The Negative Impacts of Excessive Screen-Time

Computers, tablets, smartphones, smartwatches, game consoles, television of all shapes and sizes - digital screens keep us engaged all day long. With the advent of e-learning, telecommunicating, social media, and the different forms of digital entertainment, our screen-time has grown exponentially.  Social distancing and quarantine measures have only magnified our digital attachment, raising the question: How much is too much? 

What are the negative impacts of excessive screen-time?

Sleep

Our circadian rhythm, or sleep-wake cycle, is controlled by the pineal gland, which secretes melatonin.  Light exposure, for example by smartphone screens, suppresses melatonin secretion, while audible alerts from mobile devices triggers the sympathetic (fight or flight) nervous system.  A negative feedback loop develops, where stimulation by devices interrupts the normal sleep cycle; sleep deprivation leads to daytime fatigue, which encourages more sedentary technology usage.

Normally, cortisol levels drop at night, and rise and stay sustained in the morning hours. Evening screen time alters this diurnal cortisol cycle, often producing daytime fatigue.

Behavioral/Psychological Effects

Perhaps most concerning are the behavioral and psychologic effects of excessive technology use.  Inadequate quality and quantity of sleep has been shown to be directly correlated with depression, and other forms of mental illness.

Attention deficit disorder has also been linked to excessive use of screens, especially with videogaming has been linked to attention deficit disorder. Children with low attention spans and impulsivity tend to respond to the fast pace of the games and immediate reward systems.  Over time, screen use (particularly with violent content) tends to encourage hyperactivity, while decreasing empathy and self-control. 

Visual System

Prolonged periods of staring at a screen can cause eye fatigue (from both prolonged focusing and convergence requirements) and dry eyes (mainly from reduced frequency and effectiveness blinking).  Headaches may result both from convergence effort as well as accommodative (focusing) requirements. 

Cardiovascular Health

The sedentary lifestyle resulting from greater usage of technology (particularly prolonged videogaming) is a risk factor for obesity, hypertension, diabetes, lower HDL (good cholesterol) levels, and cardiovascular disease. A recent study published in The Lancet Child & Adolescent Health, reported that children with over three hours/day of screen usage at ages two to three were less physically active at age five than age-matched children who used screens for less than an hour daily. (REF)

Orthopedics

Prolonged technology use has been associated with poor cervicospinal posture, loss of bone density (from sedentary lifestyle) and repetitive motion injuries of the wrist and arms (particularly with videogaming). 

Tips to Managing Screen-Time?

The American Academy of Ophthalmology recommends taking a break from screens every twenty minutes for twenty seconds. Changing focus from constant near work to distance can also help with ocular strain and fatigue.

Regular use of artificial tears periodically throughout screen use reduces dry eyes.  

Kids should be encouraged to participate in other activities such as traditional reading, picking up a new hobby, board games, exercise, or even imaginative play. 

Three good rules: avoid technology use during family meals to encourage and develop socialization skills in children; utilize “dark mode” or screen-dimming apps like F.lux (REF) after sundown; turn off screens sixty minutes before bedtime. 

Alina Bystritskaya, COT

(Reviewed by Benjamin H. Ticho, MD)