Too Much Screen Time is Hurting Our Kids, Literally
Last month we covered a number of social and emotional drawbacks to too much screen time. This month, we discuss the physical downsides with two local OC healthcare experts.
Typically, when parents think about physical harm that spending so many hours on tablets, phones, or gaming might cause, the obvious concern is with the accompanying sedentary lifestyle, kids lose their healthy and active habits or find themselves mindlessly snacking. Consequently, otherwise healthy children have issues with weight gain, childhood obesity, and even early signs of developing diabetes. While those are certainly cause for worry and demand a change of habits, we’d like to share a few lesser known issues that can afflict our children’s growing bodies.
Text Neck, Nothing to LOL at
With the growing use of the portable devices, particularly in younger populations, we have seen an increase in technology-induced injuries related to poor posture. “Text neck” is becoming a very real problem of epidemic proportions. If this problem is not acknowledged with efforts to change poor posture habits, we will see a boost in younger individuals requiring spine care and even surgery.
The human head weighs over 10 pounds. As we bend our neck forward, the force it experiences increases exponentially. For instance, bending the neck to 45 degrees is equivalent to having a 50 pound head. bending the neck to 60 degrees is equivalent to a 60 pound head. The average teen smartphone or iPad user spends 2-4 hours a day having poor posture while using their device. This is nearly 2,000 hours per year. Many spend even more time with their device adding the hours of poor posture up to 10,000 hours per year.
The spine is meant to balance the weight of our bodies. When we flex forward, the force and stress placed on the “text neck” can cause damage. As our bodies adapt to this bad habit, the neck may become permanently fixed in this position. In turn this can cause early arthritis and damage to the disks, bones, and muscles. Ultimately, many will require spine care and possibly surgery as a result of the damage.
The damage that occurs is cumulative. The longer we spend with our necks in poor posture positions, the higher the likelihood a neck will permanently deform and degenerate. In my practice, I have already seen a boost in younger populations requiring care for an ailing neck. One of the first lines of treatment for these patients is education. They need to understand how these positions can be damaging. Simple attention and recognition to the problem is the first step to change in habit.
Teens who have not suffered pain or disability in their neck simply do not recognize the long-term implications of poor posture. This makes enforcing habit change very difficult. The first line of making change is recognizing how much time is being spent on a given day on a device. If you estimate your child spends greater than 4 hours on a device, there needs to be change. Regulating the amount of time spent on a device is necessary not only for spine health but for psychosocial, developmental and physical health.
Watch your teen as they use their device to see how much they bend. Every attempt to try to maintain a more neutral posture should be made. Teach them to look down with their eyes, not their necks. Hold the device more directly in front of them using the arms. Keeping a device at the chest level limits the amount of bending required. Change will not happen over night but be persistent about changing their poor posture habits.
It is necessary to take breaks. I do not recommend spending longer than 20 minutes in a flexed position. Some simple exercises help prevent strain, inflammation and encourage muscle growth. Simply look to the side (rotate) until you reach the endpoint and hold your neck at this position for 5 seconds. Similarly, look up and down and hold these endpoint positions for 5 seconds. Place your hand on the side of your face and push against it, holding the same position for 5 seconds. Similarly use your hand as a form of resistance pushing forward and backward, holding for 5 seconds. One more exercise involves squeezing your shoulder blades as if you are holding a pencil in-between them. At the same time extend the neck and hold the position for 5 seconds. This exercise strengthens the “good posture” muscles. Repeat these exercises every 20 minutes.
If attention isn’t paid to maintaining good posture in the neck, permanent damage that can only be corrected with surgery is possible. It is difficult for adolescents to recognize that long-term damage can be done. Encourage good posture habits and limit the amount of time they spend on their device.
Dr. Smith is a board certified orthopedic surgeon specializing in disorders of the spine. He is fellowship trained in Orthopedic Spine Surgery, cutting edge treatment of degenerative spinal conditions. Dr. Smith’s goal is to provide OC with quality, compassionate and affordable musculoskeletal care.
The natural curvature of the neck (left) is compromised by Text Neck (right).
Sleep Issues, Don’t Fall Asleep at the Parenting Wheel
An teenager’s average sleep requirement ranges from 8 to 10 hours. As in most “averages” there are teens whose normal sleep requirement extends above or below the average, so the sleep requirement must be individualized. The combination of longer sleep requirements and a teenager’s active lifestyle often combine to create problems. Insufficient sleep is the number one reason for excessive daytime sleepiness in teens.
The circadian rhythm of teenagers is delayed relative to adulthood, so their sleep period tends to occur later, making them night owls who want to stay up and sleep-in later than adults. Although you never “make-up for lost sleep,” we have the capacity to recuperate from occasional bouts of insufficient sleep. If we pull a latenighter, we may have increased sleepiness the next day, but after a full night’s sleep we will have almost complete recovery.
Teens get into trouble when they make insufficient sleep without sufficient recovery a regular habit. A sleep debt builds and the need to sleeps spills over into the normal waking period. Newer technology causes problems in several ways…First, by introducing an activity that can easily be carried-out beyond our normal waking period; Second, by creating an activity that involves brief, recurrent episodes that stimulate the mind, such as texting or flipping with internet searches; Finally, the bright light associated with computer screens may be activating and will delay the sleep period beyond our normal sleep time.
We are animals that require regular bright light exposure to set our 24- hour circadian rhythms. Exposure to bright light at abnormal times, such as a very bright computer screen at night, may stimulate the brain and make it more difficult to sleep.
The drive to sleep is similar to the drive to breathe; you can only hold your breath until the respiratory drive forces you to breathe again and you then breathe deeper and faster. Sleep deprivation increases the drive to sleep, and if we don’t sleep at night, we begin sleeping in the daytime. Mild daytime sleepiness impairs our ability to focus and concentrate, more significant daytime sleepiness results in dozing during inappropriate times. Sleepiness also promotes irritability or a depressed mood.
Note — Overt sleepiness may not be as evident in teens who may manifest their increased sleepiness as irritability or a lack of focus and concentration; symptoms very similar to ADHD. Excessive sleepiness should be addressed as a potential cause before making the diagnosis of ADHD.
Dr. Peter Fotinakes is medical director of the Sleep Disorders Center at St. Joseph Hospital in Orange. He holds a Bachelors (Chapman), attended UCI for medical school and completed his residency in Neurology through UCI Medical Center and sub-specialty training in Sleep Medicine.