Associations of physical activity and sleep with mental health during and post-COVID-19 pandemic in chinese college students: a longitudinal cohort study

Background: The COVID-19 pandemic seriously impacted people's lifestyles, leading to changes in physical activity, sleep and mental health. This study aimed to assess the recovery of these indicators in Chinese university students post-COVID-19 pandemic, and explore the association between life...

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Main Authors: Haonan Wang, Yixiao Ding, Yinghong Dai, Zilin Fan, Shubo Wen, Xinying Wang, Jie Yuan, Yibo Wu, Liang Yu
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Comprehensive Psychiatry
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Online Access:http://www.sciencedirect.com/science/article/pii/S0010440X25000185
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author Haonan Wang
Yixiao Ding
Yinghong Dai
Zilin Fan
Shubo Wen
Xinying Wang
Jie Yuan
Yibo Wu
Liang Yu
author_facet Haonan Wang
Yixiao Ding
Yinghong Dai
Zilin Fan
Shubo Wen
Xinying Wang
Jie Yuan
Yibo Wu
Liang Yu
author_sort Haonan Wang
collection DOAJ
description Background: The COVID-19 pandemic seriously impacted people's lifestyles, leading to changes in physical activity, sleep and mental health. This study aimed to assess the recovery of these indicators in Chinese university students post-COVID-19 pandemic, and explore the association between lifestyle changes and psychological problems. Methods: A two-wave longitudinal study was conducted with 2,748 college students in Hebei, China. Self-report questionnaires measured physical activity, sleep and psychological variables (depression symptoms, anxiety symptoms, and perceived stress) in 2022 and 2024. McNemar chi-square test compared differences between the two waves. Additionally, univariate and multivariate logistic regression analyses were performed to examine the independent and joint associations between changes in lifestyle behaviors and psychological problems across this period. Results: Proportion of physical inactivity decreased from 22.5% to 16.2%, and poor sleep quality reduced from 18.3% to 16.2% after the pandemic (P < 0.05). Depression symptoms and anxiety symptoms also improved (P < 0.05), while perceived stress remained high (64.5%). Compared to consistently inactive students, those becoming physically active (depression OR = 0.40, anxiety OR = 0.34, stress 0.56) and those persistently active (depression OR = 0.43, anxiety OR = 0.38, stress 0.47) had reduced psychological symptoms. However, after adjusting for confounders, the association between improved physical activity and mental health problems was insignificant (P > 0.05). Improved sleep (depression OR = 0.42, anxiety OR = 0.24, stress 0.42) and consistently good sleep (depression OR = 0.20, anxiety OR = 0.20, stress 0.37) also demonstrated a protective effect after fully adjusting for demographics and socioeconomic status. Conclusions: This study found that high perceived stress persisted. Although physical activity improved across this period, its change was not significantly associated with mental health after adjustments. However, improved sleep quality was significantly associated with reductions in depression levels, anxiety levels, and perceived stress. These findings highlight the importance of sleep and physical activity in mental health recovery post-pandemic and the need for targeted interventions.
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spelling doaj-art-d9f844b4f60b48fb92149af218d85a5a2025-08-20T02:09:31ZengElsevierComprehensive Psychiatry0010-440X2025-05-0113915259110.1016/j.comppsych.2025.152591Associations of physical activity and sleep with mental health during and post-COVID-19 pandemic in chinese college students: a longitudinal cohort studyHaonan Wang0Yixiao Ding1Yinghong Dai2Zilin Fan3Shubo Wen4Xinying Wang5Jie Yuan6Yibo Wu7Liang Yu8Department of Exercise Physiology, School of Sport Science, Beijing Sport University, Beijing 100084, ChinaCollege of Education for the Future, Beijing Normal University, Zhuhai 519085, ChinaDepartment of Neurosurgery, Xiangya Hospital, Central South University, Changsha 410008, China; Xiangya School of Medicine, Central South University, Changsha 410008, ChinaDepartment of Exercise Physiology, School of Sport Science, Beijing Sport University, Beijing 100084, ChinaSchool of Nursing, Henan University of Science and Technology, Luoyang 471000, ChinaEngineering Research Center of Strength and Conditioning Training Key Core Technology Integrated System and Equipment of Ministry of Education, Beijing Sport University, Beijing 100084, ChinaJitang College of North China University of Technology, Tangshan 063000, ChinaSchool of Public Health, Peking University, Beijing 100191, China; Corresponding author.Department of Exercise Physiology, School of Sport Science, Beijing Sport University, Beijing 100084, China; Engineering Research Center of Strength and Conditioning Training Key Core Technology Integrated System and Equipment of Ministry of Education, Beijing Sport University, Beijing 100084, China; Corresponding author at: Engineering Research Center of Strength and Conditioning Training Key Core Technology Integrated System and Equipment of Ministry of Education, Beijing Sport University, Beijing, 100084, China.Background: The COVID-19 pandemic seriously impacted people's lifestyles, leading to changes in physical activity, sleep and mental health. This study aimed to assess the recovery of these indicators in Chinese university students post-COVID-19 pandemic, and explore the association between lifestyle changes and psychological problems. Methods: A two-wave longitudinal study was conducted with 2,748 college students in Hebei, China. Self-report questionnaires measured physical activity, sleep and psychological variables (depression symptoms, anxiety symptoms, and perceived stress) in 2022 and 2024. McNemar chi-square test compared differences between the two waves. Additionally, univariate and multivariate logistic regression analyses were performed to examine the independent and joint associations between changes in lifestyle behaviors and psychological problems across this period. Results: Proportion of physical inactivity decreased from 22.5% to 16.2%, and poor sleep quality reduced from 18.3% to 16.2% after the pandemic (P < 0.05). Depression symptoms and anxiety symptoms also improved (P < 0.05), while perceived stress remained high (64.5%). Compared to consistently inactive students, those becoming physically active (depression OR = 0.40, anxiety OR = 0.34, stress 0.56) and those persistently active (depression OR = 0.43, anxiety OR = 0.38, stress 0.47) had reduced psychological symptoms. However, after adjusting for confounders, the association between improved physical activity and mental health problems was insignificant (P > 0.05). Improved sleep (depression OR = 0.42, anxiety OR = 0.24, stress 0.42) and consistently good sleep (depression OR = 0.20, anxiety OR = 0.20, stress 0.37) also demonstrated a protective effect after fully adjusting for demographics and socioeconomic status. Conclusions: This study found that high perceived stress persisted. Although physical activity improved across this period, its change was not significantly associated with mental health after adjustments. However, improved sleep quality was significantly associated with reductions in depression levels, anxiety levels, and perceived stress. These findings highlight the importance of sleep and physical activity in mental health recovery post-pandemic and the need for targeted interventions.http://www.sciencedirect.com/science/article/pii/S0010440X25000185COVID-19StudentsPhysical activitySleepMental health
spellingShingle Haonan Wang
Yixiao Ding
Yinghong Dai
Zilin Fan
Shubo Wen
Xinying Wang
Jie Yuan
Yibo Wu
Liang Yu
Associations of physical activity and sleep with mental health during and post-COVID-19 pandemic in chinese college students: a longitudinal cohort study
Comprehensive Psychiatry
COVID-19
Students
Physical activity
Sleep
Mental health
title Associations of physical activity and sleep with mental health during and post-COVID-19 pandemic in chinese college students: a longitudinal cohort study
title_full Associations of physical activity and sleep with mental health during and post-COVID-19 pandemic in chinese college students: a longitudinal cohort study
title_fullStr Associations of physical activity and sleep with mental health during and post-COVID-19 pandemic in chinese college students: a longitudinal cohort study
title_full_unstemmed Associations of physical activity and sleep with mental health during and post-COVID-19 pandemic in chinese college students: a longitudinal cohort study
title_short Associations of physical activity and sleep with mental health during and post-COVID-19 pandemic in chinese college students: a longitudinal cohort study
title_sort associations of physical activity and sleep with mental health during and post covid 19 pandemic in chinese college students a longitudinal cohort study
topic COVID-19
Students
Physical activity
Sleep
Mental health
url http://www.sciencedirect.com/science/article/pii/S0010440X25000185
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