Joint physical activity and screen time patterns in relation to mental health and sleep among university students: A...

This study examined how joint patterns of physical activity (PA) and screen time (ST) were associated with mental health and sleep among university students.

Following PRISMA guidelines, we searched Web of Science, PubMed, PsycINFO, Embase, CINAHL, CENTRAL, CNKI, and Wanfang from inception to March 2026. Studies involving university students that assessed both PA and ST and reported relevant health associations were included. Study quality was evaluated using the Newcastle-Ottawa Scale and the AHRQ checklist. A systematic review and narrative synthesis served as the main evidence base, supplemented by a limited exploratory quantitative synthesis of studies reporting comparable odds ratios (ORs) and 95% confidence intervals (CIs). Random-effects models were used for pooling.

Fifty-five studies were included, of which six cross-sectional studies were eligible for quantitative synthesis. Across the review, a broadly consistent pattern was observed: higher PA combined with lower ST was more often associated with better mental health and sleep, whereas lower PA combined with higher ST tended to be linked to less favorable patterns. In the limited exploratory quantitative synthesis, using LPA-HST as the reference group, HPA-LST was associated with lower odds of anxiety (OR = 0.64, 95% CI: 0.46-0.90), depression (OR = 0.46, 95% CI: 0.33-0.64), and poor sleep (OR = 0.54, 95% CI: 0.45-0.66), complementing the overall directional pattern observed in the systematic review.

Joint PA-ST patterns showed directional associations with mental health and sleep among university students. The systematic review provided the main evidential basis, while the quantitative findings offered supplementary exploratory support.