IEEE Paper Template in A4 (V1) 41 This is an open access article under CC-BY-SA license. Journal of Science and Education (JSE) Vol. 1, No. 2, 2021, 41-47 DOI: 10.56003/jse.v1i2.20 ISSN: 2745-5351 Smartphone sleep technology: health apps during covid-19 to mitigate psychosocial stress among children and adolescents Cathy Mae Dabi Toquero College of Education, Mindanao State University-General Santos City, Philippines E-mail: cathymaetoquero@gmail.com Received: 13 December 2020 Accepted: 24 January 2021 Published: 1 March 2021 Abstract: Children and adolescents are prone to physical fatigue and psychosocial anxiety because of the ongoing social distancing and sleep deprivations due to the long exposure to digital technology usage during the covid-19 pandemic. This scenario of sleep deprivation affects their educational endeavors and health quality. Through the use of smartphones as a sleep technology approach in mental health, this article reviews relevant literature concerning the mobile health applications for sleep hygiene among children and adolescents. It provides insight into smartphone sleep technology utilization that can alleviate the psychosocial stress and mental health issues that children and adolescents can experience amid the pandemic. The author stressed that the collaboration among health practitioners, educators, and researchers are also pertinent to strengthen health measures and to conduct evidence-based research on digital health interventions. The scientific results can increase smartphone-based sleep applications' monitoring as health interventions for children and adolescents to practice sleep hygiene. Future investigation should also examine and assess the effectiveness of smartphone sleep technologies for sleep quality and mental health outcomes. Keywords: covid-19; psychosocial stress; mental health; mobile health technology. Abstrak: Anak-anak dan remaja rentan terhadap kelelahan fisik dan kecemasan psikososial karena penerapan jaga jarak (social distancing) dan kurang tidur akibat paparan yang lama dari penggunaan teknologi digital selama pandemi covid- 19. Skenario kurang tidur ini memengaruhi upaya pendidikan dan kualitas kesehatan mereka. Melalui penggunaan smartphone sebagai pendekatan teknologi tidur dalam kesehatan mental, artikel ini mengulas literatur yang relevan mengenai aplikasi kesehatan seluler untuk kualitas tidur di kalangan anak-anak dan remaja. Ini memberikan wawasan tentang pemanfaatan teknologi tidur pada smartphone yang mungkin dapat mengurangi kecemasan psikososial dan masalah kesehatan mental yang dapat dialami anak-anak dan remaja di tengah pandemi. Penulis menekankan bahwa kolaborasi antara praktisi kesehatan, pendidik, dan peneliti juga terkait untuk memperkuat langkah-langkah kesehatan dan melakukan penelitian berbasis bukti tentang intervensi kesehatan digital. Hasil ilmiah dapat meningkatkan pemantauan aplikasi tidur berbasis smartphone sebagai intervensi kesehatan bagi anak dan remaja untuk mempraktikkan kualitas tidur (sleep hygiene). Penyelidikan di masa depan juga harus memeriksa dan menilai efektivitas penggunaan teknologi tidur pada smartphone untuk kualitas tidur dan hasil kesehatan mental. Kata kunci: covid-19; kecemasan psikososial; kesehatan mental; teknologi kesehatan seluler. How to cite: Toquero, C. M. D. (2021). Smartphone sleep technology: health apps during covid-19 to mitigate psychosocial stress among children and adolescents. Journal of Science and Education (JSE), 1(2): 41-47. https://doi.org/10.56003/jse.v1i2.20 INTRODUCTION Many young children worldwide have been affected by the sudden changes in the school and home settings due to COVID-19. Due to social distancing measures, numerous children are diverting into emerging technologies such as social media to turn their home quarantine experience to something enjoyable using technologies. However, children and adolescents tend to experience sleep problems due to the changes in their lifestyles and schooling routines during the pandemic. https://creativecommons.org/licenses/by-sa/4.0/ https://doi.org/10.56003/jse.v1i2.20 https://portal.issn.org/resource/ISSN/2745-5351 mailto:cathymaetoquero@gmail.com https://doi.org/10.56003/jse.v1i2.20 https://crossmark.crossref.org/dialog/?doi=10.56003/jse.v1i2.20&domain=pdf&date_stamp=2022-04-30 42 Journal of Science and Education (JSE), Vol. 1, No. 2, March 2021, pp. 41-47 As children and young adults face the reality of experiencing stress and worries due to the crisis, they are also deprived of decent sleep and proper cardiorespiratory exercises as they spend countless hours playing online digital games and chatting with their friends in social network. Consequently, the relentless distressing situation due to COVID-19 and the long exposure to radiation using smartphones can be detrimental to their social, emotional, physical, and psychological well-being that can lead to anxiety and depression in the long term. Aside from these scenarios, sleep deprivations can mean barriers and challenges as children also experienced transitioning to emergency remote education (Talidong, 2020; Toquero, 2020a; Toquero, 2020b) during this pandemic that can also affect their learning behaviors. Considering their sleep problems, the use of smartphones can assess and monitor sleep patterns but there is little research on its application as an approach to depressive, anxiety, and psychotic disorders and few studies provided report on the use of smartphones for sleep problems and mental health outcomes (Aledavood, et al., 2019; Jandoo, 2020; Villanueva et al., 2017). Thus, the author examines the impact of COVID-19 to the sleeping behaviors of children and adolescents, discusses the potentials of the usage of sleep technology to mitigate sleep problems, and highlights collaboration among health practitioners to help children and their families during this emergency. METHOD This article discusses the current literature on how COVID-19 results to sleep problems and psychosocial stress to the children and adolescents that created for their health issues. The article utilized the traditional narrative review method (Bozkurt, 2019) to analyze how mobile health applications or smartphones may offer solutions to the sleep disturbances among children and adolescents. This method can provide a much need bridge between the vast and scattered assortment of articles on a topic and to link together many studies on different topics, either for purposes of reinterpretation or interconnection (Baumeister & Leary, 1997). Moreover, this way of presenting the article proves advantageous as the analysis depends on current knowledge to synthesize literature, draw conclusions, identify research gaps, and suggests for future studies (Cronin, Ryan, & Coughlan, 2008). 1. Smartphone technology and health problems due to covid-19 Some children and young adults may have some form of compromised health issues so they should be given protection amid COVID-19. The rise of smartphone utilization in a technologically-advanced world, and more than ever, the need for social relationships to be done online in social networks due to COVID-19 (Toquero & Talidong, 2020) intensify increased health risks among children and adolescents. Studies have pointed out that using mobile phones can cause health problems and sleep disturbances. Schweizer et. al. (2016) asserted that smartphones tend to cause sleep disturbance among adolescents. Valasareddy et al., (2019) also studied and confirmed that prolonged smartphone usage brings adverse effects to sleep patterns and detriment sleep health. Similarly, survey results also showed associations of technology use (such as cellphones, computers, video games, and television) and sleep difficulty among https://jse.rezkimedia.org/index.php/jse/index Toquero – Smartphone sleep technology: health apps during covid-19 … 43 children and adolescents (Fuller et al., 2017). A study also pointed out the negative effects of smart mobile devices on sleep quality in relation to academic performance (Owusu-Marfo et al., 2018). Aside from the health risks due to addiction to smartphones (Valasareddy, et al., 2019), and risks associated with long exposure to digital devices, the fear of the unknown (Arafat, Kar, & Kabir, 2020) such as the novel coronavirus and continuous social isolation can accelerate anxiety and mental health problems (Armitage & Nellums, 2020; Poletti & Raballo, 2020a; Poletti & Raballo, 2020b; Van Lancker & Parolin, 2020) in children along with self-isolation and sleep deprivation. The findings of a study suggested that insomnia is associated and highly prevalent with COVID-19 psychological reactions and irregular sleep hygiene (Li, Qin, Sun, Sanford, Vgontzas & Tang, 2020) among individuals and children and adolescents are no exemption. Thus, Köse, Yılmaz, Ocakoğlu & Özbaran (2017) suggested that behavioral and educational interventions can help improve sleep hygiene among children. 2. Opportunities of sleep technology Köse et al. (2017) stressed of behavioral and educational interventions, and reality is that, there are two sides to technology, it can offer advantages and disadvantages. Based on the aforementioned reviewed literature and studies, smartphone technology can cause addiction and sleep disturbances among children and adolescents. On the other hand, the use of smartphone technologies also offers opportunities for scientific investigation, such as using smartphone applications to monitor sleep hygiene among children and adolescents. Choi et al (2018) conducted a systematic review and concluded that smartphone applications have the potential for sleep self-management. They concluded, “consumer-targeting apps that support sleep self- management have the potential to help raise awareness and promote healthy sleep habits. However, without regulation and enforcement of clinical validation compliance, these apps should certainly be used with caution (pp. 1789).” As one study argued, sleep technologies can exhibit potential insight concerning long-term sleep patterns including circadian rhythm disturbances (Khosla & Wickwire, 2020) that people may experience due to the pandemic. In that case, the use of sleep tracking devices can increase sleep awareness among children and adolescents to program the brain to follow sleep routines and thereby achieve sleep quality. Although there are very little studies done to document smartphone-based sleep technology on mental health outcomes (Aledavood et al, 2019), there are greater research opportunities to test the effectiveness of smartphone sleep technologies to mitigate anxiety and sleep problems, especially among children and young adults. Overall, the impact of digital applications in the healthcare has not been assessed so a need arises to provide evidence-based insights in providing solutions of the effectiveness of digital applications (Jandoo, 2020). Villanueva et al. (2017) also argued the lack of evidence that has rigorously assessed the impact of mobile health and telemedicine. 44 Journal of Science and Education (JSE), Vol. 1, No. 2, March 2021, pp. 41-47 DISCUSSION During this pandemic, some prevailing questions remain such as how to use the advanced technologies to give the children and adolescents the right protection including regular sleep? How can health experts, educators on school health, and researchers give better and timely health communication (Zhang, Gui, Xu, Zhu, Zhai, Ge & Xu, 2020) to alleviate the effects of COVID-19 on the psycho-social and physical health of children and adolescents? To mitigate the sleep deprivation and psychosocial stress among children and adolescents, the utilization of smartphone sleep applications may be useful to keep track of their sleeping patterns and put off the use of their phones in scheduled time arrangements. Children and young adults can train and exercise their brain to sleep at a regular circadian rhythm and thereby avoid sleeping quandaries due to the perplexing situations that can be experienced during this COVID-19 period. The children need adult supervision to monitor the progress of their sleeping patterns since this may also affect their psychosocial health. Since some children have bedtime resistance, the solution is also on behavioral changes, so there are opportunities in the use of sleep technology as behavioral intervention. However, the use of sleep apps available in the market need health certificate compliance (Choi et al., 2018), so caution should be in mind when using smartphone sleep apps. Health experts, educators on school health, and health researchers can provide better and timely health communication to the stakeholders and guardians of children by strengthening collaboration and exchange of best practices on health interventions. They can share data, knowledge, and scientific information to update the stakeholders with evidence-based sleep hygiene and health hygiene practices. Their efforts will help the children and adolescents to manage the impacts of COVID-19 to their mental and physical well-being. The health practitioners and health researchers can make use of sleep technology paired with online mental health counseling (Liu et al, 2020) and teleconferencing to give guidance to parents and stakeholders to mitigate the psychosocial stress of the children. Recent studies also found that healthcare workers, health practitioners, and health services belong to the most trusted sources (Khosravi, 2020; Siegrist & Zingg, 2014; van der Weerd, Timmermans, Beaujean, Oudhoff, & van Steenbergen, 2011) in information dissemination. Thus, health experts should serve to communicate relevant health information, model a recommended and hygienic behavior, and create a transparent information strategy (Siegrist & Zingg, 2014). CONCLUSION Studies examined and concluded that smartphone technologies can engender poor sleep quality and other negative behaviors due to sleep deprivation that affect the overall health performance among children and adolescents. While many authors have unity in the negative effects of smartphones to sleep quality, recent body of literature points out the insufficient evidence on the impact of smartphone technology to health outcomes (sleep hygiene and mental health) of children and adolescents during COVID-19 period. https://jse.rezkimedia.org/index.php/jse/index Toquero – Smartphone sleep technology: health apps during covid-19 … 45 Based on the narrative review of existing and current literature, the cross-examination offers the following conclusions: a. Existing studies have shown the detrimental effects of smartphone applications to sleep quality. However, the use of smartphone sleep applications may present scientific opportunities to offer children with a form of psychosocial and physical support to lessen the psychosocial stress, sleep deprivations, and emotional toils that children can experience due to the heightening global health emergency. b. The collaboration and communication among practitioners can serve as model for the stakeholders to exhibit hygiene practices. However, health researchers, medical practitioners, and health educators need to conduct assessments to evaluate the effectiveness of digital applications as health interventions during this time when children tend to be most vulnerable. c. There is insufficient evidence-based assessments done on the effectiveness of smartphone sleep apps as interventions for health practices (sleep tracking devices for sleep hygiene and better psychosocial outcomes). d. Likewise, there is a need for digital health interventions that is grounded on scientific evidence to help children deal with the anxiety that they are experiencing during this pandemic. The effectiveness of sleep technology for the children and adolescents should also be assessed by health researchers and experts. 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