How Physical Activity is Related to Sleep in University Students Depends on the Country

The researchers’ goal was to conduct a systematic review and meta-analysis to evaluate observational studies of the relationship between sleep and physical activity in college students.

Additional studies involving device-based measures are needed to adequately assess the relationship between physical activity and sleep among university students. These findings from a systematic review and meta-analysis were published in Sleep Medicine Reviews.

Researchers in Pakistan and Australia searched publication databases through July 2020 for studies on sleep and exercise among college students. A total of 29 articles were included in the systematic review, 9 in the meta-analysis of exercise and sleep quality, and 4 in the meta-analysis of exercise and sleep duration, comprising a total of 141,035 participants.

Sleep was largely assessed (93.1%) by self-reporting tools such as the Pittsburgh Sleep Quality Index (PSQI), and only 2 studies incorporated device-based measurements. Physical activity was also largely based (89.7%) on self-reporting tools such as the International Physical Activity Questionnaire, and only 3 studies incorporated device-based monitoring.

No association between sleep and physical activity was found in 16 studies, 9 reported a positive relationship, and 4 a negative association.

In the meta-analysis, the investigators observed a nonsignificant negative correlation between PSQI and moderate-to-high intensity physical activity (r, -0.18; 95% CI, -0.37 to 0.03; P =.10).

The country of the study was a significant factor (P <.0001), in which the strongest correlations were observed in Romania (r, -0.84; 95% CI, -0.87 to -0.80; n=1), China (r, -0.11; 95% CI, -0.15 to -0.07; n=5), and Croatia (r, 0.10; 95% CI, 0.06-0.14; n=1) with significant heterogeneity (I2, 98.4%; P <.0001).

Similarly, increasing physical activity was associated with a nonsignificant negative relationship with sleep duration (r, -0.02; 95% CI, -0.16 to 0.12; P =.76). The country of the study was a significant factor (P =.001); the strongest correlation was observed in Germany (r, -0.27; 95% CI, -0.44 to -0.08; n=1) with high heterogeneity (I2, 81.3%; P <.0001).

This study may have been biased by its reliance on self-reported sleep and physical activity.

The study authors concluded additional studies are needed to relate physical activity with sleep among university students. Incorporating wearable devices would likely more accurately assess both sleep and activity than self-reporting instruments.


Memon AR, Gupta CC, Crowther ME, Ferguson SA, Tuckwell GA, Vincent GE. Sleep and physical activity in university students: a systematic review and meta-analysis. Sleep Med Rev. Published online March 20,2021. doi:10.1016/j.smrv.2021.101482