Insomnia severity and obesity mediated by health behaviors in adolescents.

This article investigates the mediating roles of diet, physical activity, and screen time in the relationship between insomnia severity and obesity, measured by body mass index (BMI), among U.S. adolescents aged 12–18 years. Using parent-reported data from 599 adolescents collected primarily during the COVID-19 pandemic, the study found that increased insomnia severity was associated with higher BMI through increased screen time, while diet and physical activity did not significantly mediate this relationship. The findings suggest that screen time, as a modifiable sedentary behavior, plays a notable role in linking sleep difficulties and obesity in youth, highlighting the importance for pediatric clinicians to assess and address both sleep health and screen use alongside traditional dietary and physical activity recommendations. Limitations include the cross-sectional design, reliance on parent reports, and use of BMI as the sole adiposity measure, indicating a need for longitudinal and adolescent self-report studies to clarify causal pathways.