Korean J Fam Pract.  2025 Dec;15(4):210-216. 10.21215/kjfp.2025.15.4.210.

Combined Effects of Sleep Duration and Physical Activity on Stress in Korean Adolescents: An Analysis of the 2019–2020 Korea National Health and Nutrition Examination Survey

• Ryu Y
• Yoon JY
• Lee JA

• KMID: 2575064
• DOI: http://doi.org/10.21215/kjfp.2025.15.4.210

Abstract

Background
Sleep and physical activity are crucial for adolescent health. However, their combined effects on stress remain unclear. This study examined the combined effects of sleep duration and physical activity on stress in Korean adolescents.
Methods
Data from 918 adolescents aged 12–18 years (502 boys and 416 girls) were analyzed using the 2019–2020 Korea National Health and Nutrition Examination Survey. Participants were classified into four groups based on sleep duration and physical activity levels: active with sufficient sleep, inactive with sufficient sleep, active with insufficient sleep, and inactive with insufficient sleep. Stress was assessed using a single question on the perceived level of stress in daily life. Multivariate logistic regression analysis was performed to evaluate stress levels according to sleep duration and physical activity levels.
Results
Adolescents in the inactive with insufficient sleep group showed significantly higher stress levels than those in the active with sufficient sleep group (odds ratio [OR], 2.52; 95% confidence interval [CI], 1.37–4.62). Stratified analysis revealed higher stress in boys with insufficient sleep and low activity (OR, 4.90; 95% CI, 1.85–13.00), whereas no significant associations were found in girls (OR, 1.25; 95% CI, 0.57–2.73).
Conclusion
Insufficient sleep with low physical activity is associated with higher stress levels in adolescents, particularly in boys. Adequate sleep and physical activity have been associated with improved health in adolescents.

Keyword

Sleep Duration; Physical Activity; Stress; Adolescents