Association Between Sleep Duration, Screen-Based Sedentary Time, and Weight Status Among Chinese Adolescents

Objectives: The aim of this study was to examine the association between sleep duration, screen-based sedentary time, and overweight/obesity prevalence among Chinese adolescents. Methods: A cross-sectional analysis was conducted on 6174 adolescents in Shandong Province, China, covering general demographic characteristics, sleep time, screen-based sedentary time, physical activity, and other related variables. Height and weight measurements were obtained through on-site physical examinations, while other variable data were obtained through a questionnaire. The participants were categorized based on sleep time (<8 vs. ≥8 h/d) and screen-based sedentary time (<2 vs. ≥2 h/d). Logistic regression was employed to assess the independent and combined associations. Results: The overall prevalence of overweight in the adolescents was 27.1%. Adolescents with insufficient sleep (<8 h/d) had a significantly higher rate of overweight than those with adequate sleep (29.1% vs. 25.1%, p = 0.03). Similarly, those with high screen-based sedentary time (≥2 h/d) had a higher rate of overweight than those with low screen-based sedentary time (32.6% vs. 26.4%, p = 0.012). After adjustment for confounders, insufficient sleep and high screen time were independently associated with increased odds of being overweight. While no significant multiplicative interaction was found, the combination of insufficient sleep and high screen time presented the highest risk (OR = 1.552, 95% CI: 1.162-1.911). Conclusions: Both insufficient sleep duration and excessive screen-based sedentary time are independent risk factors for overweight/obesity among Chinese adolescents. A cumulative effect is suggested, as adolescents with both behaviors face the greatest risk. Public health interventions should concurrently promote adequate sleep and reduce screen-based sedentary time to combat adolescent overweight/obesity.