Association Between Movement Behaviors,Sleep Quality,and Anxiety Symptoms in Adolescents: A School-Based Cross-Sectional Study

Abstract

The objective of this study was to investigate the association between movement behaviors, sleep quality, and anxiety symptoms in adolescents. This cross-sectional study included 250 Brazilian school adolescents (aged 16.6 ± 1.2 years) from a federal public school. Moderate-to-vigorous physical activity (MVPA; classified as physically active [≥60 min/day] and physically inactive [<60 min/day] according to the World Health Organization recommendations), sedentary behavior (SB; classified as low <8 h/day and high ≥8 h/day), and sleep quality (poor vs. good) were measured using the adapted version of the Global School-based Student Health Survey. Anxiety symptoms (≥30 points) were evaluated using the Screen for Child Anxiety Related Disorders. Poisson regression with robust variance was used to determine the prevalence ratio (PR) and 95% confidence interval to compare anxiety symptoms between categories of MVPA, SB, and sleep quality, while adjusting for confounding variables. The prevalence of anxiety symptoms was 48.8% (95% CI: 42.4, 54.8). MVPA and sleep quality were associated with anxiety(p < .05). Physically inactive participants had a higher prevalence of anxiety compared with their physically active peers (PR = 1.31, 95% CI: 1.04, 1.64; p = .021). Participants with poor sleep quality had a higher prevalence of anxiety compared with those with good sleep quality (PR = 1.47, 95% CI: 1.16, 1.88; p = .002). SB was not associated with anxiety (p > .05). In conclusion, the results suggest that physically inactive adolescents and those with poor sleep quality have a higher prevalence of anxiety symptoms. Moreover, specific combinations of physical inactivity, high SB, and poor sleep quality, as well as the concomitant presence of all three, are associated with an even greater prevalence of anxiety symptoms.