Abstract IntroductionThere has been a shift towards integrated 24-hour movement guidelines for pre-schoolers for physical activity (>3hr/d, including 1hr of ‘energetic play’), sedentary behaviour (<1hr/d of screen time [ST]) and sleep (10-13hrs/d). A few studies have assessed physical activity, but not compliance with ST and sleep guidelines in South African pre-schoolers. This study aimed to establish compliance with ST and sleep guidelines among pre-schoolers from varying income settings in South Africa. MethodsParents (n=265) from rural low-income (RL), urban low-income (UL), and urban high-income (UH) settings reported their pre-schooler’s ST and sleep. ST and sleep question results were summed to establish daily averages, after which compliance with ST and sleep guidelines were determined. Between-setting differences were assessed using Kruskal-Wallis and Chi2 analyses. ResultsST was significantly higher in UH (1.71±1.18hrs/d) than UL (0.77±0.90hrs/d, p=0.000) and RL (0.45±0.37hrs/d, p=0.000) children. Overall, 81.9% met the ST guideline. However, 33.3% UH children met the guideline, versus 74.0% and 96.5% of UL and RL children, respectively. Children slept 11.6±1.3hrs/d. Overall, 73.7% met the sleep guideline. Few children (8.7%) slept <10hrs/d, and 9.4% slept >13hr/d. Only UL (16.1%) and RL (7.1%) children exceeded the sleep guideline. Compliance with both guidelines was significantly higher in RL (82.3%), versus UL (58.0%) and UH (33.3%) children (p=0.000).ConclusionST was most concerning among UH children, while excess sleep was as prevalent as insufficient sleep. Future research should identify ways to reduce ST, particularly in UH children, and explore the effects of excess sleep on pre-schoolers, particularly UL children.