Screens have become an integral part of daily life for children and adolescents, with many having devices in their bedrooms. The widespread presence of these devices has raised concerns about their potential impact on sleep. We discuss how screen time, especially before bed, may impact sleep, and how sleep may impact screen time. Evidence suggests that while the relationship between screen time and sleep is multifaceted, screen use—particularly interactive activities like gaming—can delay sleep onset and shorten total sleep time. Furthermore, individual variability in light sensitivity and the use of screens for emotional regulation adds complexity to the issue. Recommendations are provided for tailoring sleep interventions to individual needs, emphasizing the importance of understanding the context in which screens are used and addressing screen use as part of a comprehensive approach to improving pediatric sleep health. Further research is needed to keep pace with technological advancements and their effects on sleep, particularly in children and adolescents.