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Letter to the Editor: Is poor sleep, and loneliness linked by increased use of technology?

Published online by Cambridge University Press:  03 August 2017

B. Carter*
Affiliation:
Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK Cochrane Skin Group, School of Medicine, Nottingham University,Nottingham, Nottinghamshire,UK
*
*Address for correspondence: Dr B. Carter, Ph.D., Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; Cochrane Skin Group, School of Medicine, Nottingham University, Nottingham, Nottinghamshire, UK. (Email: ben.carter@kcl.ac.uk)
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Abstract

Type
Correspondence
Copyright
Copyright © Cambridge University Press 2017 

Using data from a UK nationally-representative cohort, Matthews and colleagues found that young adults who report feeling lonely were also likely to report poor sleep (Matthews et al. Reference Matthews, Danese, Gregory, Caspi, Moffitt and Arseneault2017).

The researchers were able to attribute the findings to individual experiences of loneliness and account for shared environmental exposures and genetic factors between the twins by examining differences in loneliness and sleep between monozygotic twins. In a second key finding, it was reported that exposure to victimisation moderated the association between loneliness and sleep quality. Whilst the effects found were modest, they appeared robust, even if no casual effect could be determined; however, they did find a dose–response relationship between reduced sleep and increased level of victimisation.

It is already known that that the link between loneliness and sleep is not accounted for by: depression; BMI; or other health-related behaviours (Cacioppo et al. Reference Cacioppo, Hawkley, Berntson, Ernst, Gibbs, Stickgold and Hobson2002; Hawkley et al. Reference Hawkley, Preacher and Cacioppo2010). Furthermore, not all children who were lonely suffered from poor sleep, so draws debate to the potential moderating factors. The researchers established that individuals exposed to victimisation experienced greater loneliness and poor sleep, and this was exacerbated by severe victimisation. Whilst this study controlled for many confounders and moderators one of the few individual widespread exposures not able to be controlled for in this study was the use of screen-based technology (herein defined as device use). There is already an argument that the effect of loneliness is associated with both increased device use, and poorer sleep, as bored children turn to their device for companionship (Carter et al. Reference Carter, Ree, Hale, Bhattacharjee and Paradkar2016; Lleras & Panova, Reference Lleras and Panova2016; Ndasauka et al. Reference Ndasauka, Hou, Wang, Yang, Yang, Ye, Hao, Fallgatter, Kong and Zhang2016). Health consequence may follow in the extreme cases, as highlighted by Henry David Thoreau who wrote that the problems that arise when people become ‘tools of their tools’ and today many children are addicted to their device (Thoreau, Reference Thoreau1864). The consequence of heavy usage has already been linked to loneliness (Cacioppo et al. Reference Cacioppo, Hawkley, Berntson, Ernst, Gibbs, Stickgold and Hobson2002) as well as a multitude of poorer health outcomes, including loss of sleep, and poorer physical and mental health (Gradisar et al. Reference Gradisar, Wolfson, Harvey, Hale, Rosenberg and Czeisler2013; Owens & Committee a ASWG, Reference Owens2014). It has been reported that greater loneliness traits have been reported in those children with the greatest intensity of device usage (Ndasauka et al. Reference Ndasauka, Hou, Wang, Yang, Yang, Ye, Hao, Fallgatter, Kong and Zhang2016). Recent evidence has pointed to device use (or merely access) being linked to poorer sleep quantity, and quality, even when the device are not being used, but were present in the bedroom.

It has been argued that evening device use led to cognitive engagement, linked with poorer sleep (Carter et al. Reference Carter, Ree, Hale, Bhattacharjee and Paradkar2016), and a possible cause of the loneliness (Cacioppo et al. Reference Cacioppo, Hawkley, Berntson, Ernst, Gibbs, Stickgold and Hobson2002; Carter et al. Reference Carter, Ree, Hale, Bhattacharjee and Paradkar2016). Examples of engagement may be wide ranging from: peer engagement in social media; anticipation; fear of missing out; or in extreme cases cyber bullying; or victimisation, as highlighted by Matthews et al. (Reference Matthews, Danese, Gregory, Caspi, Moffitt and Arseneault2017).

Whilst the overriding net effect of technology on our lives is positive, it is not without consequence (Lleras & Panova, Reference Lleras and Panova2016; Ndasauka et al. Reference Ndasauka, Hou, Wang, Yang, Yang, Ye, Hao, Fallgatter, Kong and Zhang2016). There is limited guidance on media device use by the American Academy of Pediatrics (Chassiakos et al. Reference Chassiakos, Radesky, Christakis, Moreno and Cross2016; Hill et al. Reference Hill, Ameenuddin, Chassiakos, Cross, Radesky, Hutchinson, Boyd, Mendelson, Moreno, Smith and Swanson2016), but it needs development and translation into practical implementation for parents and schools. Since harmful use of technology by children would be seen by teachers, as the first to notice the signs and symptoms of daytime sleepiness, or withdrawal due to loneliness or victimisation.

I conclude, there is need to differentiate between our devices, and our relationships, that education on the short-term consequences of device is warranted. We need to recognise chronic sleep deprivation sooner, and explore the cause, if for no other reason to rule out screen-based addiction and victimisation.

Acknowledgement

We acknowledge the support of The National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London.

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