Examining the day-to-day bidirectional associations between physical activity, sedentary behavior, screen time, and sleep health during school days in adolescents

Abstract

Background Adolescence is a vulnerable period for experiencing poor sleep health. Growing studies have demonstrated lifestyle behaviors including physical activity (PA), screen time (SCT), and sedentary behaviors (SED) as the potential factors associated with sleep health in adolescents; yet, the evidence is inconclusive and the directionality of temporal associations across school days are not well understood. This study examined the day-today bidirectional associations of lifestyle behaviors with sleep health parameters in adolescents. Methods A total of 263 adolescents (58% boys) in 6 th-8 th grades wore an accelerometer for 24-hour across the three consecutive school days and completed recording SCT in time-diary and answering sleep quality (SQ) questions for each day. Sleep-wake patterns as well as time spent in moderate-and vigorous-intensity PA (MVPA) and SED were objectively quantified from the wrist-worn accelerometry data across the two segments of the day (during and after school hours). Mixed model analyses were conducted to test bidirectional associations between lifestyle factors and sleep health parameters in each temporal direction across the days. Additionally, indirect associations across the days were tested using an autoregressive cross-lagged model analysis in the framework of path analysis. Results MVPA minutes in a day did not predict sleep health parameters that night. The bidirectional associations were partially observed between SED and sleep health, but the significance and direction of the associations largely varied by the time segment of a day as well as types of sleep health parameters. Additionally, greater SCT during the day was associated with

Sleep Quality and Duration in European Adolescents (The AdolesHealth Study): A Cross-Sectional, Quantitative Study

“…This is consistent with recent research carried out on the European adolescent population and reflects the worrying prevalence of poor sleep quality in this age group [78,89]. One of the reasons that can lead to a worse sleep quality as age increases may be the exposure to screens, since the older the subjects, the longer the time of use of electronic devices [70,90]. In addition, the negative influence is higher when close to bedtime, presenting higher levels of sleep latency and difficulties falling asleep [70,90].…”

“…A possible explanation for these results can be found in the lower levels of health-related physical fitness and higher levels of body composition of adolescents from Seville [ 58 ], when compared with Reykjavik and Tartu adolescents [ 59 , 68 , 69 ]. It is known that daily physical activity practice (and the consequent increase of the fitness level) is directly related to ease of falling asleep, thus achieving a longer duration [ 70 , 71 , 72 , 73 ].…”

“…One of the reasons that can lead to a worse sleep quality as age increases may be the exposure to screens, since the older the subjects, the longer the time of use of electronic devices [ 70 , 90 ]. In addition, the negative influence is higher when close to bedtime, presenting higher levels of sleep latency and difficulties falling asleep [ 70 , 90 ].…”

Bidirectional associations between sedentary time and sleep duration among 12- to 14-year-old adolescents

“…Extra analyses conducted as part of this study confirm that it is the additional (prolonged) sedentary time during non-school hours that is significantly related to a shorter sleep duration, and not the additional (prolonged) sedentary time during school hours (see Additional file 3 ). This is in line with the study of Kim and colleagues [ 21 ] in which more sedentary time during the after-school period, and not during the school period, was associated with a shorter sleep duration the following night among young adolescents. This means that when promoting the reduction and breaking up of sedentary time during the day, there should be a focus on the non-school hours.…”

“…Another study in adolescents from the 6th and 8th grade also observed a bidirectional, negative association between sedentary time, screen-time and sleep duration, although the association varied by the specific sedentary and sleep health parameter used and by the time period of a day (e.g. sitting time during school hours vs. after school hours) [ 21 ]. In both studies sedentary time was measured using hip-worn accelerometers.…”