{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:37:50Z","timestamp":1792787870586,"version":"4.5.0"},"reference-count":80,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>With the increase in the global aging population, the mental health of older adults has become increasingly prominent. This study aims to explore the relationship between the interaction of physical activity and sleep quality in older adults and depression and anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multi-stage stratified random sampling method was employed to survey various communities within Nanchang City, collecting data from 2,497 older adults. The assessment tools included the Physical Activity Rating Scale (PARS-3), Pittsburgh Sleep Quality Index (PSQI), the 9-item Patient Health Questionnaire (PHQ-9), and the 7-item Generalized Anxiety Disorder scale (GAD-7).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 2,497 participants, 582 (23.30%) had depressive tendencies; 1,122 (44.90%) had anxiety tendencies. The detection rate of depression and anxiety was higher in females than in males. Logistic regression analysis results showed that low physical activity was positively correlated with depression and anxiety (OR = 9.46; 3.66), while poor sleep quality was positively associated with depression and anxiety (OR = 2.40; 9.96) (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). There is an interactive effect between physical activity and sleep quality in relation to anxiety and depressive symptoms in older adults. Specifically, compared to low physical activity combined with poor sleep quality, the combination of high physical activity and good sleep quality is associated with reduced levels of both anxiety and depression (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This investigation underscores the dynamic interplay among physical activity, sleep quality, depressive symptoms, and anxiety in older adults, forming a critical foundation for designing tailored interventions to enhance mental health outcomes in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1674459","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T05:38:56Z","timestamp":1761197936000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":22,"title":["The interaction of physical activity and sleep quality with depression and anxiety in older adults"],"prefix":"10.3389","volume":"13","author":[{"given":"Yuqing","family":"Yuan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenying","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"B1","unstructured":"World Population Prospects 2024: Summary of Results: Unedited Version.\n          \n          2024"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1007\/978-3-030-57296-9_119","article-title":"Mental health of older adults","author":"Baiyewu","year":"2021","journal-title":"Innovations in Global Mental Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.jad.2023.11.022","article-title":"Prevalence and factors associated with depression and anxiety among older adults: a large-scale cross-sectional study in China","volume":"346","author":"He","year":"2024","journal-title":"J Affect Disorders."},{"key":"B4","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1016\/j.jad.2020.08.070","article-title":"Comorbid depressive and anxiety symptoms and frailty among older adults: findings from the West China health and aging trend study","volume":"277","author":"Zhao","year":"2020","journal-title":"J Affect Disord."},{"key":"B5","doi-asserted-by":"publisher","first-page":"19072","DOI":"10.1038\/s41598-024-69936-w","article-title":"The associations of social isolation with depression and anxiety among adults aged 65 years and older in Ningbo, China","volume":"14","author":"Li","year":"2024","journal-title":"Sci Rep."},{"key":"B6","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1016\/j.amjmed.2023.04.036","article-title":"Association of Depression and Cardiovascular Disease","volume":"136","author":"Krittanawong","year":"2023","journal-title":"Am J Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"15492","DOI":"10.1038\/s41598-025-00366-y","article-title":"The non-linear association between depression scores and all-cause mortality: a cohort study based on NHANES 2005\u20132018 data","volume":"15","author":"Huang","year":"2025","journal-title":"Sci Rep."},{"key":"B8","doi-asserted-by":"publisher","first-page":"113353","DOI":"10.1016\/j.physbeh.2021.113353","article-title":"Exercise preconditioning ameliorates cognitive impairment and anxiety-like behavior via regulation of dopamine in ischemia rats","volume":"233","author":"Fan","year":"2021","journal-title":"Physiol Behav."},{"key":"B9","doi-asserted-by":"publisher","first-page":"829","DOI":"10.3390\/brainsci11070829","article-title":"bidirectional association between physical activity and dopamine across adulthood-a systematic review","volume":"11","author":"Marques","year":"2021","journal-title":"Brain Sci."},{"key":"B10","doi-asserted-by":"publisher","first-page":"108350","DOI":"10.1016\/j.biopsycho.2022.108350","article-title":"Associations between aerobic exercise and dopamine-related reward-processing: informing a model of human exercise engagement","volume":"171","author":"Gorrell","year":"2022","journal-title":"Biol Psychol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"24510","DOI":"10.1038\/s41598-021-04336-y","article-title":"The mediating role of resilience in the effects of physical exercise on college students' negative emotions during the COVID-19 epidemic","volume":"11","author":"Li","year":"2021","journal-title":"Sci Rep."},{"key":"B12","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1146\/annurev-med-060619-022943","article-title":"The role of exercise in management of mental health disorders: an integrative review","volume":"72","author":"Smith","year":"2021","journal-title":"Annu Rev Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e37194","DOI":"10.1016\/j.heliyon.2024.e37194","article-title":"Effect of physical exercise on negative emotions in Chinese university students: the mediating effect of self-efficacy","volume":"10","author":"Qin","year":"2024","journal-title":"Heliyon."},{"key":"B14","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1037\/\/0022-006X.61.2.235","article-title":"Cognitive-behavioral therapies with youth: guiding theory, current status, and emerging developments","volume":"61","author":"Kendall","year":"1993","journal-title":"J Consult Clin Psychol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1007\/s11845-010-0633-9","article-title":"Effects of exercise and physical activity on depression","volume":"180","author":"Dinas","year":"2011","journal-title":"Ir J Med Sci."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1136\/bjsports-2022-106282","article-title":"Exercise as medicine for depressive symptoms? A systematic review and meta-analysis with meta-regression","volume":"57","author":"Heissel","year":"2023","journal-title":"Br J Sports Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1007\/s40279-013-0023-3","article-title":"Effects of exercise training on chronic inflammation in obesity : current evidence and potential mechanisms","volume":"43","author":"You","year":"2013","journal-title":"Sports Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1761","DOI":"10.1038\/s41591-019-0633-x","article-title":"Exercise reduces inflammatory cell production and cardiovascular inflammation via instruction of hematopoietic progenitor cells","volume":"25","author":"Frodermann","year":"2019","journal-title":"Nat Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"15689","DOI":"10.1038\/s41598-025-00947-x","article-title":"Bidirectional relationships between physical exercise and depressive symptoms among Chinese older adults evidence from the China family panel studies","volume":"15","author":"Chen","year":"2025","journal-title":"Sci Rep."},{"key":"B20","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1038\/nri3041","article-title":"The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease","volume":"11","author":"Gleeson","year":"2011","journal-title":"Nat Rev Immunol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1038\/s41374-019-0232-y","article-title":"The beneficial effects of physical exercise in the brain and related pathophysiological mechanisms in neurodegenerative diseases","volume":"99","author":"Liu","year":"2019","journal-title":"Lab Invest."},{"key":"B22","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1186\/s12955-020-01609-4","article-title":"The effect of exercise on anxiety in the elderly worldwide: a systematic review and meta-analysis","volume":"18","author":"Kazeminia","year":"2020","journal-title":"Health Qual Life Outcomes."},{"key":"B23","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.sleep.2021.01.011","article-title":"A meta-analysis of the relationship between subjective sleep and depressive symptoms in adolescence","volume":"79","author":"O'Callaghan","year":"2021","journal-title":"Sleep Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"82","DOI":"10.3390\/bs13020082","article-title":"Depression and anxiety mediate the association between sleep quality and self-rated health in healthcare students","volume":"13","author":"Zhu","year":"2023","journal-title":"Behav Sci."},{"key":"B25","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1016\/j.jad.2022.05.004","article-title":"Association between sleep quality and depressive symptoms","volume":"310","author":"Joo","year":"2022","journal-title":"J Affect Disord."},{"key":"B26","doi-asserted-by":"publisher","first-page":"102601","DOI":"10.1016\/j.janxdis.2022.102601","article-title":"Why sleep is key: poor sleep quality is a mechanism for the bidirectional relationship between major depressive disorder and generalized anxiety disorder across 18 years","volume":"90","author":"Nguyen","year":"2022","journal-title":"J Anxiety Disord."},{"key":"B27","doi-asserted-by":"publisher","first-page":"e2220563","DOI":"10.1001\/jamanetworkopen.2022.20563","article-title":"Effect of electroacupuncture on insomnia in patients with depression: a randomized clinical trial","volume":"5","author":"Yin","year":"2022","journal-title":"JAMA Netw Open."},{"key":"B28","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/j.sleh.2023.11.011","article-title":"The effects of insufficient sleep and adequate sleep on cognitive function in healthy adults","volume":"10","author":"Zimmerman","year":"2024","journal-title":"Sleep Health."},{"key":"B29","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.cobeha.2020.02.002","article-title":"Sleep as a window to treat affective disorders","volume":"33","author":"Talamini","year":"2020","journal-title":"Curr Opin Behav Sci."},{"key":"B30","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1093\/sleep\/zsaa289","article-title":"The effect of sleep deprivation and restriction on mood, emotion, and emotion regulation: three meta-analyses in one","author":"Tomaso","year":"2021","journal-title":"Sleep."},{"key":"B31","first-page":"5","article-title":"Stress levels and their relationship to physical activity among college students","volume":"1994","author":"Liang","year":"1994","journal-title":"Chinese Mental Health J."},{"key":"B32","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1989","journal-title":"Psychiatry Res."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1001\/jama.282.18.1737","article-title":"Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders patient health questionnaire","volume":"282","author":"Spitzer","year":"1999","journal-title":"JAMA."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Intern Med."},{"key":"B35","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1037\/0021-9010.88.5.879","article-title":"Common method biases in behavioral research: a critical review of the literature and recommended remedies","volume":"88","author":"Podsakoff","year":"2003","journal-title":"J Appl Psychol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3389\/fpubh.2024.1444119","article-title":"Physical activity as a predictor of activities of daily living in older adults: a longitudinal study in China","author":"Wang","year":"2024","journal-title":"Front Public Health."},{"key":"B37","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.ypmed.2016.05.009","article-title":"Prevalence and trends in physical activity among older adults in the United States: a comparison across three national surveys","volume":"89","author":"Keadle","year":"2016","journal-title":"Prev Med."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1682","DOI":"10.1186\/s12889-020-09671-9","article-title":"Level of physical activity among middle-aged and older Chinese people: evidence from the China health and retirement longitudinal study","volume":"20","author":"Li","year":"2020","journal-title":"BMC Public Health."},{"key":"B39","doi-asserted-by":"publisher","first-page":"30701","DOI":"10.1038\/s41598-024-78360-z","article-title":"A cross-sectional study of physical activity and chronic diseases among middle-aged and elderly in China","volume":"14","author":"Huang","year":"2024","journal-title":"Sci Rep."},{"key":"B40","doi-asserted-by":"publisher","first-page":"15679","DOI":"10.1038\/s41598-025-00657-4","article-title":"Frequency, intensity and duration of physical activity is associated with frailty in older adults with cardiac aging","volume":"15","author":"Wang","year":"2025","journal-title":"Sci Rep."},{"key":"B41","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1007\/s40520-020-01597-x","article-title":"Gender differences in the association between physical activity and health-related quality of life among community-dwelling elders","volume":"33","author":"Liao","year":"2021","journal-title":"Aging Clin Exp Res."},{"key":"B42","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/j.jshs.2019.11.003","article-title":"Reasons why older adults play sport: a systematic review","volume":"9","author":"Stenner","year":"2020","journal-title":"J Sport Health Sci."},{"key":"B43","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1080\/08870446.2015.1014370","article-title":"The role of physical activity in the relationship between self-perceptions of ageing and self-rated health in older adults","volume":"30","author":"Beyer","year":"2015","journal-title":"Psychol Health."},{"key":"B44","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1186\/s12877-024-05214-8","article-title":"What factors preventing the older adults in China from living longer: a machine learning study","volume":"24","author":"Xiao","year":"2024","journal-title":"BMC Geriatr."},{"key":"B45","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1080\/15402002.2018.1469492","article-title":"The prevalence of sleep disturbances and sleep quality in older Chinese adults: a comprehensive meta-analysis","volume":"17","author":"Lu","year":"2019","journal-title":"Behav Sleep Med."},{"key":"B46","doi-asserted-by":"publisher","first-page":"122","DOI":"10.7812\/TPP\/22.114","article-title":"Common sleep disorders affecting older adults","volume":"27","author":"Jaqua","year":"2023","journal-title":"Perm J."},{"key":"B47","doi-asserted-by":"publisher","first-page":"100057","DOI":"10.1016\/j.nbas.2022.100057","article-title":"The prevalence of sleep loss and sleep disorders in young and old adults","volume":"3","author":"Madan","year":"2023","journal-title":"Aging Brain."},{"key":"B48","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s12877-024-05657-z","article-title":"Frailty as a mediator between sleep quality and cognitive impairment among the rural older adults: a cross-sectional study","volume":"25","author":"Dong","year":"2025","journal-title":"BMC Geriatr."},{"key":"B49","doi-asserted-by":"publisher","first-page":"767","DOI":"10.12182\/20210960507","article-title":"Analysis of the status of depression and the influencing factors in middle-aged and older adults in China","volume":"52","author":"Wu","year":"2021","journal-title":"Sichuan Da Xue Xue Bao Yi Xue Ban."},{"key":"B50","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/j.jad.2021.06.050","article-title":"Prevalence of depressive symptoms among older adults in mainland China: a systematic review and meta-analysis","volume":"293","author":"Tang","year":"2021","journal-title":"J Affect Disord."},{"key":"B51","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1186\/s12877-021-02675-z","article-title":"Factors affecting the evolution of Chinese elderly depression: a cross-sectional study","volume":"22","author":"Cui","year":"2022","journal-title":"BMC Geriatr."},{"key":"B52","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1038\/s41398-019-0424-7","article-title":"Psychobiological factors of resilience and depression in late life","volume":"9","author":"Laird","year":"2019","journal-title":"Transl Psychiatry."},{"key":"B53","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1038\/s41398-021-01469-6","article-title":"Gene expression studies in Depression development and treatment: an overview of the underlying molecular mechanisms and biological processes to identify biomarkers","volume":"11","author":"Mariani","year":"2021","journal-title":"Transl Psychiatry."},{"key":"B54","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1038\/s41392-022-01251-0","article-title":"Aging and aging-related diseases: from molecular mechanisms to interventions and treatments","volume":"7","author":"Guo","year":"2022","journal-title":"Signal Transduct Target Ther."},{"key":"B55","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.pneurobio.2012.06.010","article-title":"The serotonergic system in ageing and Alzheimer's disease","volume":"99","author":"Rodr\u00edguez","year":"2012","journal-title":"Prog Neurobiol."},{"key":"B56","doi-asserted-by":"publisher","first-page":"16","DOI":"10.3389\/fpsyg.2025.1652984","article-title":"How grit enhances physical exercise in college students: mediating roles of personal growth initiative and self-efficacy","author":"Hu","year":"2025","journal-title":"Front Psychol."},{"key":"B57","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1126\/science.847460","article-title":"The need for a new medical model: a challenge for biomedicine","volume":"196","author":"Engel","year":"1977","journal-title":"Science."},{"key":"B58","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/j.aehs.2024.11.001","article-title":"Exercise-mediated circulating metabolites for brain health","volume":"1","author":"Wang","year":"2024","journal-title":"Adv Exerc Health Sci."},{"key":"B59","doi-asserted-by":"publisher","first-page":"101894","DOI":"10.1016\/j.ajp.2019.101894","article-title":"Physical exercise prevents mice from L-Kynurenine-induced depression-like behavior","volume":"48","author":"Su","year":"2020","journal-title":"Asian J Psychiatry."},{"key":"B60","doi-asserted-by":"publisher","first-page":"e2457859","DOI":"10.1001\/jamanetworkopen.2024.57859","article-title":"Exercise interventions for depression, anxiety, and quality of life in older adults with cancer: a systematic review and meta-analysis","volume":"8","author":"Soong","year":"2025","journal-title":"JAMA Netw Open."},{"key":"B61","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1007\/978-1-62703-071-7_5","article-title":"Physical activity, stress reduction, and mood: insight into immunological mechanisms","volume":"934","author":"Hamer","year":"2012","journal-title":"Methods Mol Biol."},{"key":"B62","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1038\/s41598-024-60038-1","article-title":"The association between physical exercise behavior and psychological resilience of teenagers: an examination of the chain mediating effect","author":"Li","year":"2024","journal-title":"Sci Rep."},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-025-08248-y","article-title":"Letter to the editor regarding: \u201cleisure-time physical activity patterns and predictors in patients before and after metabolic and bariatric surgery: a cross-sectional study.\u201d","author":"Hu","year":"2025","journal-title":"Obes Surg"},{"key":"B64","doi-asserted-by":"publisher","first-page":"7","DOI":"10.23736\/S0022-4707.21.12143-7","article-title":"Regular exercise improves the levels of self-efficacy, self-esteem and body awareness of young adults","volume":"62","author":"Tikac","year":"2022","journal-title":"J Sports Med Phys Fit."},{"key":"B65","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s40359-025-02529-y","article-title":"How does physical exercise influence self-efficacy in adolescents? A study based on the mediating role of psychological resilience","author":"Peng","year":"2025","journal-title":"BMC Psychol."},{"key":"B66","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1186\/s13102-024-00947-w","article-title":"Effect of physical activity for reducing anxiety symptoms in older adults: a meta-analysis of randomized controlled trials","volume":"16","author":"Goodarzi","year":"2024","journal-title":"BMC Sports Sci Med Rehabil."},{"key":"B67","doi-asserted-by":"publisher","first-page":"16","DOI":"10.3389\/fpsyg.2025.1525811","article-title":"The relationship between physical exercise and social adjustment in Chinese university students: the sequential mediating effect of peer attachment and self-esteem","author":"Xing","year":"2025","journal-title":"Front Psychol."},{"key":"B68","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1186\/s12966-024-01676-6","article-title":"Physical activity and mental health: a systematic review and best-evidence synthesis of mediation and moderation studies","volume":"21","author":"White","year":"2024","journal-title":"Int J Behav Nutr Phy."},{"key":"B69","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s11325-025-03267-6","article-title":"The prevalence and risk factors of sleep disturbances in community-dwelling older adults: a systematic review and meta-analysis","author":"Fu","year":"2025","journal-title":"Sleep Breath."},{"key":"B70","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.gerinurse.2025.01.035","article-title":"Good sleep quality shields older adults from depressive symptoms linked to isolation: Comparing online and in-person social connections","volume":"62","author":"Jiang","year":"2025","journal-title":"Geriatr Nur."},{"key":"B71","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1177\/1559827614544437","article-title":"The bidirectional relationship between exercise and sleep: Implications for exercise adherence and sleep improvement","volume":"8","author":"Kline","year":"2014","journal-title":"Am J Lifestyle Med."},{"key":"B72","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1111\/apa.14279","article-title":"One-year longitudinal study found a bidirectional relationship between physical activity and sleep disturbance in teenage Estonian girls","volume":"107","author":"Raudsepp","year":"2018","journal-title":"Acta Paediatr."},{"key":"B73","doi-asserted-by":"publisher","first-page":"2418","DOI":"10.1249\/MSS.0000000000001706","article-title":"Long-term links between physical activity and sleep quality","volume":"50","author":"Semplonius","year":"2018","journal-title":"Med Sci Sports Exercise."},{"key":"B74","doi-asserted-by":"publisher","first-page":"42","DOI":"10.3109\/07853890.2015.1131327","article-title":"BDNF in sleep, insomnia, and sleep deprivation","volume":"48","author":"Schmitt","year":"2016","journal-title":"Ann Med."},{"key":"B75","doi-asserted-by":"publisher","first-page":"101489","DOI":"10.1016\/j.smrv.2021.101489","article-title":"Physical activity and sleep: an updated umbrella review of the 2018 Physical Activity Guidelines Advisory Committee report","volume":"58","author":"Kline","year":"2021","journal-title":"Sleep Med Rev."},{"key":"B76","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1038\/s44323-024-00018-w","article-title":"The impact of exercise on sleep and sleep disorders","volume":"2","author":"Korkutata","year":"2025","journal-title":"npj Biol Timing Sleep."},{"key":"B77","doi-asserted-by":"publisher","first-page":"20","DOI":"10.5664\/jcsm.11106","article-title":"Effects of different types of exercise on sleep quality based on Pittsburgh Sleep Quality Index in middle-aged and older adults: a network meta-analysis","author":"Gao","year":"2024","journal-title":"J Clin Sleep Med : JCSM : Off Publ Am Acad Sleep Med."},{"key":"B78","doi-asserted-by":"publisher","first-page":"e24085","DOI":"10.1016\/j.heliyon.2024.e24085","article-title":"An RCT META analysis based on the effect of tai chi exercise therapy on the outcome of elderly patients with moderate-to-severe sleep disorders-a systematic review study","volume":"10","author":"Li","year":"2024","journal-title":"Heliyon."},{"key":"B79","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1001\/jamapsychiatry.2024.1321","article-title":"Integrative modeling of accelerometry-derived sleep, physical activity, and circadian rhythm domains with current or remitted major depression","volume":"81","author":"Kang","year":"2024","journal-title":"JAMA Psychiatry."},{"key":"B80","doi-asserted-by":"publisher","DOI":"10.1111\/jan.70183.","article-title":"Exploring healthcare providers' roles in surrogate end-of-life decisions for people with dementia in Korean Long-term care hospitals","author":"Hu","year":"2025","journal-title":"J Adv Nurs"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1674459\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T05:39:01Z","timestamp":1761197941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1674459\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,23]]},"references-count":80,"alternative-id":["10.3389\/fpubh.2025.1674459"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1674459","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,23]]},"article-number":"1674459"}}