Document Type


Publication Date




Publication Title

International Journal of Environmental Research and Public Health






7257 (1-9)


The purpose of this study was to examine the impacts of academic stress on physical activity and sleep, and subsequently their impacts on anxiety and depression. Methods: This cross-sectional study collected data from a convenience sample of 1533 adolescents in an eastern province in China. Surveys were used to collect data on academic stress, anxiety, depression, sleep, physical activity, and demographics. Descriptive statistics, correlation analysis, and path analysis were used to analyze data. Results: The participants reported about 6.77 ± 0.89 h of sleep per day and 1.62 ± 1.79 days of 60 min of physical activity each week. Academic stress was positively correlated with anxiety and depression, which were negatively correlated with physical activity and sleep. The path analysis showed that academic stress directly predicted anxiety (β = 0.54) and depression (β = 0.55), and hours of sleep (β = 0.024) and the number of days of 60 min physical activity (β = 0.014) mediated the relation. Conclusion: The results largely supported our hypotheses and supported the need to lessen academic stress experienced by Chinese adolescents, in effort to enhance mental health indices directly, and by allowing for engagement in health-related behaviors such as physical activity and sleep.


© 2021 by the authors.

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International (CC BY 4.0) license.

Original Publication Citation

Zhu, X., Haegele, J. A., Liu, H., & Yu, F. (2021). Academic stress, physical activity, sleep, and mental health among Chinese adolescents. International Journal of Environmental Research and Public Health, 18(14), 1-9, Article 7257.


0000-0002-8580-4782 (Haegele)