Association of Cardiorespiratory Fitness and Quality of Sleep among Adolescents in Lahore: A Cross-Sectional Study
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Background: Cardiorespiratory fitness and sleep are modifiable determinants of health during childhood and adolescence, yet their direct relationship remains inconsistent and is understudied in South Asian school populations. Objective: To examine the association of sleep duration and sleep disturbance with field-estimated cardiorespiratory fitness among school-going participants aged 10–15 years in Lahore, Pakistan. Methods: A cross-sectional observational study was conducted in schools in Lahore using stratified random sampling. Sleep was assessed using reported sleep duration and the parent-reported Children's Sleep Habits Questionnaire (CSHQ), while cardiorespiratory fitness was assessed using the 20-m multistage shuttle run test and estimated VO₂max. Descriptive statistics, Spearman's rank correlations, and Kruskal–Wallis tests were applied according to data distribution. Results: Mean sleep duration across age strata ranged from 7.84 to 8.14 hours, while mean CSHQ scores ranged from 43.82 to 46.22. Shuttle-run performance increased with age, from 2.43 ± 1.01 stages at age 10 to 6.86 ± 1.70 stages at age 15. No consistent statistically significant association was observed between sleep duration and estimated VO₂max or between CSHQ score and estimated VO₂max. Estimated cardiorespiratory fitness also did not differ significantly across study-defined sleep categories. Conclusion: Short or borderline sleep duration and elevated sleep-disturbance scores were common; however, sleep characteristics were not consistently associated with estimated cardiorespiratory fitness. Sleep health and physical fitness should therefore be considered important but independently relevant targets for adolescent health promotion
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