Skip to main content
Log in

Relationship of sleep quality with screen-based sedentary time and physical activity in adolescents — the moderating effect of body mass index

  • Sleep Breathing Physiology and Disorders • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Objective

To analyze the association of sleep quality with reported screen-based sedentary time and reported physical activity, among overweight adolescents.

Methods

Adolescents aged 10 to 17 years enrolled in public and private schools were included. Data collection was carried out during the school semesters of 2014–2015 and participants who did not participate in all evaluations were excluded. Sleep quality and physical activity were assessed by validated questionnaires. Screen-based sedentary time was assessed by self-reported mean daily hours spent on television, computer, smartphone/tablet, and videogames. Body mass index was objectively measured and adolescents were classified into normal weight and overweight according to cutoff points for age and sex. Multiple linear regression models adjusted by covariates (age, sex, ethnicity, and socioeconomic status) were used to analyze the relationship between variables.

Results

A total of 1008 adolescents were assessed, with a mean age of 13.2 ± 2.4 years and a mean body mass index of 20.4 ± 4.3 kg/m2. Overweight was observed in 28.0% of sample, while 53.0% reported non-white ethnicity. Self-reported screen-based sedentary time was significantly related to poor sleep quality in adolescents (β = 0.116, p = 0.005), remaining significant only in those who were normal weight (β = 0.101, p = 0.007) in sensitivity analysis. Self-reported physical activity showed no relationship with sleep quality in both normal weight and overweight adolescents.

Conclusion

Self-reported screen-based sedentary time was associated with poor sleep quality in adolescents, mainly among those with normal weight. The time spent on screen-based sedentary activities can impair sleep quality even in normal weight adolescents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Hagenauer MH, Lee TM (2013) Adolescent sleep patterns in humans and laboratory animals. Horm Behav 64(2):270–279. https://doi.org/10.1016/j.yhbeh.2013.01.013

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hayes JF, Balantekin KN, Altman M, Wilfley DE, Taylor CB, Williams J (2018) Sleep patterns and quality are associated with severity of obesity and weight-related behaviors in adolescents with overweight and obesity. Child Obes 14(1):11–17. https://doi.org/10.1089/chi.2017.0148

    Article  PubMed  PubMed Central  Google Scholar 

  3. Pacheco SR, Miranda AM, Coelho R, Monteiro AC, Bragança G, Loureiro HC (2017) Overweight in youth and sleep quality: is there a link? Arch Endocrinol Metab 61(4):367–373. https://doi.org/10.1590/2359-3997000000265

    Article  PubMed  Google Scholar 

  4. McHill AW, Wright KP Jr (2017) Role of sleep and circadian disruption on energy expenditure and in metabolic predisposition to human obesity and metabolic disease. Obes Rev Suppl 1:15–24. https://doi.org/10.1111/obr.12503

    Article  Google Scholar 

  5. Wolf C, Wolf S, Weiss M, Nino G (2018) Children’s environmental health in the digital era: understanding early screen exposure as a preventable risk factor for obesity and sleep disorders. Children (Basel) 5(2):31. https://doi.org/10.3390/children5020031

    Article  Google Scholar 

  6. Sallis JF, Conway TL, Cain KL et al (2018) Neighborhood built environment and socioeconomic status in relation to physical activity, sedentary behavior, and weight status of adolescents. Prev Med 110:47–54. https://doi.org/10.1016/j.ypmed.2018.02.009

    Article  PubMed  PubMed Central  Google Scholar 

  7. Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Carson V, Latimer-Cheung AE, Chastin SFM, Altenburg TM, Chinapaw MJM, SBRN Terminology Consensus Project Participants (2017) Sedentary Behavior Research Network (SBRN) — Terminology Consensus Project process and outcome. Int J Behav Nutr Phys Act 14(1):75. https://doi.org/10.1186/s12966-017-0525-8

    Article  PubMed  PubMed Central  Google Scholar 

  8. Zhang Z, Pereira JR, Sousa-Sá E, Okely AD, Feng X, Santos R (2018) Environmental characteristics of early childhood education and care centres and young children’s weight status: a systematic review. Prev Med 106:13–25. https://doi.org/10.1016/j.ypmed.2017.10.002

    Article  PubMed  Google Scholar 

  9. Hale L, Guan S (2015) Screen time and sleep among school-aged children and adolescents: a systematic literature review. Sleep Med Rev 21:50–58. https://doi.org/10.1016/j.smrv.2014.07.007

    Article  PubMed  Google Scholar 

  10. Kredlow MA, Capozzoli MC, Hearon BA, Calkins AW, Otto MW (2015) The effects of physical activity on sleep: a meta-analytic review. J Behav Med 38(3):427–449. https://doi.org/10.1007/s10865-015-9617-6

    Article  PubMed  Google Scholar 

  11. Master L, Nye RT, Lee S, Nahmod NG, Mariani S, Hale L, Buxton OM (2019) Bidirectional, daily temporal associations between sleep and physical activity in adolescents. Sci Rep 9(1):7732. https://doi.org/10.1038/s41598-019-44059-9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Chen B, Somers VK, Tang X, Li Y (2021) Moderating effect of BMI on the relationship between sympathetic activation and blood pressure in males with obstructive sleep apnea. Nat Sci Sleep 13:339–348

    Article  PubMed  PubMed Central  Google Scholar 

  13. Gupta NK, Mueller WH, Chan W, Meininger JC (2002) Is obesity associated with poor sleep quality in adolescents? Am J Hum Biol 14(6):762–768

    Article  PubMed  Google Scholar 

  14. Mendelson M, Borowik A, Michallet AS et al (2016) Sleep quality, sleep duration and physical activity in obese adolescents: effects of exercise training. Pediatr Obes 11(1):26–32. https://doi.org/10.1111/ijpo.12015

    Article  CAS  PubMed  Google Scholar 

  15. Mota J, Vale S (2010) Associations between sleep quality with cardiorespiratory fitness and BMI among adolescent girls. Am J Hum Biol 22(4):473–475. https://doi.org/10.1002/ajhb.21019

    Article  PubMed  Google Scholar 

  16. Tebar WR, Ritti-Dias RM, Farah BQ, Zanuto EF, Vanderlei LCM, Christofaro DGD (2018) High blood pressure and its relationship to adiposity in a school-aged population: body mass index vs waist circumference. Hypertens Res 41(2):135–140. https://doi.org/10.1038/hr.2017.93

    Article  PubMed  Google Scholar 

  17. Delfino LD, Dos Santos Silva DA, Tebar WR et al (2018) Screen time by different devices in adolescents: association with physical inactivity domains and eating habits. J Sports Med Phys Fitness 58(3):318–325. https://doi.org/10.23736/S0022-4707.17.06980-8

    Article  PubMed  Google Scholar 

  18. Tebar WR, Ritti Dias RM, Scarabottolo CC et al (2020) Sedentary behavior is more related with cardiovascular parameters in normal weight than overweight adolescents. J Public Health (Oxf) 42(3):e215–e222. https://doi.org/10.1093/pubmed/fdz082

    Article  Google Scholar 

  19. Zanuto EF, Ritti-Dias RM, Tebar WR et al (2020) Is physical activity associated with resting heart rate in boys and girls? A representative study controlled for confounders. J Pediatr (Rio J) 96(2):247–254. https://doi.org/10.1016/j.jped.2018.10.007

    Article  Google Scholar 

  20. Zomer J, Peled R, Rubin AH, Lavie P (1985) Mini Sleep Questionnaire (MSQ) for screening large population for EDS complaints. In: Koella WP, Rüther E, Schulz H, editors., Sleep 467–470, 1985

  21. Falavigna A, de Souza Bezerra ML, Teles AR et al (2011) Consistency and reliability of the Brazilian Portuguese version of the Mini-Sleep Questionnaire in undergraduate students. Sleep Breath 15(3):351–355. https://doi.org/10.1007/s11325-010-0392-x

    Article  PubMed  Google Scholar 

  22. Baecke JA, Burema J, Frijters JE (1982) A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr 36(5):936–942. https://doi.org/10.1093/ajcn/36.5.936

    Article  CAS  PubMed  Google Scholar 

  23. Philippaerts RM, Westerterp KR, Lefevre J (1999) Doubly labelled water validation of three physical activity questionnaires. Int J Sports Med 20(5):284–289. https://doi.org/10.1055/s-2007-971132

    Article  CAS  PubMed  Google Scholar 

  24. Guedes DPL, Guedes JERP, Stanganelli LC (2006) Reproducibility and validity of the Baecke questionnaire for assessing of the habitual physical activity in adolescents. Rev Port Ciências e Desporto 6(3):265–274

    Article  Google Scholar 

  25. Byun W, Dowda M, Pate RR (2012) Associations between screen-based sedentary behavior and cardiovascular disease risk factors in Korean youth. J Korean Med Sci 27(4):388–394. https://doi.org/10.3346/jkms.2012.27.4.388

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Martins M de O, Cavalcante VLF, Holanda G dos S, et al. (2012) Association between sedentary behavior and psychosocial factors and environmental among adolescents from northeastern Brazil. Rev Bras Ativ Fís Saúde 17(2):143–150

  27. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320(7244):1240–1243. https://doi.org/10.1136/bmj.320.7244.1240

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Critério de Classificação Econômica Brasil, Assoc Bras Empres Pesqui. 2015. Available from: https://www.abep.org/Servicos/Download.asp. Accessed 20 Feb 2021

  29. Foerster M, Henneke A, Chetty-Mhlanga S, Röösli M (2019) Impact of adolescents’ screen time and nocturnal mobile phone-related awakenings on sleep and general health symptoms: a prospective cohort study. Int J Environ Res Public Health 16(3):518. https://doi.org/10.3390/ijerph16030518

    Article  PubMed Central  Google Scholar 

  30. Olds TS, Maher CA, Matricciani L (2011) Sleep duration or bedtime? Exploring the relationship between sleep habits and weight status and activity patterns. Sleep 34(10):1299–1307. https://doi.org/10.5665/SLEEP.1266

    Article  PubMed  PubMed Central  Google Scholar 

  31. Chaput JP (2014) Sleep patterns, diet quality and energy balance. Physiol Behav 134:86–91. https://doi.org/10.1016/j.physbeh.2013.09.006

    Article  CAS  PubMed  Google Scholar 

  32. Hart CN, Cairns A, Jelalian E (2011) Sleep and obesity in children and adolescents. Pediatr Clin N Am 58(3):715–733. https://doi.org/10.1016/j.pcl.2011.03.007

    Article  Google Scholar 

  33. Lang C, Brand S, Feldmeth AK, Holsboer-Trachsler E, Pühse U, Gerber M (2013) Increased self-reported and objectively assessed physical activity predict sleep quality among adolescents. Physiol Behav 120:46–53. https://doi.org/10.1016/j.physbeh.2013.07.001

    Article  CAS  PubMed  Google Scholar 

  34. Xu F, Adams SK, Cohen SA, Earp JE, Greaney M (2019) Relationship between physical activity, screen time, and sleep quantity and quality in us adolescents aged 16–19. Int J Environ Res Public Health 16(9):1524. https://doi.org/10.3390/ijerph16091524

    Article  PubMed Central  Google Scholar 

  35. Oliveira LMFT, Silva AOD, Santos MAMD, Ritti-Dias RM, Diniz PRB (2018) Exercise or physical activity: which is more strongly associated with the perception of sleep quality by adolescents? Rev Paul Pediatr 36(3):322–328

    Article  PubMed  PubMed Central  Google Scholar 

  36. Negele L, Flexeder C, Koletzko S et al (2020) Association between objectively assessed physical activity and sleep quality in adolescence. Results from the GINIplus and LISA studies. Sleep Med 72:65–74. https://doi.org/10.1016/j.sleep.2020.03.007

    Article  PubMed  Google Scholar 

Download references

Funding

This study was funded by the Brazilian National Council of Scientific and Technological Development (CNPq) — process number 442395/2014‐0.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tatiana M. Damato.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the national research committee study proponent (São Paulo State University- protocol: 21600613.4.0000.5402) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Damato, T.M., Tebar, W.R., Oliveira, C.B.S. et al. Relationship of sleep quality with screen-based sedentary time and physical activity in adolescents — the moderating effect of body mass index. Sleep Breath 26, 1809–1816 (2022). https://doi.org/10.1007/s11325-021-02519-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-021-02519-5

Keywords

Navigation