<![CDATA[Introduction: Cyberbullying has emerged as a major adolescent health concern in the digital era. Although its psychological consequences are well documented, less is known about how cyberbullying relates simultaneously to sleep disturbance and physiological stress responses. Understanding these interconnected effects is important for developing comprehensive adolescent health assessment and intervention strategies. Objective: This study aimed to analyze the association between cyberbullying exposure, sleep disturbance, perceived stress, and physiological stress responses among adolescents. Methods: : A cross-sectional analytical study was conducted among 150 adolescents aged 15–18 years enrolled in senior high schools in West Java, Indonesia. Participants were selected using multistage cluster sampling. Cyberbullying exposure was assessed using the Cyberbullying Victimization Scale, sleep quality using the Pittsburgh Sleep Quality Index, and perceived stress using the Perceived Stress Scale-10. Physiological stress response was measured using resting heart rate variability (HRV) obtained under standardized resting conditions. Data were analyzed using IBM SPSS Statistics version 26.0 and AMOS version 24.0 through descriptive statistics, Pearson correlation, multiple linear regression, and structural equation modeling. Results: Participants reported moderate cyberbullying exposure (mean = 24.36, SD = 7.12), poor sleep quality (mean PSQI = 7.48, SD = 3.05), moderate perceived stress (mean = 18.92, SD = 5.64), and reduced HRV (mean = 42.15, SD = 10.83). Cyberbullying was positively correlated with sleep disturbance (r = .46, p .01) and perceived stress (r = .52, p .01), and negatively correlated with HRV (r = −.41, p .01). Structural modeling indicated that cyberbullying was associated with HRV both directly and through pathways involving sleep disturbance and perceived stress. Conclusion: Cyberbullying is significantly associated with behavioral, psychological, and physiological stress responses in adolescents. Early multidimensional assessment is needed to reduce its long-term health consequence]]>
