Screen time and sleep duration in pediatric critical care: Secondary analysis of a pilot observational study.

The analysis included only eight children, all aged 1 to 4 years, mostly under 2 years, with low illness severity and no invasive ventilation, so it says little about older or sicker PICU patients. Screen time was defined broadly as electronic media in the room, even if the child was asleep or not watching, so high screen time does not mean the child was actively using screens. Video coding was difficult when screens, faces, or audio were not visible, and child engagement could not be determined in 20.6% of sampling intervals. The 5-minute sampling method may have missed short periods of engagement or co-viewing. Actigraphy can overestimate total sleep time in critically ill children because they move little. Some observation hours were missing, and one child removed the sleep band for 2.7 hours. This was a secondary analysis of a pre-existing dataset, so parents were not interviewed about home screen use, and the direction of any relationship cannot be determined. Race and home-condition differences rested on very small subgroups, including 3 Black and biracial children and 2 children with pre-existing conditions, and did not account for household income.

Do not conclude that screen time caused poor sleep or that children were actively watching for 10.7 hours. The study was observational, included only eight children, and screen time was defined as electronic media present in the room even when the child was not engaged.