Digital Devices Use and Sleep in Adolescents: An Umbrella Review
Abstract
1. Introduction
2. Materials and Methods
2.1. Umbrella Review Methods
2.2. Search Strategy
2.3. Eligibility Criteria
2.4. Data Extraction
2.5. Overlap
2.6. Assessment of Methodological Quality of Included Studies
2.7. Evaluation of the Strength of Evidence
3. Results
3.1. Study Selection
3.2. Characteristics and Methodological Quality of the Included Studies
3.3. Effects of Digital Device Use on Adolescent’s Sleep by Device Type and Activity
3.3.1. Total Sleep Duration
General Digital Screen
Smartphone
Television
Computer
Social Media
Internet Use
Video Games
3.3.2. Bedtime Procrastination
General Digital Screens
Smartphone
Computer
Television
Video Games
Internet Use
3.3.3. Sleep Quality
General Digital Screens
Smartphone
Television
Computer
Social Media
Internet Use
Video Game
4. Discussion
Strength and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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First Author, Year | Study Methodology | Objective | Database Searched | Publication Date Range | Number and Study Design | Number and Country | Total Participants | Sex | Age (Years) |
---|---|---|---|---|---|---|---|---|---|
Bartel, 2015 [28] | Meta-Analysis | Investigating the correlation between video gaming, phone, computer and internet use and evening lighting with late going to sleep | ProQuest Central Flinders University search engine Sage PubMed Google Scholar | 2005–2014 | 17 15 cross-sectional, 2 non-RCT. | USA (4) Japan (3) Sweden (2) Australia (2) England (1) Germany (1) Spain (1) Belgium (1) Israel (1) Taiwan (1) | 43,340 | F 57.7% | Means from 12.2 to 16.9 |
Kokka, 2021 [29] | Systematic review | Investigating the impact of problematic internet use on adolescent sleep | PubMed, Scopus | 2009–2020 | 12 12 cross-sectional. | Asia (11) Europe (1) | 18,987 | F 50.6% | Mean 15.6 |
Lund, 2021 [30] | Systematic review | Investigating the effects of electronic media use on sleep in children and adolescents | CINAHL, Web of Science, EMBASE, Medline | 2009–2019 | 23, 7 cohort, 14 cross-sectional, 1 non-RCT, 1 RCT. | USA (5), England (2), Australia (2), Finland (2), Netherlands (2), Germany (2), Switzerland (2), Sweden (1), Spain (1), Canada (1), Finland (1), France (1), Denmark (1). | 467,202 | Not reported | Min 13, max 15 |
da Silva, 2022 [31] | Systematic review | Investigating the impact of digital screen use on adolescents’ sleep quality | MEDLINE, PubMed, ILACS, SciELO, Scopus, EMBASE, Web of Science, IBECS, Cochrane Library ClinicalTrials.gov, Open Gray | 2011–2020 | 23 3 cohort, 20 cross-sectional. | UK (3), China (2), USA (2), Brazil (2), South Korea (2), Spain (2), Chile (1), France (1), Iran (1), Iceland (1), Japan (1), Lebanon (1), Slovakia (1), Switzerland (1), Turkey (1), New Zealand (1). | 153,352 | Not reported | Min 10, max 19 |
Dibben, 2023 [32] | Systematic review | To assess the association between adolescents’ interactive electronic device use with sleep outcomes, and the role of sleep as a mediator or mechanism between screen time and mental health and well-being outcomes | CINAHL, EBSCO, EMBASE, Medline, Web of Science, IBSS, ASSIA | 2014–2022 | 28 16 cohort, 8 cross-sectional, 1 non-RCT, 3 RCT. | Australia (7), USA (6), Korea (3), Switzerland (3), Netherlands (1), Finland (1), Canada (1), Japan (1), Taiwan (1), New Zealand (1), Germany (1). | 47,247 | F 52.0% | Median of means: 14.8, Min 10, max 19 |
Pagano, 2023 [33] | Meta-Analysis | Study the relationship between different aspects of digital media use and sleep health pattern | Web of Science, Scopus, PsycINFO, PsycArticles, PubMed, MEDLINE, ERIC, ProQuest, Dissertations and Theses, and GreyNet | 2012–2023 | 23 12 Cohort, 10 cross-sectional, 1 non RCT | USA (7) Netherlands (3) Switzerland (3) Germany (2) China (2) Finland (1) Iran (1) Taiwan (1) 1Kuwait (1) Iceland (1) Korea (1) | 116,431 | F 53.2% | Mean 13.4, Standard Deviation 1.8 Min 9.6, max 16.5 |
Gale, 2025 [34] | Systematic review | Examining determinants of poor sleep quality in adolescents | MEDLINE, EMBASE, Ovid, Web of Science, Scopus, PsychInfo, CINAHL, Cochrane Library | 2014–2023 | 7 5 cross-sectional, 1 longitudinal, 1 cohort | UK (2) Canada (1) India (1) Australia (1) Norway (1) Iran (1) | 21,205 | F 50.9% | Means from 10.0 ± 0.4 to 15.0 ± 1.3 |
Study, Year | Total Sleep Duration | Quality Assessment (AMSTAR 2) and Strength of Evidence * (GRADE) | Bedtime Procrastination | Quality Assessment (AMSTAR 2) and Strength of Evidence * (GRADE) | Sleep Quality | Quality Assessment (AMSTAR 2) and Strength of Evidence * (GRADE) |
---|---|---|---|---|---|---|
Bartel, 2015 [28] | Computer use r = −0.157 (4 **) Internet use r = −0.087 (5) Phone use r = −0.104 (7) Television r = −0.590 (10) Videogames r = −0.059 (8) | Very low confidence Low strength | Computer use r = 0.40 (1) Internet r = 0.080 (3) Phone use r = 0.039 (2) Television r = 0.010 (6) Videogames r = 0.031 (8) | Very low confidence Low strength | Not applicable | Not applicable |
Kokka, 2021 [29] | Problematic internet use: negative association (6) | Low confidence Moderate strength | Problematic internet use: positive association (2) | Low confidence Moderate strength | Problematic internet use or excessive internet use: negative association (7) | Low confidence Moderate strength |
Lund, 2021 [30] | Computer/internet: negative association (5) Smartphone: negative association (3) Social media: negative association (1), no association (1) Television: negative association (1), positive association (1), no association (2) Total screen time: negative association (6), no association (2) Videogames: negative association (1) no association (2) | Low confidence Moderate strength | Computer/internet: positive association (1), no association (1) Digital screens use: positive association (9) Smartphone: positive association (1), no association (2) Social media: positive association (2) no association (1) Television: no association (2) Total screen time: positive association (5) no association (1) Video games: no association (1), positive (1), and negative association (1) | Low confidence Moderate strength | Computer/internet: no association (2) Smartphone: no association (3) Social media: negative association (3) Television: no association (2) Total screen time: negative association (2), no association (4) Video games: no association (1) | Low confidence Moderate strength |
da Silva, 2022 [31] | Computer: negative association (1) Digital screens use: negative association (19) Internet use: negative association (2) Online games: negative association (1) Smartphone: negative association (5) Social media: negative association (1) Television: negative association (4) Total screen time: negative association (3), no association (1) Video games: negative association (3) | Moderate confidence Moderate strength | Digital screens use at bedtime: positive association (1) Internet use: positive association (1) Smartphone: positive association (2) Social media: positive association (2) Total screen time: positive association (3) | Moderate confidence Moderate strength | Digital screens use (10) Internet use: negative association (1) Smartphones: negative association (7) Television: negative association (1) Total screen time: positive association (4) Video games: negative association (1) | Moderate confidence Moderate strength |
Dibben, 2023 [32] | Videogames: no association (2), negative association (1) Smartphone: no association (3), negative association (2) Social media use: no association (1) Tecnology use: no association (1) | Moderate confidence Moderate strength | Digital screens evening use: positive association (1) Digital screens use: no association (1), positive association (1) Problematic internet use: positive association (1) Smartphone use at bedtime: positive association (2) Social media: positive association (1) Videogames: No association (1), positive association (5) | Moderate confidence Moderate strength | Computer use: positive association (1) Digital screens use: no association (1) Smartphones: no association (1), positive association (1) Smartphone use at bedtime: positive association (3) Social media: positive association (2) Videogames: no association (1) | Moderate confidence Moderate strength |
Pagano, 2023 [33] | Digital screens use at bedtime: weak association (1); Problematic internet use: small association (1) Social media use: no association (1), moderate association (1) Total screen time: no association (2), weak association (1), moderate association (2); Videogames: no association (2), positive association (1) | Moderate confidence Moderate strength | Digital screens use: positive association (1) Social media: no association (2), positive association (1) Total screen time: no association (1), positive association (1) | Moderate confidence Moderate strength | Total screen time: no association (1), small association (1) Social media: no association (1) Problematic use: no association (1) | Moderate confidence Moderate strength |
Gale, 2025 [34] | Screen time: negative association (1) | Moderate confidence Moderate strength | Videogames: positive association (1) Screen time: positive associaton (2) | Moderate confidence Moderate strength | Internet use: negative association (1) Screen time: negative association (1) High number of screens: negative association (1) | Moderate confidence Moderate strength |
Device/Activity | Outcome | Direction of Association | Strength/Consistency of Evidence | Notes |
---|---|---|---|---|
Smartphone (general use) | Sleep quality | Negative | High consistency, moderate certainty | Stronger effect with bedtime or late-night use |
Smartphone (bedtime use) | Bedtime procrastination | Positive | High consistency, moderate certainty | Linked to later sleep onset and reduced sleep duration |
Problematic internet use | Sleep quality and duration | Negative | High consistency, moderate certainty | Dose–response relationship observed |
Social media (problematic use) | Sleep quality | Negative | High consistency, moderate certainty | Higher impact with interactive engagement |
General screen time (bedtime use) | Bedtime procrastination | Positive | High consistency, moderate certainty | Effect stronger when multiple devices are used |
Computer use | Sleep duration | Negative | Moderate consistency, low–moderate certainty | Effect size smaller than smartphones |
Television | Sleep outcomes (all) | Mixed/weak | Low consistency, low certainty | Weaker associations than interactive devices |
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Fiore, M.; Arena, D.; Crisafi, V.; Grieco, V.; Palella, M.; Timperanza, C.; Conti, A.; Cuffari, G.; Ferrante, M. Digital Devices Use and Sleep in Adolescents: An Umbrella Review. Int. J. Environ. Res. Public Health 2025, 22, 1517. https://doi.org/10.3390/ijerph22101517
Fiore M, Arena D, Crisafi V, Grieco V, Palella M, Timperanza C, Conti A, Cuffari G, Ferrante M. Digital Devices Use and Sleep in Adolescents: An Umbrella Review. International Journal of Environmental Research and Public Health. 2025; 22(10):1517. https://doi.org/10.3390/ijerph22101517
Chicago/Turabian StyleFiore, Maria, Desiree Arena, Valentina Crisafi, Vittorio Grieco, Marco Palella, Chiara Timperanza, Antonio Conti, Giuseppe Cuffari, and Margherita Ferrante. 2025. "Digital Devices Use and Sleep in Adolescents: An Umbrella Review" International Journal of Environmental Research and Public Health 22, no. 10: 1517. https://doi.org/10.3390/ijerph22101517
APA StyleFiore, M., Arena, D., Crisafi, V., Grieco, V., Palella, M., Timperanza, C., Conti, A., Cuffari, G., & Ferrante, M. (2025). Digital Devices Use and Sleep in Adolescents: An Umbrella Review. International Journal of Environmental Research and Public Health, 22(10), 1517. https://doi.org/10.3390/ijerph22101517