The effect of physical activity on anxiety through sleep quality among Chinese high school students: evidence from cross-sectional study and longitudinal study

Abstract Background Anxiety disorder is a significant concern in the context of mental health among Chinese high school students. Based on cross-sectional study and longitudinal study, this study constructed mediation models in order to evaluate the mediation effects of sleep quality in the improvem...

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Main Authors: Xianghe Chen, Yuxin Yang, Chenghao Zhong, Xinyu Zeng, Xiao Qiu, Xiangxiang Zhou, Chi Liu, Zhikai Tian, Bo Liu, Rongbin Yin
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-025-06909-x
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author Xianghe Chen
Yuxin Yang
Chenghao Zhong
Xinyu Zeng
Xiao Qiu
Xiangxiang Zhou
Chi Liu
Zhikai Tian
Bo Liu
Rongbin Yin
author_facet Xianghe Chen
Yuxin Yang
Chenghao Zhong
Xinyu Zeng
Xiao Qiu
Xiangxiang Zhou
Chi Liu
Zhikai Tian
Bo Liu
Rongbin Yin
author_sort Xianghe Chen
collection DOAJ
description Abstract Background Anxiety disorder is a significant concern in the context of mental health among Chinese high school students. Based on cross-sectional study and longitudinal study, this study constructed mediation models in order to evaluate the mediation effects of sleep quality in the improvement of anxiety by physical activity among Chinese high school students. Methods A total of 32,974 Chinese high school students were surveyed using the International Physical Activity Questionnaire (IPAQ), the Pittsburgh Sleep Quality Index (PSQI), and the Generalized Anxiety Disorder 7-item Scale (GAD-7). We conducted the survey to construct a mediation model of anxiety, and then verified it with longitudinal data. After 12 weeks of exercise, 80 high school students were tested for physical activity level, sleep quality score and anxiety level. Results The mediation model based on cross-sectional study showed a good fit with the data. Physical activity significantly positively predicted sleep quality but negatively predicted anxiety. Sleep quality significantly negatively predicted anxiety and had a mediation effect between physical activity and anxiety. Further longitudinal study proved that physical activity could improve both sleep quality and anxiety among high school students. Conclusions Evidence from cross-sectional study and longitudinal study indicated the mediation role of sleep quality in the relationship between physical activity and anxiety among high school students, providing a theoretical and practical basis for physical exercise to improve high school students’ anxiety and other psychological problems. Besides, physical activity could relieve anxiety through sleep quality, but causality cannot be inferred when using only a cross-sectional study design.
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spelling doaj-art-6863dfdde7444e0bbecf1aa4f8c2687b2025-08-20T03:53:57ZengBMCBMC Psychiatry1471-244X2025-05-0125111410.1186/s12888-025-06909-xThe effect of physical activity on anxiety through sleep quality among Chinese high school students: evidence from cross-sectional study and longitudinal studyXianghe Chen0Yuxin Yang1Chenghao Zhong2Xinyu Zeng3Xiao Qiu4Xiangxiang Zhou5Chi Liu6Zhikai Tian7Bo Liu8Rongbin Yin9College of Physical Education, Yangzhou UniversityCollege of Physical Education, Yangzhou UniversityCollege of Physical Education, Yangzhou UniversityCollege of Physical Education, Yangzhou UniversityCollege of Physical Education, Yangzhou UniversityCollege of Physical Education, Yangzhou UniversityCollege of Physical Education, Yangzhou UniversityCollege of Physical Education, Yangzhou UniversityJiangSu College of TourismPhysical Education and Sports School of Soochow UniversityAbstract Background Anxiety disorder is a significant concern in the context of mental health among Chinese high school students. Based on cross-sectional study and longitudinal study, this study constructed mediation models in order to evaluate the mediation effects of sleep quality in the improvement of anxiety by physical activity among Chinese high school students. Methods A total of 32,974 Chinese high school students were surveyed using the International Physical Activity Questionnaire (IPAQ), the Pittsburgh Sleep Quality Index (PSQI), and the Generalized Anxiety Disorder 7-item Scale (GAD-7). We conducted the survey to construct a mediation model of anxiety, and then verified it with longitudinal data. After 12 weeks of exercise, 80 high school students were tested for physical activity level, sleep quality score and anxiety level. Results The mediation model based on cross-sectional study showed a good fit with the data. Physical activity significantly positively predicted sleep quality but negatively predicted anxiety. Sleep quality significantly negatively predicted anxiety and had a mediation effect between physical activity and anxiety. Further longitudinal study proved that physical activity could improve both sleep quality and anxiety among high school students. Conclusions Evidence from cross-sectional study and longitudinal study indicated the mediation role of sleep quality in the relationship between physical activity and anxiety among high school students, providing a theoretical and practical basis for physical exercise to improve high school students’ anxiety and other psychological problems. Besides, physical activity could relieve anxiety through sleep quality, but causality cannot be inferred when using only a cross-sectional study design.https://doi.org/10.1186/s12888-025-06909-xPhysical activitySleep qualityHigh school studentsAnxiety
spellingShingle Xianghe Chen
Yuxin Yang
Chenghao Zhong
Xinyu Zeng
Xiao Qiu
Xiangxiang Zhou
Chi Liu
Zhikai Tian
Bo Liu
Rongbin Yin
The effect of physical activity on anxiety through sleep quality among Chinese high school students: evidence from cross-sectional study and longitudinal study
BMC Psychiatry
Physical activity
Sleep quality
High school students
Anxiety
title The effect of physical activity on anxiety through sleep quality among Chinese high school students: evidence from cross-sectional study and longitudinal study
title_full The effect of physical activity on anxiety through sleep quality among Chinese high school students: evidence from cross-sectional study and longitudinal study
title_fullStr The effect of physical activity on anxiety through sleep quality among Chinese high school students: evidence from cross-sectional study and longitudinal study
title_full_unstemmed The effect of physical activity on anxiety through sleep quality among Chinese high school students: evidence from cross-sectional study and longitudinal study
title_short The effect of physical activity on anxiety through sleep quality among Chinese high school students: evidence from cross-sectional study and longitudinal study
title_sort effect of physical activity on anxiety through sleep quality among chinese high school students evidence from cross sectional study and longitudinal study
topic Physical activity
Sleep quality
High school students
Anxiety
url https://doi.org/10.1186/s12888-025-06909-x
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