Background Within the framework of domain-specific, the impact of sedentary behavior (SB) and physical activity (PA) on sleep remains domain-specific. While leisure-time PA is beneficial, active commuting or occupational PA may paradoxically impair sleep. This study uses isotemporal substitution model to evaluate how reallocating time between SB, active commuting, occupation and leisure PA affects sleep. Methods This cross-sectional, population-based study analyzed data from the 2024 Vigitel survey (n=27,048). Wakeful movement behaviors, including SB, active commuting, occupational PA, and leisure-time moderate (MPA) and vigorous (VPA) activity, were treated as continuous variables. Sleep outcomes included habitual/desired duration, the sleep gap, insomnia symptoms, and OSA symptoms. Isotemporal substitution models estimated the theoretical associations between reallocating 10 to 30 min/day between behaviors using survey-weighted linear and logistic regression, adjusted for sociodemographic and health covariates, and stratified by educational attainment. Results Inadequate sleep duration affected 52.3% of the population, while 31.8% reported insomnia symptoms and 11.9% were at high risk for OSA. Isotemporal substitution showed that replacing 10 min/day of SB with MPVA reduced the odds of sleep disorders by 12% (OR: 0.88; 95% CI: 0.85–0.91), while increasing sleep duration by up to 3.8 min. Conversely, reallocating 10 min/day of SB to active commuting increased sleep disorder odds by 7% (OR: 1.07; 95% CI: 1.01–1.14). Stratified analysis indicated that replacing 10 min/day of active commuting with MVPA was associated with lower odds of sleep disorders across all educational strata, with the most pronounced association observed in the highest education group (OR: 0.80; 95%CI: 0.72–0.89) compared to those with 0–8 years (OR: 0.85; 95%CI: 0.73–0.98) and 9–11 years of study (OR: 0.91; 95%CI: 0.83–0.99). Conversely, replacing 10 min/day of occupational physical activity with active commuting was associated with higher odds of sleep disorders, specifically among individuals with higher educational attainment (OR: 1.14; 95%CI: 1.03–1.26). Conclusion The relationship between movement behaviors and sleep health is domain-specific and moderated by education. While substituting sedentary or occupational time with LTPA is consistently associated with better sleep health, active commuting may represent a temporal or physiological stressor, particularly for high-education groups. These findings suggest that public health interventions should prioritize LTPA promotion while considering the potential sleep-disrupting impact of active travel in certain socioeconomic contexts.
Luiz Menezes-Júnior (Mon,) studied this question.