Physical activity intensity moderates the relationship between sleep quality and depressive symptoms among Indonesian working-age adults: Findings from the Indonesia Family Life Survey

Background: Few studies have explored the interaction between sufficient physical activity and good sleep quality in determining depression symptoms among adults. This study aims to examine the moderating role of physical activity levels in the association between sleep quality and depressive symptoms. Methods: This cross-sectional study analyzed secondary data from the Indonesia Family Life Survey (IFLS) 2014-2015 involving 28,469 Indonesian adults aged 15–64. Data were collected through self-report interviews. This study utilized hierarchical regression analysis with physical activity, sleep, and their interaction were regressed on depression scores while controlling for sociodemographic variables. Results: More severe depression symptoms were associated with higher physical activity intensity and poorer sleep quality after controlling sociodemographic variables. However, upon introducing the interaction between physical activity and sleep in the regression to assess evidence for moderation, we found that high physical activity was a risk factor for worsened depression symptoms among individuals with poor quality sleep but not among those with good sleep quality. The effects of physical activity were also partially explained by variations in educational attainment. Limitations: The cross-sectional nature of the IFLS dataset meant that the causality of the association between the variables could not be properly established. Conclusions: The findings suggest that the effects of physical activity on depression may differ on the basis of sleep quality. The role of physical activity on depression in the Indonesian population was divergent from findings in higher income countries, suggesting that the context of activity may have an important role in mood.