Rural-urban differences in the association between afternoon napping and depressive symptoms among middle-aged and older adults in China

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ObjectiveThis study aimed to examine the association between afternoon napping and depressive symptoms among Chinese middle-aged and older adults and to evaluate the rural-urban differences. MethodsA total of 11,056 participants, aged≥45, 5646 rural and 5410 urban, were included using data from CFPS. Each participant provided data on afternoon napping through field interviews. CESD8 was used to measure depressive symptoms. Multivariable logistic regressions were used to investigate the association. Results2654 (24.01 %) participants had depressive symptoms and 7239 (65.48 %) napped. Nappers were likely to have a lower risk of depressive symptoms (OR = 0.899; 95%CI =0.816–0.991). A significantly lower risk of depressive symptoms was found in the moderate-duration afternoon napping groups (31–60 min/day) compared with non-nappers (OR = 0.816; 95%CI =0.727–0.917). In terms of rural-urban differences, rural participants had a lower risk of depressive symptoms compared with non-nappers (OR = 0.813; 95%CI =0.716–0.926). A significant association was also found between age groups. Participants aged 65–74 years old had a lower risk of depressive symptoms compared with non-nappers (OR = 0.776; 95%CI = 0.627–0.959). LimitationsFirst, the cross-sectional study may limit the ability to infer causality. Second, only those who responded to the questionnaire were included; selection bias was unavoidable. Finally, answers were retrospective self-reported, which may cause recall bias and social desirability bias. ConclusionsAfternoon napping was associated with a lower risk of depressive symptoms among Chinese middle-aged and older adults. The associations varied between rural-urban and age. We recommend taking a moderate-duration afternoon napping every day to prevent the risk of potential depression.