Associations of physical activity and sedentary behavior with insomnia in middle-aged and older adults: a cross-sectional study

High PA levels were associated with a reduced risk of both mild and moderate-to-severe insomnia in middle-aged and older adults, while SB ≥ 3 h/day increased insomnia risk-with the highest risk observed at SB ≥ 6 h/day. Clinically, these findings support non-pharmacological interventions for insomnia prevention and management in this population: recommending achievement of high PA levels (e.g., ≥1,500 MET-minutes/week of vigorous activity or ≥3,000 MET-minutes/week of combined activity) and limiting daily SB to <3 h. Targeted PA/SB intervention programs should be prioritized for high-risk subgroups, such as women and low-income individuals.