Lifestyle Elements for Improving Mental and Physical Health: Subjective Sleep Quality is a Common Key Factor

By Dr. Takemune Fukuie

In developed societies, our lifestyles changed rapidly and unexpectedly due to technological advances and more recently, the outbreak of a pandemic. Strategies for maintaining high levels of physical and mental function are even more required in such stressful societies. As the burden of medical welfare continues to grow in the aging population, the prevention of disease and the maintenance of high mental and physical function through methods that do not rely on drugs, that is by improving individual lifestyles, will be a global challenge in the future.

Physical activity, diet, and sleep are the three most important elements of lifestyle, and these elements have a significant impact on mental and physical health. Improving lifestyles by focusing on the current status of physical and mental health issues in university students is important for establishing subsequent lifestyles. Depression is the main problem among university students. Regarding physical health, increasing screen time strengthens eye fatigue and decreases work efficiency, which is a major issue in a digital society. Therefore, we focused on depression as a representative outcome of mental health and subjective eye fatigue as a representative outcome of physical health.

This study aimed to reveal the key lifestyle elements (physical activity, nutrition, and sleep) to improve physical (eye fatigue) and mental (depression) health in Japanese university students.

290 first-year students participated in this study between October 2021 and December 2021. Outcomes were daily step counts measured using accelerometers, dietary intake by nutrient category, sleep duration and subjective sleep quality, exercise frequency and duration by exercise type, screen time, depression level, and subjective fatigue by body part.

The results showed that the amount of physical activity was lower than the recommended line, vegetable and fruit intake was insufficient, and sleep debt could accumulate on weekdays in university students. In particular, online classes were found to reduce physical activity compared to weekends. These issues will need to be addressed for the participants’ future health. Regarding current physical and mental health, subjective sleep quality predicted depression and eye fatigue levels. A simple question, “How much do you feel refreshed upon awakening,” which was used to assess subjective sleep quality in the current study, is a useful and easy-to-use measure in daily life. Participants with a higher subjective sleep quality performed more frequent aerobic exercise, longer session times of physical relaxation exercise, and shorter screen time. These results suggest that subjective sleep quality could be a key factor in good physical and mental health outcomes, and performing aerobic exercise and physical relaxation, and reducing screen time may be ideal for improving lifestyle. To detect causal relationships, further study is required.

This study provides fundamental knowledge for university students to achieve a high state of physical and mental outcomes and well-being by acquiring an ideal lifestyle in a digital society. As shown in the relationship between subjective sleep quality and the implementation of physical activity, the three lifestyle elements influence each other, so it is important to take a comprehensive view of the three elements and make improvements. Although there are issues that need to be resolved and further study is needed, if your subjective sleep quality deteriorates, try to review your lifestyle. One option would be to do more aerobic exercise and stretching, and reduce screen time.

Article Details
Lifestyle Elements for Improving Mental and Physical Health in Japanese University Students: Subjective Sleep Quality is a Common Key Factor
Takemune Fukuie, PhD, Koshiro Inoue, PhD, and Akihiko Yamaguchi, PhD
First published online February 9, 2023
DOI: .10.1177/15598276231156546
American Journal of Lifestyle Medicine

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