Interaction between sex and daily physical exercise duration in relation to sleep quality among adolescents

ZHENG Lijuan; DAI Li; LU Juanjuan; XIANG Weiwei; MIN Xinwen; XU Hao; WU Wenwen

doi:10.11852/zgetbjzz2025-1505

PDF(916 KB)

Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (10) : 1128-1133. DOI: 10.11852/zgetbjzz2025-1505

Health Promotion

Interaction between sex and daily physical exercise duration in relation to sleep quality among adolescents

ZHENG Lijuan^1,2*, DAI Li^3*, LU Juanjuan¹, XIANG Weiwei², MIN Xinwen¹, XU Hao¹, WU Wenwen^2,4

Author information +

History +

Abstract

Objective To examine the interaction between sex and daily physical exercise duration in relation to sleep quality among adolescents, so as to provide evidence for developing tailored sleep intervention strategies. Methods This cross-sectional study used cluster sampling to recruit adolescents aged 12-17 years from 13 middle schools in Shiyan, Hubei Province in October 2023. Data were collected through questionnaires and physical examinations. A total of 10 607 participants were included. Linear mixed-effects models with school included as a random effect were used to analyze the associations of sex, daily physical exercise duration, and their interaction with Pittsburgh Sleep Quality Index (PSQI) scores. Results The interaction between sex and daily physical exercise duration was statistically significant (F=3.239, P=0.039). Among boys, compared with those exercising for 30 to <60 min/d, those exercising for <30 min/d had higher PSQI scores (β =0.27, 95%CI: 0.13 to 0.41), whereas those exercising for ≥60 min/d had lower PSQI scores (β=-0.25, 95%CI: -0.42 to -0.07). Among girls, neither the <30 min/day group nor the ≥60 min/d group differed significantly from the 30 to <60 min/d group in PSQI score (P>0.05). Exercise-duration-stratified analyses showed that boys had lower PSQI scores than girls in both the 30 to <60 min/d and ≥60 min/d groups (β=-0.32,-0.36, P<0.01), whereas no significant sex difference was found in the <30 min/d group (P>0.05). Conclusions Sex and daily physical exercise duration interact in relation to sleep quality among adolescents, with the association between exercise duration and sleep quality observed primarily among boys. Adolescent sleep-health promotion strategies should consider both sex characteristics and physical exercise levels when developing tailored interventions.

Key words

adolescents / sex / daily physical exercise duration / sleep quality / interaction

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

ZHENG Lijuan, DAI Li, LU Juanjuan, XIANG Weiwei, MIN Xinwen, XU Hao, WU Wenwen. Interaction between sex and daily physical exercise duration in relation to sleep quality among adolescents[J]. Chinese Journal of Child Health Care. 2026, 34(10): 1128-1133 https://doi.org/10.11852/zgetbjzz2025-1505

References

[1] 许志飞, 杨琴, 江帆, 等. 中国儿童睡眠健康百问百答[J]. 中华实用儿科临床杂志, 2023, 38(3): 169-191.
Xu ZF, Yang Q, Jiang F, et al. One hundred questions and answers about children's sleep health in China[J]. Chin J Appl Clin Pediatr, 2023, 38(3): 169-191. (in Chinese)
[2] Fatima G, Shukla V, Magomedova A, et al. Mobile phone addiction and sleep quality among children and adolescents: Unraveling the health consequences[J]. Cureus, 2026, 18(1): e102460.
[3] Li Y, Guo K. Research on the relationship between physical activity, sleep quality, psychological resilience, and social adaptation among Chinese college students: A cross-sectional study[J]. Front Psychol, 2023, 14: 1104897.
[4] Quevedo-Blasco R, Díaz-Román A, Quevedo-Blasco VJ. Associations between sleep, depression, and cognitive performance in adolescence[J]. Eur J Investig Health Psychol Educ, 2023, 13(2): 501-511.
[5] 彭莲华, 刘冬冬, 朱肖, 等. 睡眠质量和抑郁在童年不良经历青少年神经质人格与执行功能之间的链式中介作用[J]. 中国儿童保健杂志, 2022, 30(8): 851-855.
Peng LH, Liu DD, Zhu X, et al. Chain mediating effects of sleep quality and depression on neurotic personality and executive function in adolescents with adverse childhood experiences[J]. Chin J Child Health Care, 2022, 30(8): 851-855. (in Chinese)
[6] Galan-Lopez P, Domínguez R, Gísladóttir T, et al. Sleep quality and duration in European adolescents (the AdolesHealth study): A cross-sectional, quantitative study[J]. Children, 2021, 8(3): 188.
[7] de Jesus Silva Soares Junior N, Dias-Filho CAA, Ferreira AC, et al. Sleep quality and regular physical activity in reducing cardiac risk[J]. Sleep Breath, 2023, 27(3): 953-960.
[8] Naing L, Hassen S, Sharbini S, et al. The relationship between the use of screen-based devices and self-reported sleep quality in adolescents aged 13-19 years in Brunei[J]. BMC Public Health, 2024, 24(1): 3270.
[9] Olorunmoteni OE, Gómez-Olivé FX, Fatusi AO, et al. Multidimensions of sleep health among in-school adolescents in rural and urban areas in southwestern Nigeria[J]. Sleep Health, 2024, 10(1): S170-S179.
[10] Gürbüz M, Bayram HM. The bidirectional association between Internet use, sleep quality and eating behavior: A cross-sectional study in northwestern Thrace Region in Türkiye[J]. J Am Nutr Assoc, 2025, 44(1): 50-58.
[11] Nanyonga B, Thomas KA, Ssesanga T, et al. Sleep health epidemiology and associations with menstrual health, mental health, and educational performance among in-school female adolescents in Uganda: A longitudinal study[J]. Sleep Health, 2025, 11(2): 174-183.
[12] Acharya S, Chalise A, Marasine NR, et al. Exploring the association between sleep quality, Internet addiction, and related factors among adolescents in Dakshinkali Municipality, Nepal[J]. PLoS One, 2025, 20(1): e0317747.
[13] Cheng J, Peng C, Rong F, et al. Mobile phone addiction and suicide behaviors among Chinese adolescents: The mediation of poor sleep quality[J]. J Behav Addict, 2024, 13(1): 88-101.
[14] 胡正春, 陈福乐, 皋萍, 等. 中学生睡眠质量与超重肥胖的关联[J]. 中国学校卫生, 2025, 46(6): 779-782, 787.
Hu ZC, Chen FL, Gao P, et al. Association of sleep quality with overweight and obesity among middle school students[J]. Chin J Sch Health, 2025, 46(6): 779-782, 787. (in Chinese)
[15] 魏嘉霖, 马珠江, 布威佐热姆·艾力. 青少年抑郁症状特征与睡眠质量和心理韧性的关系[J]. 中国学校卫生, 2025, 46(6): 842-846.
Wei JL, Ma ZJ, ELI Buzohre. Association of depressive symptom characteristics with sleep quality and psychological resilience in adolescents[J]. Chin J Sch Health, 2025, 46(6): 842-846. (in Chinese)
[16] Alnawwar MA, Alraddadi MI, Algethmi RA, et al. The effect of physical activity on sleep quality and sleep disorder: A systematic review[J]. Cureus, 2023, 15(8): e43595.
[17] Korkutata A, Korkutata M, Lazarus M. The impact of exercise on sleep and sleep disorders[J]. npj Biol Timing Sleep, 2025, 2: 5.
[18] 刘倩倩, 叶琴, 李县兰, 等. 体质指数与性别对成都市农村老年居民睡眠质量的交互作用[J]. 现代预防医学, 2025, 52(2): 193-197, 219.
Liu QQ, Ye Q, Li XL, et al. Interaction effect of body mass index and sex on sleep quality among rural older adults, Chengdu[J]. Mod Prev Med, 2025, 52(2): 193-197, 219. (in Chinese)
[19] 周成超, 楚洁, 王婷, 等. 简易心理状况评定量表Kessler10中文版的信度和效度评价[J]. 中国临床心理学杂志, 2008, 16(6): 627-629.
Zhou CC, Chu J, Wang T, et al. Reliability and validity of 10-item Kessler scale (K10) Chinese version in evaluation of mental health status of Chinese population[J]. Chin J Clin Psychol, 2008, 16(6): 627-629. (in Chinese)
[20] 陈子玥, 蔡珊, 马宁, 等. 中国9~18岁儿童青少年心理困扰流行现状[J]. 中华流行病学杂志, 2023, 44(10): 1537-1544.
Chen ZY, Cai S, Ma N, et al. Prevalence of psychological distress among Chinese children and adolescents aged 9-18 years[J]. Chin J Epidemiol, 2023, 44(10): 1537-1544. (in Chinese)
[21] 刘贤臣, 唐茂芹, 胡蕾, 等. 匹兹堡睡眠质量指数的信度和效度研究[J]. 中华精神科杂志, 1996, 29(2): 103-107.
Liu XC, Tang MQ, Hu L, et al. Reliability and validity of the Pittsburgh sleep quality index[J]. Chin J Psychiatry, 1996, 29(2): 103-107. (in Chinese)
[22] 国家质量监督检验检疫总局, 中国国家标准化管理委员会. 学生健康检查技术规范: GB/T 26343—2010[S]. 北京: 中国标准出版社, 2011.
[23] Ye J, Jia X, Zhang J, et al. Effect of physical exercise on sleep quality of college students: Chain intermediary effect of mindfulness and ruminative thinking[J]. Front Psychol, 2022, 13: 987537.
[24] Fei LL, Zhao SX, Chen YF, et al. Exercise and sleep health in college students: Efficacy, mechanisms, and implications for practice[J]. World J Psychiatry, 2025, 15(10): 108884.
[25] Zhao H, Lu C, Yi C. Physical activity and sleep quality association in different populations: A meta-analysis[J]. Int J Environ Res Public Health, 2023, 20(3): 1864.
[26] Olds TS, Maher CA, Matricciani L. Sleep duration or bedtime? Exploring the relationship between sleep habits and weight status and activity patterns[J]. Sleep, 2011, 34(10): 1299-1307.
[27] Wang T, Li W, Deng J, et al. The impact of the physical activity intervention on sleep in children and adolescents with neurodevelopmental disorders: A systematic review and meta-analysis[J]. Front Neurol, 2024, 15: 1438786.
[28] Master L, Nye RT, Lee S, et al. Bidirectional, daily temporal associations between sleep and physical activity in adolescents[J]. Sci Rep, 2019, 9(1): 7732.
[29] Wang Y, Wang X, Wang Q, et al. The role of bedtime procrastination, rumination, loneliness, and positive body image in predicting sleep quality among university students: A sex-specific analysis[J]. Alpha Psychiatry, 2025, 26(3): 44142.
[30] Strilciuc Ş, Chira D, Verişezan-Roşu O, et al. Sleep health patterns in Romania: Insights from a nationwide cross-sectional online survey[J]. Brain Sci, 2024, 14(11): 1086.
[31] Forest G, Gaudreault P, Michaud F, et al. Gender differences in the interference of sleep difficulties and daytime sleepiness on school and social activities in adolescents[J]. Sleep Med, 2022, 100: 79-84.