What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Mental health (n=15122). Intervention: Vigorous physical activity (VPA) vs. Students without VPA. Primary outcome: Perceived stress, sleep quality and quantity, and mental health.

What does this research mean for the field?

Vigorous physical activity provides only partial mental health benefits for university students, as it is associated with reduced perceived stress and better subjective health, but also higher rates of depression and no improvements in sleep or PTSD symptoms. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 25, 2026Open Access

Vigorous physical activity, perceived stress, sleep and mental health among university students from 23 low-and middle-income countries

Key Result

Meeting vigorous physical activity recommendations was associated with lower perceived stress and better subjective health, but also higher depression, compared to students without VPA.

Key Points

This study aims to explore the relationships between vigorous physical activity, perceived stress, sleep quality, and mental health among university students.
Cross-sectional design using anonymous questionnaires.
Sample of 15122 university students from 23 low- and middle-income countries.
Assessment with the International Physical Activity Questionnaire and sociodemographic measures.
Students meeting VPA guidelines reported lower perceived stress levels compared to those not engaging in VPA.
No significant association found between VPA and sleep quality or PTSD symptoms.
Overall, VPA showed partial benefits for the mental well-being of university students.

Study Design

Type

Cross-Sectional (n=15,122)

Multicenter

Yes

Structured PICO

Does meeting vigorous physical activity recommendations improve perceived stress, sleep, and mental health in university students?

Population

15,122 university students (42.1% male, 57.9% female, mean age 20.6) from 23 low- and middle-income countries in the Americas, Africa, and Asia.

Intervention

Meeting vigorous physical activity (VPA) recommendations

Comparator

Not meeting vigorous physical activity (VPA) recommendations

Outcome

Perceived stress, sleep quality and quantity, and mental health (subjective good health, depression, PTSD symptoms)patient reported

Vigorous physical activity is associated with lower perceived stress and better subjective health, but also higher reported depression, with no effect on sleep or PTSD among university students in low- and middle-income countries.

Abstract

Vigorous physical activity(VPA) may be beneficial for mental health.The aim of the study was to investigate cross-sectional associations between VPA, perceived stress, sleep quality and quantity and mental health among university students. In a cross-sectional study, using anonymous questionnaires, data was collected from 15122 (42.1% male and 57.9% female) university students mean age 20.6, standard deviation (SD) = 2.0 from 23 countries in the Americas,Africa and Asia.They were assessed using the International Physical Activity Questionnaire (shortversion),and measures of sociodemographic,health status,health behaviour and anthropometrics. Students who met VPA recommendations were less likely to report perceived stress, more likely to report subjective good health and depression than students without VPA. There was no association between VPA and sleep quality and quantity and PTSD symptoms. This study only found partial benefits of VPA in relation to well-being of university students.