{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T05:49:16Z","timestamp":1782107356215,"version":"3.54.5"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"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>Objective<\/jats:title>\n                    <jats:p>To examine the associations of smartphone addiction, physical activity, and sedentary time with sleep quality and neck\/shoulder symptoms during the previous 7\u202fdays in university students, and to assess the potential modifying role of physical activity in outcomes associated with smartphone addiction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted among 585 students from a single university in Jilin Province, China. Smartphone addiction, physical activity, sedentary time, sleep quality, and neck\/shoulder symptoms were assessed using validated questionnaires. Multivariable linear regression and Poisson regression with robust variance were used to examine adjusted associations and interaction terms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the participants, 43.8% were classified as having poor sleep, and 46.2% reported at least one neck\/shoulder symptoms during the previous 7\u202fdays. After adjustment for covariates, higher smartphone addiction and longer sedentary time were both associated with higher PSQI scores, a higher prevalence of poor sleep, and a higher prevalence of neck\/shoulder symptoms during the previous 7\u202fdays. Meeting physical activity recommendations was associated with lower PSQI scores and a lower prevalence of poor sleep, but showed no independent association with neck\/shoulder symptoms. After further adjustment for PSQI, smartphone addiction, sedentary time, and PSQI score were still significantly associated with a higher prevalence of neck\/shoulder symptoms. Interaction plots showed descriptively lower predicted PSQI scores and lower predicted probabilities of neck\/shoulder symptoms among students who met physical activity recommendations at comparable levels of smartphone addiction; however, the formal interaction terms were not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Smartphone addiction and sedentary time were consistently associated with poorer sleep quality and more frequent neck\/shoulder symptoms. Physical activity was more consistently associated with sleep outcomes than with neck\/shoulder symptoms. These findings support considering smartphone use, sedentary behaviour, physical activity, and sleep management together in campus health promotion research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1848640","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T05:38:15Z","timestamp":1782106695000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of smartphone addiction and physical activity with sleep quality and neck\/shoulder symptoms in university students: a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Wei","family":"Yue","sequence":"first","affiliation":[{"name":"College of Physical Education, Jilin Normal University, Siping","place":["Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shen","family":"Cao","sequence":"additional","affiliation":[{"name":"Football School, Hebei Institute of Communications","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinglei","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Culture, Tourism, Health and Wellness Education, Dongying Vocational College","place":["Dongying, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Culture, Tourism, Health and Wellness Education, Dongying Vocational College","place":["Dongying, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weigang","family":"Lai","sequence":"additional","affiliation":[{"name":"Sports Committee, Dongying Vocational College","place":["Dongying, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Faculty of Education and Liberal Studies, City University Malaysia","place":["Kuala Lumpur, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuexin","family":"Cui","sequence":"additional","affiliation":[{"name":"Office of Academic Affairs, Dongying Vocational College","place":["Dongying, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e12648","DOI":"10.1111\/jsr.12648","article-title":"Prevalence of sleep disturbances in Chinese university students: a comprehensive Meta-analysis","volume":"27","author":"Li","year":"2018","journal-title":"J Sleep Res"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1093\/sleepadvances\/zpaf083","article-title":"Global prevalence of insomnia symptoms in undergraduate university students: a systematic review and Meta-analysis","volume":"6","author":"Spyridonidis","year":"2025","journal-title":"Sleep Adv"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1007\/s11121-020-01093-8","article-title":"How sedentary are university students? 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