Associations between social media use, physical activity, and sleep quality in adolescent girls across three years of the COVID-19 pandemic

Social media use, sleep, and physical activity (PA) are behaviors that influence the physical and mental health of adolescent girls. Examining the associations between these behaviors during the COVID-19 pandemic is particularly important, as public health restrictions led to disruptions in normal daily life. This study aimed to examine associations between social media use, sleep quality, and PA among 887 adolescent girls (12–14 years) in Ireland and Northern Ireland (NI) across pre-pandemic (2019), lockdown (2020), and post-lockdown (2021) periods. This study was a secondary data analysis of data collected as part of the Walking In ScHools (WISH) Study. Social media use was self-reported, sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and PA was assessed using accelerometers. The relationship between these variables was investigated using linear regression, binary logistic regression, and mediation analysis. Increased social media use was associated with poorer sleep quality pre-pandemic (P<.001) and post-lockdown (P<.001), but not during lockdown (P=.050). Pre-pandemic, social media use was associated with lower total (P=.027) and light physical activity (LPA) (P=.030), while during lockdown, it was linked to increased moderate physical activity (MPA) (P=.025), but no associations were found post-lockdown. Sleep quality did not mediate these relationships. The relationship between social media use, sleep quality, and PA among adolescent girls varied across pre-pandemic, lockdown and post-pandemic periods as daily routines and behavioral patterns may have changed. These findings highlight the context-dependent nature of adolescent health behaviors and the importance of considering environmental and temporal factors to better support adolescent well-being.