Body and Mind Intertwined: Physical Activity Intensity, Sleep Quality, and Depressive Symptoms: Cross-Sectional Associations and Exploratory Path Analysis
Jul 2026· Journal of Clinical Medicine· Vol 15, pp. 5754· 0 citations· 43 references
Medicine
TL;DR
Systematic, high-intensity PA, especially for a prolonged period of time, is significantly associated with lower depressive symptoms, highlighting the mind–body connection and demonstrating that PA might be an intervention supporting mental well-being.
Abstract
Background: The alarming trend of rising depression and insomnia among the world’s population, especially in young adults, demands urgent attention from both clinical and lifestyle medicine perspectives. This study aimed to evaluate whether habitual physical activity (PA) could improve sleep quality and depressive symptoms. It explores whether sleep parameters mediate the relationship between training intensity and depression. Methods: This cross-sectional study examined the relationships between PA, sleep quality, and depression in 349 participants, predominantly young adults, aged 16–54 (Median: 21, Q1–Q3: 20–23). Depressive symptoms and sleep quality were assessed using the Beck Depression Inventory (BDI) and Pittsburgh Sleep Quality Index (PSQI). PA parameters, including training intensity and frequency, were evaluated via a study-specific self-report tool. Mediation effects were assessed utilising Structural Equation Modelling (SEM) to evaluate direct, indirect, and total effects. Results: Higher training intensity and training volume were associated with lower depressive symptoms. Except for the daytime dysfunction domain, the current data did not support sleep as a mediator in the relationship between physical activity and depressive symptoms. Participants with 3–5 years of training experience exhibited lower BDI scores compared to those with less than 12 months of experience. Interestingly, the type of PA did not influence BDI or PSQI scores, suggesting that consistency and intensity are more critical than the kind of exercise itself. Conclusions: Systematic, high-intensity PA, especially for a prolonged period of time, is significantly associated with lower depressive symptoms. The exploratory nature of this study highlights training frequency and intensity as potential factors that need further research. These findings highlight the mind–body connection and demonstrate that PA might be an intervention supporting mental well-being.
Background: Physical activity, mental health, and sleep are interconnected factors influencing well-being in young adults. This study investigated the relationships among physical activity, psychological symptoms (depression, anxiety, stress), sleep quality, and body composition in a sample of Turkish university students.Methods: A cross-sectional study included 572 university students, with 50.5% female participants and a mean age of 20.79±2.71 years. Physical activity was measured using the Physical Activity Scale–2 (PAS-2), psychological symptoms using the DASS-21, and sleep quality using the Basic Scale for Insomnia Complaints and Sleep Quality, Body composition was assessed with the InBody 120 (BIA). Descriptive statistics, Pearson correlation analyses, and multiple regressions were conducted to examine the relationships between the study variables.Results: Physical activity did not show significant associations with psychological symptoms or sleep quality (p>.05). Higher depression and stress scores predicted poorer sleep quality (β=.175 and β=.246, respectively p
Background/Objectives: Sleep quality, anxiety symptoms, physical activity, musculoskeletal pain, and multimorbidity are interrelated health domains, but evidence examining these factors together among adults aged ≥50 years in Saudi Arabia remains limited. This study described their prevalence and assessed cross-sectional associations among these domains. Methods: A cross-sectional online survey using convenience sampling was conducted in Saudi Arabia between December 2024 and April 2025. Participants completed measures of musculoskeletal pain, self-reported morbidity, physical activity (Global Physical Activity Questionnaire), sleep quality (Brief Version of the Pittsburgh Sleep Quality Index), and anxiety symptoms (Generalized Anxiety Disorder-7). Associations were examined using Spearman rank correlations and logistic regression with core adjustment for age, sex, and BMI. The Benjamini–Hochberg false discovery rate correction was applied to eight focal comparisons; Firth penalized logistic regression was applied as a sensitivity analysis for models in which multimorbidity was the outcome. Results: The sample included 298 adults (mean age 58.2 +/− 6.3 years; 75.5% male). Musculoskeletal pain was reported by 73.8%, multimorbidity by 8.4%, poor sleep by 43.3%, and moderate-to-severe anxiety symptoms by 23.8%. Better sleep quality was moderately associated with lower anxiety severity (Spearman rho = −0.45, p < 0.001). Poor sleep was associated with higher odds of moderate-to-severe anxiety symptoms (OR 6.49, 95% CI 3.45–12.20), and low total physical activity was associated with higher odds of both moderate-to-severe anxiety symptoms (OR 7.87, 95% CI 2.68–23.08) and poor sleep (OR 5.09, 95% CI 2.40–10.83). These focal associations remained significant after FDR correction. In an exploratory sensitivity analysis, the poor sleep–multimorbidity association remained comparable when Firth regression was applied (OR 2.71, 95% CI 1.12–7.06; p = 0.027). Conclusions: In this online convenience sample of adults aged ≥50 years, sleep quality, anxiety symptoms, and total physical activity showed consistent cross-sectional associations. Findings involving multimorbidity were exploratory because of the limited number of events. These results require confirmation in representative longitudinal studies.
Hammad S. Alhasan, M. Alshehri· Journal of Clinical Medicine· 0 citations
Poor sleep and mental health are closely linked in adolescence, yet most studies rely on self-reported sleep. We investigated cross-sectional associations between objective sleep features (sleep duration, duration variability, and onset time) and mental health outcomes in 1371 U.S. adolescents from the Adolescent Brain Cognitive Development℠ Study (ABCD®) [year 4 follow-up; mean age 14.09 ± 0.69, 51.86% female], controlling for age, sex, race/ethnicity, and parental education. Mental health outcomes were internalizing symptoms (emotional distress directed inward) and emotion regulation, including cognitive reappraisal (reframing emotional situations) and expressive suppression (inhibiting outward expression). Sleeping ≤7.05 h (β = 0.06 [95% CI: 0.00-0.11], p = 0.036), higher sleep duration variability (β = 0.09 [0.03-0.14], p = 0.001), with stronger effects in females (interaction: β = -0.12 [-0.22 to -0.02], p = 0.020), and later sleep onset times (β = 0.06 [0.01-0.11], p = 0.030) were all associated with greater internalizing symptoms. Sleep was not linked to reappraisal (all p > 0.05). Higher variability was associated with greater suppression (β = 0.09 [0.03-0.14], p = 0.001). Conclusively, objective sleep features were differentially associated with mental health outcomes.
S. Izabel, Orsolya Kiss, Adam J. Krause et al.· npj Mental Health Research· 0 citations
Sleep disturbance, chronic pain and mental health symptoms frequently co-occur in older adults, but data from the Middle East remain limited.
This study aimed to examine sleep quality and its associations with pain and mental health symptoms among community-dwelling older adults in Jordan.
A cross-sectional study was conducted among adults aged ≥60 years recruited from geriatric clinics and rehabilitation centres. Sleep quality (primary outcome) was assessed using the Pittsburgh Sleep Quality Index (PSQI). The Insomnia Severity Index (ISI), International Restless Legs Syndrome Severity Rating Scale (IRLS), daytime sleepiness via the Epworth Sleepiness Scale (ESS), Depression Anxiety Stress Scale (DASS-21) and the Brief Pain Inventory were measured. Correlation and multiple linear regression models by domain (demographic, lifestyle/health, sleep-specific, mental health and pain), followed by a fully adjusted model, were performed.
A total of 121 participants (mean age 67.9 ± 7.5 years, 44.6% female) were included. Mean PSQI score was 13.5 ± 3.2, indicating poor sleep quality. In bivariate analysis, higher ISI, IRLS, ESS, DASS-21 and pain severity/interference were significantly associated with poorer sleep quality (all
p
< 0.01). Domain-specific models identified insomnia severity, depressive and anxiety symptoms and pain variables as significant predictors. In the fully adjusted model (adjusted
R
2
= 0.268), only insomnia severity remained as an independent predictor of poorer sleep quality, with retirement showing a borderline association.
Poor sleep quality is highly prevalent among community-dwelling older adults in Jordan and is driven primarily by insomnia severity rather than demographic or health factors. Targeting insomnia may yield the greatest improvements in sleep quality in this population.
Introduction. Current evidence highlights the significant cognitive and physiological benefits of regular sports engagement, with well-established positive impact on both sleep quality and executive functions (EF).
Objective. The present study aimed to compare sleep quality parameters between young adults practicing individual and team sports, as well as to examine the direct and indirect structural relationships among sports participation indicators, sleep quality, and executive functioning.
Method. The sample consisted of 132 young adults aged 18 to 40 years (M = 23.89, SD = 4.93). A sociodemographic and sports questionnaire was employed, along with the Pittsburgh Sleep Quality Index (PSQI) and the Adult Executive Functioning Inventory (ADEXI). Data analysis included Confirmatory Factor Analysis (CFA), Pearson’s r correlation analyses, MANCOVA, and Structural Equation Modeling (SEM). Bootstrapping with 5000 resamples was used to test mediation effects.
Results. The CFA supported the two-factor structure of the ADEXI —working memory and inhibition— with acceptable fit. Sports participation was associated with distinct sleep quality profiles. Specifically, individual sports practitioners reported better sleep quality and shorter sleep latency, team sports practitioners exhibited higher sleep efficiency. Structural equation modeling indicated that sleep quality statistically mediated the relationship between sports participation indicators (current sports practice, weekly hours, and total years of practice) and EF. Additionally, an earlier age of initiation into sports directly predicted fewer EF difficulties, independent of sleep quality, suggesting that early sports participation may contribute to the development of a resilient cognitive reserve.
Conclusion. Regular sports engagement, especially when it begins early in life, is associated with better subjective sleep quality and executive functioning. These findings highlight the potential protective role of sports in promoting cognitive health among and support the incorporation of regular sports participation into public health and health promotion strategies aimed at preserving executive functioning.
Josué Díaz Saint Pere, Vanessa Arán Filippetti· Revista de Investigación e I...· 0 citations
Background and Objectives: Physical activity may relate to mental health differently depending on whether it is performed at work, for transport, or during leisure. Evidence regarding this distinction in Romanian community samples remains limited, and it is unclear whether these associations persist after accounting for perceived stress. We examined domain-specific physical activity, sedentary time and perceived stress in relation to anxiety and somatic symptom burden. Materials and Methods: This cross-sectional online survey included 307 Romanian adults aged 18–65 years. Physical activity was measured with the Global Physical Activity Questionnaire, perceived stress with the 14-item Perceived Stress Scale, anxiety with the Beck Anxiety Inventory, and somatic symptoms with the Patient Health Questionnaire-15. Spearman correlations were adjusted for multiple testing with the Benjamini–Hochberg false-discovery-rate procedure. Multivariable linear models used HC3 robust standard errors and included sex, age group, education, body mass index and religious affiliation as covariates. Scores for each physical activity domain were log(1 + x)-transformed and standardized. Sensitivity analyses considered participation versus non-participation, symptom severity categories, total activity and exclusion of an extreme activity value. Results: Median scores were 24 for perceived stress, 10 for anxiety and 7 for somatic symptoms. Perceived stress correlated with both anxiety (rho = 0.486) and somatic symptoms (rho = 0.428; both false-discovery-rate-adjusted p < 0.001). Vigorous leisure-time activity was inversely correlated with somatic symptoms (rho = −0.205; adjusted p = 0.002), whereas total physical activity was not associated with either outcome. In the fully adjusted models, a one-standard-deviation-higher PSS-14 score was associated with 5.57 more BAI points (95% CI 4.50–6.63) and 2.12 more PHQ-15 points (95% CI 1.62–2.63). Vigorous leisure-time activity remained associated with a lower PHQ-15 score (−0.84 points per standard deviation; 95% CI −1.35 to −0.32), but its association with BAI was no longer statistically significant after adjustment for perceived stress. Conclusions: Perceived stress showed the strongest association with both anxiety and somatic symptom burden. The use of a single total activity score concealed a more specific inverse association between vigorous leisure-time activity and somatic symptoms. Longitudinal studies using more representative sampling, objective measures of activity and broader confounder assessment are needed to clarify directionality and determine the potential relevance of vigorous leisure-time activity to somatic symptom burden.
M. Fadgyas Stănculete, O. Căpățînă, Catalin Alexandru Chihaia· Medicina· 0 citations