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Does Sleep Mediate the Association between School Pressure, Physical Activity, Screen Time, and Psychological Symptoms in Early Adolescents? A 12-Country Study

1
Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 4K3, B-9000 Ghent, Belgium
2
Fund for Scientific Research Flanders (FWO), Egmontstraat 5, B-1000 Brussels, Belgium
3
Department of Psychiatry: Pedicatric Sleep Center, Ghent University Hospital, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
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Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium
5
Faculty of Sport and Health Sciences, PO Box 35, FI-40014 University of Jyväskylä, Finland
6
Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(6), 1072; https://doi.org/10.3390/ijerph16061072
Received: 6 February 2019 / Revised: 18 March 2019 / Accepted: 22 March 2019 / Published: 25 March 2019
(This article belongs to the Collection Sedentary Behaviour and Health)
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Abstract

This study examines the mediating role of sleep duration and sleep onset difficulties in the association of school pressure, physical activity, and screen time with psychological symptoms in early adolescents. Data were retrieved from 49,403 children (13.7 ± 1.6 years old, 48.1% boys) from 12 countries participating in the World Health Organization (WHO) “Health Behaviour in School-aged Children” 2013/2014 study. A validated self-report questionnaire assessed psychological symptoms (feeling low, irritability or bad temper, feeling nervous), school pressure, physical activity (number of days/week 60 min moderate-to-vigorous), screen time, sleep duration on week- and weekend days, and perceived difficulties in getting asleep. Multilevel mediation analyses were conducted. School pressure and screen time were positively associated with psychological symptoms, whereas physical activity was negatively associated. With the exception of sleep duration in the association between physical activity and psychological symptoms, all associations were significantly mediated by sleep duration on week- and weekend days and sleep onset difficulties. Percentages mediated ranged from 0.66% to 34.13%. This study partly explains how school pressure, physical activity, and screen time are related to adolescents’ psychological symptoms. Future interventions improving adolescents’ mental well-being could target schoolwork, physical activity, and screen time, as these behaviours are directly and indirectly (through sleep) related to psychological symptoms. View Full-Text
Keywords: mental health; adolescents; sleep mental health; adolescents; sleep
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Vandendriessche, A.; Ghekiere, A.; Van Cauwenberg, J.; De Clercq, B.; Dhondt, K.; DeSmet, A.; Tynjälä, J.; Verloigne, M.; Deforche, B. Does Sleep Mediate the Association between School Pressure, Physical Activity, Screen Time, and Psychological Symptoms in Early Adolescents? A 12-Country Study. Int. J. Environ. Res. Public Health 2019, 16, 1072.

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