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Physical activity is associated with better sleep quality in adolescents, mediated by psychological resilience and academic stress, and moderated by peer support.

In a cross-sectional study of 1,347 high school students in Shanghai, physical activity was negatively associated with PSQI scores (indicating better sleep quality), with a direct association (β = -0.202, 61.3% of total effect) and indirect associations through psychological resilience (β = -0.053, 16.0%), academic stress (β = -0.040, 12.1%), and the serial pathway of resilience and academic stress (β = -0.035, 10.6%). Peer support weakened the positive association between academic stress and PSQI scores.

Last updated: Aug 26, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Sleep Quality and Physical Activity of Night Shift Nurses Working at Hospitals: A Cross-Sectional Survey Study.

observational

Zydziunaite V · Nursing reports (Pavia, Italy) (2026)

Participants: N/A
Duration: N/A
Intervention: Physical activity levels (measured via International Physical Activity Questionnaire-Short Form)
Outcome: Sleep quality (measured via Pittsburgh Sleep Quality Index total score and subscales including sleep latency, sleep medication use)
Effect Size: r = -0.162
Population: 400 night shift nurses working at hospitals

Result:

PubMed: 42506010DOI: 10.3390/nursrep16070223

Study 2. The association between physical activity and sleep quality among adolescents: the serial mediating roles of psychological resilience and academic stress and the moderating role of peer support.

observational

Leng H, Ni D, Xiao M, Yu F, Ji B, Zhou Z, Li S · Frontiers in public health (2026)

Participants: N/A
Duration: Cross-sectional (single time point)
Intervention: Physical activity (measured via Physical Activity Questionnaire for Adolescents)
Outcome: Sleep quality (Pittsburgh Sleep Quality Index, PSQI scores; higher scores indicate poorer sleep quality)
Effect Size: Direct association β = -0.202; indirect via resilience β = -0.053; via academic stress β = -0.040; serial β = -0.035
Population: 1,347 high school students from four districts in Shanghai, China

Result:

PubMed: 42638717DOI: 10.3389/fpubh.2026.1879316

Mechanism Graph

Physical activity is positively associated with psychological resilience.
↓
Higher psychological resilience is negatively associated with academic stress.
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Lower academic stress is negatively associated with PSQI scores (better sleep quality).
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Result: Physical activity is associated with better sleep quality through increased resilience and reduced academic stress.

Limitations

  • ⚠Cross-sectional design prevents causal or temporal inference.
  • ⚠Reliance on self-report questionnaires may introduce response bias.
  • ⚠Sample limited to Shanghai high school students, limiting generalizability.
  • ⚠Potential unmeasured confounders not fully controlled.

Frequently Asked Questions

Does physical activity improve sleep quality in adolescents?▼

This study found a negative association between physical activity and PSQI scores, suggesting that higher physical activity is associated with better sleep quality, but due to cross-sectional design, causality cannot be established.

What role does psychological resilience play in the physical activity-sleep link?▼

Psychological resilience partially mediates the association: physical activity is positively associated with resilience, which in turn is negatively associated with academic stress and PSQI scores, contributing to better sleep quality.

How does academic stress affect sleep quality?▼

Academic stress is positively associated with PSQI scores, indicating that higher academic stress is associated with poorer sleep quality. Peer support moderates this relationship, weakening the negative impact.

Can peer support buffer the effect of academic stress on sleep?▼

Yes, the positive association between academic stress and PSQI scores was weaker among adolescents with higher peer support, suggesting a protective role of peer support.

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References

  1. 1.Zydziunaite V. "Sleep Quality and Physical Activity of Night Shift Nurses Working at Hospitals: A Cross-Sectional Survey Study.." Nursing reports (Pavia, Italy), 2026. PMID: 42506010 DOI: 10.3390/nursrep16070223
  2. 2.Leng H, Ni D, Xiao M, Yu F, Ji B, Zhou Z, Li S. "The association between physical activity and sleep quality among adolescents: the serial mediating roles of psychological resilience and academic stress and the moderating role of peer support.." Frontiers in public health, 2026. PMID: 42638717 DOI: 10.3389/fpubh.2026.1879316
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.