Exercise Frequency Is Associated With Greater Susceptibility to Sleep Disruption From Bedtime Smartphone Use: A Multi-University Cross-Sectional Study

Exercise Frequency Is Associated With Greater Susceptibility to Sleep Disruption From Bedtime Smartphone Use: A Multi-University Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Exercise Frequency Is Associated With Greater Susceptibility to Sleep Disruption From Bedtime Smartphone Use: A Multi-University Cross-Sectional Study Weizhi Liu, Kaixin Lei, Yuwei Chen, Siyao Li, Jian Li, Xiangdong Tang, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7752679/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Digital behaviors and physical activity jointly shape sleep in young adults, yet their interactive effects remain unclear. We conducted a short-term, multi-university cross-sectional survey of 4,730 Chinese undergraduates during a non-examination period to test whether sleep quality mediates the association between bedtime smartphone use and psychological symptoms, and how components of weekly exercise dose moderate these associations with attention to chronotype. Bedtime smartphone use was associated with poorer sleep quality, which in turn related to higher anxiety and depressive symptoms. Sleep quality mediated the associations of smartphone use with anxiety and depression, with significant indirect effects and minimal direct effects. Unexpectedly, higher weekly exercise dose amplified rather than attenuated the adverse association between bedtime smartphone use and sleep quality. Decomposition of the dose indicated that frequency was the dominant contributor to this amplification, followed by duration and with only a minor role for intensity. Effects were directionally consistent in sensitivity analyses and more pronounced among evening chronotypes. These findings highlight sleep quality as a key pathway linking pre-sleep smartphone use to mental health and suggest that dose-sensitive exercise scheduling, prioritizing fewer weekly sessions or earlier timing, together with chronotype-tailored digital hygiene, may better protect sleep in student populations with high digital exposure. Health sciences/Diseases Health sciences/Health care Biological sciences/Neuroscience Biological sciences/Psychology Social science/Psychology Health sciences/Risk factors Full Text Additional Declarations No competing interests reported. Supplementary Files Table1T1demographicCharacteristics.xlsx SupplementaryTableS4.KeyPointsforMediationModelInterpretation.xlsx SupplementaryTableS3.DecompositionofDirectandIndirectEffectsinMediationModels.xlsx SupplementaryTableS2.StandardizedPathCoefficientsFromStructuralEquationModels.xlsx SupplementaryTableS1.STROBEChecklistforCrossSectionalStudyReporting.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7752679","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":532355663,"identity":"16a35f6c-d4f0-4a8a-886f-878682431d00","order_by":0,"name":"Weizhi Liu","email":"","orcid":"","institution":"West China Hospital of Sichuan University","correspondingAuthor":false,"prefix":"","firstName":"Weizhi","middleName":"","lastName":"Liu","suffix":""},{"id":532355664,"identity":"f411affa-cc7b-4602-b6b6-2401d7926b54","order_by":1,"name":"Kaixin Lei","email":"","orcid":"","institution":"West China Hospital of Sichuan 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Smartphone Use: A Multi-University Cross-Sectional Study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research 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We conducted a short-term, multi-university cross-sectional survey of 4,730 Chinese undergraduates during a non-examination period to test whether sleep quality mediates the association between bedtime smartphone use and psychological symptoms, and how components of weekly exercise dose moderate these associations with attention to chronotype. Bedtime smartphone use was associated with poorer sleep quality, which in turn related to higher anxiety and depressive symptoms. Sleep quality mediated the associations of smartphone use with anxiety and depression, with significant indirect effects and minimal direct effects. Unexpectedly, higher weekly exercise dose amplified rather than attenuated the adverse association between bedtime smartphone use and sleep quality. Decomposition of the dose indicated that frequency was the dominant contributor to this amplification, followed by duration and with only a minor role for intensity. Effects were directionally consistent in sensitivity analyses and more pronounced among evening chronotypes. These findings highlight sleep quality as a key pathway linking pre-sleep smartphone use to mental health and suggest that dose-sensitive exercise scheduling, prioritizing fewer weekly sessions or earlier timing, together with chronotype-tailored digital hygiene, may better protect sleep in student populations with high digital exposure.","manuscriptTitle":"Exercise Frequency Is Associated With Greater Susceptibility to Sleep Disruption From Bedtime Smartphone Use: A Multi-University Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-22 14:49:09","doi":"10.21203/rs.3.rs-7752679/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"88b17a60-d4d0-42c1-abec-dcd0410a51ec","owner":[],"postedDate":"October 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":56587232,"name":"Health sciences/Diseases"},{"id":56587233,"name":"Health sciences/Health care"},{"id":56587234,"name":"Biological sciences/Neuroscience"},{"id":56587235,"name":"Biological sciences/Psychology"},{"id":56587236,"name":"Social science/Psychology"},{"id":56587237,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2026-01-08T04:09:39+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-22 14:49:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7752679","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7752679","identity":"rs-7752679","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}