Associations of Physical Activity and Sleep with Depression, Anxiety, and Loneliness Among U.S. Adults: A Population-Based Cross-Sectional Study

Abstract

Introduction. Physical activity, strength training, and sleep are important determinants of mental health. This study examined the associations of these lifestyle behaviors with emotional health outcomes among U.S. adults.

Methods. Authors conducted a cross-sectional analysis of data from the 2024 Health Information National Trends Survey 7, a nationally representative survey of U.S. adults aged ≥18 years (N = 7278). Outcomes included depression (PHQ-2), anxiety (GAD-2), overall loneliness (PROMIS Social Isolation Short Form), social loneliness, and emotional loneliness. Predictors included moderate-intensity physical activity (≥150 min/week), strength training (≥2 days/week), and weekday and weekend sleep duration. Survey-weighted logistic and multinomial logistic regression analyses were performed, adjusting for sociodemographic and health-related covariates.

Results. Most respondents screened negative for depression (79.4%) and anxiety (78.4%), and 61.6% reported low loneliness. Most respondents did not meet the recommended levels of moderate-intensity physical activity (56.6%) or strength training (55.4%). In adjusted analyses, meeting strength-training guidelines was associated with lower odds of depression (adjusted odds ratio [aOR], 0.71; 95% confidence interval [CI], 0.53-0.95) and loneliness (aOR, 0.65; 95% CI, 0.43-0.98). Moderate-intensity physical activity was not independently associated with emotional health outcomes. Obtaining the recommended 7-9 hours of weekend sleep was associated with lower odds of depression, anxiety, and loneliness, whereas obtaining the recommended weekday sleep duration was associated with lower social and emotional loneliness.

Conclusions. Strength training and adequate sleep were independently associated with better emotional health among U.S. adults. These findings support muscle-strengthening activities and healthy sleep habits as potential targets for mental health promotion.