SCREENS: Sleep, Circadian Rhythms, and Electronics in the EveNing Study

NCT ID: NCT06192745

Last Updated: 2025-05-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

220 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-01-10

Study Completion Date

2028-08-30

Brief Summary

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The proposed project aims to disentangle the impact of evening light exposure emitted from tablet devices from the impact of arousing media content on children's sleep regulation, circadian physiology and next-day emotion regulation and executive functioning.

Detailed Description

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Investigators will conduct a 4-group randomized, controlled trial including 200 children (8 to 11 years; Tanner stage 1 or 2) assigned to an unfiltered bright light screen (BL; 109 lux) or a dim light screen (DL; \<5 lux) condition in room lighting (40-50 lux) matched with either calming (CC) or exciting content (EC). Children will participate in two weekend protocols, an experimental and a control weekend. During the experimental weekend, children will be exposed to 1 hour of tablet use in the hour before bed under the following conditions: 1) unfiltered bright screen light and exciting content (BL/EC), 2) unfiltered bright screen light and calming content (BL/CC) 3) filtered dim screen light and exciting content (DL/EC) and 4) filtered dim screen light and calming content (DL/CC). To control for the effect of screen media which is common to all 4 conditions irrespective of screen brightness and the nature of the content, each child will undergo a "control condition weekend" in which the child will participate in the same weekend study protocol, but instead of using screen media in the hour before bed, children will participate in non-screen based quiet activities in room lighting (40-50 lux). The control condition will serve as a negative internal control. The order in which children are exposed to the experimental or control weekends will be randomized (i.e., counterbalanced) to control for possible order effects.

Following a week of typical sleep and media use, a 3-day weekend protocol will be implemented in the home facilitated by research staff on two occasions (one week apart, counterbalanced). To assess a potential shift in circadian phase, dim light melatonin onset (DLMO; time at which melatonin level rise above 4pg/mL) will be assessed by research staff on Nights 1 and 3 of the weekend protocol via saliva samples collected under tightly-controlled dim light conditions (i.e., DLMO-Night 3 to DLMO-Night 1). To facilitate the assessment of circadian phases under dim light conditions (\<5 lux), research staff will place temporary covers over windows and adjust the lighting in the child's bedroom. A light meter will be used to ensure appropriate lighting conditions.

On Night 2, children will be exposed to either the experimental condition to which they were assigned or the control condition. A background of room lighting (40-50 lux) will be common to both the experimental and control condition.

During the experimental condition, children will exposed to screen media according to the experimental condition they were assigned (BL/EC, BL/CC, DL/EC, DL/CC) via a handheld tablet (at eye level, 45 cm in front of the child). To standardize the distance of the iPad from the eye across participants, the tablet (or non-screen-based activity) will be placed on an adjustable bed desk at a distance of 45cm from the eye. Children will sit upright in bed with a pillow behind them. A similar posture will be used in the control condition. Assessments on Night 2, will be as follows: 1) children's sleep will be assessed via actigraphy, 2) children's arousal will be assessed via heart rate (HR), and heart rate variability (HRV) 3)subjective sleepiness ratings will be collected before the start of the experimental condition, after 30 minutes, and again at bedtime. 4) ambient light will be assessed via a light sensor clipped onto the shirt collar. The next afternoon, emotion regulation (subjective reports and respiratory sinus arrhythmia; RSA) and executive functioning (neurocognitive testing) will be measured to assess these secondary outcomes. Research staff (in teams of 2) will be present in the home to conduct the circadian phase assessments, administer the experimental conditions on the Night 2, and to conduct the executive functioning and emotion regulation assessments in the afternoon of Night 3.

During the weekend protocols, children will be able to participate in daytime activities as usual with the exception that on days when melatonin is assessed, children will be asked to refrain from strenuous physical activity as this is known to affect melatonin.

During the week prior to each weekend assessment, the procedures will be the same for all participants. Parents will select a bedtime and wake time for their child based on their habitual sleep times (+/- 30 mins). Families will be asked to maintain this sleep schedule for the duration of the 2-week protocol, except on nights when DLMO is assessed. Adherence to sleep/wake patterns will be assessed via actigraphy. Because previous exposure to light and screen media can impact future responsiveness to light and screen media, the research team will assess children's ambient light exposure using a reliable sensor clipped near the shirt collar. Mobile device screen use will be assessed using an app downloaded onto the tablet. Other types of screen media use will be assessed by parent report. Variables assessed during the weeks preceding the experimental weekend will be used as covariates in the analysis.

While 200 children are needed to be powered to examine the interaction effect of light and content on children's total sleep time, an additional 20 children will be recruited to account for attrition. The total sample size will be up 220 children.

Conditions

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Sleep Circadian Rhythm Executive Function Emotion Regulation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Investigators
The investigators will be blinded to treatment condition in the analysis of outcomes

Study Groups

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Group 1

Children will participate in 2 exposure conditions in their own homes (i.e., experimental and internal negative control), facilitated by research staff (one week apart, counterbalanced to control for possible order effects). The internal negative control will be the same for all groups, but the experimental exposure will differ. Both exposures will take place for 1 hour before bed in room lighting (40-50 lux).

Experimental exposure: children in Group 1 will be exposed to a tablet with unfiltered bright screen light and exciting media content (BL/EC).

Internal negative control exposure: children will participate in non-screen-based quiet activities

Group Type EXPERIMENTAL

no screen control with dim light and calming activities

Intervention Type BEHAVIORAL

Non-screen-based quiet activities for 1 hour before bed in room lighting 40-50 lux

unfiltered Bright tablet screen

Intervention Type BEHAVIORAL

Bright light screen media exposure will be delivered on an iPad Pro provided by the research team which will be set to the brightest light intensity setting for 1 hour before bed in room lighting 40-50 lux

Exciting content

Intervention Type BEHAVIORAL

We will create a 1-hour recording of movie clips containing exciting content from age-appropriate movies for 8- to 11-year-old children as rated by Common Sense Media.

Group 2

Children will participate in 2 exposure conditions in their own homes (i.e., experimental and internal negative control), facilitated by research staff (one week apart, counterbalanced to control for possible order effects). The internal negative control will be the same for all groups, but the experimental exposure will differ. Both exposures will take place for 1 hour before bed in room lighting (40-50 lux).

Experimental exposure: children in Group 2 will be exposed to a tablet with unfiltered bright screen light and calming media content (BL/CC).

Internal negative control exposure: children will participate in non-screen-based quiet activities

Group Type EXPERIMENTAL

no screen control with dim light and calming activities

Intervention Type BEHAVIORAL

Non-screen-based quiet activities for 1 hour before bed in room lighting 40-50 lux

unfiltered Bright tablet screen

Intervention Type BEHAVIORAL

Bright light screen media exposure will be delivered on an iPad Pro provided by the research team which will be set to the brightest light intensity setting for 1 hour before bed in room lighting 40-50 lux

Calming Content

Intervention Type BEHAVIORAL

We will create a 1-hour recording of movie clips containing calming content from age-appropriate movies for 8- to 11-year-old children as rated by Common Sense Media.

Group 3

Children will participate in 2 exposure conditions in their own homes (i.e., experimental and internal negative control), facilitated by research staff (one week apart, counterbalanced to control for possible order effects). The internal negative control will be the same for all groups, but the experimental exposure will differ. Both exposures will take place for 1 hour before bed in room lighting (40-50 lux).

Experimental exposure: children in Group 3 will be exposed to a tablet with filtered dim screen light and exciting media content (DL/EC).

Internal negative control exposure: children will participate in non-screen-based quiet activities

Group Type EXPERIMENTAL

no screen control with dim light and calming activities

Intervention Type BEHAVIORAL

Non-screen-based quiet activities for 1 hour before bed in room lighting 40-50 lux

Filtered dim tablet screen

Intervention Type BEHAVIORAL

Filtered dim light screen media exposure will be delivered for 1 hour before bed in room lighting 40-50 lux on an iPad Pro provided by the research team. A blue light filter will be used to alter the spectral distribution of the emitted light and the screen brightness will be dimmed to the lowest possible setting

Exciting content

Intervention Type BEHAVIORAL

We will create a 1-hour recording of movie clips containing exciting content from age-appropriate movies for 8- to 11-year-old children as rated by Common Sense Media.

Group 4

Children will participate in 2 exposure conditions in their own homes (i.e., experimental and internal negative control), facilitated by research staff (one week apart, counterbalanced to control for possible order effects). The internal negative control will be the same for all groups, but the experimental exposure will differ. Both exposures will take place for 1 hour before bed in room lighting (40-50 lux).

Experimental exposure: children in Group 4 will be exposed to a tablet with filtered dim screen light and calming media content (DL/CC).

Internal negative control exposure: children will participate in non-screen-based quiet activities

Group Type EXPERIMENTAL

no screen control with dim light and calming activities

Intervention Type BEHAVIORAL

Non-screen-based quiet activities for 1 hour before bed in room lighting 40-50 lux

Filtered dim tablet screen

Intervention Type BEHAVIORAL

Filtered dim light screen media exposure will be delivered for 1 hour before bed in room lighting 40-50 lux on an iPad Pro provided by the research team. A blue light filter will be used to alter the spectral distribution of the emitted light and the screen brightness will be dimmed to the lowest possible setting

Calming Content

Intervention Type BEHAVIORAL

We will create a 1-hour recording of movie clips containing calming content from age-appropriate movies for 8- to 11-year-old children as rated by Common Sense Media.

Interventions

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no screen control with dim light and calming activities

Non-screen-based quiet activities for 1 hour before bed in room lighting 40-50 lux

Intervention Type BEHAVIORAL

unfiltered Bright tablet screen

Bright light screen media exposure will be delivered on an iPad Pro provided by the research team which will be set to the brightest light intensity setting for 1 hour before bed in room lighting 40-50 lux

Intervention Type BEHAVIORAL

Filtered dim tablet screen

Filtered dim light screen media exposure will be delivered for 1 hour before bed in room lighting 40-50 lux on an iPad Pro provided by the research team. A blue light filter will be used to alter the spectral distribution of the emitted light and the screen brightness will be dimmed to the lowest possible setting

Intervention Type BEHAVIORAL

Exciting content

We will create a 1-hour recording of movie clips containing exciting content from age-appropriate movies for 8- to 11-year-old children as rated by Common Sense Media.

Intervention Type BEHAVIORAL

Calming Content

We will create a 1-hour recording of movie clips containing calming content from age-appropriate movies for 8- to 11-year-old children as rated by Common Sense Media.

Intervention Type BEHAVIORAL

Other Intervention Names

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internal negative control

Eligibility Criteria

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Inclusion Criteria

* children between 8.0 and 11.9 year old
* Tanner stage 1 and 2
* live with their parent(s) (biological or legal guardian at least 50% of the time and has a primary role of caring for the child).
* Children who sleep between 8.5 to 11 hours per night habitually
* Children must sleep alone most nights
* parent and child able to communicate and read and write in English
* The child does not have to have access to a mobile device (tablet or Phone), but if they do, the primary device they use has to be an a) Android OS ≥5.0 either used only by the study child or shared with others, b) Amazon Fire OS ≥5.0 that only the child uses or c) an Apple iOS ≥14.0 that only the child uses.
* If the child's primary device is a Android or Amazon Fired device, the parent and child agree to install Chronicle App (Android or Amazon). If the child's primary device is an Apple device, the parent and child agree to allow us to gather usage screenshots from the primary iPad or iPhone.
* Families must live in the greater Houston area.

Exclusion Criteria

* child blindness or colorblindness
* significant vision problems
* developmental or cognitive delays
* diagnosis of a sleep or psychiatric disorder
* diagnosed cognitive or learning impairment affecting executive functioning (e.g., attention deficit hyperactivity disorder)
* medical conditions that impact sleep
* taking medications that impact sleep
* travel beyond 2 time zones in the month before starting the study
Minimum Eligible Age

8 Years

Maximum Eligible Age

11 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

Baylor College of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Jennette P. Moreno, PhD

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jennette P Moreno, PhD

Role: PRINCIPAL_INVESTIGATOR

Baylor College of Medicine

Candice A Alfano, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Houston

Locations

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Children's Nutrition Research Center

Houston, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Insia Raza, MPH

Role: CONTACT

713-798-0555

Hafza Dadabhoy

Role: CONTACT

718-798-0557

Facility Contacts

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Insia Raza, MPH

Role: primary

713-798-0555

Hafza Dadabhoy, MS RD LD

Role: backup

713-798-0557

Other Identifiers

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R01HD112349

Identifier Type: NIH

Identifier Source: secondary_id

View Link

H-53533

Identifier Type: -

Identifier Source: org_study_id

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