Mediating role of sleep duration in the association between problematic media use and sleep disturbance in children with neurodevelopmental disabilities.

BACKGROUND: This study examined associations between problematic media use, sleep duration, and sleep disturbance among children with neurodevelopmental disabilities and investigated whether sleep duration mediates this relationship. METHODS: This cross-sectional study included 205 caregivers of children aged 4-11 years with neurodevelopmental disabilities attending community-based special education and rehabilitation centers in Türkiye. Data were collected using a sociodemographic questionnaire, the Problematic Media Use Measure-Short Form, and the Children's Sleep Habits Questionnaire. Hierarchical linear regression analyses identified factors associated with sleep disturbance. Mediation analysis was performed using Hayes' PROCESS macro with bootstrapping. RESULTS: In adjusted model, older age (β = 0.172, p < 0.05), personal technological device ownership (β = 0.266, p < 0.001), and problematic media use (β = 0.201, p < 0.01) were associated with higher sleep disturbance. Problematic media use was negatively associated with sleep duration (B = - 0.326, p < 0.001), while shorter sleep duration was associated with greater sleep disturbance (B = - 0.953, p = 0.023). Sleep duration partially mediated this relationship. Problematic media use remained directly associated with sleep disturbance (B = 1.383, p = 0.016) and indirectly via reduced sleep duration (B = 0.310, 95% CI: 0.016-0.712), accounting for 18.3% of the total effect. CONCLUSIONS: These findings highlight the importance of considering sleep duration as a potential pathway linking problematic media use with sleep disturbance in children with neurodevelopmental disabilities. Given the importance of healthy sleep for functioning and quality of life, routine assessment of problematic media use and sleep duration should be integrated into clinical and rehabilitation care. Interventions targeting problematic media use and promoting healthy sleep habits may improve sleep and quality of life.