Sleep duration, sleep location, and physical activity were significantly associated with mental health outcomes among Hawai'i adolescents, with longer sleep and more frequent physical activity protective against sadness/hopelessness and suicidality.
Key Findings
Results
Longer sleep duration was associated with lower odds of sadness/hopelessness among Hawai'i adolescents.
Adolescents sleeping 6-7 hours had lower odds of sadness/hopelessness compared to those sleeping 0-5 hours (aOR=0.59, 95% CI=0.52-0.67)
Adolescents sleeping 8+ hours had even lower odds of sadness/hopelessness compared to those sleeping 0-5 hours (aOR=0.36, 95% CI=0.32-0.41)
Data were drawn from the 2017-2021 Hawai'i State High School Youth Risk Behavior Survey (YRBS)
Models adjusted for covariates including race, bullying, and the COVID-19 pandemic
Results
Longer sleep duration was associated with lower odds of suicidality among Hawai'i adolescents.
Adolescents sleeping 6-7 hours had lower odds of suicidality compared to those sleeping 0-5 hours (aOR=0.64, 95% CI=0.54-0.76)
Adolescents sleeping 8+ hours had lower odds of suicidality compared to those sleeping 0-5 hours (aOR=0.38, 95% CI=0.31-0.46)
The association was dose-dependent, with greater sleep duration corresponding to greater reduction in odds
Results
Adolescents without a stable place to sleep had higher odds of suicidality.
Lacking a stable sleep location was associated with suicidality (aOR=1.69, 95% CI=1.29-2.21)
Sleep location was identified as a distinct variable from sleep duration in the analysis
This finding highlights housing instability as a mental health risk factor among adolescents
Results
Greater frequency of physical activity was associated with lower odds of both sadness/hopelessness and suicidality.
Adolescents active 6-7 days per week had lower odds of sadness/hopelessness compared to those active 0-2 days (aOR=0.75, 95% CI=0.65-0.87)
Adolescents active 6-7 days per week had lower odds of suicidality compared to those active 0-2 days (aOR=0.71, 95% CI=0.61-0.83)
Physical activity frequency was the measure used rather than intensity or type
Results
Boys had lower odds of both sadness/hopelessness and suicidality compared to girls.
Sex was identified as a significant covariate in adjusted logistic regression models
This finding reflects a gender disparity in adolescent mental health outcomes
The direction of the association held for both mental health outcomes examined
Results
Compared with White adolescents, Filipino, other Asian, and Pacific Islander adolescents had lower odds of suicidality.
Racial/ethnic group was included as a covariate in the adjusted logistic regression models
Filipinos, other Asians, and Pacific Islanders each showed lower odds of suicidality relative to Whites
These findings highlight unique racial/ethnic patterns in mental health outcomes specific to the Hawai'i adolescent population
Results
Adolescents surveyed during the COVID-19 pandemic had increased odds of sadness/hopelessness.
The COVID-19 pandemic period was included as a covariate in the logistic regression models
The survey spanned 2017-2021, allowing for a pre- and during-pandemic comparison
Pandemic exposure was associated with increased odds of sadness/hopelessness but the abstract does not report a specific aOR for this finding
What This Means
This research suggests that how much sleep teenagers get, where they sleep, and how physically active they are all have meaningful connections to their mental health. Using survey data collected from high school students in Hawai'i between 2017 and 2021, researchers found that teens who slept more were substantially less likely to report persistent feelings of sadness or hopelessness and less likely to report suicidal thoughts or behaviors. Teens who did not have a stable place to sleep were significantly more likely to report suicidality, pointing to housing instability as an important risk factor. Being physically active more days per week was also linked to better mental health outcomes.
The study also found notable differences by gender and racial/ethnic background. Girls were more likely than boys to report both sadness/hopelessness and suicidality. Among racial groups in Hawai'i, Filipino, other Asian, and Pacific Islander teens had lower odds of suicidality compared to White teens, highlighting that mental health patterns in Hawai'i may differ from national trends due to the state's unique demographic makeup. Teens surveyed during the COVID-19 pandemic reported higher rates of sadness and hopelessness than those surveyed before the pandemic.
This research suggests that promoting adequate sleep and regular physical activity could be important strategies for protecting adolescent mental health, and that addressing housing instability among teens may also reduce suicide risk. The findings highlight the importance of tailoring mental health prevention and intervention programs to reflect the specific demographic and social characteristics of adolescent populations, particularly in a diverse state like Hawai'i.
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Chen M, Okamoto S, Lim E. (2026). Associations Between Mental Health Status and Sleep and Physical Activity Among Adolescents in Hawai'i.. Hawai'i journal of health & social welfare. https://doi.org/10.62547/ILTH5588