JMIR Publications

ABSTRACT

Background:

It is recommended that children avoid eating dinner, being physically active or using screens in the hour before bed to ensure good sleep health. However, the evidence base behind these guidelines is weak and limited to cross-sectional studies using questionnaires.

Objective:

The aim of this randomised crossover trial is to use objective measures to experimentally determine whether recommendations to improve sleep by banning electronic media, physical activity, or food intake in the hour before bed, impact sleep quantity and quality in youth.

Methods:

After a baseline week to assess usual behaviour, 72 children (10-14.9 years) will be randomised to four conditions: 1) avoid all three behaviours, 2) use screens for at least 30 minutes, 3) be physically active for at least 30 minutes, and 4) eat a large meal, during the hour before bed on days 5-7 of weeks 2 to 5. Intervention adherence and shuteye latency (time from getting into bed until attempting sleep) will be measured by wearable and stationary video cameras. Sleep (total sleep time, sleep onset, wake after sleep onset) will be measured using actigraphy (baseline, days 5-7 of each intervention week). Mixed effects regression models with a random effect for participant will be used to estimate mean differences (95% CI) for conditions 2-4 compared to condition 1.

Results:

Results should be available in 2026.

Conclusions:

Using objective measures, we will be able to establish if causal relationships exist between pre-bedtime behaviours and sleep in children. Such information is critical to ensure appropriate and achievable sleep guidelines. Clinical Trial: Australian and New Zealand Clinical Trials Registry (www.anzctr.org.au, ACTRN12624000206527