Physical activity moderates the association between school start time and sleep duration in a cross-sectional national sample of adolescents.

Background: Adolescent insufficient sleep is an endemic issue that may result in compromised functioning throughout the course of the day and is associated with increased risk for a variety of adverse outcomes. Early school start time (SST) has been consistently found to be detrimental to adolescents' sleep achievement on school nights. However, there are logistical barriers to changing SST. Evidence supports daily engagement in moderate-to-vigorous intensity physical activity (MVPA) to enhance adolescents' nightly sleep achievement. However, the role of MVPA in the association between SST and sleep duration is unknown. This study examines the potential moderating effect of MVPA in the association between SST and sleep duration on a typical school day among adolescents. Methods: This study examined data (collected in April and October 2014) from a national sample of 1132 adolescents (mage = 14.5 years) living in the United States from the Family Life, Activity, Sun, Health, and Eating study, a cross-sectional, internet-based survey. First, three linear regressions were computed to examine bivariate associations between SST, MVPA, and sleep duration while controlling for participant sex, race and ethnicity, household income, school level, and the presence of a TV in the bedroom. Next, a three-step multiple regression was computed with sleep duration as the dependent variable, and the final step included an interaction term between SST and MVPA. Results: Later SST (b1 = 0.41, p < 0.001) and increased MVPA (b1 = 0.39, p < 0.001) were both associated with increased sleep duration, while SST and MVPA were not significantly associated. In the final multiple regression model, which included the interaction term, school day MVPA moderated the positive association between SST and school night sleep duration (b1 = − 3.7, p < 0.05), such that the greater the MVPA on a typical school day, the weaker the positive association between early SST and sleep duration. In post-hoc analysis, the interaction effect was only significant for females and not males. Conclusions: The significant buffering effect of MVPA on the association between SST and sleep duration suggests that in the absence of SST changes, promoting MVPA among adolescents may be a promising strategy to mitigate insufficient sleep among US adolescents. [ABSTRACT FROM AUTHOR]