Avoiding violent TV or shows meant for older kids may improve sleep in preschoolers, a new study suggests. Nearly 600 families took part in the study. The children's ages ranged from 3 to 5. Families were randomly divided into 2 groups. Both groups were asked questions about many things, including sleep and eating habits. One group received education about the best kinds of TV and other media for young children. They also got suggestions about suitable programs on channels available to them. Examples included Dora the Explorer and Sesame Street. They were encouraged to watch TV with their kids and talk about what they saw. The other group received education about healthy eating. Both groups kept sleep diaries for their children. They also received home visits and other follow-up. After a year, kids in the group who got education about TV had fewer sleep problems. They were less likely to be sleepy in the daytime as well. The journal Pediatrics published the study online. USA Today wrote about it August 6.

By Claire McCarthy, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

If you want your preschooler to sleep better, don't let him or her watch violent TV shows.

It sounds obvious. But there hasn't been much in the way of actual proof that it's true. There's always been a sort of chicken-and-egg problem when it comes to media and kids. Do the media cause the trouble? Or is the cause related to something else about families who allow children to watch things that are violent or not meant for kids?

Researchers studied about 500 children in the Seattle area. Their age range was 3 to 5. The kids were randomly assigned to 2 groups. Parents in the study group were given education about the kind of TV and videos their children should watch. The education discouraged anything that was violent or meant for older kids or adults. Parents were encouraged to have their kids watch educational and pro-social shows such as Curious George, Sesame Street or Dora the Explorer. The "control" group was given education on healthy nutrition, not TV.

Parents were asked about all sorts of things, including their child's sleep habits. Researchers asked whether the child:

• Had trouble falling asleep
• Woke up at night
• Had nightmares
• Had difficulty waking up in the morning
• Was tired in the daytime

At the end of the study, kids in the study group had fewer sleep problems than the ones in the control group.

This is important, because poor sleep has been shown to increase the risk of:

• School problems
• Obesity
• Injuries
• Problems with behavior and emotions

It has become increasingly clear that parents need to do everything they can to be sure their children get a good night's sleep. This study shows that to make sure preschoolers sleep well, families need to be careful about what they watch.

What Changes Can I Make Now?

This study adds to the growing evidence that the kind of media children are exposed to matters. About a year ago, the same researcher showed that fast-paced cartoons (such as SpongeBob Squarepants) can interfere with executive function. This includes skills such as paying attention, controlling impulses, organizing and solving problems.

We know that being exposed to violence increases the risk of aggressive behavior. We also know that being exposed to sex in shows and movies makes kids more likely to have sex earlier.

And we know, too, that screen time, no matter what you are watching or doing, can have negative effects. Spending more than two hours a day in front of a screen raises a child's risk of obesity. Screen time for young children increases the risk of behavior problems and attention-deficit hyperactivity disorder (ADHD). This is all information that parents need to take seriously.

The American Academy of Pediatrics (AAP) recommends that children spend no more than 2 hours a day in front of a screen. This includes watching TV and movies, playing video games, surfing the Internet, etc. The AAP recommends no screen time at all for children under the age of 2.

But it's also very important that parents choose wisely what children see and do in those two hours. Avoid anything violent, fast-paced, meant for older people or sexualized. Go for educational videos and shows that are slow-paced and meant for children. Watch them with your kids to gauge their reactions. Talk with them about what they are seeing.

What Can I Expect Looking to the Future?

Media have become a bigger part of all of our lives. So it is especially important that we really understand the effects -- and how we can best use media to help children, not hurt them.

This study adds to what we know in an important way. I hope that we can take its lessons, and the lessons of the other studies about kids and media, and put them to good use.