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The impact of lifestyle sports on the sleep quality of depressed high school students in Jiangsu Province, China: based on cross-sectional study

樱花视频 volume听25, Article听number:听1114 (2025) Cite this article

Abstract

Objective

Lifestyle sports refer to the stable forms and behavioral characteristics formed by individuals or groups of individuals who regularly and consciously participate in sports activities, which are divided into six dimensions: joviality type, challenge type, health type, beauty type, study type, and society type. High school students have a high prevalence of depression, and lifestyle sports are important factors affecting depression and depression-induced sleep quality problems. This paper intends to investigate the relationship between the six dimensions of lifestyle sports and the sleep quality of depressed high school students.

Methods

In 129 high schools in 13 cities of Jiangsu Province, approximately 300 male and female students were selected for a questionnaire survey in each high school via the Lifestyle Sports Scale, the Self-rating Depression Scale (SDS), and the Pittsburgh Sleep Quality Index Scale (PSQI), and a stratified random sampling method was used. A total of 40,000 questionnaires were distributed, and 32,974 questionnaires were valid. The mediation model of depression between lifestyle sports and sleep quality was constructed via the Model4 model and other models in the SPSS macro program Process4.0. From the 32,974 valid questionnaires, 14,943 depressed high school students (SDS鈥夆墺鈥�53) were screened out, and structural equation modeling of the relationships between the six dimensions of lifestyle sports and the sleep quality of depressed high school students has been established via AMOS 28.0.

Results

(1) Lifestyle sports significantly and positively predicted depression (P鈥�&濒迟;鈥�0.001), positively predicted sleep quality (P鈥�&濒迟;鈥�0.001), and depression significantly and positively predicted sleep quality (P鈥�&濒迟;鈥�0.001), and depression significantly mediated the relationship between high school students鈥� lifestyle sports and sleep quality (尾鈥�=鈥�0.004, accounting for 29.91% of the total effect value). (2) The joviality type, challenge type, health type, beauty type, study type and society type of lifestyle sports significantly and positively predicted sleep quality in depressed high school students (P鈥�<鈥�0.01), with the correlation coefficients between joviality type (尾鈥�=鈥�0.75, P鈥�<鈥�0.01) and study type (尾鈥�=鈥�0.75, P鈥�<鈥�0.01) of lifestyle sports and the sleep quality of depressed high school students being the largest.

Conclusion

Depression significantly mediated the relationship between lifestyle sports and sleep quality in high school students. All six dimensions of lifestyle sports are significantly positively correlated with sleep quality in depressed high school students, with the strongest correlations for the joviality type and study type.

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Introduction

Depression occurrence is the result of the dynamic interactions of various factors. Analyses from physiological, external, environmental, and macro social development perspectives reveal that significant hormonal fluctuations, low physical activity levels, and high academic pressures can all induce low spirits in high school students, resulting in a high incidence of depression [1, 2]. The 鈥淐hinese National Mental Health Development Report鈥� has noted that between 2009 and 2020, approximately 40% of high school students were diagnosed with depression, with a staggering 12.5% being severe cases [3]. The high incidence of depression has led to widespread concerns from the state and society due to resulting issues such as aversion to school, dropout, and high suicide risk. In 2021, the Ministry of Education included depression screening in student health check-ups, and the 鈥�14th Five-Year Plan (2021鈥�2025) for National Economic and Social Development of the People鈥檚 Republic of China鈥� clearly stipulates the need to strengthen the prevention and treatment of psychological issues such as depression in high school students. This study is closely integrated with China鈥檚 national policies and actual situation, adopts an interdisciplinary perspective, breaks through the limitations of traditional single factor analysis, and aims to implement the requirements of the prevention and treatment of mental health problems in high school students, showing the policy orientation and practical application value of the research.

Depression can lead to significant decreases in sleep duration, quality, and chronotype in individuals, and decreased sleep quality can exacerbate depression [4]. This study focused on exploring the impact of depression on sleep quality. On the basis of the environment鈥抌ehavior theory, the negative effect of depression on sleep quality is caused by the interaction of multiple factors, such as gene expression, hormones, and the social environment. For example, the down-regulation of the sleep factor CLOCK leads to biological rhythm disorders [5], sleep-wake rhythm disorders induced by reduced melatonin secretion [6, 7], and greater environmental stress (such as academic pressure) in students with depression [8]. A study investigated 516 students from three junior high schools in Tokyo has reported that the prevalence of depressive sleep disorders was 17.064 times greater than that of non-depressed junior high school students and resulted in abnormal sleep structure (sleep duration, quality, and chronotype) [9]. Up to now, there has been no similar comprehensive research report on senior high school students. This study fills the gap in the field of research on senior high school students, and provides a new perspective and basis for in-depth understanding of the relationship between depression and sleep quality in senior high school students.

Lifestyle sports refer to the stable form and behavioral characteristics formed by individuals or groups of individuals who participate in sports activities regularly and consciously and can be divided into six forms of expression: joviality type, challenge type, health type, beauty type, study type, and society type [10]. Joviality type refers to a lifestyle in which individuals participate in physical activities on the basis of the principles of free choice, moderation, and moderation, with a focus on physical and mental pleasure and relaxation. The challenge type refers to enjoying stimulating and challenging sports activities and gaining satisfaction and a sense of achievement in the process of intense and exciting sports. Health type refers to the concern for one鈥檚 own physical health status, and participation in physical activity is aimed mainly at maintaining one鈥檚 physical health. The beauty type refers to a lifestyle-oriented towards self-management of body shape and improvement in appearance. Study type refers to a lifestyle that focuses on physical activity for continuous learning and growth with the goal of acquiring and consolidating sports knowledge. Society type refers to a lifestyle in which individuals participate in sports through conscious participation and precise control to achieve personal health, social interaction, cultural experience, or the pursuit of certain social goals and other diverse purposes [11, 12]. Lifestyle sports include not only physical exercise but also all activities related to sports, which promote the physical and mental health of high school students from multiple perspectives [13]. The self-efficacy theory proposed by Bandura suggests that lifestyle sports as a stable and regular task can lead to positive changes in one鈥檚 psychological state and improve self-efficacy to improve depressed mood [14]. To understand the impact of rural secondary school students鈥� lifestyle sports on their physical and mental health, a study from China has investigated 1,825 people using the Applied Mental Health Symptom Self-Assessment Scale and the Lifestyle Sports Scale for Secondary School Students and has reported that the detection rate of depression in rural high school students in northwestern Anhui Province who did not have good lifestyle sports was significantly greater [15]. Although this study compared the gap in depression detection rates among high school students with different lifestyle sports, it lacked an analysis of the relationship between the two. There are six types of lifestyle sports, namely, joviality type, challenge type, health type, beauty type, study type, and society type, and joviality and health are significantly and positively associated with college students鈥� depression [16]. This study has used college students as subjects and has had a small sample size (1950 [17] and 483 [18]), and there has been a dearth of research or paucity of data regarding the relationship between lifestyle sports and depression.

Physical exercise is an important method to improve sleep quality in depressed patients, and 8 weeks of aerobic exercise significantly improves sleep quality in depressed patients, but the individual effect is not significant [19, 20]. These findings suggest that exercise improves sleep quality decline in depressed patients in the long-term cumulative effect. Comparing the effects of multiple types of exercise on sleep quality in depressed patients is a current research hotspot. A meta-analysis has revealed that both aerobic exercise and resistance exercise significantly improve the sleep quality of depressed adolescents and that resistance exercise has the largest effect size; meditation exercise had a significant effect on the sleep quality of depressed older adults, whereas other types of exercise are not significant [21]. These findings suggest that different types of exercise should be used for depressed patients in different age groups. In addition to empirical studies, two mediation effect analyses from China have confirmed the mediating role of sleep quality in the relationship between physical activity and depression in college students and old people [22, 23], and depression positively predicts sleep quality [24]. Studies have confirmed that lifestyle sports are a more comprehensive way to improve mental health in depressed patients [13, 25,26,27], but studies have yet to be conducted exploring the relationship between lifestyle sports and its six dimensions with sleep quality in depressed high school students have yet to be conducted.

In summary, this study intends to investigate the relationships between the six dimensions of lifestyle sports and the sleep quality of depressed high school students, and the following specific research hypotheses were proposed.

Hypothesis 1

Depression positively predicts sleep quality in high school students.

Hypothesis 2

Lifestyle sports positively predict depression in high school students.

Hypothesis 3

Lifestyle sports positively predict sleep quality in high school students.

Hypothesis 4

Depression mediates the relationship between lifestyle, sports, and sleep quality in high school students.

Hypothesis 5

Six dimensions of lifestyle sports positively predict sleep quality in depressed high school students.

Methods

Study design and population

This study utilized a cross-sectional analytical survey with a stratified, multistage, cluster sampling method [28]. Initially, 8鈥�12 representative high schools were selected from each of the 13 cities in Jiangsu Province, considering factors like school level and urban-rural distinctions, between September 2020 and September 2022. This resulted in 129 high schools participating. Systematic sampling was used to distribute 40,000 paper-based questionnaires, completed on-site. Inclusion criteria were (1) voluntary participation with written consent; (2) enrollment in ordinary high schools; and (3) ages 14鈥�19. Exclusion criteria included (1) questionnaires completed in under 180听s; and (2) incomplete questionnaires. The Ethics Committee of the College of Nursing, Yangzhou University (code: YZUHL2020018) approved and supervised the study. Participants were informed about the study, signed consent forms, and confidentiality was maintained. Incomplete questionnaires and those failing manual validation were excluded, and students with depressive moods (SDS鈥夆墺鈥�53) were identified for further analysis.

Sample size

In our study, the sample size was initially calculated using the Charles Kirkland formula, which suggested surveying approximately 1,066 students. However, to ensure more comprehensive data, we expanded this number to 40,000. We targeted high school students from 129 high schools across 13 cities in Jiangsu province, selecting around 300 students from each school. The cities covered the entire province, aligning with our focus on high school students in Jiangsu. We employed stratified random sampling to choose the high schools, considering education level, school level, and urban-rural distribution, ensuring a representative sample of diverse educational environments and socioeconomic backgrounds. Within each school, classes from Grades 10, Grade 11, and Grade 12 were randomly selected, and all students in these classes were surveyed to maintain randomness and capture a balanced view of the student experience. By surveying entire classes, we aimed to accurately represent the student population at each school, thus providing a more accurate representation of the cities and the province as a whole. The systematic sampling method was used for the final selection of samples, and the distribution, completion, and collection of the 40,000 paper questionnaires were conducted on-site.

Instruments and measurements

  1. (1)

    Lifestyle sports Scale

To satisfy the purpose of this study, it was combined with the lifestyle sports questionnaire in the Handbook of Assessment of Psychological Scales Commonly Used in Sports Science by Zhang Liwei and Mao Zhixiong [29]. Dan Yujin鈥檚 鈥楧evelopment and application of lifestyle sports scale for secondary school students鈥� [30] and Karageorghis 鈥楲ifestyle sports scale鈥� [31] were revised to compile a preliminary scale for high school students鈥� lifestyle sports. The scale consists of two dimensions, self-needs and social expansion, six factors, and 30 items: health, society, beauty, challenge, study, and joviality. Among them, health refers to paying attention to one鈥檚 own physical health status and participating in sports activities mainly to maintain physical health, and its main influencing factors are physical and mental status and health outlook; it consists of 4, 10, 16, 22, 28. Society type refers to liking social communicative sports activities, achieving the purpose of communicating with others through common activities with others, caring about sports and cultural activities, and making a wide range of friendships. Society type refers to those who like to participate in group sports activities; it was composed of 5, 11, 17, 23, and 29. Beauty type refers to those who are concerned about others or their own cognitive evaluation of their own physical appearance and are concerned about their satisfaction with their bodies and personal management of their bodies; it was composed of 6, 12, 18, 24, and 30. Challenge type refers to those who like stimulating and challenging sports activities and who like to obtain satisfaction from the intense and exciting process of sports. Study type refers to participation in sports activities to master and consolidate sports methods and skills, to improve one鈥檚 own sports ability and other aspects of ability, or to better learn other aspects of knowledge, purposeful exercise, which was composed of 3, 9, 15, 21, and 27. Joviality type refers to being in a good mood, being able to feel the beauty or pleasurable enjoyment in participating in sports activities, and enjoying participating in dynamic, moderately or mildly strenuous activities, which can improve one鈥檚 mood and maintain a good state of mind; it consists of 1, 7, 13, 19, and 25. When a 5-point Likert score was used, the higher the total score of an individual鈥檚 scale was, the higher the level of his/her corresponding dimension. the higher. The Cronbach鈥檚 alpha coefficient for this scale is 0.86.

  1. (2)

    Self-rating Depression Scale (SDS)

For the purpose of this study, the scale was revised with reference to the studies of William W.K. Zung [32] and Mingyuan Zhang [33]. The scale contains 20 items rated via a four-point Likert-type scale, with 10 items worded negatively (presence of symptoms) and 10 items worded positively (absence of symptoms). Positive items are scored inversely. For each item, the respondent rates whether the item occurred 1鈥�=鈥塧 little of the time, 2鈥�=鈥塻ome of the time, 3鈥�=鈥塧 good part of the time, or 4鈥�=鈥塵ost of the time. The positive scores of all the items are summed to obtain the total raw score, which is then multiplied by 1.25 to convert it into the standard score, with the scale ranging from 鈥�25 to 100.鈥� According to the Chinese norm [34], a score of 鈥�<53鈥� is considered normal, 鈥�53鈥�59鈥� indicates mild depression, 鈥�60鈥�69鈥� indicates moderate depression, and a score of 鈥�70鈥� or above indicates severe depression. The Cronbach鈥檚 alpha coefficient for this scale is 0.91.

  1. (3)

    Pittsburgh Sleep Quality Index Scale (PSQI)

For the purpose of this study, the scale developed by Daniel J. Buysse [35] was used, and the Chinese version of the scale revised by Liu Xianchen et al. [36] was used. The scale consists of 18 self-assessment items and 7 components (sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction). The component scores range from 0 (no difficulty) to 3 (severe difficulty), and each part is added together to produce a global score ranging from 0 to 21. The higher the PSQI score is, the worse the sleep quality. A PSQI score of <鈥�3 was defined as good sleep quality, a PSQI score of 3鈥�7 was defined as intermediate sleep quality, and a PSQI score鈥�>鈥�7 was defined as sleep quality problems [37]. The Cronbach鈥檚 alpha coefficient for this index is 0.89.

Before conducting the survey for this study, we re-validated the revised scale鈥檚 reliability and validity to ensure its reliability and effectiveness. We performed a reliability analysis on the revised scale using SPSS 27.0. We performed a reliability analysis on the revised scale, and the Cronbach鈥檚 alpha obtained all exceeded the threshold of 0.7. This indicates that the scale has good reliability and confirms its applicability in this study鈥檚 sample.

Statistical analysis

First, high school students were analyzed to explore the relationships among the three variables of lifestyle sports, depression, and sleep quality. Based on the above mediation theory, depressed high school students were then analyzed to explore the relationships between the six dimensions of lifestyle sports and the sleep quality of depressed high school students.

IBM SPSS and SPSS AMOS software were used to analyze the data. The characteristics of the 32,974 high school students were described by Harman鈥檚 one-way test and descriptive statistics (mean, standard deviation) to detect common method bias. Descriptive analysis and Pearson correlation analysis were used to explore the relationship between sports lifestyle and depression and sleep quality. PROCESS was used to construct and test the mediation model of depression, and the structural equation model (SEM) was established to reveal the relationship between physical education lifestyle and its six dimensions and sleep quality scores of high school students with depression. ADF method was used to analyze the SEM, and NFI, GFI, TLI, IFI, RMSEA and other indexes were used to evaluate the fitting of the model. Given the large sample size, the Bollen-Stine method was used to correct standard errors and test statistics to account for deviations from normality. The two-tailed p-values at the 0.05 level were considered statistically significant.

Results

Common method deviation test

The Harman one-way test was used to check for common method bias problems in this study [38], and the results revealed a total of two factors with eigenvalues greater than 1, with a maximum factor variance explained of 36.36% (<鈥�40%), and no factors with excessive explanatory power, so there were no serious common method bias problems with the data of this study.

Demographic characteristics of the participants

In this study, 129 high schools in 13 cities in Jiangsu Province were surveyed, with a total of 40,000 questionnaires distributed, 36,573 recovered (91.4% recovery rate), and 32,974 valid questionnaires (90.2%validity rate). The grade, class type, gender, age, urban-rural distribution, only child, mode of residence, and family structure of the obtained samples all conformed to the demographic characteristics. The demographic characteristics of the participants were as follows (Table听1): 32,974 high school students; 10,974 (33.3%) were in Grade 10 high school; 9,841 (29.8%) were in Grade 11 high school; and 12,159 (36.9%) were in Grade 12 high school. There were 16,896 (51.2%) males and 16,078 (48.8%) females, and the mean age was 16.55鈥壜扁��0.873 years. Age stratification revealed that there were 3,233 high school students aged 14鈥�15 years (9.8%), 25,857 high school students aged 16鈥�17 years (78.4%), and 3,884 high school students aged 18鈥�19 years (11.8%), of whom 18,578 were enrolled in science classes (56.3%), 11,123 in humanities (33.7%), 1,941 in art classes (5.9%), and 1,332 in sports classes (4.1%). In terms of place of residence, there were 18,364 (55.7%) in rural areas and 14,610 (44.3%) in urban areas, of whom 15,158 (46%) were only children and 17,816 (54%) were not. In terms of mode of residence, 21,145 (64.1%) lived at home, 10,010 (30.4%) in dormitory areas, and 1,819 (30.4%) lived on lodging or trusteeship. In terms of family structure, there were 29,591 (89.7%) two-parent families, 2,251 (6.8%) single-parent families, and 1,132 (3.5%) reconstituted families.

Table 1 Demographic characteristics of the participants(N鈥�=鈥�32974)
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Correlation analysis of lifestyle sports, depression, and sleep quality scores among high school students

Pearson鈥檚 correlation analysis revealed (Table听2) that lifestyle sports were significantly and positively correlated with depression (r鈥�=鈥�0.095, P鈥�<鈥�0.01) and that lifestyle sports were significantly and positively correlated with sleep quality (r鈥�=鈥�0.081, P鈥�&濒迟;鈥�0.01). Depression was significantly positively correlated with sleep quality (r鈥�=鈥�0.263, P鈥�&濒迟;鈥�0.01).

Table 2 Correlation analysis among major variables(N鈥�=鈥�32974)
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Mediating effect test for depression between lifestyle sports and sleep quality in high school students

The correlations among lifestyle sports, depression, and sleep quality were significant and met the prerequisites for the mediation test. Using lifestyle sports as the independent variable, depression as the mediator variable, and sleep quality score as the dependent variable, mediated effects analyses were conducted via the Model 4 model in the SPSS macro program Process 4.1. The mediated effects analysis revealed (Table听3) that lifestyle sports significantly and positively predicted sleep quality (尾鈥�=鈥�0.012, t鈥�=鈥�14.802, P鈥�&濒迟;鈥�0.001) and remained significantly and positively predictive of sleep quality with the addition of the mediating variable (depression) (尾鈥�=鈥�0.008, t鈥�=鈥�10.675, P鈥�&濒迟;鈥�0.001). Lifestyle sports significantly positively predicted depression (尾鈥�=鈥�0.055, t鈥�=鈥�17.280, P鈥�&濒迟;鈥�0.001), and depression significantly positively predicted sleep quality (尾鈥�=鈥�0.065, t鈥�=鈥�48.269, P鈥�&濒迟;鈥�0.001). The results of the Bootstrap method used to test the mediating effect (Table听4) revealed that the total effect of lifestyle sports on sleep quality was 0.012, the direct effect was 0.008 (70.09% of the total effect ratio), and the mediating effect was 0.004 (29.91% of the total effect ratio). The Bootstrap method was used to construct confidence intervals for the mediating effects. The mediation model constructed in this study was tested, 95% confidence intervals for the effect values were estimated, and the study samples were repetitively sampled 5000 times. The results revealed that the direct effect of lifestyle sports on sleep quality scores, the indirect effect with depression as the mediating pathway, and the total effect of all three factors were significant, and the 95% confidence intervals did not contain 0. Therefore, the direct and indirect effects were significant, and a mediating effect of depression was established (Fig.听1).

Table 3 Data for the analysis of mediating effect of lifestyle sports on sleep quality and depression
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Table 4 Bootstrap test results for mediation effect
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Fig. 1
figure 1

Moderated mediation model of depression between lifestyle sports and sleep quality. Note: *** means P鈥�&濒迟;鈥�0.001

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Correlations between lifestyle sports and sleep quality in depressed high school students

To further validate the associations between the six dimensions of lifestyle sports and the sleep quality of depressed high school students, high school students with depressed moods (SDS鈥夆墺鈥�53) were screened from 32,974 valid questionnaires, totaling 14,943. Among them, 5,636 grade 10 students, 4,910 grade 11 students, 4,397 grade 12 students, 7,460 male students and 7483 female students were included. Next, we took depressed high school students as the research subjects. The results of Pearson鈥檚 bivariate correlation analysis of the six dimensions of lifestyle sports with sleep quality showed (Table听5) that joviality, challenge, health, beauty, study and society type of lifestyle sports were significantly and positively correlated with sleep quality (all p鈥�&濒迟;鈥�0.01).

Table 5 Correlation analysis between variables (N鈥�=鈥�14943)
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Construction and testing of structural equation models of lifestyle sports and sleep quality among depressed high school students

The structural equation model was used to test the path relationships among the variables (Fig.听2), and the fit indices of the model were as follows: x2/df鈥�=鈥�1.011, RMSEA鈥�=鈥�0.001, NFI鈥�=鈥�0.998, IFI鈥�=鈥�1.000, TLI鈥�=鈥�1.000, and CFI鈥�=鈥�1.000. All the fit metrics were within the standard range, indicating that the model was well-fitted. Hypothesis testing of model regression coefficients Model regression coefficient hypothesis tests revealed the following (Table听6): (1) Lifestyle sports significantly and positively predicted sleep quality (尾鈥�=鈥�0.11, P鈥�&濒迟;鈥�0.01). (2) Joviality (尾鈥�=鈥�0.75, P鈥�<鈥�0.01), challenge (尾鈥�=鈥�0.59, P鈥�<鈥�0.01), health (尾鈥�=鈥�0.62, P鈥�<鈥�0.01), beauty (尾鈥�=鈥�0.39, P鈥�<鈥�0.01), study (尾鈥�=鈥�0.75, P鈥�<鈥�0.01) and society (尾鈥�=鈥�0.65, P鈥�<鈥�0.01) all had significant positive correlations with sleep quality, with the largest correlation coefficients for Joviality and Study.

Fig. 2
figure 2

Structural equation model of six dimensions of lifestyle sports and sleep quality

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Table 6 Hypothesis testing of model regression coefficients
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Discussion

This study explored the relationships between lifestyle sports, depression, and sleep quality in high school students. It found that depression significantly predicts poor sleep quality, confirming Hypothesis H1. High academic pressure worsens depression, impacting sleep through negative memory bias and cognitive dysfunction. Depressive rumination and inflammatory responses further degrade sleep quality. A significant correlation between lifestyle sports and depression supports Hypothesis H2. Unlike studies on college or diabetic populations, this research used a 鈥楲ifestyle Sports Scale鈥� for high schoolers, showing that lifestyle sports reduce HPA axis activation and boost 5-HT secretion, improving depression through self-efficacy and self-esteem. Lifestyle sports also predict better sleep quality by lowering cortisol and enhancing mental resilience, confirming Hypothesis H3. Depression mediates the relationship between lifestyle sports and sleep quality, supporting Hypothesis H4. Students engaging in lifestyle sports experience increased enjoyment and stress resilience, improving sleep quality by shifting focus from negative thoughts. The study also identified that joviality and study dimensions of lifestyle sports most strongly correlate with improved sleep in depressed students, supporting Hypothesis H5. These findings highlight the important role of lifestyle sports in influencing depression and sleep quality among high school students, offering valuable insights for interventions aimed at enhancing adolescent mental health through physical activity.

In the present study, we found that depression significantly and positively predicted sleep quality among high school students, aligning with previous research [9]. Two studies from China explore the relationship between depression and sleep quality in high school students and report that depression significantly and positively predicts sleep quality in high school students [39, 40]. External environmental factors such as high study pressure can lead to the occurrence of depression in high school students, which in turn affects sleep [41]. For this reason, high negative memory bias levels in depressed mood mediate the positive moderating effects of depression on sleep quality [42]. Cognitive abilities such as attentional shifting, memory-biased processing, and executive functioning are significantly reduced in depressed high school students, and high school students with heightened negative memory bias remember more negative information, persistently focusing on their depressed negative mood and poor sleep quality [43]. Increased depressive rumination leads to sleep overthinking in high school students, resulting in sleep disorders such as slow and shallow sleep onset [44]. Furthermore, upregulated expression of serum inflammatory factors (IL-1尾 and TNF-伪) in depressed patients also leads to decreased sleep quality [45, 46].

Building on these findings, we examined the correlation between lifestyle sports and depression scores, discovering a significant positive relationship with lifestyle sports predicting depression. In previous studies, most of the subjects were college students and type 2 diabetic patients, and few high school students were included. Moreover, the present study was conducted to evaluate the physical lifestyle of high school students using the 鈥楲ifestyle sports scale,鈥� which is superior to previous studies that used weekly exercise frequency, time, intensity, and the number of exercises to rate lifestyle sports [15]. Analysis of the neuroendocrine hypothesis reveals that lifestyle sports significantly suppressed HPA axis activation and promoted 5-HT secretion to improve depression, and the suppression of the HPA axis was caused by a reduction in cortisol and adrenocorticotropic hormone-releasing factor during exercise [47]. From the perspective of psychological mechanisms, lifestyle sports significantly improve self-efficacy and individual self-esteem and facilitate distraction from negative thoughts in high school students, thus improving depression [48,49,50].

Continuing our analysis, we confirmed that lifestyle sports positively predicted sleep quality in high school students, consistent with previous research [51]. This finding indicates that the better their lifestyle is, the greater their sleep quality. This can be analyzed in terms of physiology, psychology, and the interactions between the two: (1) Sleep disorders lead to an increase in the secretion of hormones such as cortisol, whereas lifestyle sports significantly inhibit cortisol secretion, which reduces the perceived stress of high school students, decreases the individual鈥檚 susceptibility to the external environment, and improves sleep quality [52, 53]. (2) Lower levels of lifestyle sports lead to increased activation of the amygdala, which controls emotions, bipolar disorders in the thalamus, and hippocampal structural atrophy and neuronal regeneration insufficiency, inhibiting the functional connectivity network of the dorsolateral prefrontal and limbic brain regions in the middle frontal pole region [54], and higher individual vulnerability traits can lead to greater exposure to negative emotions in high school students. (3) Lifestyle sports are significantly and positively correlated with mental toughness and self-control, and the above psychological factors positively predicted sleep quality. The study confirmed that increased mental toughness enhances high school student鈥檚 ability to cope with external environmental disturbances [55], and the strength model of self-control suggests that lifestyle sports is significantly and positively associated with self-control, the theory of bedtime procrastination suggests that students with weak self-control are vulnerable to disturbances from external things, resulting in sleep deprivation, sleep fatigue, and other problems [56].

Furthermore, our study reveals that depression significantly mediates the relationship between lifestyle sports and sleep quality. The cognitive-behavioral hypothesis of 鈥榖ehavior, emotion, and cognition鈥� suggests that emotion mediates the regulation between behavior and cognition and that lifestyle sports, as an independent predictor of depressive mood, significantly improve high school students鈥� own sense of enjoyment, self-esteem, and resistance to stress [57, 58], which helps diverts individuals鈥� attention from negative thinking. Facilitating high school students to disengage from unpleasant, stressful, anxious, and painful somatic complaints [59, 60] and, in turn, improves the biological changes in circadian rhythms and sleep homeostatic balance, shortens the time prebedtime, and relieves anxiety prebedtime [61]. Furthermore, physical exercise significantly changes lifestyle sports, and high school students鈥� depressed mood is significantly improved at the same time as 5-HT secretion increases in the body, which in turn improves central nervous system function and alleviates anxiety; reduced cortisol secretion increases melatonin secretion and inhibits the activation of the HPA axis, which improves the role of the circadian rhythm of sleep-wakefulness [62, 63].

In a further exploration of these relationships, we constructed a structural equation model that highlights the positive correlation between the six dimensions of lifestyle sports and the sleep quality of depressed high school students. Joviality, study, health, challenge, beauty, and society type of lifestyle sports were all significantly and positively correlated with the sleep quality of depressed high school students, with joviality type and study type having the highest correlation. A joviality type of lifestyle sports can improve prebedtime anxiety, shorten the time to sleep, and improve the sleep quality of depressed high school students by improving their positive social psychology and increasing their social behaviors [64]. From the perspective of physiological psychology, joviality type of lifestyle sports upregulates 5-HT expression and binds to 5-HT receptors in the nucleus accumbens and hippocampus, activates the projection loop of the nucleus accumbens-hippocampus pathway [65, 66], reduces depressive mood while causing a decrease in rapid eye movement sleep and an increase in slow-wave sleep, and improves sleep quality [67, 68]. Depressed high school students can significantly improve their sleep by learning sports knowledge and skills to divert their attention. Social learning theory suggests that depressed high school students observe the positive attitudes and healthy lifestyles of their peers in physical education and that obtaining social support can change their behaviours and thinking, alleviate depression and promote sleep [69]. It also improves sleep quality by enhancing self-efficacy and optimising cognitive patterns in depressed high school students [70]. In stress adaptation theory, moderate physical challenges can help increase mental toughness, effectively cope with stress, and reduce depression-induced sleep disturbances in depressed students [71]. Challenge type of lifestyle sports can improve sleep quality by enhancing positive coping strategies and increasing awareness and control of the body in depressed high school students [72, 73]. Self-determination theory states that satisfying depressed high school students鈥� sense of autonomy, competence, and belonging increases their intrinsic motivation, enhances motivation for life, and improves sleep quality [74]. These findings suggest that fitness-based factors significantly positively predicted sleep quality in this study and that regular physical activities positively affected sleep quality by regulating body physiology, such as promoting endocrine balance, increasing endorphin secretion, and alleviating depression [75]. By improving the body shape and appearance of depressed high school students, a beauty type of lifestyle sports can increase their satisfaction with their body shape, thereby positively affecting their mental health. By engaging in beauty-type lifestyle sports, depressed high school students can not only increase their sense of control over their body shape but also improve their sense of self-efficacy and psychological resilience, which can help improve sleep quality [76]. Society type of lifestyle sports emphasizes the function of sports activities in terms of social aspects, and social support theory suggests that social support is crucial for reducing depressive symptoms and improving sleep quality and that depressed high school students gain emotional support and a sense of belonging, relieve stress, and enhance sleep quality in society type of lifestyle sports [77, 78]. In addition, by participating in socially orientated physical activities, depressed high school students are able to experience a sense of achievement and self-efficacy, which helps to improve their depressive mood and sleep quality [79].

The present study revealed the mediating relationship of depression between lifestyle sports and sleep quality in high school students and verified the positive effects of the six dimensions of lifestyle sports on sleep quality in depressed high school students. In the context of the high prevalence of depression in high school students, the above findings provide a theoretical basis for the use of physical exercise to prevent and control depression and its triggers in high school students, as well as a solid scientific basis for the development of precise exercise prescriptions to improve depressive symptoms and sleep quality in depressed high school students. However, this study has several limitations: (1) This study reflects only the situation of high school students鈥� depression and other variables at one point in time and lacks a tracking survey for multiple points in time within a certain period of time to explore the trend of change. (2) There are fewer current relevant studies and this study investigated only high school students in Jiangsu Province. If different populations of adolescents in different cultures throughout China or around the world could be investigated, it would be more meaningful for the government, schools, and others to formulate policies related to preventing and controlling the high incidence of depression among adolescents. (3) This study is only a cross-sectional study and lacks a longitudinal intervention study, which, in turn, makes the findings more convincing.

Conclusions

Depression was a significant mediator between lifestyle sports and sleep quality in high school students, and all six dimensions of lifestyle sports were significantly and positively correlated with sleep quality in depressed high school students, with the greatest correlations having been found for joviality type and study type. In addition, in the future, the specific mechanisms of lifestyle sports to improve depression or sleep quality can be explored in depth, including physiological, psychological, and neurobiological dimensions, in order to reveal more comprehensively their intrinsic connections and principles of action and to provide a more targeted and effective strategic basis for the promotion of physical and mental health of high school students.

Data availability

(1) Data Sources and Access: Although the data are not publicly available, we ensure that, upon reasonable request, the data are available with the necessary approvals.

(2) Data format and supporting files: Data will be provided in an appropriate format with supporting files to aid understanding and use, including data dictionaries and associated codes.

(3) Restrictions and permissions: The use of data is restricted by ethics committee and institutional policies and will be used in accordance with relevant permissions after obtaining necessary approvals.

(4) Raw data: Raw data supporting the conclusions of this article will be provided by the authors without undue restrictions.

(5) Contact Information: If you have any questions or need further information, please feel free to contact me or the corresponding author (Professor Xianghe Chen, huashixh@163.com).

Abbreviations

SDS:

Self-rating Depression Scale

PSQI:

Pittsburgh Sleep Quality Index Scale

M:

Mean

SD:

Standard deviation

SEM:

Structural Equation Modelling

ADF:

Asymptotically Distribution-Free

NFI:

Standardised Fit Index

GFI:

Goodness of Fit Index

TLI:

Tucker Lewis Index

IFI:

Incremental

RMSEA:

Approximation

滨尝-1尾:

Interleukin 鈭掆��1 beta

罢狈贵-伪:

Tumor Necrosis Factor - alpha

HPA:

Hypothalamus Pituitary Adrenal

5-HT:

5 - Hydroxytryptamine

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Acknowledgements

The authors thank all participants in study. Furthermore, we thank Home for Researchers editorial team () for language editing service.

Funding

This work was funded by The National Social Science Foundation of China [Grant number: CLA200279].

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Author notes

  1. Xianghe Chen, Yuxin Yang and Jianbo Hu contributed equally to this work.

Authors and Affiliations

  1. College of Physical Education, Yangzhou University, Yangzhou, 225127, China

    Xianghe Chen,听Yuxin Yang,听Jianbo Hu,听Shengjie Jin,听Pengcheng Lu,听Xinyu Zeng,听Xiaoyan Yi听&听Chenghao Zhong

  2. Physical Education and Sports School of Soochow University, Soochow, 215021, China

    Rongbin Yin

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Contributions

XC and RY contributed to the study design, while XZ, YY and JH contributed to the data collection. Interpretation of results was performed by XY and CZ, whereas XC, YY, SJ, PL,听and JH drafted the manuscript and edited the language. All authors participated in the critical revisions and approved the final version of the manuscript.

Corresponding authors

Correspondence to Xianghe Chen or Rongbin Yin.

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Ethics approval and consent to participate

The study designed was approved by the Ethics Committee of School of Nursing, Yangzhou University (Approval Code: YZUHL2020018). We have obtained informed consent from the school teachers, students and their parents.

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Not applicable.

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The authors declare no competing interests.

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Chen, X., Yang, Y., Hu, J. et al. The impact of lifestyle sports on the sleep quality of depressed high school students in Jiangsu Province, China: based on cross-sectional study. 樱花视频 25, 1114 (2025). https://doi.org/10.1186/s12889-024-21238-6

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  • DOI: https://doi.org/10.1186/s12889-024-21238-6

Keywords

樱花视频

ISSN: 1471-2458

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