Associations of media use behaviors by types and content with sleep problems in Chinese adolescents.

Background: Electronic media has become integral to adolescents' daily lives, yet sleep problems remain a critical public health concern. This cross-sectional study investigated the associations between media use behaviors (by types and content) and sleep problems among Chinese adolescents, with a focus on school days, non-school days and their difference respectively.

Methods: A sample of 5194 adolescents from Shandong Province completed a questionnaire contained the Pittsburgh Sleep Quality Index (PSQI) and a media use behaviors scale. Multivariate logistic regression and restricted cubic spline models were used to analyze the associations.

Results: Excessive use (>120 min) of electronic media across all types and content on non-school days was significantly associated with sleep problems. Sex-specific associations emerged: online shopping was predominantly associated with females (school days >120 min: OR = 2.486, 95 % CI = 1.343-4.604), whereas online communication (non-school days >120 min: OR = 1.768, 95 % CI = 1.284-2.434) and leisure and entertainment (non-school days >120 min: OR = 2.116, 95 % CI = 1.381-3.241) were associated with males. Adolescents living off campus exhibited stronger associations between school-day media use behaviors and sleep problems. Nonlinear dose-response associations were observed for time differences in media use between school and non-school days.

Conclusions: The associations between media use behaviors and sleep problems differ by types and content. Based on these patterns, tailored interventions limiting specific media exposures and promoting balanced schedules may be considered to address sleep concerns in Chinese adolescents.