Kristensen J, Pallesen S, King D, Hysing M, Erevik E. Problematic Gaming and Sleep: A Systematic Review and Meta-Analysis Frontiers in Psychiatry. 2021 Jan;12. https://doi.org/10.3389/fpsyt.2021.675237
Problematic gaming has been linked to poor sleep outcomes; however, these associations have not yet been synthesized quantitatively. This review employed a meta-analysis to investigate the relationship between problematic gaming and sleep-related outcomes. A search of Medline, Embase, Web of Science, PsycINFO, and Google Scholar identified a total of 763 studies, including 34 studies (n = 51,901 participants) eligible for inclusion. Papers were included if available in any European language, addressed problematic gaming, contained original data, and provided sufficient data for calculation of effect sizes. Two researchers independently extracted data using pre-defined fields including quality assessment. Sleep-related outcomes were meta-analyzed for sleep parameters that were reported by 5 or more papers. Significant overall effects were found for sleep duration (g = −0.238, 95% CI = −0.364, −0.112), poor sleep quality (OR = 2.02, 95% CI = 1.47, 2.78), daytime sleepiness (OR = 1.57, 95% CI = 1.00, 2.46) and sleep problems (OR = 2.60, 95% CI = 1.94, 3.47). Between-study heterogeneity was detected for all meta-analyses. Subgroup analyses showed a higher inverse effect size for adolescent samples compared to adult or non-specific age samples in terms of sleep duration. For daytime sleepiness, a larger effect size was found for studies based on single-item sleep measures compared to multi-item sleep measures. For sleep problems, the subgroup analysis showed the opposite with a higher effect size for studies based on single-item sleep measures than multi-item sleep measures. Across all sleep parameters, problematic gamers consistently reported a more adverse sleep status than non-problematic gamers.
There are a number of possible mechanisms by which gaming may influence sleep (25). As proposed by the media displacement hypothesis (26, 27), gaming could displace sleep directly as the individual chooses to engage in games over sleep, or indirectly by disregarding behaviors that are essential for good sleep hygiene (e.g., physical activity). For problematic gamers, the displacement may not be by choice but rather driven by an inability to stop playing. Arousal is another possible mechanism both due to social engagement, structural characteristics of the games (e.g., high event frequency), and the thrill related to winning or losing, which may interfere with sleep. The artificial blue-spectrum light emitted by screens projecting the visual gaming content may also directly enhance alertness and arousal (28), and suppresses nighttime melatonin secretion, important in regulating the sleep-wake cycle (29, 30). Followingly, late-night gaming may delay the sleep phase, making it difficult to fall asleep at needed or wanted times. Prolonged gaming may also negatively affect sleep by creating physical discomforts such as muscular pain and headache (31). Lastly, sleep may also be interfered by exposure to electromagnetic fields that are emitted by wireless gaming devices, which may alter the total sleep time, sleep efficiency, sleep architecture, as well as inhibit the secretion of melatonin (32–34).