Effects of Active Gamification on Sleep and Anxiety Reduction in Spanish Primary School Children

<b>Background/Objectives</b>: Active gamification, which incorporates game elements with physical interaction, is presented as an innovative strategy to address anxiety problems and sleep quality in children. This study aimed to evaluate the impact of an active gamification program on the aforementioned variables in children in primary education. <b>Methods</b>: This study utilized a randomized, controlled trial with 120 children between 8 and 11 years of age, divided into an experimental group, which participated in a 12-week gamified program, and a control group, which continued with traditional physical education classes. <b>Results</b>: The main findings indicate that the intervention had a significant impact on reducing anxiety, with improvements in most of the subscales evaluated except for the obsessive-compulsive disorder subscale. Significant improvements were also found in sleep quality, with reductions in bedtime resistance, nighttime awakenings, parasomnias, and sleep-disordered breathing, although no significant changes were noted in sleep-onset delay, sleep duration, sleep anxiety, and daytime sleepiness. <b>Conclusions</b>: The gamification intervention in physical exercise showed positive effects in reducing anxiety and improving sleep quality in primary school children, highlighting its potential as an intervention strategy in primary education classrooms.