# Associations of sedentary behaviour and physical activity with stress-related sleep disturbance among adolescents in 69 countries: a population-based study

## TL;DR

This study finds that spending too much time being sedentary increases the risk of stress-related sleep problems in adolescents worldwide.

## Contribution

The study provides global evidence linking sedentary behavior and physical activity to stress-related sleep disturbances in adolescents using standardized data.

## Key findings

- Higher sedentary behavior is strongly linked to increased odds of stress-related sleep disturbances.
- Combining high sedentary behavior with low physical activity further increases the risk of sleep disturbances.
- Reducing sedentary time may help reduce stress-related sleep problems in adolescents.

## Abstract

Stress-related sleep disturbance have become a serious public health problem among adolescents worldwide. There is a paucity of research employing standardised methodologies to evaluate the association between sedentary behaviour, physical activity, and stress-related sleep disturbance among adolescents. We aimed to examine the association between sedentary behaviour and/or physical activity with stress-related sleep disturbance among adolescents worldwide.

We used data from the Global School-based Student Health Survey (GSHS) conducted from 2010 to 2019, encompassing 275 483 adolescents aged 12–17 years across 69 countries. Multi-variable logistic regression analysis was performed to assess the independent and joint effect of sedentary behaviour and physical activity on stress-related sleep disturbance.

30.0% of adolescents spend ≥2 hours in sedentary behaviour daily, only 15.4% engage in physical activity for over one hour each day, and 8.3% of adolescents suffer from stress-related sleep disturbances. Compared with those who engaged sedentary behaviour <2 hours/day, 3–4 hours (odds ratio (OR) = 1.168; 95% CI = 1.027–1.329), 5–6 hours (OR = 1.413; 95% CI = 1.169–1.707), and ≥7 hours (OR = 1.792; 1.548–2.076) of daily sedentary behaviour are positively associated with stress-related sleep disturbances among adolescents. Compared with adolescents with low sedentary behaviour and sufficient physical activity, adolescents with low sedentary behaviour and insufficient physical activity (OR = 1.303; 95% CI = 1.052–1.615), high sedentary behaviour and insufficient physical activity (OR = 1.666; 95% CI = 1.350–2.056), and adolescents with high sedentary behaviour and sufficient physical activity (OR = 1.852; 95% CI = 1.432–2.396) are positively associated with stress-related sleep disturbance.

Sedentary behaviour is associated with a higher risk of stress-related sleep disturbances among adolescents. Reducing sedentary behaviour time may serve as a potential intervention strategy for addressing stress-related sleep disturbances, while the potential benefits of increasing physical activity require further research and validation.