Sleep

The associations between sleep problems and physical exercise among Chinese university students: A network analysis of gender differences.

TL;DR

Network analysis of Chinese university students revealed gender-specific bridge nodes connecting sleep problems and physical exercise, with fatigue-exercise duration being the strongest connection in males and difficulty falling asleep-exercise frequency in females.

Key Findings

In the overall sleep problems network, subjective sleep quality and sleep satisfaction showed the closest association and served as core nodes.

  • The study used the Youth Self-Rating Insomnia Scale (YSIS) to assess sleep problems
  • Network analysis identified influential nodes and edges within the sleep problems structure
  • The sample consisted of 7978 undergraduate students in a cross-sectional design
  • These two nodes were identified as central to the internal network structure of sleep problems

Among male students, the strongest connection in the sleep problems-physical exercise bridge network was between fatigue and physical exercise duration.

  • Difficulty falling asleep functioned as the bridge node in the male student network
  • Physical exercise was assessed using the Physical Activity Rating Scale-3 (PARS-3)
  • Gender-specific patterns emerged in the bridge network between sleep problems and physical exercise
  • The finding suggests fatigue and exercise duration are the key linkage point for males

Among female students, the strongest connection in the sleep problems-physical exercise bridge network was between difficulty falling asleep and physical exercise frequency.

  • Insufficient sleep served as the bridge node in the female student network
  • The bridge node differed between genders: difficulty falling asleep for males, insufficient sleep for females
  • The strongest edge also differed: fatigue-duration for males versus difficulty falling asleep-frequency for females
  • These gender-specific patterns were identified through network structure comparison between male and female students

A cross-sectional study was conducted among 7978 undergraduate students using standardized scales to assess both sleep problems and physical exercise.

  • The Youth Self-Rating Insomnia Scale (YSIS) was used to assess sleep problems
  • The Physical Activity Rating Scale-3 (PARS-3) was used to assess physical exercise
  • The study population consisted of Chinese undergraduate students
  • Network analysis was employed to identify influential nodes, edges, and to compare network structures between genders

The findings from the sleep problems-physical exercise network were proposed to inform the design of exercise-based interventions for sleep problems with gender-specific strategies.

  • Gender-specific intervention strategies were supported by the differing bridge nodes and strongest edges found in male versus female networks
  • For males, interventions targeting fatigue and exercise duration may be most relevant
  • For females, interventions targeting difficulty falling asleep and exercise frequency may be most relevant
  • The authors identified this as a practical application of the network analysis approach to intervention design

What This Means

This research suggests that sleep problems and physical exercise are connected differently in male and female Chinese university students. Using a large sample of nearly 8,000 students and a statistical technique called network analysis, the researchers mapped out which specific aspects of sleep problems are most strongly linked to which aspects of exercise. They found that feeling subjectively satisfied with sleep and perceiving good sleep quality are the most central features of sleep problems overall. When looking at how sleep and exercise connect to each other, the study found clear gender differences. In male students, fatigue had the strongest link to how long they exercised (exercise duration), and difficulty falling asleep acted as the key 'bridge' connecting the sleep and exercise networks. In female students, difficulty falling asleep was most strongly connected to how often they exercised (exercise frequency), and not getting enough sleep served as the main bridge node between the two networks. This research suggests that exercise-based programs aimed at improving sleep should not take a one-size-fits-all approach. Because the connections between sleep problems and exercise differ by gender, targeting fatigue and exercise duration may be more effective for male students, while addressing difficulty falling asleep and exercise frequency may be more relevant for female students. The network analysis approach used here may help researchers and health professionals better understand which specific symptoms to target when designing sleep interventions.

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Citation

Feng H, Liang J, Guo Z, Wu Q, Zeng H. (2026). The associations between sleep problems and physical exercise among Chinese university students: A network analysis of gender differences.. Journal of affective disorders. https://doi.org/10.1016/j.jad.2025.121104