Effects of Screen Time on Emotional and Behavioral Functioning in Pediatric Cancer Survivors: The Potential Mediating Role of Sleep and Fatigue

Pediatric cancer survivors commonly experience fatigue and sleep-related problems, which can be associated with worse neurobehavioral functioning. In healthy children, sleep variables have been shown to mediate the relationship between screen time and psychological/behavioral functioning. Pediatric cancer survivors often undergo lengthy hospitalizations, during which time they have few entertainment options that are not screen-based, yet minimal research has examined the effects of screen time in this population. The present study examined the relationships between screen time, sleep duration and quality, fatigue, and emotional/behavioral functioning in pediatric cancer survivors. Parents of 66 pediatric cancer survivors ages 4–19 years completed standardized questionnaires assessing these domains. Mediation analyses supported an inverse relationship between screen time and sleep duration but showed no significant effect of screen time on emotional functioning. However, sleep problems were significantly related to emotional and behavioral functioning, and an indirect effect of sleep duration on externalizing problems and behavioral functioning emerged. Additionally, sleep disturbance and fatigue consistently predicted emotional and behavioral functioning problems. These findings underscore the importance of prioritizing sleep for pediatric cancer patients, with implications for parenting practices and the procedures of medical teams involved in these patients’ care.