Network analysis of interrelationships among physical activity, sleep disturbances, depression, and anxiety in...

Physical activity, sleep disturbances, anxiety, and depression are interrelated, but prior research focused on overall scores, neglecting symptom interactions and triggering effects. This study employed network analysis to explore these connections from a symptom-network perspective.

Physical Activity Scale-3, Pittsburgh Sleep Quality Index Scale, Self-Reating Depression Scale, and Self-Reating Anxiety Scale were conducted on 4683 college students from September to October 2024 by convenience sampling method. Spearman correlation is used to explore the relationship between these variables. Network analysis revealed structural connections between physical activity and sleep disturbances, identifying core and bridge symptoms. Flow network further explored the impacts of physical activity and sleep disturbances on depression and anxiety.

Physical activity was negatively correlated with sleep disturbances, depression, and anxiety (p < 0.05), while sleep disturbances was positively correlated with depression and anxiety (p < 0.01). In the symptom network of physical activity and sleep disturbances, "sleep quality" (EI = 0.009) and "daytime dysfunction"(EI = 0.827) were the core symptoms, while "daytime dysfunction" (BEI = 0.035) and "intensity of physical activity" (BEI = 0.015) were the bridge symptoms. In the flow networks, "physical activity frequency" (r=-0.14) and "daytime dysfunction"(r = 0.13) were particularly correlated with depression. "Sleep disruptions"(r = 0.18) and "physical activity frequency" (r=-0.14) showed a strong correlation with anxiety.

The study identified the core and bridge symptoms of the physical activity and sleep disturbances symptom network, as well as key symptoms linked to anxiety and depression. Targeting these symptoms could disrupt their interactions, prevent negative outcomes, and enhance college student well-being.