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      Associations of Physical Activity, Screen Time with Depression, Anxiety and Sleep Quality among Chinese College Freshmen

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          Abstract

          Objectives

          To investigate the independent and interactive associations of physical activity (PA) and screen time (ST) with depression, anxiety and sleep quality among Chinese college students.

          Methods

          A cross-sectional study was conducted in Wuhan University, China from November to December 2011. The students reported their PA, ST and socio-economic characteristics using self-administered questionnaires. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). Depression and anxiety were assessed using the Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS), respectively. Multivariate logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the independent and interactive relationships of PA and ST with depression, anxiety and sleep quality.

          Results

          A total of 1106 freshmen (471 females and 635 males) aged 18.9±0.9 years were included in the study. After adjustment for potential confounders, high PA and low ST were independently associated with significantly lower risks for poor sleep quality (OR: 0.48, 95% CI: 0.30–0.78) and depression (OR: 0.67, 95%CI: 0.44–0.89), respectively. An interactive inverse association was observed for combined effects of PA and low ST on depression (OR: 0.62, 95%CI: 0.40–0.92) and sleep quality (OR: 0.51, 95%CI: 0.27–0.91). No statistically significant associations were found between PA, ST and anxiety among the participants.

          Conclusions

          These findings suggest an independent and interactive relationship of high PA and low ST with significantly reduced prevalence of depressive problems and favorable sleep quality among Chinese college freshmen.

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          Most cited references23

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          Exercise and sleep.

          This paper reviews the literature on the association between exercise and sleep. The epidemiological and experimental evidence for whether or not acute and chronic exercise promote sleep is discussed, as well as moderating factors and agendas for future directions of study. The expectation that exercise will benefit sleep can partly be attributed to traditional hypotheses that sleep serves energy conservation, body restoration or thermoregulatory functions, all of which have guided much of the research in this field. Exercise is a complex activity that can be beneficial to general well-being but may also stress the body. Differences in the exercise protocols studied (e.g. aerobic or anaerobic, intensity, duration) and interactions between individual characteristics (e.g. fitness, age and gender) cloud the current experimental evidence supporting a sleep-enhancing effect of exercise. In addition, the tendency to study changes in small groups of good sleepers may also underestimate the efficacy of exercise for promoting sleep. Athough only moderate effect sizes have been noted, meta-analytical techniques have shown that exercise increased total sleep time and delayed REM sleep onset (10 min), increased slow-wave sleep (SWS) and reduced REM sleep (2-5 min). The sleep-promoting efficacy of exercise in normal and clinical populations has yet to be established empirically.
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            Self-rating depression scale in an outpatient clinic. Further validation of the SDS.

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              Persistence of mental health problems and needs in a college student population.

              Cross-sectional studies indicate a high prevalence of mental health problems among college students, but there are fewer longitudinal data on these problems and related help-seeking behavior. We conducted a baseline web-based survey of students attending a large public university in fall 2005 and a two-year follow-up survey in fall 2007. We used brief screening instruments to measure symptoms of mental disorders (anxiety, depression, eating disorders), as well as self-injury and suicidal ideation. We estimated the persistence of these mental health problems between the two time points, and determined to what extent students with mental health problems perceived a need for or used mental health services (medication or therapy). We conducted logistic regression analyses examining how baseline predictors were associated with mental health and help-seeking two years later. Over half of students suffered from at least one mental health problem at baseline or follow-up. Among students with at least one mental health problem at baseline, 60% had at least one mental health problem two years later. Among students with a mental health problem at both time points, fewer than half received treatment between those time points. Mental health problems are based on self-report to brief screens, and the sample is from a single university. These findings indicate that mental disorders are prevalent and persistent in a student population. While the majority of students with probable disorders are aware of the need for treatment, most of these students do not receive treatment, even over a two-year period.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                25 June 2014
                : 9
                : 6
                : e100914
                Affiliations
                [1 ]School of Public Health, Wuhan University, Wuhan, P. R. China
                [2 ]Global Health Institute, Wuhan University, Wuhan, P. R. China
                Institute of Psychiatry, United Kingdom
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: QQH. Performed the experiments: QF QLZ YD QQH. Analyzed the data: QF. Contributed reagents/materials/analysis tools: QF QLZ YD YLY QQH. Wrote the paper: QF QQH.

                Article
                PONE-D-14-01771
                10.1371/journal.pone.0100914
                4071010
                24964250
                605f6100-a6fa-4d2a-90b1-6cd724426269
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 14 January 2014
                : 1 June 2014
                Page count
                Pages: 5
                Funding
                This study is a social science research project at Wuhan University, supported by the Fundamental Research Funds for the Central Universities (No. 2012GSP101) and National Undergraduate Innovative Research Training Program of Wuhan University (No. 201310486083). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Psychology
                Medicine and Health Sciences
                Epidemiology
                Social Epidemiology
                Mental Health and Psychiatry
                Social Sciences
                Sociology
                Social Research

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                Uncategorized

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