JMIR Publications

ABSTRACT

Background:

Short-form video (SFV) has transformed how entertainment is consumed. This is especially true for the adolescent population, which is the highest proportion of users, with 74% of 16-17 year olds having TikTok. Studies have shown that SFV can be addictive, through features such as infinite scrolling and autoplay features. This has led to concerns regarding the impact of SFV on sleep in adolescents.

Objective:

The objective of this systematic review was to examine the impact that SFV has on adolescent sleep.

Methods:

We used the PRISMA guidelines to help form our study and conducted searches of Embase, MEDLINE, and PubMed, supplemented by a grey literature search conducted using Google Scholar. This study used an extraction table modelled after the Joanna Briggs Institute extraction table, which collected data on study characteristics, participant characteristics and key quantitative and qualitative findings. Moreover, the Joanna Briggs Institute critical appraisal checklist was used to assess the risk of bias. The data searched covered literature published from January 1st, 2000 to 31st December, 2025.

Results:

From the initial search, 753 references were identified across three databases and a grey literature search. After removal of 288 duplicates, 465 original references remained eligible for title and abstract screening, of which 47 progressed to full-text screening and 14 were selected for data extraction. At extraction, 2 studies were removed as they had erroneously passed to the full text stage, and a further 4 studies assessing physical activity were subsequently excluded following removal of this secondary outcome, leaving a total of 8 studies which assessed SFV use and sleep. All 8 included studies were cross-sectional, with six of the studies being conducted in China, one in Greece and one in Spain. Study samples ranged from 219 to 3,309 (total N = 9,060). Five studies reported poorer sleep with SFV use, one reported better sleep, and two found no statistically significant association. Only one of the five studies reporting harm had adjusted for any covariate. Unadjusted analyses reported harm more often than adjusted analyses, which tended to report no association or even a protective association between SFV use and sleep.

Conclusions:

This review found that the current evidence is insufficient to establish a robust, independent association between short-form video use and sleep outcomes. Findings across the eight included studies were mixed: five reported poorer sleep, one reported better sleep, and two found no association. However, studies reporting harm were largely unadjusted, while the most rigorously adjusted studies found no or protective associations, suggesting that the negative effects on sleep observed in the unadjusted analyses might be attributable to confounding. Clinical Trial: The protocol for this systematic review was preregistered in the PROSPERO database (Reference ID: CRD420261360477)