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NEWARK, N.J.—The average American adult spends more than 10 hours a day online, according to a recent Optimum (Altice) survey. This significant screen time—from devices like laptops, televisions, tablets, and virtual reality headsets—can harm eye health and sleep quality, experts suggest, with the use of smartphones right before or shortly after getting into bed being especially detrimental. A separate study in the journal Frontiers in Psychiatry involving more than 45,000 students demonstrated this correlation: every extra hour of screen time before bed was associated with a 63 percent higher risk of insomnia and a loss of 24 minutes of sleep.
According to the Casper-Gallup State of Sleep in America report, about 84 million American adults, or 33 percent, describe the quality of their sleep as “fair” or “poor.” For young adults, that percentage rises to 38 percent. In addition, just 35 percent of U.S. residents were likely to get the recommended eight hours of sleep daily. In addition to disrupted sleep, extended screen use often can cause symptoms that include dry or burning eyes, dry eye, blurred vision, headaches, eye fatigue, and difficulty focusing, according to experts at the Cleveland Clinic.
“Bright screens and blue-rich light in particular stimulate regions of the brain that regulate wakefulness. Use of devices near bedtime can delay melatonin release, making it harder to fall asleep and reducing overall quality of sleep. REM cycles take longer to start and can lead to more restless nights,” Aamena M. Kazmi, OD, Bellaire Family Eye Care, Bellaire, Texas, told VMAIL. “Additionally, the light itself is not the only issue. Mental stimulation, such as scrolling through the news or emotionally engaging content on social media, increases cognitive and emotional arousal. This can make it harder to wind down and can be linked to reduced REM sleep.”
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| Aamena M. Kazmi, OD. |
She added, “Phones require sustained near-focusing. Doing this for prolonged periods of time, especially in dim lighting before bed, can cause eye strain/fatigue. Excessive near-work over time is considered a risk factor for myopia or nearsightedness progression in the pediatric population. Lastly, blink rate is reduced when using screens, especially phones. This reduction in blinking is tied to meibomian gland dysfunction—a subcategory of dry eye that causes symptoms including intermittent blur/fluctuating vision, irritation, burning and eye fatigue.”
While exposure to some blue light during the day is beneficial for alertness, excessive exposure, particularly in the evening, can disrupt melatonin production and subsequently delay sleep, experts say. Beyond impacting sleep, prolonged screen use frequently results in symptoms such as dry or burning eyes, blurred vision, headaches, eye fatigue, and difficulty focusing.
The National Sleep Foundation (NSF) recently convened an expert group of researchers to develop consensus guidelines for screen use and sleep. The group found that screen use across the day can impair sleep health for both children and teens, but that viewing content before bed was particularly bad for sleep.
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| Jenn Lyerly, OD. |
According to the American Academy of Ophthalmology (AAO), one recommendation for gaining better sleep is to set devices to night or dark mode in the evening. This setting lowers screen brightness, and its warm colors are less likely to confuse your body into thinking it’s daytime. They also recommend avoiding avoid use of screens one to two hours before going to sleep.
“One of the most frequent complaints I get from patients is that sometimes when they wake up in the morning their eyes are still taking a really long time to focus. My first question is always ‘do you use your cell phone before bed?’ Transient smartphone blindness is a newly documented visual phenomenon that has popped up in the last decade,” said Jenn Lyerly, OD, TrueVision Eye Care in Raleigh, N.C. “It can cause temporary blurry vision or even blindness lasting from 10-15 minutes or even into the next day after using a smartphone at night. The CDC and National Sleep Foundation recommend avoiding device use at least 30 minutes before you go to sleep.”
There are plenty of valid reasons to limit screen time in children, according to the AAO. Research links increased screen time in young children to other health issues, the group said, including attention-related disorders, obesity and myopia.
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| Emma C. Vicuna, OD, FAAO. |
“The discussion of cell phone use before bedtime not only pertains to children, but also to adults,” Emma C. Vicuna, OD, FAAO, Sahara Eye Center, Las Vegas, Nev., told VMAIL.
“I usually address sleep as the first issue, that prolonged screen time affects the REM cycle of sleep and even staying asleep,” Dr. Vicuna said. “The blue light tricks your brain into thinking it’s still daytime because melatonin levels are suppressed. As far as children are concerned, prolonged screen time can increase myopia. Just as the brain is tricked to suppress melatonin, prolonged screen time can signal the eye to grow which increases nearsightedness. Most of my patients do not like to hear this discussion, but it is definitely something that is discussed frequently in my exam room.
“I have been recommending that patients shut down their electronics at least 1-2 hours before bedtime,” Dr. Vicuna added. “I have also been recommending a sleeping mask to keep extraneous light out, and it can also help patients with dry eyes.”
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