Author(s): HONG, J., KIM, Y., Institution: SEOUL NATIONAL UNIVERSITY, Country: KOREA, SOUTH, Abstract-ID: 1588

Introduction
The purpose of this study was to evaluate the independent and joint associations of meeting physical activity (PA) guidelines and sleep duration (SD) recommendations with psychological well-being in Korean adolescents. Additionally, we aimed to identify potential differences in these associations stratified by sex and school level.
Methods
We analyzed data from the 2021 Survey on Youth Play and Sports Activities conducted by the National Youth Policy Institute (NYPI). The participants included students from elementary to high school (4th-12th grade). Psychological well-being was assessed using the 26-item Ryff's Psychological Well-being Scale, with a high level of well-being defined as a total score above the median (>=87) of the study population. PA was dichotomized based on meeting the guideline of >=60 minutes per day. SD was dichotomized based on age-specific recommendations: 9-12 hours for elementary students and 8-10 hours for middle and high school students. Participants were classified into four groups based on adherence to PA and SD recommendations: Neither (met neither recommendation), Only SD (met only SD recommendation), Only PA (met only PA recommendation), and Both (met both recommendations). Logistic regression analysis was performed to estimate the odds ratios (ORs) for independent associations and joint associations across these four groups.
Results
A total of 2,566 participants were included in the final analysis. In the independent analysis, meeting PA guidelines (OR=1.72, 95% CI: 1.44-2.04) and SD recommendations (OR=1.29, 95% CI: 1.06-1.58) were significantly associated with a high level of psychological well-being.
In the joint analysis, compared to the Neither group, the Only SD group did not show a significant association (OR=1.19, 95% CI: 0.90-1.58). However, significant associations were observed in the Only PA group (OR=1.65, 95% CI: 1.35-2.01) and the Both group (OR=2.27, 95% CI: 1.72-2.98).
In sex-stratified analysis, the association in the Both group was more pronounced in females (OR=3.60, 95% CI: 2.27-5.68) compared to males (OR=1.69, 95% CI: 1.19-2.42). In school-level analysis, significant associations for the Both group were observed in elementary (OR=2.25, 95% CI: 1.47-3.43) and middle school students (OR=2.79, 95% CI: 1.77-4.40). However, for high school students, the association was not statistically significant (OR=1.60, 95% CI: 0.76-3.37), likely due to the small sample size meeting both recommendations (3.8%, n=32/N=848).
Conclusion
Meeting PA guidelines was associated with a high level of psychological well-being, with the most pronounced association when combined with SD recommendations. This association was more pronounced in females. High school students showed markedly low adherence to both guidelines. These findings suggest the need for integrated PA and sleep strategies tailored to sex and school level.