The Latest Research: The Link Between Health Behaviors, Sleep, and Mental Health
From birth to early adulthood, multiple factors – many of which are out of our control – play a role in mental health. Research shows that health behaviors that are mostly within our control such as sleeping enough, exercising often, and eating well can help combat negative mental health issues. Several recent studies have further explored how these factors are interrelated.
Study 1:
Wickham, Amaraseka, Bartonicek, and Conner (2020) examined links between diet, exercise, and sleep in young adults aged 18-25 living in New Zealand or the U.S. The researchers asked about sleep quantity (how many hours of sleep they usually got), sleep quality (how refreshed did they feel upon waking up), physical activity (how often each week they exercised for at least 30 minutes), and diet (how often each week they ate raw fruits and vegetables, fast food, sweets, and soda). Additionally, they used the Center for Epidemiological Studies Depression Scale and the Flourishing Scale to gauge depressive symptoms and well-being, respectively.
On average, participants reported sleeping 7 hours each night, being somewhat refreshed each morning, exercising 3 days a week, and eating 3 servings of fruits and vegetables a day. While the average depressive symptom score indicated a risk of clinical depression, overall well-being was slightly positive. Although participants had negative feelings (felt depressed or bothered by things that normally don’t bother them), they still felt that they were living a meaningful life and engaging in interesting daily activities. The researchers also found that as depressive symptoms increased, well-being decreased; that physical activity was the second strongest predictor of depressive symptoms, and that diet was not a predictor of depression.
Sleep quality was the most important factor in predicting mental health and well-being in young adults and adolescents when compared to sleep quantity, diet, and exercise. In addition, getting more than 12 hours or less than 8 hours of sleep was associated with higher depressive symptoms and lower well-being. Exercise and diet were important but were secondary compared to the importance of sleep. Given that this study was correlational, causal conclusions cannot be drawn, and further research is needed to better understand these relationships.
Study 2:
A group of Brazilian researchers examined associations between daytime sleepiness and a variety of lifestyle behaviors in 876 adolescents (Malheiros, da Costa, Lopes, Chaput, and Silva, 2021) . The research participants completed a survey including a questionnaire designed to measure daytime sleepiness. They were also asked about the frequency and duration of physical activity, time spent using devices with screens (e.g., television, computer, smartphone), and what types of food they ate.
Excessive daytime sleepiness was present in just under half (46.6%) of participants. Results showed that less physical activity, more processed food consumption, and more time using social media were all associated with more daytime sleepiness. Although these results seem to imply that health behaviors such as poor diet, lack of exercise, and screen time are resulting in daytime sleepiness, it’s important to keep in mind that these results are correlational. For example, one possible explanation that the authors discuss is that excessive daytime sleepiness was preventing the participants from being physically active, but the direction of the relations between the different health behaviors cannot be known from the current study.
Study 3:
A consensus statement from the National Sleep Foundation, published in Sleep Health (2024), examined the impact of sleep regularity on overall health, including mental well-being. The expert panel, composed of leading sleep scientists and clinicians, reviewed existing research to form evidence-based recommendations on maintaining consistent sleep and wake times. Their conclusions were based on a broad synthesis of studies that used both subjective self-reports and objective measures (e.g., actigraphy) to assess sleep behavior and health outcomes.
The panel found that inconsistent sleep schedules—frequent variations in bedtimes and wake times—were linked to a range of negative health effects. Specifically, individuals with irregular sleep patterns experienced poorer emotional regulation, higher stress levels, and increased symptoms of anxiety and depression. Conversely, those who maintained regular sleep routines showed improvements in alertness, mood, and even cardiovascular and metabolic health markers.
Interestingly, the panel also noted that sleeping an additional one to two hours on non-work or non-school days could help recover from sleep debt, though this was not a substitute for consistent daily habits. These findings emphasize that when we sleep matters just as much as how much we sleep. While the consensus is not based on one specific experimental study, it draws from a robust body of evidence, offering strong guidance for health professionals and the general public alike.
Study 4:
A 2023 systematic review published in BMC Psychology examined the relationship between screen time and mental health outcomes in adolescents. The researchers analyzed data from multiple studies investigating how different types of screen use—including social media, video streaming, and gaming—affected mental health indicators such as depression, anxiety, and overall emotional well-being.
The review found a consistent association between high levels of screen time and increased risk of mental health problems. Adolescents who reported using screens excessively, especially during the evening hours, were more likely to experience symptoms of depression and anxiety. These effects were particularly pronounced when screen use displaced sleep or occurred immediately before bedtime, interfering with melatonin production and delaying sleep onset.
The researchers also called attention to the complex nature of screen engagement. It’s not only the amount of screen time that matters but also the type of content consumed, the emotional tone of interactions on social media, and the individual’s reasons for using screens. While the review was correlational and did not establish causation, it highlighted the growing evidence that screen habits can meaningfully impact both sleep and mental health.
Study 5:
A comprehensive study published in BMC Psychiatry in 2023 examined the association between sleep duration and suicidal ideation and behavior among U.S. adolescents, with a focus on racial and ethnic disparities. Utilizing data from the Youth Risk Behavior Surveillance System (YRBSS) spanning 2007 to 2019, the study analyzed responses from over 100,000 high school students.bmcpsychiatry.biomedcentral.com
The researchers found that adolescents who reported sleeping less than 8 hours on school nights had higher odds of experiencing suicidal thoughts, making suicide plans, and attempting suicide compared to those who slept 8 or more hours. Notably, the strength of these associations varied across racial and ethnic groups. For instance, while short sleep duration was significantly associated with increased suicide risk among White adolescents, the association was less pronounced or not statistically significant among Black and Hispanic adolescents.
These findings underscore the importance of considering racial and ethnic differences when addressing sleep and mental health issues in adolescents. Tailored interventions that account for these disparities are crucial for effective prevention strategies.
Health and Sleep
The complexities of maintaining optimal health can feel daunting, especially for adolescents and young adults developing lifelong habits. While these studies are correlational, they collectively suggest that prioritizing sleep may positively influence other health behaviors, which in turn may contribute to improved mental health and well-being. Further research on the interactions among sleep, diet, exercise, and digital media use is necessary.
Article 1:
Wickham, S., Amaraseka, N.A., Bartonicek, A., & Conner, T.S. (2020). The big three health behaviors and mental health and well-being among young adults: a cross-sectional investigation of sleep, exercise, and diet. Frontiers in Psychology, 11. doi: 10.3389/fpsyg.2020.579205
Article 2:
Malheiros, L.E.A., da Costa, B.G.G., Lopes, M.V.V., Chaput, J. & Silva, K. (2021). Association between physical activity, screen time activities, diet patterns and daytime sleepiness in a sample of Brazilian adolescents. Sleep Medicine, 78, 1-6. doi: 10.1016/j.sleep.2020.12.004
Article 3:
Hirshkowitz, M., et al. (2024). The importance of sleep regularity: A consensus statement by the National Sleep Foundation. Sleep Health, 10(2).
https://www.sleephealthjournal.org/article/S2352-7218%2823%2900166-3/fulltext
Article 4:
Grimaldi-Puyana, M., et al. (2023). Association between screen time and mental health in adolescents: A systematic review. BMC Psychology, 11(1).
https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-023-01166-7
Article 5:
Liu, C.H., Stevens, C., Wong, S.H.M., & Chen, J.A. (2023). Racial/ethnic disparities in the association between sleep duration and suicide risk among U.S. adolescents: A population-based study. BMC Psychiatry, 23(1).
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-05074-3