Experts examine: How much screen time is too much?

It’s all but impossible for physicians to avoid excessive screen time. The COVID-19 pandemic has scaled the use of telemedicine and smartphone-based technologies like virtual assistants— digitizing tasks that once required more human touch and less time looking at a computer. Legacy tools, like electronic health records (EHR), still demand ample screen time. Never mind the binge-watching and social media scrolling that physicians do outside the hospital.

All of that screen time adds up. According to a 2020 study published in the Annals of Internal Medicine just before the pandemic, physicians spend roughly 16 minutes using the EHR during each patient encounter. More broadly, as COVID-19 took hold last March, Nielsen reported that adults spent nearly 13.5 hours per day glued to some sort of screen, up from 8 hours and 41 minutes the prior summer.

Of course, it’s nearly impossible to live disconnected in the modern era. Screens are necessary for work, education, and even relaxation. That said, some studies have found that too much screen time can be detrimental to physical and mental health, while others have found no undesirable effects. 

So, is too much screen time bad? And how can we temper our attachment to devices?

How screen time affects the body and mind

There’s no need to go screen-free, but limiting screen time can provide a number of benefits, according to the Mayo Clinic. These include lowered risk of obesity, improved mood, enhanced relationships, and more time to spend on other activities. The Mayo Clinic cautions that too much screen time can lead to undesirable effects such as disturbed sleep, anxiety, depression, and shorter attention spans. Other organizations, such as the American Academy of Child & Adolescent Psychiatry (AACAP) echo similar claims.

But does the evidence support these concerns? 

One study, published in Preventive Medicine Reports in 2017, examined potential associations between screen time and depression. Using data from the National Health and Nutritional Examination Survey 2011/2012, researchers analyzed health profiles of roughly 3,200 US adults aged 20 or older. They found that those who spent more than 6 hours a day looking at screens were more likely to have moderate or severe depression.

Another study, published in 2020 in Mayo Clinical Proceedings, followed roughly 500,000 participants aged 37-73 over a period of 12 years. The study included various types of screen time, including phone use and television watching. Researchers found that participants had the lowest risk of developing health issues like cancer and cardiovascular disease when daily screen time was limited to 2 hours or less. In fact, they concluded that if all participants had lowered their screen time to less than 2 hours, more than 5% of all deaths and almost 8% of deaths due to cardiovascular disease could have been prevented or delayed.

Likewise, a review of studies, published in the International Journal of Mental Health and Addiction in 2019, found that excessive smartphone use may increase the risk of early onset dementia in late adulthood. Other findings included associations among increased screen time and negative outcomes like decreased self-esteem, higher incidence and severity of mental health issues and addictions, slower learning and acquisition, and a greater risk of premature cognitive decline. 

But not all studies come to this conclusion. A 2019 review of studies on the effects of screen time on the health and well-being of children and adolescents, published in the BMJ, concluded that while there is moderately strong evidence that more screen time is associated with higher rates of obesity and depressive symptoms, the evidence to suggest associations with issues like anxiety, poorer cognitive development, and disturbed sleep outcomes is weak.

The authors of the review concluded that there is only limited evidence to guide policy on “safe” levels of screen time. They reported that arguments exist for why digital media could provide health, social, and cognitive benefits—and that the aforementioned harms are overstated.

How much screen time is OK? 

Given the pandemic, it might be hard to cut down your screen time. In that case, check out some advice that focuses less on time limits and more on being mindful of technology use, courtesy of Dr. Michael Rich, MD, a pediatrician who heads the Center on Media and Child Health at Boston Children’s Hospital and an associate professor at Harvard Medical School and the Harvard T.H. Chan School of Public Health. Rather than implementing a time-based target, all screen users should be more aware of their behaviors. How? Watch for media distraction. If you often find yourself distracted during a conversation with someone, consider limiting your screen time and occasionally leaving your phone in another room. Likewise, banning screens before bed could improve sleep.

Of course, it’s not always easy to reduce phone usage, but the evidence suggests it’s a worthwhile endeavor. According to a 2018 study published in Guilford Press Periodicals, which looked at 143 undergraduates at the University of Pennsylvania, limiting social media use to 30 minutes daily can lead to significant decreases in anxiety and fear of missing out and improvements in general well-being.