# Analysis of the correlation between physical activity level, sleep quality, and anxiety levels in middle-aged and older adults: a cross-sectional study

**Authors:** Bin Tang, Ying Hu, Chuanjie Xu, Nana Wang, Yu Li, Jianping Li

PMC · DOI: 10.3389/fpubh.2025.1629695 · Frontiers in Public Health · 2025-10-30

## TL;DR

This study shows that better sleep quality and regular physical activity are linked to lower anxiety in middle-aged and older adults.

## Contribution

The study identifies sleep quality as a key factor in anxiety, independent of sleep duration, and highlights gender and lifestyle differences.

## Key findings

- Good sleep quality and sufficient physical activity are independently linked to reduced anxiety risk.
- Sleep quality is more important than sleep duration in affecting anxiety levels.
- The associations are stronger in females, non-smokers, and urban residents.

## Abstract

This study aimed to investigate the associations between physical activity levels, sleep quality, and anxiety status in a cross-sectional sample of middle-aged and older adults.

Anxiety was assessed using the Generalized Anxiety Disorder 7 (GAD-7) scale, and sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Physical activity levels were evaluated using the International Physical Activity Questionnaire (IPAQ). Multivariable logistic regression models were used to analyze the associations, adjusting for potential confounders such as age, gender, body mass index (BMI), smoking, and alcohol use.

A total of 488 participants were included. Both good sleep quality and adherence to recommended physical activity levels were independently associated with a significantly reduced risk of anxiety (p < 0.001). Sleep quality, rather than sleep duration, emerged as a key factor of anxiety. Stratified analyses showed that these associations were more pronounced in females, non-smokers, and urban residents.

This study underscores the importance of sleep quality and physical activity in reducing anxiety risk. These findings suggest that integrated strategies promoting better sleep and increased physical activity may be effective for anxiety prevention and intervention among middle-aged and older adults.

## Linked entities

- **Diseases:** anxiety (MONDO:0005618)

## Full-text entities

- **Diseases:** Anxiety (MESH:D001007), Generalized Anxiety Disorder (MESH:C000726808)
- **Chemicals:** alcohol (MESH:D000438)

## Full text

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## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12611680/full.md

## References

28 references — full list in the complete paper: https://tomesphere.com/paper/PMC12611680/full.md

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Source: https://tomesphere.com/paper/PMC12611680