Associations of sleep quality and physical activity with anxiety and depressive symptoms among university students

A cross-sectional study

Bibliographic Data

ID22068000
AuthorsRobinson Ramírez-Vélez (Instituto de Salud Carlos III), Juan Carlos Calderón-González (Central University of Valle del Cauca), Luis Hebert Palma-Pulido (Central University of Valle del Cauca), Andrés Felipe Mejía-Vásquez (Central University of Valle del Cauca), Carolina Arias-Álzate (Central University of Valle del Cauca), Juan Carlos Urriago-Fontal (Central University of Valle del Cauca), Gustavo Adolfo Gutiérrez-Quintero (Central University of Valle del Cauca), Julián David Ortiz-López (Central University of Valle del Cauca), Diana Milena Bedoya-Salazar (Central University of Valle del Cauca), Gonzalo Romero-Martínez (Central University of Valle del Cauca), Mikel Izquierdo (0000-0002-1506-4272, Instituto de Salud Carlos III)
Year2026
Volume14
Pages1799311-1799311
Publication date2026-03-19
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2026.1799311
PMID41938931
OpenAlexW7139071229
LanguageEN
References cited35

Sleep disturbances and insufficient physical activity are common in university populations and have been associated with adverse mental health outcomes; however, evidence integrating these factors in Latin American student populations remains limited. This study examined the associations of sleep quality and physical activity with anxiety and depressive symptoms among university students and assessed whether physical activity moderates the association between sleep quality and mood symptoms. This cross-sectional analysis was conducted within the EpiHealth-UCEVA project and included 1,125 undergraduate students from a Colombian public university. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS), sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and physical activity using the International Physical Activity Questionnaire (IPAQ). Multivariable linear regression models, along with moderation analyses using PROCESS (Model 1), were conducted. In adjusted regression models, poorer sleep quality was associated with higher anxiety ( B = 0.59) and depressive symptoms ( B = 0.10). Moderate physical activity was associated with lower anxiety, whereas high physical activity was associated with lower depressive symptoms. In moderation analyses, the overall sleep × physical activity interaction was not statistically significant. These findings suggest complementary roles of sleep quality and physical activity in students’ mental health and highlight the potential value of integrated lifestyle-based strategies to support mental well-being in university settings

Anxiety · Hospital Anxiety and Depression Scale · Mental health · Moderation · Mood · Physical activity · Pittsburgh Sleep Quality Index · Health and Lifestyle Studies · Physical Activity and Health · Sleep and related disorders

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