Using Structural Equation Modeling to Examine Pathways between Physical Activity and Sleep Quality among Chinese TikTok Users

TikTok, the most popular social media, brings various benefits to nowadays living. However, the problematic use of TikTok has also elicited a range of health problems, such as sleep problems. Physical activity (PA) appears to play a protective role in the problematic use of TikTok and its health consequences, but the pathways between PA and sleep health are understudied. Therefore, we aimed to propose a framework to check whether PA can benefit the sleep health of TikTok users by reducing bedtime delays for TikTok. Stress and mental health issues were also considered as they are potential mediators between PA and sleep health and may also influence the problematic use of smartphones. A cross-sectional investigation that involved 660 Chinese TikTok users was conducted in April 2021. The volume of PA, perceived stress (PSS-10), depression (PHQ-9), anxiety (GAD-7), bedtime delay for TikTok use, and sleep quality (PSQI) were investigated through an online questionnaire survey. Structural equation modeling was employed to examine pathways from PA to sleep quality through stress, mental health issues (depression and anxiety), and bedtime delay for TikTok. We found that PA exerted a significant effect on sleep quality through indirect pathways (β = -0.056, p = 0.001). Stress was a critical mediator of all indirect pathways, and the pathway mediated by stress and mental health issues made a major contribution to the total effect (β = -0.048, p = 0.002). The identified pathways mediated by bedtime delay for TikTok were relatively weak but significant. PA showed a distinct effect on bedtime delay for TikTok through stress and mental health issues (β = -0.043, p = 0.001). In conclusion, our framework highlights some pathways to understanding the benefits of PA on TikTok users' sleep quality. Future research is warranted to explore extra indirect pathways and re-examine the causal relationships between variables.