Association between habitual weekday sleep duration and depressive symptoms among Chinese adolescents:The role of mode of birth delivery

Abstract

BackgroundDepressive symptoms among adolescents are common. This study aimed to assess, among Chinese adolescents, the associations of habitual weekday sleep duration with depressive symptoms and whether these associations varied with the mode of birth delivery. MethodsData were from the 2015 School-based Chinese Adolescents Health Survey, and 150,053 students’ questionnaires were qualified for analysis. Multi-level logistic regression models were performed. ResultsA weekday sleep duration of ≤5 h/night was associated with depressive symptoms (adjusted odds ratio [aOR]=2.98, 95% CI=2.75–3.24), and adolescents who reported a weekday sleep duration of 5–7 h/night (aOR=1.69, 95% CI=1.60–1.79) and >9 h/night (aOR=1.28, 95% CI=1.11–1.45) were also at a higher risk of depressive symptoms. Stratification analyses showed that in both adolescents delivered by vaginal birth and cesarean section (CS), a weekday sleep duration of ≤5 h/night, 5–7 h/night, and >9 h/night were associated with the increased risk of depressive symptoms in the adjusted models, and the magnitudes of the aORs in adolescents delivered by CS were slightly higher than those in adolescents delivered by vaginal birth. LimitationsThe cross-sectional study design and self-reported sleep duration and depressive symptoms. ConclusionThis study demonstrates a significant U-shaped association between weekday sleep duration and depressive symptoms among Chinese adolescents. In both adolescents delivered by vaginal birth and CS, those who reported having abnormal sleep duration were at a high risk of depressive symptoms. Based on the findings of this study, we suggest sleep duration and mode of delivery should be a matter of concern for public health authorities.