Nighttime screen use is hypothesized to attenuate the physiological nocturnal fall in blood pressure, contributing to the non-dipper phenotype in adolescents.
This narrative review proposes that intensive nighttime screen use, through mechanisms such as melatonin suppression and sympathetic activation, disrupts circadian control of the cardiovascular system, leading to a reduced nocturnal blood pressure dip (non-dipper phenotype). The paper positions 24-hour ambulatory blood pressure monitoring as the reference standard for detecting this at-risk phenotype and masked hypertension, which are invisible to office readings. The review integrates subclinical biomarkers and emerging wearable/AI tools into a proposed screening pathway.
Evidence Score
Study Evidence
Study 1. Detecting the Non-Dipper Phenotype in Adolescents Exposed to Nighttime Screen Use-Digital Chronotoxicity as a Proposed Integrative Framework: A Narrative Review of Ambulatory Blood Pressure Monitoring, Subclinical Biomarkers, and Emerging Wearable and AI-Based Screening.
observationalTupu AE, Tudor SS, Tudor IM, Stefan CS, Munteanu AE, Nechita A · Diagnostics (Basel, Switzerland) (2026)
Result:
Mechanism Graph
Limitations
- ⚠Narrative review, not a systematic review or meta-analysis, so evidence synthesis may be selective
- ⚠The concept of 'digital chronotoxicity' is proposed but not empirically validated in this paper
- ⚠No quantitative effect sizes or direct experimental data are provided
Frequently Asked Questions
What is digital chronotoxicity?▼
It is a proposed integrative concept that describes the disruptive effect of nighttime screen use on circadian control of the cardiovascular system, leading to chronic sleep loss and increased cardiovascular risk.
Why is the non-dipper phenotype important in adolescents?▼
The non-dipper phenotype, where nocturnal blood pressure does not fall sufficiently, is a predictor of early vascular aging and is invisible to office blood pressure measurements, making it a hidden risk factor.
How is the non-dipper phenotype detected?▼
It is detected using 24-hour ambulatory blood pressure monitoring (ABPM), which is positioned as the reference standard for identifying the at-risk phenotype and masked hypertension.
What are the proposed mechanisms linking screen use to non-dipping?▼
The mechanisms include melatonin suppression, sustained sympathetic and neuroendocrine activation, oxidative stress, and metabolic dysregulation, which together attenuate the physiological nocturnal blood pressure fall.
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References
- 1.Tupu AE, Tudor SS, Tudor IM, Stefan CS, Munteanu AE, Nechita A. "Detecting the Non-Dipper Phenotype in Adolescents Exposed to Nighttime Screen Use-Digital Chronotoxicity as a Proposed Integrative Framework: A Narrative Review of Ambulatory Blood Pressure Monitoring, Subclinical Biomarkers, and Emerging Wearable and AI-Based Screening.." Diagnostics (Basel, Switzerland), 2026. PMID: 42587597 DOI: 10.3390/diagnostics16152355