Relationship Between Screen Time Duration and Sleep Duration with Emotional Behavioral Problems in Preschool Children in Kindergartens In Denpasar City
Emotional behavioral problems in children are quite serious problems because they affect their development, cause disabilities, reduce their productivity and quality of life. In this digital era, the use of gadgets has become a habit and has been introduced to children since preschool age. Excessive screen time can have an impact on children's sleep quality, one of which is reduced sleep duration. Excessive screen time and insufficient sleep duration are often associated with the child's development process. This study aims to prove that screen time and sleep duration have a significant relationship with the incidence of emotional behavioral problems in preschool children in Denpasar City Kindergartens. This study used a cross-sectional design with an analytical method conducted during the period January 2024–March 2024 using the emotional behavior problems questionnaire. The sample size used was total sampling in the research sampling, which was 108 children. For the result mental emotional problems experienced in 38.9% subjects. The gender that experienced the most mental emotional problems was male at 52.4%. Working and highly educated mothers were more dominant in children who experienced mental emotional problems with a percentage of 69% and 78.6%. Children who experienced complications at birth were 9.5% experiencing mental emotional problems. There was a significant relationship between screen time duration (p=0.045 [PR 2.25; 95% CI 1.01-5.04]) and sleep duration (p=0.023 [PR 2.66; 95% CI 1.12-6.29]) with emotional behavioral problems in preschool children. Screen time >1 hour and sleep duration <11 hours have been shown to have a significant relationship with emotional behavioral problems in preschool-aged children.
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Duration, Emotional Behavioral Problems, Preschool-aged, Screen Time, Sleep
1. Introduction
Emotional behavior refers to efforts made by an individual to adapt to their environment and experiences. The development of emotional behavior in children is beneficial for focusing attention, controlling emotions, and communicating with their surroundings. Emotional behavioral problems in children are quite serious, as they can interfere with development, cause disabilities, and lower both productivity and quality of life.
[1]
Centers for Disease Control and Prevention. Children’s Mental Health. 2022. Download from
The preschool period, between 60 to 72 months of age, is a critical stage in which children's skills and cognitive processes develop rapidly. During this time, children begin to express their desires alongside their physical and mental growth. Not only do they interact within their home environment, but they are also introduced to external environments, such as outdoor play and social interactions with peers. As children are being prepared for formal schooling, their sensory organs, stimulus reception systems, and memory processes must be ready to support effective learning.
[2]
Kementrian Kesehatan RI. Pedoman Pelaksanaan Stimulasi, Deteksi, dan Intervensi Dini Tumbuh Kembang Anak di Tingkat Pelayanan Kesehatan Dasar. Jakarta; 2022.
[2]
The prevalence of emotional behavioral problems in preschool-aged children is quite high. According to the National Institute of Mental Health (NIMH), the global prevalence of such problems in this age group is around 10–15%.
[3]
KMHO. Childrens Behavioral and Emosional Disorders. 2019. Download from
The 2018 Indonesian Basic Health Research (Riskesdas) report stated that the prevalence of emotional behavioral problems in Indonesia was 9.6%, an increase from 6.0% in 2013.
Subekti N, Nurrahima A. Gambaran Keadaan Mental Emosional Anak Usia Prasekolah di Daerah Pesisir. Jurnal PPNI Jateng. 2019.
[6]
Riskesdas. Laporan Provinsi Bali Riskesdas 2018. Jakarta; 2018.
[5, 6]
in Semarang in 2019 revealed that 57.1% of preschool children living in coastal areas experienced emotional and mental disturbances. However, data on the prevalence of emotional behavioral problems among preschool children in Bali, particularly Denpasar City, remains scarce.
Several factors can contribute to emotional behavioral problems in children. In the study by Subekti et al.
[5]
Subekti N, Nurrahima A. Gambaran Keadaan Mental Emosional Anak Usia Prasekolah di Daerah Pesisir. Jurnal PPNI Jateng. 2019.
[5]
in Semarang, the most influential factors included mothers who did not work (68%), low maternal education, mostly at junior high school level (67.9%), low parental income (63%), multiple parental marriages (83.3%), and children who were stepchildren (100%). Another study conducted in Sukabumi in 2020 using the Emotional Behavioral Problems Questionnaire reported that such problems were influenced by authoritarian parenting style [OR = 5.88 (95% CI: 3.45–10.02)], birth complications [OR = 3.36 (95% CI: 1.95–5.81)], divorced parents [OR = 3.00 (95% CI: 1.09–8.23)], working mothers [OR = 1.77 (95% CI: 1.04–3.00)], and low maternal education [OR = 1.74 (95% CI: 1.02–2.95)].
[7]
Utami S, Hanifah D. Faktor Risiko Masalah Mental Emosional pada Anak Prasekolah di Kota Sukabumi. Buletin Penelitian Sistem Kesehatan 2020; 24 (3): 192-201.
[7]
In this digital era, gadget use has become a habit and is often introduced to children from preschool age. The World Health Organization (WHO) defines screen time as the amount of time children spend watching various screen-based media, such as television, computers, mobile devices, tablets, and so on. Screen time is typically a sedentary activity, where children remain relatively inactive while watching screens. Prolonged sedentary screen time is now believed to contribute to various health issues, developmental delays, and behavioral and cognitive problems in children. Excessive screen time can also disrupt sleep patterns. Most sleep disturbances in children result from inadequate sleep duration (quantity) or fragmented sleep (poor quality). Both prolonged screen time and sleep disturbances are frequently associated with emotional behavioral issues in preschool-aged children.
[7]
Utami S, Hanifah D. Faktor Risiko Masalah Mental Emosional pada Anak Prasekolah di Kota Sukabumi. Buletin Penelitian Sistem Kesehatan 2020; 24 (3): 192-201.
[8]
Chikmah AM, Fitrianingsih D. Pengaruh Durasi Penggunaan Gadget Terhadap Masalah Mental Emosional Anak Prasekolah di TK Pembina Kota Tegal. Jurnal SIKLUS 2018; 7(2): 295-98.
[7, 8]
A study conducted in Semarang by Lukmasari et al.
[9]
Lukmasari A, Hartanto F, Bahtera T, Muryawan MH. Hubungan antara Gangguan Tidur dengan Gangguan Mental Emosional pada Anak usia 4-6 Tahun di Semarang. Sari Pediatri 2017; 18(5): 345-49.
[9]
showed that most parents did not implement proper sleep hygiene practices for their children. Sleep hygiene includes enforcing consistent sleep schedules, using dim lighting at night, maintaining clean sleeping environments, and avoiding electronic devices in bedrooms. Sleep disturbances were found to increase the risk of emotional problems by 2.7 times (p = 0.003) and behavioral problems by 1.8 times (p = 0.005). Another study by Chikmah et al.
[8]
Chikmah AM, Fitrianingsih D. Pengaruh Durasi Penggunaan Gadget Terhadap Masalah Mental Emosional Anak Prasekolah di TK Pembina Kota Tegal. Jurnal SIKLUS 2018; 7(2): 295-98.
[8]
in Pembina Tegal Kindergarten, in 2018 using the Emotional Behavioral Problems Questionnaire also found a significant relationship (p = 0.002) between screen time duration and emotional behavioral problems in children.
Child development depends on the child's maturity. Maturity of the body and brain is the readiness to master various new abilities in children. Early childhood is a child who is in a period of growth and development because during this period there is basic growth that will affect the child's development in the future. Developmental delays caused by behavioral and emotional disturbances in infants and children can negatively affect social life and learning abilities.
[10]
Wijirahayu A, Pranaji D, Muflikhati I. Kelekatan Ibu-anak, Pertumbuhan Anak, dan Perkembangan Sosial Emosi Anak Usia Prasekolah. Jurnal Ilmu Keluarga dan Konsumen 2016; 9(3): 171-82.
[11]
Kopp M, Linduer M, Garthus-Niegel S. Association between Maternal Employment and Child’s Mental Health: A Systematic Review with Meta-Analysis. European Child and Adolescent Psychiatry 2024; 33: 3025-42.
[10, 11]
Early screening and diagnosis are necessary to detect such disorders. This study aims to prove the association between screen time duration and sleep duration with emotional behavioral problems in preschool children in kindergartens across Denpasar City.
2. Materials and Methods
This study used a cross-sectional design with an analytical approach to investigate the relationship between risk factors (screen time duration and sleep duration) and the incidence of emotional behavioral problems in preschool children attending kindergartens in Denpasar City from January to March 2024. The instrument used in this study was the Emotional Behavioral Problems Questionnaire (Kuesioner Masalah Perilaku Emosional/KMPE) completed by the parents or guardians of the subjects. The KMPE is a screening tool for emotional behavioral issues, with outcomes categorized as either normal or problematic. A child was considered to have a possible problem if there was at least one “Yes” response out of the 12 KMPE questions. The inclusion criteria were children aged 4–5 years attending kindergartens in Denpasar City and parents or guardians who agreed to participate in the study. Exclusion criteria were incomplete questionnaire responses, children with special needs, children with a previous diagnose of emotional behavioral disorders. Data were collected from questionnaire completed by the parents or guardians, which included age, gender, maternal occupation and education, average monthly parental income, parental marital status, presence of birth complications, daily screen time duration, daily sleep duration, and emotional behavioral status as determined by KMPE. A cluster sampling method was used, beginning with the random selection of 4 subdistricts in Denpasar City. From these, 10 kindergarten clusters were randomly selected, and within each selected cluster, subjects were chosen through systematic random sampling until the required sample size was achieved. The minimum sample size was calculated using the formula for unpaired categorical analytical studies, considering Zα = 1.96 for 5% error, Zβ = 0.842 for 20% error. For screen time > 1 hour P1 = 0.7 (proportion with emotional behavioral problems) and P2 = 0,4 (proportion without problems) so the minimum sample size = 78. For sleep duration < 11 hours P1 = 0.8 dan P2 = 0,3 and the minimum sample size = 60. Therefore, 78 samples was used as the minimum sample size for this study.
Independent variables in this study were creen time duration classified as >1 hour or ≤1 hour per day (based on Indonesian Pediatric Society/IDAI recommendations) and sleep duration classified as <11 hours or ≥11 hours per day (recommended sleep duration for preschoolers is 11–12 hours/day by IDAI). Dependent variable is Emotional behavioral problems, based on KMPE screening outcomes.
Characteristic variable were age: 4 and 5 years. Gender: male or female. Maternal occupation: employed or housewife. Maternal education: low or high. Parental income: lower or highr then minimum wage of Denpasar City. Parent’s marital status: married or divorce. Birth complications (e.g., admitted >14 days after birth): yes or no.
Data were analyzed using SPSS software and presented in tabular form. Bivariate analysis was performed using the Chi-square test to determine the relationship between screen time duration and sleep duration with emotional behavioral problems. A p-value < 0.05 was considered statistically significant.
This study was approved by the Ethics Committee of the Faculty of Medicine, Udayana University / Prof. I G.N.G. Ngoerah Hospital, with ethical clearance No: 0031/UN14.2.2.VII.14/LT/2023, and permission was granted by PAUD Cluster Chairperson Lely (Cluster IV) with letter number 05/G.Lely.II.2024.
3. Results
This study involved parents or guardians of students in selected kindergartens who were asked to complete the questionnaire. A total of 7 kindergartens were included, with a combined total of 476 students. However, some students were not picked up by their parents, which meant their guardians could not complete the questionnaire. Ultimately, 108 parents who met the inclusion and exclusion criteria were present, willing to participate, and completed the questionnaire. Among these, 38.9% of the children were identified as having possible emotional behavioral problems. Table 1. shows the general characteristics of the study subjects based on emotional behavioral status.
Table 1. Characteristics of subjects based on emotional behavioral profile.
characteristics
Emotional behavior profile
Possible problem (n=42)
Normal development (n=66)
Gender, n (%)
Male
22 (52.4)
23 (34.8)
Female
20 (47.6)
43 (65.2)
Mother’s occupation, n (%)
Employed
29 (69)
42 (63.6)
Housewife
13 (31)
24 (36.4)
Mother’s education, n (%)
low
9 (21.4)
13 (19.7)
high
33 (78.6)
53 (80.3)
Parental income, n (%)
< min. wage
14 (33.3)
21 (31.8)
> min. wage
28 (66.7)
45 (68.2)
Marital status, n (%)
Married
42 (100)
64 (97)
Divorce
0 (0)
2 (3)
Komplikasi saat lahir, n (%)
Ya
4 (9.5)
3 (4.5)
Tidak
38 (90.5)
63 (95.5)
Screen time duration, n (%)
> 1 hour
28 (66.7)
31 (47)
< 1 hour
14 (33.3)
35 (53)
Durasi tidur, n (%)
< 11 hours
32 (76.2)
36 (54.5)
> 11 hours
10 (23.8)
30 (45.5)
Most subjects were 5 years old (86.1%), with 41.7% boys and 58.3% girls. The majority of mothers had higher education (senior high school or university) at 79.6%. A greater proportion of mothers were employed (65.7%) compared to housewives. Most families had incomes equal to or above the Denpasar minimum wage (67.6%), and only 1.9% of parents were divorced. More children had screen time >1 hour per day and sleep duration <11 hours per day compared to those who met the recommended durations.
Children whose screen time and sleep durations did not meet recommended standards were more likely to experience emotional behavioral problems. The relationship between these two variables and emotional behavioral outcomes was analyzed using the Chi-square test, as shown in Table 2.
The results in Table 2 show a significant relationship between both screen time and sleep duration with emotional behavioral problems. Preschool children with screen time >1 hour per day were 2.25 times more likely to have emotional behavioral problems (95% CI: 1.01–5.04). Similarly, those who slept less than 11 hours per day were 2.66 times more likely to experience emotional behavioral issues (95% CI: 1.12–6.29).
Table 2. Relationship between screen time and sleep duration with emotional behavioral problems.
Possible emotional behavior problem
PR (95% CI)
p-value
Yes
No
Scree time duration
>1 hour
28
31
2.25 (1.01 – 5.04)
0.045
<1 hour
14
35
Sleep duration
<11 hours
32
36
2.66 (1.12 – 6.29)
0.023
>11 hours
10
30
4. Discussion
The World Health Organization (WHO) recommends that preschool-aged children should have no more than 1 hour of screen time per day. Excessive screen time at this age is associated with multiple risks, including obesity, poor sleep quality, delayed development, cognitive-academic problems, and behavioral-emotional disorders.
[12]
WHO. Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children under 5 years of age. 2019.
[12]
This study showed that children with screen time exceeding 1 hour per day (66.7%) were more likely to experience emotional behavioral problems compared to those with ≤1 hour per day (33.3%). Bivariate analysis revealed that preschoolers with >1 hour of screen time were 2.25 times more likely to experience emotional behavioral problems, with a significant p-value (p = 0.045). Similar findings were reported by Chikmah et al. (2018) in TK Pembina Tegal, where a significant correlation was found between screen time duration and emotional behavioral problems in preschoolers.
[8]
Chikmah AM, Fitrianingsih D. Pengaruh Durasi Penggunaan Gadget Terhadap Masalah Mental Emosional Anak Prasekolah di TK Pembina Kota Tegal. Jurnal SIKLUS 2018; 7(2): 295-98.
[8]
Excessive screen time has been consistently linked to various emotional and behavioral issues in children. A study analyzing 62,395 Chinese children and adolescents found that increased screen time correlated with poorer mental health outcomes, including heightened emotional problems and reduced prosocial behaviors. Notably, these associations were more pronounced during weekdays and varied by gender and educational stage. Similarly, a study involving 8,900 preschoolers in China revealed that children engaging in two or more hours of screen time daily exhibited higher scores on behavioral problem assessments, such as the Strengths and Difficulties Questionnaire (SDQ) and the Clancy Autism Behavior Scale (CABS)
[13]
Xiaoyan W et all. 2017. The relationship between screen time, nighttime sleep duration, and behavioural problems in preschool children in China. Eur Child Adolesc Psychiatry.
During infancy (under 2 years), the child’s brain structure and function are still limited in terms of attention, recognition, memory storage, and three-dimensional processing. At this age, introducing screen-based digital media and providing screen time does not offer opportunities for children to master new knowledge. In contrast, during preschool age (3–6 years), the brain develops more complex executive functions such as reasoning, creativity, and emotional regulation. These abilities develop best through responsive, interactive activities between children and their caregivers. However, most digital media content today is not designed to promote such parent–child interaction.
[14]
Suryawan A. Rekomendasi Screen Time pada Anak. In prosciding book Simposium Nasional Ikatan Dokter Anak Indonesia (IDAI). 2020. Page. 87-96.
[15]
Madigan S, Browne D, Racine N, Merl C, Tough S. Association Between Screen Time and Children’s Performance on a Developmental Screening Test. JAMA Pediatr 2019; 173(3): 244-50.
[14, 15]
Sleep duration is also linked to emotional behavior. Sleep is a reversible state of reduced responsiveness and interaction with the environment and consists of two main components: REM (rapid eye movement) and non-REM sleep. The REM phase is crucial as it is associated with the release of neurotransmitters such as noradrenaline to the medial prefrontal cortex and amygdala. Disrupted sleep can affect neurotransmitter balance in the emotional control centers (e.g., amygdala). Sleep disorders have been associated with emotional and behavioral disturbances in children and adolescents.
[16]
Gregory A, Sadeh A. Sleep, Emotional and Behavioral Difficulties in Children and Adolescents. Sleep Med Rev 2012; 16: 129-36.
[16]
Children’s sleep disturbances may be due to inadequate sleep duration or poor sleep quality. Sleep needs vary with age. At age 2 is 13 hours/day, at ages 3-4 is 12 hours/day, and at age 5 is 11 hours/day.
[16]
Gregory A, Sadeh A. Sleep, Emotional and Behavioral Difficulties in Children and Adolescents. Sleep Med Rev 2012; 16: 129-36.
[17]
IDAI. Perkembangan Tidur Normal pada Batita. 2016. Download from https://www.idai.or.id/artikel/seputar-kesehatan-anak/perkembangan-tidur-normal-pada-batita
[16, 17]
When a child’s sleep needs are not met for several consecutive days, this leads to sleep debt, resulting in functional deficits between the amygdala and the ventral anterior cingulate cortex (vACC). This can cause mood disturbances and a heightened response from the amygdala to negative stimuli. Studies show that sleep debt is linked to mental health issues, including irritability, aggression, hyperactivity, and tantrums.
[18]
Saghir Z, Syeda J, Muhammad S. The Amygdala, Sleep Debt, Sleep Deprivation, and Emotion of Anger: A Possible Connection?. Cureus 2018; 10(7): 2912.
[19]
Bauducco S, Flink K, Linton S. Sleep Duration and Patterns in Adolescents: Correlates and The Role of Daily Stressors. Sleep Health 2016; 2: 211-18.
[18, 19]
In this study, children who slept less than 11 hours per day (76.2%) had a higher prevalence of emotional behavioral problems than those who slept 11 hours or more (23.8%). Preschool children with <11 hours of sleep were found to be 2.66 times more likely to develop emotional behavioral problems. This finding is consistent with the study by Lukmasari et al. in Semarang, which found a relationship between sleep disorders and emotional behavioral problems in children aged 4–6 years.
[9]
Lukmasari A, Hartanto F, Bahtera T, Muryawan MH. Hubungan antara Gangguan Tidur dengan Gangguan Mental Emosional pada Anak usia 4-6 Tahun di Semarang. Sari Pediatri 2017; 18(5): 345-49.
[9]
Similarly, a cross-sectional study by Bauducco et al. among adolescents aged 12–16 found that those who slept less than the recommended duration tended to show emotional dysregulation, including anger, depression, and anxiety, as well as norm-breaking behavior.
[20]
Izzaturahman N, Safira L, Herardi R, Muktamiroh H. Hubungan antara Durasi Penggunaan Media Layar dengan Pola Tidur pada Anak Usia Tiga sampai Lima tahun saat Masa Pandemi COVID-19. Sari Pediatri 2023; 24 (6): 382-87.
[21]
Sekartini R, Purwito N. Gangguan Tidur pada Anak Usia Bawah Tiga Thun di Lima Kota di Indonesia. Sari Pediatri 2006; 7(4): 188-93.
[20, 21]
Adequate sleep is vital for children's emotional regulation and overall well-being. A longitudinal study of rural preschool children in China demonstrated that longer nighttime sleep duration was associated with fewer emotional and behavioral problems. Specifically, children who slept more at night showed significant reductions in total difficulties and prosocial behavior problems over time
[22]
Haixia L et all. 2023. Longitudinal association of nighttime sleep duration with emotional and behavioral problems among rural preschool children. Spinger Nature Link. Volume 33, pages 267-277.
[22]
.
5. Study Limitations
This study has several weaknesses, namely the presence of recall bias which can affect the results of the study. This study did not include sleep quality, which may potentially contribute to emotional and behavioral problems in preschool-aged children.
6. Conclusions
This study found that nearly half of preschool children attending kindergartens in Denpasar City experienced possible emotional behavioral problems (38.9%). Among children with screen time >1 hour, 47% showed possible emotional behavioral issues. Similarly, 47% of children who had sleep duration <11 hours also experienced possible emotional behavioral problems. Bivariate analysis confirmed that both screen time duration of more than 1 hour per day and sleep duration of less than 11 hours per day were significantly associated with an increased risk of emotional behavioral problems in preschool-aged children.
Abbreviations
WHO
World Health Organization
KMPE
Kuesioner Masalah Perilaku Emosional
IDAI
Ikatan Dokter Anak Indonesia
REM
Rapid Eye Movement
vACC
ventral Anterior Cingulate Cortex
Acknowledgments
We thank Departement of Pediatrics medical school of Udayana University, Ngoerah Hospital.
Author Contributions
Putu Satya Prameswari: Data curation, Formal Analysis, Investigation, Software, Visualization, Writing-original draft
I Gusti Ayu Trisna Windiani: Conceptualization, Resources, Methodology, Validation, Supervision, Writing-review & editing
I Gusti Agung Ngurah Sugitha Adnyana: Conceptualization, Resources, Methodology, Validation, Supervision, Writing-review & editing
Funding
This work is not supported by any external funding.
Data Availability Statement
The data supporting the outcome of this research work has been reported in this manuscript.
Conflicts of Interest
The authors declare no conflicts of interest.
References
[1]
Centers for Disease Control and Prevention. Children’s Mental Health. 2022. Download from
Kementrian Kesehatan RI. Pedoman Pelaksanaan Stimulasi, Deteksi, dan Intervensi Dini Tumbuh Kembang Anak di Tingkat Pelayanan Kesehatan Dasar. Jakarta; 2022.
[3]
KMHO. Childrens Behavioral and Emosional Disorders. 2019. Download from
Subekti N, Nurrahima A. Gambaran Keadaan Mental Emosional Anak Usia Prasekolah di Daerah Pesisir. Jurnal PPNI Jateng. 2019.
[6]
Riskesdas. Laporan Provinsi Bali Riskesdas 2018. Jakarta; 2018.
[7]
Utami S, Hanifah D. Faktor Risiko Masalah Mental Emosional pada Anak Prasekolah di Kota Sukabumi. Buletin Penelitian Sistem Kesehatan 2020; 24 (3): 192-201.
[8]
Chikmah AM, Fitrianingsih D. Pengaruh Durasi Penggunaan Gadget Terhadap Masalah Mental Emosional Anak Prasekolah di TK Pembina Kota Tegal. Jurnal SIKLUS 2018; 7(2): 295-98.
[9]
Lukmasari A, Hartanto F, Bahtera T, Muryawan MH. Hubungan antara Gangguan Tidur dengan Gangguan Mental Emosional pada Anak usia 4-6 Tahun di Semarang. Sari Pediatri 2017; 18(5): 345-49.
[10]
Wijirahayu A, Pranaji D, Muflikhati I. Kelekatan Ibu-anak, Pertumbuhan Anak, dan Perkembangan Sosial Emosi Anak Usia Prasekolah. Jurnal Ilmu Keluarga dan Konsumen 2016; 9(3): 171-82.
[11]
Kopp M, Linduer M, Garthus-Niegel S. Association between Maternal Employment and Child’s Mental Health: A Systematic Review with Meta-Analysis. European Child and Adolescent Psychiatry 2024; 33: 3025-42.
[12]
WHO. Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children under 5 years of age. 2019.
[13]
Xiaoyan W et all. 2017. The relationship between screen time, nighttime sleep duration, and behavioural problems in preschool children in China. Eur Child Adolesc Psychiatry.
Suryawan A. Rekomendasi Screen Time pada Anak. In prosciding book Simposium Nasional Ikatan Dokter Anak Indonesia (IDAI). 2020. Page. 87-96.
[15]
Madigan S, Browne D, Racine N, Merl C, Tough S. Association Between Screen Time and Children’s Performance on a Developmental Screening Test. JAMA Pediatr 2019; 173(3): 244-50.
[16]
Gregory A, Sadeh A. Sleep, Emotional and Behavioral Difficulties in Children and Adolescents. Sleep Med Rev 2012; 16: 129-36.
[17]
IDAI. Perkembangan Tidur Normal pada Batita. 2016. Download from https://www.idai.or.id/artikel/seputar-kesehatan-anak/perkembangan-tidur-normal-pada-batita
[18]
Saghir Z, Syeda J, Muhammad S. The Amygdala, Sleep Debt, Sleep Deprivation, and Emotion of Anger: A Possible Connection?. Cureus 2018; 10(7): 2912.
[19]
Bauducco S, Flink K, Linton S. Sleep Duration and Patterns in Adolescents: Correlates and The Role of Daily Stressors. Sleep Health 2016; 2: 211-18.
[20]
Izzaturahman N, Safira L, Herardi R, Muktamiroh H. Hubungan antara Durasi Penggunaan Media Layar dengan Pola Tidur pada Anak Usia Tiga sampai Lima tahun saat Masa Pandemi COVID-19. Sari Pediatri 2023; 24 (6): 382-87.
[21]
Sekartini R, Purwito N. Gangguan Tidur pada Anak Usia Bawah Tiga Thun di Lima Kota di Indonesia. Sari Pediatri 2006; 7(4): 188-93.
[22]
Haixia L et all. 2023. Longitudinal association of nighttime sleep duration with emotional and behavioral problems among rural preschool children. Spinger Nature Link. Volume 33, pages 267-277.
Prameswari, P. S., Windiani, I. G. A. T., Adnyana, I. G. A. N. S. (2025). Relationship Between Screen Time Duration and Sleep Duration with Emotional Behavioral Problems in Preschool Children in Kindergartens In Denpasar City. American Journal of Pediatrics, 11(2), 108-113. https://doi.org/10.11648/j.ajp.20251102.21
Prameswari, P. S.; Windiani, I. G. A. T.; Adnyana, I. G. A. N. S. Relationship Between Screen Time Duration and Sleep Duration with Emotional Behavioral Problems in Preschool Children in Kindergartens In Denpasar City. Am. J. Pediatr.2025, 11(2), 108-113. doi: 10.11648/j.ajp.20251102.21
Prameswari PS, Windiani IGAT, Adnyana IGANS. Relationship Between Screen Time Duration and Sleep Duration with Emotional Behavioral Problems in Preschool Children in Kindergartens In Denpasar City. Am J Pediatr. 2025;11(2):108-113. doi: 10.11648/j.ajp.20251102.21
@article{10.11648/j.ajp.20251102.21,
author = {Putu Satya Prameswari and I Gusti Ayu Trisna Windiani and I Gusti Agung Ngurah Sugitha Adnyana},
title = {Relationship Between Screen Time Duration and Sleep Duration with Emotional Behavioral Problems in Preschool Children in Kindergartens In Denpasar City
},
journal = {American Journal of Pediatrics},
volume = {11},
number = {2},
pages = {108-113},
doi = {10.11648/j.ajp.20251102.21},
url = {https://doi.org/10.11648/j.ajp.20251102.21},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20251102.21},
abstract = {Emotional behavioral problems in children are quite serious problems because they affect their development, cause disabilities, reduce their productivity and quality of life. In this digital era, the use of gadgets has become a habit and has been introduced to children since preschool age. Excessive screen time can have an impact on children's sleep quality, one of which is reduced sleep duration. Excessive screen time and insufficient sleep duration are often associated with the child's development process. This study aims to prove that screen time and sleep duration have a significant relationship with the incidence of emotional behavioral problems in preschool children in Denpasar City Kindergartens. This study used a cross-sectional design with an analytical method conducted during the period January 2024–March 2024 using the emotional behavior problems questionnaire. The sample size used was total sampling in the research sampling, which was 108 children. For the result mental emotional problems experienced in 38.9% subjects. The gender that experienced the most mental emotional problems was male at 52.4%. Working and highly educated mothers were more dominant in children who experienced mental emotional problems with a percentage of 69% and 78.6%. Children who experienced complications at birth were 9.5% experiencing mental emotional problems. There was a significant relationship between screen time duration (p=0.045 [PR 2.25; 95% CI 1.01-5.04]) and sleep duration (p=0.023 [PR 2.66; 95% CI 1.12-6.29]) with emotional behavioral problems in preschool children. Screen time >1 hour and sleep duration <11 hours have been shown to have a significant relationship with emotional behavioral problems in preschool-aged children.
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TY - JOUR
T1 - Relationship Between Screen Time Duration and Sleep Duration with Emotional Behavioral Problems in Preschool Children in Kindergartens In Denpasar City
AU - Putu Satya Prameswari
AU - I Gusti Ayu Trisna Windiani
AU - I Gusti Agung Ngurah Sugitha Adnyana
Y1 - 2025/06/12
PY - 2025
N1 - https://doi.org/10.11648/j.ajp.20251102.21
DO - 10.11648/j.ajp.20251102.21
T2 - American Journal of Pediatrics
JF - American Journal of Pediatrics
JO - American Journal of Pediatrics
SP - 108
EP - 113
PB - Science Publishing Group
SN - 2472-0909
UR - https://doi.org/10.11648/j.ajp.20251102.21
AB - Emotional behavioral problems in children are quite serious problems because they affect their development, cause disabilities, reduce their productivity and quality of life. In this digital era, the use of gadgets has become a habit and has been introduced to children since preschool age. Excessive screen time can have an impact on children's sleep quality, one of which is reduced sleep duration. Excessive screen time and insufficient sleep duration are often associated with the child's development process. This study aims to prove that screen time and sleep duration have a significant relationship with the incidence of emotional behavioral problems in preschool children in Denpasar City Kindergartens. This study used a cross-sectional design with an analytical method conducted during the period January 2024–March 2024 using the emotional behavior problems questionnaire. The sample size used was total sampling in the research sampling, which was 108 children. For the result mental emotional problems experienced in 38.9% subjects. The gender that experienced the most mental emotional problems was male at 52.4%. Working and highly educated mothers were more dominant in children who experienced mental emotional problems with a percentage of 69% and 78.6%. Children who experienced complications at birth were 9.5% experiencing mental emotional problems. There was a significant relationship between screen time duration (p=0.045 [PR 2.25; 95% CI 1.01-5.04]) and sleep duration (p=0.023 [PR 2.66; 95% CI 1.12-6.29]) with emotional behavioral problems in preschool children. Screen time >1 hour and sleep duration <11 hours have been shown to have a significant relationship with emotional behavioral problems in preschool-aged children.
VL - 11
IS - 2
ER -
Prameswari, P. S., Windiani, I. G. A. T., Adnyana, I. G. A. N. S. (2025). Relationship Between Screen Time Duration and Sleep Duration with Emotional Behavioral Problems in Preschool Children in Kindergartens In Denpasar City. American Journal of Pediatrics, 11(2), 108-113. https://doi.org/10.11648/j.ajp.20251102.21
Prameswari, P. S.; Windiani, I. G. A. T.; Adnyana, I. G. A. N. S. Relationship Between Screen Time Duration and Sleep Duration with Emotional Behavioral Problems in Preschool Children in Kindergartens In Denpasar City. Am. J. Pediatr.2025, 11(2), 108-113. doi: 10.11648/j.ajp.20251102.21
Prameswari PS, Windiani IGAT, Adnyana IGANS. Relationship Between Screen Time Duration and Sleep Duration with Emotional Behavioral Problems in Preschool Children in Kindergartens In Denpasar City. Am J Pediatr. 2025;11(2):108-113. doi: 10.11648/j.ajp.20251102.21
@article{10.11648/j.ajp.20251102.21,
author = {Putu Satya Prameswari and I Gusti Ayu Trisna Windiani and I Gusti Agung Ngurah Sugitha Adnyana},
title = {Relationship Between Screen Time Duration and Sleep Duration with Emotional Behavioral Problems in Preschool Children in Kindergartens In Denpasar City
},
journal = {American Journal of Pediatrics},
volume = {11},
number = {2},
pages = {108-113},
doi = {10.11648/j.ajp.20251102.21},
url = {https://doi.org/10.11648/j.ajp.20251102.21},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20251102.21},
abstract = {Emotional behavioral problems in children are quite serious problems because they affect their development, cause disabilities, reduce their productivity and quality of life. In this digital era, the use of gadgets has become a habit and has been introduced to children since preschool age. Excessive screen time can have an impact on children's sleep quality, one of which is reduced sleep duration. Excessive screen time and insufficient sleep duration are often associated with the child's development process. This study aims to prove that screen time and sleep duration have a significant relationship with the incidence of emotional behavioral problems in preschool children in Denpasar City Kindergartens. This study used a cross-sectional design with an analytical method conducted during the period January 2024–March 2024 using the emotional behavior problems questionnaire. The sample size used was total sampling in the research sampling, which was 108 children. For the result mental emotional problems experienced in 38.9% subjects. The gender that experienced the most mental emotional problems was male at 52.4%. Working and highly educated mothers were more dominant in children who experienced mental emotional problems with a percentage of 69% and 78.6%. Children who experienced complications at birth were 9.5% experiencing mental emotional problems. There was a significant relationship between screen time duration (p=0.045 [PR 2.25; 95% CI 1.01-5.04]) and sleep duration (p=0.023 [PR 2.66; 95% CI 1.12-6.29]) with emotional behavioral problems in preschool children. Screen time >1 hour and sleep duration <11 hours have been shown to have a significant relationship with emotional behavioral problems in preschool-aged children.
},
year = {2025}
}
TY - JOUR
T1 - Relationship Between Screen Time Duration and Sleep Duration with Emotional Behavioral Problems in Preschool Children in Kindergartens In Denpasar City
AU - Putu Satya Prameswari
AU - I Gusti Ayu Trisna Windiani
AU - I Gusti Agung Ngurah Sugitha Adnyana
Y1 - 2025/06/12
PY - 2025
N1 - https://doi.org/10.11648/j.ajp.20251102.21
DO - 10.11648/j.ajp.20251102.21
T2 - American Journal of Pediatrics
JF - American Journal of Pediatrics
JO - American Journal of Pediatrics
SP - 108
EP - 113
PB - Science Publishing Group
SN - 2472-0909
UR - https://doi.org/10.11648/j.ajp.20251102.21
AB - Emotional behavioral problems in children are quite serious problems because they affect their development, cause disabilities, reduce their productivity and quality of life. In this digital era, the use of gadgets has become a habit and has been introduced to children since preschool age. Excessive screen time can have an impact on children's sleep quality, one of which is reduced sleep duration. Excessive screen time and insufficient sleep duration are often associated with the child's development process. This study aims to prove that screen time and sleep duration have a significant relationship with the incidence of emotional behavioral problems in preschool children in Denpasar City Kindergartens. This study used a cross-sectional design with an analytical method conducted during the period January 2024–March 2024 using the emotional behavior problems questionnaire. The sample size used was total sampling in the research sampling, which was 108 children. For the result mental emotional problems experienced in 38.9% subjects. The gender that experienced the most mental emotional problems was male at 52.4%. Working and highly educated mothers were more dominant in children who experienced mental emotional problems with a percentage of 69% and 78.6%. Children who experienced complications at birth were 9.5% experiencing mental emotional problems. There was a significant relationship between screen time duration (p=0.045 [PR 2.25; 95% CI 1.01-5.04]) and sleep duration (p=0.023 [PR 2.66; 95% CI 1.12-6.29]) with emotional behavioral problems in preschool children. Screen time >1 hour and sleep duration <11 hours have been shown to have a significant relationship with emotional behavioral problems in preschool-aged children.
VL - 11
IS - 2
ER -
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