Multiple regression analyses examined associations between (1) sociodemographic factors (age, sex, race and ethnicity, sexual orientation, household income, parental education, and number of siblings) and adolescent-reported bedtime screen use and (2) bedtime screen use and sleep outcomes (caregiver-reported sleep disturbance and self-reported sleep duration). Results: Older age, female sex, sexual minority status, lower household income, and lower parent education were associated with more bedtime screen use. Black, Native American, and Latino/Hispanic race/ethnicity were associated with more bedtime screen use compared with White race, regardless of household income or parent education. More bedtime screen use was linked to greater sleep disturbances, with stronger effects observed in male adolescents. More bedtime screen use was also associated with shorter sleep duration, particularly among female adolescents and individuals from households with higher income and parental education levels. Although sexual minority identification was associated with more bedtime screen use, it was not associated with worse sleep outcomes among these adolescents. Conclusions: Given sociodemographic differences in bedtime screen use, digital literacy education and anticipatory guidance could focus on at-risk early adolescent populations. Findings can inform targeted counseling by pediatricians and family media plans for diverse populations.