Abstract
Recently the Swedish Public Health Agency published recommendations of a maximum of two-to-three hours of daily leisure screen time for adolescents aged 13-18, partly to promote better sleep (2024-Sep-02). Biologically and socially, adolescence is characterized by belated sleep times, and depressive effects of screen time can arise through sleep displacements. Theorized links between screen time, sleep, and depression, merited examination of four sleep mediators to determine their relative importance and determine which of them mediate future depression. Hypotheses were preregistered. Three-wave psychometric health data were collected from healthy Swedish students (N = 4810; 51% Boys; ages 12-16; N = 55 schools; n = 20 of 26 Stockholm municipalities). Multiple imputation bias-corrected missing data. Gender-wise Structural Equation Modelling tested four sleep facets as competing mediators (quality, duration, chronotype, social jetlag). The primary model result included the three first mediators to achieve acceptable fit indices (RMSEA = 0.02; SRMR = 0.03; CFI = 0.95; TLI = 0.94). Screen time deteriorated sleep within three months and effect sizes varied between mediators (Beta weights ranged: 0.14-0.30) but less between genders. Among boys, screen time at baseline had a direct adverse effect on depression after twelve months (Beta = 0.02; p <0.038). Among girls, the depressive effect was mediated through sleep quality, duration, and chronotype (57, 38, 45% mediation). Social jetlag remained non-significant. This study supports a modernized 'screen-sleep-displacement theory'. It empirically demonstrates that screen-sleep displacements impact several aspects of sleep simultaneously. Displacements led to elevated depressive symptoms among girls but not boys. Boys may be more prone to externalizing symptoms due to sleep loss. Results could mirror potentially beneficial public health effects of national screen time recommendations.