CONCLUSIONS AND RELEVANCE To date, this study is the first systematic review and
meta-analysis of the association of access to and the use of media devices with sleep
outcomes. Bedtime access to and use of a media device were significantly associated with the
following: inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness. An
integrated approach among teachers, health care professionals, and parents is required to
minimize device access at bedtime, and future research is needed to evaluate the influence of
the devices on sleep hygiene and outcomes.
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