Associations of sedentary behaviour and physical activity with stress-related sleep disturbance among adolescents in 69 countries: a population-based study

Background: Stress-related sleep disturbance have become a serious public health problem among adolescents worldwide. There is a paucity of research employing standardised methodologies to evaluate the association between sedentary behaviour, physical activity, and stress-related sleep disturbance among adolescents. We aimed to examine the association between sedentary behaviour and/or physical activity with stress-related sleep disturbance among adolescents worldwide. Methods: We used data from the Global School-based Student Health Survey (GSHS) conducted from 2010 to 2019, encompassing 275 483 adolescents aged 12-17 years across 69 countries. Multi-variable logistic regression analysis was performed to assess the independent and joint effect of sedentary behaviour and physical activity on stress-related sleep disturbance. Results: 30.0% of adolescents spend ≥2 hours in sedentary behaviour daily, only 15.4% engage in physical activity for over one hour each day, and 8.3% of adolescents suffer from stress-related sleep disturbances. Compared with those who engaged sedentary behaviour