Sedentary Behavior and Sleep Problems: a Systematic Review and Meta-Analysis

Purpose Sedentary behavior, characterized by a sitting or reclining posture and low-energy expenditure, has been recognized as an independent health risk factor. We conducted a systematic review and meta-analysis to examine the association between sedentary behavior and sleep problems. Keyword and reference search were performed in PubMed, Cochrance Library, and Web of Science databases to identify relevant studies. The methodological quality of each study was assessed by standardized tools. The pooled estimates on the relationship between sedentary behavior and sleep problems were calculated in meta-analysis. Subgroup analyses were conducted for studies examining alternative sedentary behavior types, using self-reported or objective measures of sedentary behavior, different age groups, and assessed with different study quality levels. Sixteen eligible studies were identified through a literature search. Meta-analysis found sedentary behavior to be associated with an increased risk of insomnia (pooled odds ratio [POR] = 1.176, 95% confidence interval [CI] = 1.014-1.364) and sleep disturbance (POR = 1.381, 95% CI = 1.282-1.488). No association between sedentary behavior and daytime sleepiness and/or poor sleep quality was observed. Except for study quality levels, no significant differences in sleep disturbance were observed across alternative sedentary behavior types, sedentary behavior measures, and age groups in subgroup analyses. Prolonged sedentary behavior tends to be associated with an elevated risk of insomnia and sleep disturbance in the existing literature. Future studies with experimental study design and longer follow-up periods are warranted to demonstrate the long-term causal impact of sedentary behavior on sleep problems.