How technology affects health, according to experts

By Naveed Saleh, MD, MS
Published August 17, 2021

Key Takeaways

It’s safe to say that Americans spend an inordinate amount of time in front of screens. According to Nielsen, the average time glued to media platforms is almost 12 hours a day. Moreover, three-quarters of Americans are adding additional streaming subscriptions and TV-connected devices to their viewing habits. During the pandemic, already-high levels of media consumption were compounded by a nearly 60% increase in content viewing.

For physicians, it’s all but impossible to avoid a certain amount of time in front of a computer, but the evidence suggests that curtailing screen time outside of work might be a worthwhile endeavor.  

In the meantime, let’s examine the health effects associated with all of this technology. 

Gaming disorder

Many video games may seem innocuous but, just like drugs and gambling, they can induce dependence in a minority. 

Gaming disorder is included in the International Classification of Diseases, 11th Revision (ICD-11) as a pattern of gaming behavior characterized by impaired control over gaming and increasing importance allotted to gaming vs other activities. Such prioritization outpaces other interests and daily activities to the point of negative repercussions. Nevertheless, game play continues or escalates in those with the condition. 

To be diagnosed with gaming disorder, this pattern of behavior must be severe enough to interfere with personal, family, social, occupational, educational, and other areas of functioning during a period of at least one year.

“The inclusion of gaming disorder in ICD-11 follows the development of treatment programs for people with health conditions identical to those characteristic of gaming disorder in many parts of the world, and will result in the increased attention of health professionals to the risks of development of this disorder and, accordingly, to relevant prevention and treatment measures,” according to the WHO.

This disorder affects just a small percentage of people who engage in digital- or video-gaming activities, notes the WHO. However, fans of gaming should be cognizant of the amount of time they spend at it, especially if it gets in the way of other daily activities and responsibilities, or results in changes in their physical or mental health and social functioning.  

Computer vision syndrome

For those finding themselves continually poring over EHRs, computer vision syndrome may be familiar.

This condition is marked by eye- and vision-related issues, and goes by other names such as digital eye strain (DES) and visual fatigue. It has been a noted health issue for more than two decades, and millions are at risk—especially those who work with computers for a living. This condition leads to increased work-related errors and more frequent breaks needed by users, which results in vast economic losses, according to a review published in BMJ Open Ophthalmology

The most common symptoms linked to DES are eye strain, dry eyes, headaches, blurred vision, and neck/shoulder pain. The technical term for eye strain is asthenopia, which consists of external and internal manifestations. Internal symptoms are strain, ache, and headache behind the eyes, and these symptoms lead to accommodative stress with or without binocular vision stress. On the other hand, external symptoms include burning, irritation, tearing, and dryness. External symptoms are closely related to dry eye.

This condition may be transient or chronic, and a concordance between objective and subjective measures is not always evident. Subjective measures include questionnaires, whereas objective measures include critical flicker-fusion frequency (CFF), blink rate/completeness, and accommodative function/pupil characteristics.

Of note, blinking maintains the normal eye surface, and mediates secretion, dispersal, evaporation, and drainage of tears. Decreased rates of blinking are observed in computer users, and closely relate to the dry eye symptoms of DES. CFF frequency is a measure of fatigue and mental workload, and defined as the frequency at which a flickering light is indistinguishable from a steady, non-flickering light.

“A range of management approaches exist for DES including correction of refractive error and/or presbyopia, management of dry eye, incorporating regular screen breaks and consideration of vergence and accommodative problems,” wrote the researchers. “Recently, several authors have explored the putative role of blue light-filtering spectacle lenses on treating DES, with mixed results. Given the high prevalence of DES and near-universal use of digital devices, it is essential that eye care practitioners are able to provide advice and management options based on quality research evidence.”

To learn more, check out Experts examine how much screen time is too much, at MDLinx.

Carpal tunnel syndrome

While using the mouse and keyboard, upper extremity posture and task duration can lead to musculoskeletal discomfort. Use of the keyboard and mouse increase carpal tunnel load, and lead to deformation of the median nerve. Alterations in wrist posture, finger movement, and contact stress can increase in carpal tunnel pressure. Changes in wrist or finger movements can decrease the cross-sectional area of the median nerve.

Although exact causes are unknown, various factors may play a role in the development carpal tunnel syndrome including age, sex, obesity, medical conditions, diabetes mellitus, and arthritis. 

Results from a small study (n=15) published in the Journal of Occupational Health elucidated the effects of typing on wrist kinematics, wrist anthropometrics, and median nerve cross-sectional area.

“This study demonstrated changes in the median nerve after continuous keyboard typing. Changes in the median nerve were greater during typing using a keyboard tilted at 20° than during typing using a keyboard tilted at 0°,” the authors concluded, noting that a 30-minute rest time sufficiently allows the median nerve to return to the baseline measurement. 

Moreover, keeping the keyboard in a neutral position (0°) could prevent a high wrist extension angle during typing, and could reduce acute changes in the median nerve, they added.

Sleep problems

The biological clock is set to a 24-hour sleep-wake cycle. When the sun comes up, the body produces cortisol, which helps you stay awake and alert, whereas sleep-promoting melatonin is produced at night.

Cell phones, tablets, readers, computers, and other back-lit devices emit short-wavelength enriched light (ie, blue light). This light delays time spent in slow-wave or REM sleep, which are necessary for proper cognitive functioning.

“Children are particularly vulnerable to sleep problems stemming from electronic devices that emit blue light,” according to the Sleep Foundation. “Numerous studies have established a link between using devices with screens before bed and increases in sleep latency, or the amount of time it takes someone to fall asleep. Additionally, children who use these devices at night often do not receive enough high-quality sleep and are more likely to feel tired the next day.”

Trivia: Which two researchers were the first to “discover” REM sleep? Click here to take the quiz.

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