The association between 24-hour activity, sedentary and sleep compositions and mental health in Australian adults: a cross-sectional study.

backgroundPhysical activity, sedentary behaviour, and sleep are key components to health and well-being. Compositional data analysis of activity data overcomes the limitations of traditional statistical approaches and comprehensively assesses the association of all activities throughout a 24-hour day. Few studies have used compositional analysis to explore associations between movement behaviours and mental health. This study examined the association between 24-hour activity compositions and mental health in middle-aged Australian adults.

methodsThis study used cross-sectional data from participants (n = 322; mean age 40.4 years; 58.1% female; 47.8% university degree; 84.8% partnered) in the longitudinal Annual Rhythms in Adults' lifestyle and health study (Adelaide, Australia). Activity composition (sleep, sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity) was derived using 24-hour Fitbit accelerometry from the first month of participation (December). Mental health outcomes (depression, anxiety, and stress) were obtained from the Depression Anxiety Stress Scale 21-item short-form (DASS-21). The associations between activity composition (conveyed as isometric log ratios) and DASS-21 scores were examined using compositional multi-level linear regression models with a random intercept for clustering of individuals within families. Using the compositional time reallocation model, expected differences in mental health were examined for hypothetical time reallocations between individual activities.

resultsFavourable associations were observed when time (15 min) was reallocated to light physical activity from sleep (depression: -0.31 [95% CI=-0.57: -0.06]; anxiety: -0.20 [95% CI=-0.37: -0.03] and from sedentary behaviour (depression: -0.29 [95% CI=-0.46: -0.13]; anxiety: -0.14 [95% CI=-0.25: -0.03]; stress: -0.16 [95% CI=-0.31: -0.01]). Detrimental associations were observed when time was reallocated away from light physical activity to sleep (depression: 0.32 [95% CI = 0.07: 0.58]; anxiety: 0.20 [95% CI = 0.03: 0.37]) and to sedentary behaviour (depression: 0.30 [95% CI = 0.13: 0.48); anxiety: 0.15 [95% CI = 0.03: 0.26]; stress: 0.17 [95% CI = 0.01: 0.32]). There were no associations when time was allocated to or from moderate-to-vigorous physical activity.

conclusionThe way adults spend their time across a 24-hour day is associated with their mental health. Spending more time in light physical activity appears favourable if this time is taken from sleep and sedentary behaviour. These findings provide support for "move more, sit less" public health messages.

trial registrationThis study was prospectively registered on the Australian New Zealand Clinical Trial Registry (Trial ID: ACTRN12619001430123) on the 16/10/2019.