Substituting Book Reading for Screen Time Benefits Preschoolers’ Sleep Health: Results from the Ulm SPATZ Health Study

Figures & data

Table 1 Media Use, Book Reading, Total CSHQ Score, and CSHQ Subscales for the Total SPATZ Sample and by Sex at Different Ages

Total Sample	Age 4 (n=581)	Age 5 (n=508)	Age 6 (n=426)	R^2 (%)
Media use (min per day)	30 (0, 120)	39 (3, 129)	39 (0, 150)	0.3
Book reading (min per day)	60 (12, 145)	51 (12, 129)	51 (12, 144)	0.4
Total CSHQ score	43 (36, 56)	43 (35, 55)	42 (35, 54)	<0.1
Daytime sleepiness	11 (8, 17)	11 (8, 17)	11.5 (8, 17)	0.2
Sleep-disordered breathing	3 (3, 4)	3 (3, 4)	3 (3, 4)	<0.1
Parasomnias	7 (6, 10)	7 (6, 10)	7 (6, 10)	0.2
Night waking	4 (3, 7)	4 (3, 7)	3 (3, 7)	1.6
Sleep anxiety	6 (4, 9.2)	5 (4, 9)	5 (4, 9)	0.5
Sleep duration	3 (3, 6)	3 (3, 6)	3 (3, 6)	0.3
Sleep onset delay	1 (1, 2)	1 (1, 2)	1 (1, 3)	<0.1
Bedtime resistance	8 (6, 13)	7 (6, 13)	7 (6, 14)	0.7
Girls	Age 4 (n=290)	Age 5 (n=249)	Age 6 (n=215)	R^2 (%)
Media use (min per day)	34 (0, 111)	34 (3, 120)	39 (9, 166)	0.5
Book reading (min per day)	60 (12, 150)	54 (12, 129)	54 (12, 131)	0.5
Total CSHQ score	44 (36, 55)	42 (35, 54)	42 (35, 54)	0.8
Daytime sleepiness	12 (8, 17)	11 (8, 16)	12 (8, 17)	0.5
Sleep-disordered breathing	3 (3, 4)	3 (3, 4)	3 (3, 4)	0.9
Parasomnias	7 (6, 10)	7 (6, 9.9)	7 (6, 9.8)	0.6
Night waking	4 (3, 7)	3 (3, 7)	3 (3, 7)	2.1
Sleep anxiety	6 (4, 10)	5 (4, 9)	5 (4, 9)	1.7
Sleep duration	3 (3, 6)	3 (3, 6)	3 (3, 6)	0.4
Sleep onset delay	1 (1, 2)	1 (1, 2)	1 (1, 3)	<0.1
Bedtime resistance	8 (86 13)	7 (6, 13)	6 (6, 14)	1.1
Boys	Age 4 (n=291)	Age 5 (n=259)	Age 6 (n=211)	R^2 (%)
Media use (min per day)	30 (0, 133)	39 (0.7, 133)	39 (0, 146)	0.3
Book reading (min per day)	60 (12, 132)	47 (12, 128)	51 (9, 158)	0.3
Total CSHQ score	43 (36, 57)	43 (36, 56)	42 (35, 56)	0.2
Daytime sleepiness	11 (8, 16)	11 (8, 17)	11 (8, 17)	0.4
Sleep-disordered breathing	3 (3, 4.1)	3 (3, 5)	3 (3, 4)	<0.1
Parasomnias	7 (6, 10)	7 (6, 10)	7 (6, 10)	<0.1
Night waking	4 (3, 7)	4 (3, 7)	4 (3, 7)	1.2
Sleep anxiety	6 (4, 9)	6 (4, 9)	5 (4, 9.9)	<0.1
Sleep duration	3 (3, 5)	3 (3, 6)	3 (3, 6)	0.2
Sleep onset delay	1 (1, 2)	1 (1, 2)	1 (1, 2)	<0.1
Bedtime resistance	8 (6, 13.2)	7 (6, 13)	7 (6, 14)	0.4

Notes: A total CSHQ score of ≥41 indicates a pediatric sleep problem. R² represents the variance explained by observational time according to the non-parametric analogue of the ordinary coefficient of determination. Data are reported as the median with 5th to 95th percentile range.

Abbreviation: CSHQ, Children’s Sleep Habits Questionnaire.

Figure 1 Partition model analyses of the association between one-hour exposure to media use and book reading during the week, on weekdays, and at weekends, and total CSHQ score and subscales. Results are provided as a metric of Cohen’s standardized effect size (horizontal axis) by CSHQ overall score and subscales.

Abbreviation: CSHQ, Children’s Sleep Habits Questionnaire.

Figure 2 Substitution model analyses of the association between the substitution of 50% of the time spent on media use with an equal amount of time spent with book reading during the week, on weekdays, and at weekends, and total CSHQ score and subscales. Results are provided as a metric of Cohen’s standardized effect size (horizontal axis) by CSHQ overall score and subscales.

Abbreviation: CSHQ, Children’s Sleep Habits Questionnaire.