Isotemporal substitution analysis of time between sedentary behavior, and physical activity on sleep quality in younger adults: a multicenter study

Abstract

Objective: To evaluate the effects of replacing time spent in sedentary behavior (SB) with moderate to vigorous physical activity on sleep quality in young adults.

Methods: Multicenter cross-sectional study, carried out with students enrolled in undergraduate courses at universities in Brazil. Sleep quality was assessed using a question of the World Health Organization Quality of Life (WHOQOL-brief) and classified as good or poor sleep quality. SB was evaluated by self-reported total sitting time, and the level of leisure-time PA was classified according to the intensity of moderate-intensity physical activity (MPA) and vigorous-intensity physical activity (VPA), which were assessed using a self-reported questionnaire. An isotemporal replacement logistic model was used to evaluate the effects of different SB, MPA, and VPA sessions on sleep quality.

Results: A total of 8,059 study participants were evaluated, the majority had poor sleep quality (64.79%), were physically inactive (48.28%, defined as practicing < 150 min of MPA or < 75 min of VPA per week), and spent ≥ 9 h/day in SB (55.08%). The multivariate model showed an association between non-adherence to wake-based movement guidelines and poor sleep quality, where those with one altered behavior were 43% more likely to have poor sleep quality (OR:1.43;95%CI:1.27 to 1.60), while individuals with two altered behaviors were 97% more likely (OR:1.97;95%CI:1.73 to 2.24). In the isotemporal analysis, replacing MPA and VPA with equivalent time in SB increased the odds of poor sleep at all times assessed, with peaks of 56% for MPA and 68% for VPA.

Conclusion: The results of the present study indicate that replacing SB with the same amount of MPA or VPA may reduce poor sleep quality.

Keywords: Epidemiological surveys; Public health; Sedentary behavior; Sleep quality.

Fig. 1

Directed acyclic graph (DAG) of the association between wake-based movement behaviors and sleep quality during the COVID-19 pandemic Legend: The variable in green and with the “►” symbol inside the rectangle was the exposure variable; those in blue and with the letter “I” inside the rectangle were the response variables; variables in blue are the antecedents of the outcome variable; and those in red are antecedents of the outcome and exposure variables

Fig. 2

Histogram of the distribution of sleep quality in young adults PADu-multicentric (2021–2022) Legend: Sleep quality is assessed based on the answer to question 16 of the WHOQOL-BREF scale, which addresses the influence of sleep and rest on the individual’s quality of life

Fig. 3

Distribution of movement behaviors of young adults PADu-multicentric (2021–2022) Legend: Distribution of movement behaviors of young adults, showing (A) the histogram of time spent in sedentary behavior (hours/day), (B) the histogram of time spent in moderate physical activity (minutes/day), (C) the histogram of time spent in vigorous physical activity (minutes/day), (D) bar graph showing the prevalence of individuals with physical inactivity and high sedentary behavior, and (E) the combination of adherence to movement behavior guidelines, complete adherence (i.e. individuals with less than 9 h of SB per day and no PI), partial adherence (SB elevated or PI) and non-adherence (SB elevated and PI)