In recent years, there has been an unprecedented increase in the amount of time people spend looking at screens.

With the proliferation of smartphones, tablets, laptops, and televisions, it's become all too easy to spend hours on end glued to a screen. However, this widespread use of screens is not without its negative consequences on cardiac and general health.

What are the adverse health effects of prolonged screen time?

1. Vision problems

Prolonged screen time can cause eye strain, blurred vision, dry eyes, and headaches. This is known as computer vision syndrome. CVS can also cause neck and shoulder pain due to poor posture while using screens.

2. Sedentary lifestyle

Excessive screen time is associated with a sedentary lifestyle, which is considered a major risk factor for heart disease. A study published in the Journal of the American College of Cardiology in 2018 found that higher levels of screen time were associated with an increased risk of cardiovascular complications, independent of other risk factors such as smoking, diabetes, and hypertension.

3. Poor diet

People who spend more time in front of screens tend to consume more high-calorie, low-nutrient foods. This can lead to weight gain and an increased risk of obesity and metabolic disorders such as diabetes.

4. Poor mental health

Excessive screen time has been linked to depression, anxiety, and loneliness. This may be because screen time can replace face-to-face social interactions and outdoor or nature exposure, both of which are important for mental health.

5. Poor sleep quality

One of the well-documented effects of screen time is its impact on sleep quality. Blue light emitted from screens can suppress melatonin production, the brain sleep hormone, making it harder to fall asleep at night. This can lead to sleep deprivation or to a non-restorative sleep, which has a host of negative health effects, and adverse work and academic consequences.

How much screen time is too much by age groups?

The American Academy of Paediatrics provides general guidelines for screen time based on age groups:

1. Children under 18 months

The AAP recommends avoiding all screen time, except for video chatting with family and friends.

2. Children ages 18 months to 5 years

Screen time should be limited to high-quality, educational programming and should be watched together with a parent or caregiver. The recommended amount of screen time is no more than one hour per day.

3. Children ages 6 years and older

The AAP suggests that parents establish consistent limits on the amount of time their children spend on screens, and that children prioritise physical activity, social interaction, and sleep over screen time. The recommended amount of screen time is no more than one to two hours.

4. Adolescents

The AAP suggests that adolescents prioritise non-screen-based activities, such as in-person classes, regular physical activity and socialising with friends. The recommended amount of screen time should be no more than two hours per day for non-educational purposes.

5. Adults

There is no universally agreed upon recommended limit for screen time in adults, as it can depend on various factors such as an individual's occupation, lifestyle, and health status.

However, the American Heart Association suggests that adults should aim to limit their screen time to no more than two hours per day, excluding time spent for work or educational purposes.

Is the screen time content important? It goes without saying: Yes!

Social media and news scrolling

A study published in 2021 from the University of Pennsylvania found that college students who used social media for no more than 30 minutes per day had the highest wellbeing compared to those who either didn’t use social media at all or who used it excessively: they were the most connected, least lonely, and least depressed group. Similar conclusions were drawn from studies on adults who spend excessive time on news browsing or what is called “doom scrolling”.

Gaming

ADHD behaviour was found linked to screen-related sleep problems, overall screen time, and violent and fast-paced gaming content, which activates “dopamine reward” pathways. Early and prolonged exposure to violent content is also linked to risk for antisocial behaviour. Cumulative screen time use generates a craving attitude described as “digital media addiction disorder”, that resembles drug-dependence behaviour.

Screen time and overall performance

Since screen time has steadily increased over the past ten years, while the number of productivity hours per day has remained the same, it goes without saying that the many hours of fruitless screen time must come at the expense of either less night-time sleep, as mentioned above, or less daytime productivity and focus.

Multiple reports have now been published that explore the lack of efficiency and concentration in schools and workplace related to constant mixing or “dilution” of productive time with intrusive notifications or reflexive digital devices use. This has created a paradox of some sort, where people who complain the most of being busy and lacking time for exercise, education and socialisation, tend to score the highest numbers of wasted daily screen hours.

What measures can be taken to decrease screen time?

1. Set a limit on the amount of screen time allowed each day, and stick to it. For example, limit screen time to one hour per day for younger children and two hours per day for older children and teenagers.

2. Create screen-free zones at home, such as the dining room or bedrooms.

3. Turn off unnecessary notifications.

4. Encourage physical activity by scheduling regular exercise or outdoor playtime.

5. Promote alternatives such as board games, puzzles, or reading, to replace screen time.

6. Lead by example and limit your own screen time. If children see their parents engaging in other activities, they are more likely to follow suit.

7. Utilise parental control features on devices and internet browsers to limit access to certain websites or social media apps. This can help to promote a safer and more balanced online experience.

8. By taking these measures, it is possible to decrease screen time and promote a healthier lifestyle.

Nisrine Atieh is a Boston-based paediatrician and an American board-certified obesity medicine specialist. Joe Yammine is a consultant cardiologist at the Bermuda Hospitals Board. The information herein is not intended as medical advice nor as a substitute for professional medical opinion. Always seek the advice of your physician