Associations among physical activity and smartphone use with perceived stress and sleep quality of Chinese college students

This study aimed to examine the association among physical activity and smartphone use with sleep quality and perceived stress, after controlling for potential confounding factors. The sample population was taken from three public universities in China and consisted of 3,864 college sophomores. The study was performed in April 2019. Sociodemographic and anthropometry characteristics and lifestyle behaviors such as physical activity, smartphone use, sleep quality and perceived stress were assessed using questionnaires. Participants were respectively divided into three categories according to the tertile of smartphone use and perceived stress scores. The results showed that a combination of insufficient physical activity and heavy smartphone use was positively associated with high levels of perceived stress and poor sleep quality. Furthermore, students with both insufficient physical activity and heavy smartphone use behaviors tended to have significantly higher odds of reporting high levels of perceived stress and poor sleep quality than students with only one behavior or neither of them, even after controlling for the effects of gender, age, nationality, BMI, tobacco and alcohol use, and mother's educational level. We conclude that interventions meant to improve sleep quality and decrease perceived stress of college students should aim to increase physical activity and reduce smartphone use.