More screen time, less sleep: What researchers observed in children with obesity

By Tarun Sai LomteReviewed by Susha Cheriyedath, M.Sc.Nov 2 2026

Researchers examined screen habits, sleep patterns, and metabolic health in 70 Spanish children, revealing intriguing differences in daily routines and an unexpected finding about diet quality.

Study: Screen time exposure, sleep alterations, and their relationship with excess weight in children and adolescents. Image Credit: Golubovy / Shutterstock

In a study appearing in the World Journal of Clinical Pediatrics, researchers examined the associations between sleep quality, screen exposure, and the prevalence of excess weight in children.

The prevalence of childhood obesity has substantially risen in recent years, representing a serious public health challenge. Play and structured exercise have traditionally occupied much of childhood, but the increasing use of tablets, smartphones, and other electronic devices has changed how many children spend their free time.

This exposure is linked to sedentary behaviors, a known risk factor for obesity. Screen use is also associated with disrupted sleep, another factor associated with excess weight. Because obesity’s metabolic complications emerge in childhood, investigating how lifestyle factors interact with its development is crucial.

About the study

The researchers compared recreational screen exposure and sleep characteristics between children with obesity and their normal-weight peers in a pediatric clinical population. Children eligible for recruitment were aged 3–15 years and attended a tertiary pediatric endocrinology clinic in Spain. The study excluded patients with underlying chronic diseases that could interfere with the study and those taking medications that affect sleep. Participants were categorized into two groups: normal weight and obesity. Blood samples were collected after a 12-hour overnight fast.

Thyroid-stimulating hormone, insulin, and cortisol were measured alongside fasting plasma glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), and liver function markers.

Researchers also calculated the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index. The Krece Plus questionnaire was administered to assess sedentary behaviors and physical activity; it also included items on recreational screen time exposure. The Mediterranean Diet Quality Index for children and adolescents (KIDMED) was used to evaluate dietary quality. Bioelectrical impedance analysis was performed to assess body composition.

A multidimensional questionnaire was administered, which encompassed sleep dimensions: habitual sleep onset time, duration, chronic sleep disorders and symptoms, and the age at onset and resolution of sleep disturbances. Differences between groups were tested using the chi-square or Wilcoxon-Mann-Whitney test. Logistic regression models were used to estimate odds ratios for sleep disturbances and obesity.

Findings

The study included 70 patients (50% female), with an average age of 10.8 years. Twenty-six children were of normal weight, while 44 were obese. Children with obesity had significantly higher body fat percentages and visceral fat area. More children with obesity had a family history of diabetes. Maternal educational attainment was also lower among children with obesity.

The obesity group had significantly higher systolic blood pressure, insulin, and HOMA-IR levels and lower HDL-C levels than children with normal weight. Other biochemical variables did not differ significantly between the two groups. The authors reported altered sleep quality in 14 children (20% of the full cohort), but chronic sleep disturbance data were available for only 55 participants. Among these 55 children, 14 (25.5%) experienced chronic sleep disturbances, affecting 8.3% of the normal-weight group and 39% of the obesity group.

Children with obesity slept for less time (8.4 h) than those with normal weight (9.1 h). A greater proportion of the obesity group (34%) had a very low diet quality compared to children with normal weight (19%). Conversely, a higher proportion of children with obesity (20.5%) had optimal KIDMED diet scores than the normal-weight group (3.8%). Further, 77% of the normal-weight group and 45% of the obesity group were on diets that needed improvement, respectively.

The obesity group had lower physical activity than the normal-weight group. Most children with normal weight (58%) engaged in high or moderate physical activity, compared with only 34% in the obesity group. Daily recreational screen time exposure was also significantly higher in the obesity group (2.9 h/day) than in children with normal weight (2.1 h/day). After adjustment for potential confounding factors, higher screen-time scores were associated with approximately threefold greater odds of obesity. The association between screen time and sleep disturbances did not reach statistical significance.

Conclusions

Children with obesity reported greater recreational screen exposure and shorter sleep duration than normal-weight children, alongside less favorable metabolic profiles. The higher proportion of optimal diet scores among children with obesity may reflect dietary changes after diagnosis, closer clinical monitoring, or reporting biases.

The study's limitations include its cross-sectional design, small sample size, and reliance on parent-reported sleep and screen habits rather than objective tracking. Recruitment from a specialized clinic also limits generalizability, and some potential confounders were unmeasured. 

The authors recommend addressing sleep hygiene and recreational screen use alongside dietary counseling, but the findings cannot establish causality or demonstrate that changing these behaviors reduces obesity.