A steady stream of overnight social media notifications can disrupt a teenager’s sleep and lead to depression, lower cognition, and suicidal tendencies, according to research led by Jason Nagata, MD, MSc, UC San Francisco pediatrician and research expert on youth screen time and digital media use.

So, it’s not surprising he views this week’s Meta’s settlement of $17.1 billion — with an agreement to quiet overnight notifications on children’s accounts, among other changes — as a step in the right direction when it comes to reducing kids’ addiction to social media.

The settlement, one of the largest reached by a tech company in litigation with states, overshadows the $7.4 billion settlement reached by Purdue Pharma, the maker of OxyContin, for charges of causing patients’ addictions to the pain medication — renewing questions about the methods social media platforms use to keep children online and what excessive use can mean for their health and development.

We asked Nagata about the potential impacts of the settlement, the health impacts of problematic social media use, and what families can do to encourage healthier habits.

Is the settlement good for kids?

I think this is a meaningful step in the right direction. Importantly, the settlement shifts some responsibility from individual children and parents to the platforms themselves.

What are the platforms responsible for under the settlement?

They agreed to set default time limits, restrict nighttime notifications, offer young users the option of a non-personalized feed, and to implement stronger age assurance, which all have the potential to reduce problematic use.

You’ve said there is “good” and “bad” screen time. What do you mean?

It’s not just about time. Not all screen time is equal. There can be beneficial uses such as education, exercise classes, or communicating with family members. And social media can promote social connection, support identity development, and provide access to health information.

What is a social media addiction?

Problematic or addictive social media use occurs when children have difficulty controlling their use, even when they try to cut back. It can involve patterns seen with other addictions, including loss of control, withdrawal, and needing increasing amounts of use. For children and adolescents, these patterns can interfere with sleep, school, relationships, and other important activities.

How common is a social media addiction?

Our research found that 11- to 12-year-old preteens were susceptible to elements of social media addiction, including the inability to stop, withdrawal, tolerance, conflict, and relapse. Key findings were:

  • 22.5% say, “I spend a lot of time thinking about social media apps or planning my use of social media apps”
  • 18.4% say, “I use social media apps so I can forget about my problems”
  • 15.5% say, “I’ve tried to use my social media apps less but I can’t”

What makes social media so difficult for children and adolescents to put down?

This actually gets at the heart of the settlement. Some social media platforms are designed to promote engagement and keep people on the platform as long as possible. Likes, notifications, personalized algorithms, and infinite scroll features provide frequent rewards that encourage continued use and make disengagement difficult. For teenagers, social feedback is especially compelling because peer relationships are so important.

Are kids more vulnerable than adults?

Yes. Teenagers’ brains are still developing, and they are undergoing puberty and significant changes in their bodies and brains. They can be particularly susceptible to likes, notifications, and peer feedback. Our recent brain imaging research found that greater social media use in early adolescence was associated with differences in brain structure in regions involved in attention, cognitive control, and other important functions.

Peers and influencers are extremely important during adolescence and can exert a strong influence on teenagers’ lives. That may be one reason we see such high social media use among teenagers.

Does addictive social media use affect mental health?

Our research following thousands of adolescents found that social media addiction is associated with a wide range of health and developmental concerns. Young people with these addictive patterns of use had greater depression, suicidal behaviors, sleep disturbances, and substance initiation one year later. We have also found that addictive social media use is associated with lower performance on cognitive tests of memory and language, and, among boys, with greater ADHD symptoms the following year.

What about impacts on physical health?

Our research also linked excessive social media use to binge eating and sedentary behavior. For example, studies have found that children who eat while distracted by screens may be more likely to overeat because they aren’t paying as much attention to hunger and fullness cues, and to be inactive because they are tied to their screens.

What warning signs should parents look for to know if social media becomes concerning?

Parents should look beyond the number of hours their child is online and pay attention to how social media is making their child feel and how it is affecting their daily life.

Is it making them feel worse about themselves? Is it creating conflicts with friends or family? Are they becoming more isolated because being on the phone is crowding out in-person relationships and conversations? Is it interfering with schoolwork or sleep? Are they trying to cut back but finding that they can’t?

Some of this information can only be learned by talking to your teenager. Even if you know what their screen-time report says, that doesn’t tell you whether they’re experiencing cyberbullying or other problematic content. Regular, open-ended conversations about the benefits and problems with social media use are important.

What can parents do?

Some of the most consistent findings from our research include creating screen-free times, such as during mealtimes and bedtime. Limiting bedtime use means keeping phones and other devices outside the bedroom and turning them off at night.

Screen-free mealtimes are an opportunity for parents to check in with their children about their day, which can create opportunities for children to bring up problems such as cyberbullying or problematic media use.

Parents modeling good screen behavior is also very important to reducing a child’s screen time. More parental screen use is associated with higher addictive screen use in their children. If parents make a family rule to not text at the dinner table, they should follow it too.

What can we learn from this settlement?

We need independent research to determine whether these design changes actually improve young people’s health and well-being. It will also be important to study and preserve internal industry documents released through social media litigation.

As we learned from tobacco and opioid litigation, these records can provide important insights into how products were designed, what companies understood about their effects, and how we can better protect young people in the future.