Sleep Research: A Primer for Media Scholars.

The average amount of sleep people of all ages get has declined sharply in the past 50 years. The detrimental health effects of sleep deprivation are well documented and substantial. Even though electronic media use often takes place in the hours before sleep, the extent to which media use may interact with sleep is understudied and not well understood. Communication scholars are well positioned to contribute to this area, as a systematic, theoretical understanding of the relationship between media and sleep is still lacking. This primer charts the state of knowledge on electronic media and sleep and explores possible next steps. First, we introduce the problem of sleep deprivation and describe the basic science of sleep with relevant terminology. Then, we review the research on electronic media and sleep and offer an agenda for research.

Sleep latency versus shuteye latency: Prevalence, predictors and relation to insomnia symptoms in a representative sample of adults.

Shuteye latency (SEL) refers to the time spent performing activities in bed before attempting sleep. This study investigates (a) the prevalence, duration and predictors of SEL, (b) its association with insomnia symptoms (sleep onset latency [SOL], sleep quality and fatigue), and (c) the activities engaged in during SEL. A representative sample of 584 adults (18-96 years old) participated in an online survey. Respondents reported their SEL on weekday nights (Sunday to Thursday) and weekend nights (Friday and Saturday), and activities during SEL. One in five adults tried to sleep immediately at bedtime. Around 16% of respondents were awake >30 min on both weekday and weekend nights. Younger people and those with an eveningness preference reported longer SEL. Longer SEL corresponded with a progressive decline in sleep quality, increased SOL and more fatigue. Those with an SEL >30 min reported using both passive (e.g. television) and interactive (e.g. smartphone) media more frequently than respondents with an SEL < 30 min, but there was no difference between the groups for non-screen-related activities. Implications of SEL for measurements commonly used in sleep research are discussed. Shuteye latency may be symptomatic of how a modern lifestyle puts increasing pressure on sleep, but may also reveal a previously undocumented behaviour associated with insomnia symptoms.

Casual Sexual Scripts on the Screen: A Quantitative Content Analysis.

While existing content analyses have provided insightful information in terms of contextual factors and frequency of sexual behaviors, not much is known about the relational context in which sexual depictions generally occur. The current study addresses this void by employing content analytic methods to measure the frequency and context of depictions of sexual behavior within nine popular television shows produced in the U.S., while taking into account the type of sexual behavior. The results suggest that, in the analyzed television shows, sexual behaviors within a casual sexual context were almost as frequently shown as sexual behaviors within a committed relationship context. Whereas sexual behaviors within a committed relationship context were mainly limited to passionate kissing, sexual behaviors within a casual sexual context mostly consisted of explicit portrayals of sexual intercourse. Additionally, genre seemed to be an important factor when examining casual sexual television content. The situational comedy genre, for example, had no explicit portrayals of intercourse and mainly portrayed kissing couples within a committed relationship. The comedy drama genre, on the contrary, had the largest proportion of explicit sexual portrayals, usually between casual sexual partners. A second goal of this study was to analyze the portrayals of the typical casual sexual experience script and the typical casual sexual relationship script in which these sexual behaviors often occur. For instance, our analyses revealed that female characters were more likely to initiate casual sex compared to male characters. Moreover, casual sex often occurred between former partners.

Cancer-Diagnosed Individuals' Use of Television and the Internet as a Source for Peer Stories and Associated Emotional Responses.

When people are confronted with a potentially life-threatening disease such as cancer, they are likely to feel an urgent need for information about the disease and support from peers. Studies have shown that the mass media contain a lot of experiential information (i.e., peer stories) about cancer, either from real individuals or from fictional characters. To date, most studies have focused on using the Internet for peer support. This study aimed to extend this line of research by investigating (1) whether cancer-diagnosed individuals use both television and the Internet to access peer stories, (2) whether exposure to these stories results in different emotional outcomes, and (3) whether this differs depending on gender. A cross-sectional survey among 621 cancer-diagnosed individuals in Flanders (Belgium) showed that both television and the Internet were used as a source for following peer stories. Respondents indicated feeling fearful and concerned when following peer stories on entertainment television, but following peer stories on online forums was associated with feeling supported. These different emotional responses could be the result of the differences between these two content categories (i.e., fictional versus non-fictional peer stories). Future research should further examine these relationships by investigating the role of mass media content and how different psychological coping styles and personality traits moderate these associations.

Bedtime, shuteye time and electronic media: sleep displacement is a two-step process.

This study argues that going to bed may not be synonymous with going to sleep, and that this fragmentation of bedtime results in a two-step sleep displacement. We separated bedtime (i.e. going to bed) from shuteye time (i.e. attempting to go to sleep once in bed) and assessed the prevalence of electronic media use in both time slots. A convenience sample of 338 adults (aged 18-25 years, 67.6% women) participated in an online survey. Results indicated a gap of 39 min between bedtime and shuteye time, referred to as 'shuteye latency'. Respondents with a shuteye latency of, respectively, ≤30 min, ≤1 or >1 h, were 3.3, 6.1 and 9.3 times more likely to be rated as poor sleepers compared to those who went to sleep immediately after going to bed. Before bedtime, volume of electronic media use (17 h 55 min per week) was higher than non-media activities (14 h per week), whereas the opposite was true after bedtime (media = 3 h 41 min, non-media = 7 h 46 min). Shuteye latency was related exclusively to prebedtime media use. Findings confirmed the proposed fragmentation of bedtime. Sleep displacement should therefore be redefined as a two-step process, as respondents not only engage in the delay of bedtime, but also in the delay of shuteye time once in bed. Theoretical, methodological and practical implications are discussed.

The Use of Media as a Sleep Aid in Adults.

A sample of 844 adults, aged 18-94 years old, was queried about media habits and sleep behavior in face-to-face interviews with standardized questionnaires. A substantial proportion of this sample reported using books (39.8%), television (31.2%), music (26.0%), Internet (23.2%), and videogames (10.3%) as a sleep aid. The use of media as sleep aids was associated with increased fatigue and higher scores on the Pittsburgh Sleep Quality Index (PSQI), indicating poorer sleep quality. There was no relationship with sleep duration. Finally, results suggest that media use coincides with later bedtimes, but also later rise times, a process called time shifting.

Stem cell research: the role of information seeking and scanning.

BACKGROUND: The mass media have held an ongoing debate about stem cell research. However, few studies have investigated how individuals obtain information on stem cell research and whether this affects their knowledge and perspectives on stem cell research. OBJECTIVE: This study aims to investigate whether (i) cancer-diagnosed and non-diagnosed individuals differ in terms of their acquisition of stem cell research information, (ii) whether this information acquisition is associated with stem cell research knowledge and perspectives and (iii) whether having had a cancer diagnosis moderates these associations. METHOD: A standardised, cross-sectional survey was conducted among a convenience sample of 621 cancer-diagnosed and 1387 non-diagnosed individuals in Flanders (Belgium). RESULTS: The results indicate that stem cell research information acquisition explains a significant part of the variance of stem cell research knowledge (8.9%) and of the societal benefits of stem cell research (6.7%) and of embryonic stem cell research evaluation (3.9%) and morality (2%). These associations did not differ between cancer-diagnosed and non-diagnosed individuals but cancer-diagnosed individuals did seek more stem cell research information. CONCLUSION: Acquiring stem cell research information, both intentionally and unintentionally, is positively related to stem cell research knowledge and perspectives. Future research should further identify ways to promote health information acquisition behaviour because it is associated with better knowledge and more positive opinion formation.

Sleep quality is negatively related to video gaming volume in adults.

Most literature on the relationship between video gaming and sleep disturbances has looked at children and adolescents. There is little research on such a relationship in adult samples. The aim of the current study was to investigate the association of video game volume with sleep quality in adults via face-to-face interviews using standardized questionnaires. Adults (n = 844, 56.2% women), aged 18-94 years old, participated in the study. Sleep quality was measured using the Pittsburgh Sleep Quality Index, and gaming volume was assessed by asking the hours of gaming on a regular weekday (Mon-Thurs), Friday and weekend day (Sat-Sun). Adjusting for gender, age, educational level, exercise and perceived stress, results of hierarchical regression analyses indicated that video gaming volume was a significant predictor of sleep quality (ß = 0.145), fatigue (ß = 0.109), insomnia (ß = 0.120), bedtime (ß = 0.100) and rise time (ß = 0.168). Each additional hour of video gaming per day delayed bedtime by 6.9 min (95% confidence interval 2.0-11.9 min) and rise time by 13.8 min (95% confidence interval 7.8-19.7 min). Attributable risk for having poor sleep quality (Pittsburgh Sleep Quality Index > 5) due to gaming >1 h day was 30%. When examining the components of the Pittsburgh Sleep Quality Index using multinomial regression analysis (odds ratios with 95% confidence intervals), gaming volume significantly predicted sleep latency, sleep efficiency and use of sleep medication. In general, findings support the conclusion that gaming volume is negatively related to the overall sleep quality of adults, which might be due to underlying mechanisms of screen exposure and arousal.

Media use, cancer knowledge and lifestyle choices: a cross-sectional analysis.

BACKGROUND: Both media use and cancer knowledge have been identified as important predictors of a healthy lifestyle. However, little is known about the interplay between these two variables, and about differences between cancer diagnosed and non-diagnosed consumers of media and knowledge. This study investigated the relationship between media use (television and internet exposure) and lifestyle choices of cancer diagnosed and non-diagnosed individuals, and looked at the influence of cancer knowledge on this relationship. METHODS: A cross-sectional, quantitative survey (the Leuven Cancer Information Survey) was administered to 621 cancer diagnosed and 1387 non-diagnosed individuals, aged 16-88 years old in Flanders (Belgium). Bivariate analyses, hierarchical linear regression analyses and advanced moderation and mediation analyses were conducted. RESULTS: Internet exposure was not a predictor of lifestyle choices. Television exposure, however, was a negative predictor of healthy lifestyle choices. Moreover, television exposure was a direct negative predictor of cancer knowledge, which in turn positively predicted lifestyle choices. However, no differences were found in the investigated relationships between the two subsamples. CONCLUSION: These results indicate that higher levels of television exposure coincide with less cancer knowledge and with less healthy lifestyle choices. It offers a pathway for intervention by suggesting that improving cancer knowledge through television might positively affect lifestyle choices.

Violent video games and delinquent behavior in adolescents: A risk factor perspective.

Over the years, criminological research has identified a number of risk factors that contribute to the development of aggressive and delinquent behavior. Although studies have identified media violence in general and violent video gaming in particular as significant predictors of aggressive behavior, exposure to violent video games has been largely omitted from the risk factor literature on delinquent behavior. This cross-sectional study therefore investigates the relationship between violent video game play and adolescents' delinquent behavior using a risk factor approach. An online survey was completed by 3,372 Flemish adolescents, aged 12-18 years old. Data were analyzed by means of negative binomial regression modelling. Results indicated a significant contribution of violent video games in delinquent behavior over and beyond multiple known risk variables (peer delinquency, sensation seeking, prior victimization, and alienation). Moreover, the final model that incorporated the gaming genres proved to be significantly better than the model without the gaming genres. Results provided support for a cumulative and multiplicative risk model for delinquent behavior. Aggr. Behav. 41:267-279, 2015. © 2015 Wiley Periodicals, Inc.

Predictors of cancer fear: the association between mass media and fear of cancer among cancer diagnosed and nondiagnosed individuals.

Few studies have explored the impact of mass media on fear of cancer levels. This study investigates whether television and Internet use are associated with fear of cancer, and whether this association is different for cancer diagnosed and nondiagnosed individuals. A quantitative, standardized survey was used and administered to 2008 respondents in Flanders (Belgium), of which 621 individuals were diagnosed with cancer. For statistical analyses, hierarchical regression analyses, independent samples T-tests and post hoc mediation analyses were conducted. The results indicated that cancer diagnosed individuals differed from nondiagnosed individuals in terms of perceived cancer susceptibility, perceived cancer severity, fear of cancer, and media use. Furthermore, television exposure was directly and positively related to fear of cancer, whereas Internet use was not. The relationship between television and Internet use and fear of cancer was not different for cancer diagnosed and nondiagnosed individuals. Additional post hoc mediation analyses, however, seemed to suggest that watching more television and surfing more on the Internet could both lead to having a more negative perceived health and this was in turn associated with higher fear of cancer. To help reduce the burden of fear of cancer, cancer educators and individuals working with cancer patients need to be aware of the possible negative effects media use might have on health perception and on the levels of fear of cancer.

Fear of cancer is associated with cancer information seeking, scanning and avoiding: a cross-sectional study among cancer diagnosed and non-diagnosed individuals.

BACKGROUND: Nowadays, there is an abundance of health and cancer information in the mass media. Because of this high amount of information, it is possible for individuals to find or incidentally encounter cancer information, but it is also possible to be overloaded by this information and, consequently, to avoid it. Previous studies have indicated that fear of cancer could be both positively and negatively related to behaviours such as screening, help-seeking and information avoidance. OBJECTIVE: The aims of this study were (1) to assess the relationship between fear of cancer and cancer information acquisition and avoiding behaviour, (2) to examine whether this relationship was curvilinear, and (3) to determine whether this relationship was moderated by being diagnosed with cancer or not. METHOD: Six hundred and twenty-one cancer diagnosed and 1387 non-diagnosed individuals were recruited through a convenience sample in Flanders (Belgium) and filled in a standardised survey questionnaire. RESULTS: The results showed a positive linear association between fear of cancer and information seeking, scanning and avoiding. Being diagnosed with cancer or not did not moderate this relationship. CONCLUSION: Fear of cancer is positively associated with cancer information acquisition and avoiding behaviour. This suggests that fear of cancer predicts different behaviours in different individuals.

The swine flu emergency department: the relationship between media attention for the swine flu and registrations in an emergency medicine unit.

INTRODUCTION: When the world is faced with a new potential pandemic outbreak, the media report heavily about it. Media are an important disseminator of health threat information. This study examined potential media effects during the 2009 outbreak of A/H1N1 influenza. HYPOTHESIS: To examine the relationship between media reports of the swine flu and self-registrations in an emergency department (ED) of a tertiary hospital in Flanders, Belgium. METHODS: All articles concerning swine flu published in seven Flemish newspapers were selected during the biggest flu peak in Belgium. This number was compared with the number of patients who presented themselves with a self-diagnosis of swine flu symptoms during the same time frame. The Pearson's correlation coefficient was selected to determine the relationship. The cross-correlation function determined the direction of this relationship. RESULTS: A strong correlation was found between the number of potential patients (n = 308) and the number of articles in the Flemish press (n = 1657). The number of patients was the leading indicator; increases in the volume of written press followed increases in the number of patients. CONCLUSION: Media reporting is extensive when a new infectious disease breaks out and intensifies when it is feared that pandemic levels are reached. This was also the case with the swine flu outbreak in Flanders. These findings suggest that a rise in the number of media reports follows a rise in the number of cases, rather than the reverse.

The impact of screen use on sleep health across the lifespan: A National Sleep Foundation consensus statement.

OBJECTIVE: To achieve consensus on whether screen-based digital media (1) in general, (2) via prebedtime content, and (3) via prebedtime light impairs sleep health in (a) childhood, (b) adolescence, and (c) adulthood. Furthermore, to address whether employing behavioral strategies and interventions may reduce the potential negative effects of screens on sleep health. METHODS: The National Sleep Foundation convened a 16-person multidisciplinary expert panel ("Panel"). Panelists met virtually 5 times throughout 2023, during which they followed a modified Delphi RAND/UCLA Appropriateness Method to reach consensus. RESULTS: The Panel conducted a literature review starting with 2209 articles, narrowed down to 522 relevant empirical articles and 52 relevant review articles. The search was refined to include 35 experimental/intervention studies that examined whether there was a causal link between screen-based digital media and sleep. In addition, panelists reviewed 5 recent relevant systematic review articles. After reviewing the summarized current literature, panelists voted on 10 candidate statements about whether screen use impairs sleep health. The Panel met virtually to discuss the results of the first round of votes, which was then followed by a second round of voting, ultimately achieving consensus on 5 out of the 10 statements. CONCLUSIONS: The Panel achieved consensus that (1) in general, screen use impairs sleep health among children and adolescents, (2) the content of screen use before sleep impairs sleep health of children and adolescents, and (3) behavioral strategies and interventions may attenuate the negative effects of screen use on sleep health.

Digital Communications Technology Use and Feelings of Anxiety, Depression, and Loneliness Among Older Adults During the COVID-19 Pandemic.

Some have touted technology as a panacea for overcoming the isolation associated with COVID-19 mitigation policies; yet, these tools are not widely adopted by older adults. With data from the COVID-19 supplement to the National Health and Aging Trends Survey, we conduct adjusted Poisson regression modeling to examine digital communications use during COVID-19 and feelings of anxiety, depression, and loneliness during the COVID-19 pandemic among older adults (65+ years of age). Adjusted Poisson regression revealed that those who reported frequent use of video calls with friends and family (aPR = 1.22, 95% CI:1.06-1.41) and with healthcare providers (aPR = 1.22, 95% CI:1.03-1.45) were more likely to report feelings of anxiety than those not using these platforms; yet, reports of in-person visits with friends and family (aPR = 0.79, 95% CI: 0.66-0.93) and with healthcare providers (aPR = 0.88, 95% CI: 0.77-1.01) were associated with fewer feelings of depression and loneliness, respectively. Future research is needed to tailor digital technology to support older adults.

Examining understandability, information quality, and presence of misinformation in popular YouTube videos on sleep compared to expert-led videos.

The Internet is a common source of sleep information but may be subject to commercial bias and misinformation. We compared the understandability, information quality, and presence of misinformation of popular YouTube videos on sleep to videos with credible experts. We identified the most popular YouTube videos on sleep/insomnia and 5 videos from experts. Videos were assessed for understanding and clarity using validated instruments. Misinformation and commercial bias were identified by consensus of sleep medicine experts. The most popular videos received, on average, 8.2 (± 2.2) million views; the expert-led videos received, on average, 0.3 (± 0.2) million views. Commercial bias was identified in 66.7% of popular videos and 0% of expert videos (P < .012). The popular videos featured more misinformation than expert videos (P < .001). The popular videos about sleep/insomnia on YouTube featured misinformation and commercial bias. Future research may explore methods for disseminating evidence-based sleep information. CITATION: Robbins R, Epstein LJ, Iyer JM, et al. Examining understandability, information quality, and presence of misinformation in popular YouTube videos on sleep compared to expert-led videos. J Clin Sleep Med. 2023;19(5):991-994.

Fear effects by the media.

UNLABELLED: Both news media and entertainment fiction may lead to short-term and enduring fright reactions. Even TV programs, movies and news made for children may trigger fear. Preoperational children (3 to 7 years of age) are most afraid of fantasy characters, transformations and interpersonal violence. Operational children (8 to 11 years) are more afraid of abstract ideas and imagined implications regarding their own risk. Pediatricians must include media in their history taking and beware of ensuing fear, phobias, sleep and behavior problems. Parents can play a vital role in preventing exposure to or mediating the effects of frightening media. Hospitals must have a pediatric media exposure policy. CONCLUSION: Media use can have immediate and enduring fear effects that affect many children and that are far from trivial.

Television viewing, internet use, and self-reported bedtime and rise time in adults: implications for sleep hygiene recommendations from an exploratory cross-sectional study.

This study examined whether the availability of the Internet and TV in the bedroom and overall Internet use and TV viewing were related to sleep variables in a sample of 711 residents of Flanders, Belgium. Although the relations were small, there was some evidence of time shifting: Internet access in the bedroom predicted later bedtime (ß = .12, p < .05) and later rise time (ß = .11, p < .05) on weekdays and later bedtime (ß = .10, p < .001) on weekends. Internet use volume predicted later bedtime (ß = .10, p < .001) and rise time (ß = .07, p < .05) on weekends, and TV viewing predicted later bedtime (ß = .10, p < .05) on weekends. However, neither the availability of the Internet or TV in the bedroom, nor the volume of Internet use or TV viewing, was a significant predictor of reduced sleep window or tiredness. Reducing media use might not be important for sleep hygiene advice to adults.

Music video viewing as a marker of driving after the consumption of alcohol.

This study has two main objectives. First, it is examined whether the frequent exposure to music video viewing is associated with driving after the consumption of alcohol. Second, it is examined which theoretical framework, a combination of Cultivation Theory and the Theory of Planned Behavior or the Problem Behavior Theory, is suited best to explain this relationship. Participants were 426 Flemish adolescents who took part in a two-wave panel survey (2006-2008) about media use, risk-taking attitudes, intentions, and behaviors. In line with Cultivation Theory and the Theory of Planned Behavior, the results showed that adolescents' music video viewing is a significant marker of later risky driving behavior and that this relationship is mediated through their attitudes and intentions. No support was found for the hypothesis that music video viewing is part of a cluster of problem behaviors (Problem Behavior Theory). Thus, the results of this study seem to indicate that a combination of Cultivation Theory and the Theory of Planned Behavior provides a more useful framework for explaining the relationship between music video viewing and driving after the consumption of alcohol. The implications for prevention and the study's limitations are discussed.

Television news coverage about cervical cancer: impact on female viewers' vulnerability perceptions and fear.

BACKGROUND: The objective of this study was to examine the relationship between exposure to television news messages about cervical cancer and women's vulnerability perceptions and fear. METHODS: Five-hundred women aged 18-85 years were randomly recruited to participate in a survey-interview. A standardized questionnaire assessed risk perception, fear of cervical cancer, exposure to cervical cancer messages in television news and a number of potential confounders such as demographics and trait anxiety. RESULTS: Results from multinomial regression analyses showed that women who had been occasionally exposed to cervical cancer messages were two times more likely to be very afraid of getting cervical cancer. Women who had been frequently exposed were three times more likely to be very afraid and three times more likely to be extremely afraid. Women who had been regularly exposure to cervical cancer messages were also three times more likely to perceive a moderate risk and seven times more likely to perceive a large risk of being diagnosed with cervical cancer. CONCLUSION: These results suggest that television news may be an effective means for health education.