Associations of evening-type and insomnia symptoms with depressive symptoms among youths

Jianyu Que; Sijing Chen; Ngan Yin Chan; Suying Wu; Li Zhang; Yaoyi Chen; Jingrou Liu; Mingxuan Chen; Lixia Chen; Shirley Xin Li; Duoduo Lin; Farong Liu; Yun Kwok Wing

doi:10.1016/j.sleep.2024.04.009

Associations of evening-type and insomnia symptoms with depressive symptoms among youths

Sleep Med. 2024 Apr 9:118:81-87. doi: 10.1016/j.sleep.2024.04.009. Online ahead of print.

Authors

Jianyu Que¹, Sijing Chen², Ngan Yin Chan³, Suying Wu¹, Li Zhang⁴, Yaoyi Chen¹, Jingrou Liu⁵, Mingxuan Chen⁶, Lixia Chen⁴, Shirley Xin Li⁷, Duoduo Lin⁸, Farong Liu⁹, Yun Kwok Wing³

Affiliations

¹ Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China.
² Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China; Centre de Recherche CERVO/Brain Research Center, École de Psychologie, Université Laval, Quebec City, Quebec, Canada.
³ Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China.
⁴ Inner Mongolia Autonomous Region Mental Health Center, Hohhot, Inner Mongolia, China.
⁵ Xiamen University of Technology, Xiamen, Fujian, China.
⁶ Chongqing Medical University, Chongqing, China.
⁷ Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region of China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region of China.
⁸ Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China. Electronic address: 82004879@qq.com.
⁹ Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China. Electronic address: liufarong@sohu.com.

PMID: 38626648
DOI: 10.1016/j.sleep.2024.04.009

Abstract

Background: Evening-type and insomnia symptoms are significantly related to each other and independently associated with depressive symptoms, yet few studies have examined the potential interaction between these two conditions. Therefore, we aimed to examine the associations of evening-type and insomnia symptoms with depressive symptoms among Chinese youths, with a specific focus on the joint effects of the two conditions on depressive symptoms.

Methods: Participants aged between 12 and 25 were invited to participate in an online survey from December 15, 2022, to May 26, 2023. Multivariate logistic regression models and additive interaction models were used to examine the independent and joint effects of chronotypes and insomnia symptoms on depressive symptoms, respectively.

Results: Of the 6145 eligible youths, the prevalence of evening-type and insomnia symptoms were 24.9 % and 29.6 %, respectively. Both evening-type (adjusted OR, [AdjOR]: 3.21, 95 % CI: 2.80-3.67) and insomnia symptoms (AdjOR: 10.53, 95 % CI: 9.14-12.12) were associated with an increased risk of depressive symptoms. In addition, the additive interaction models showed that there is an enhanced risk of depression related to interaction between evening-type and insomnia symptoms (relative excess risk due to interaction, [RERI]: 11.66, 95 % CI: 7.21-16.11).

Conclusions: The present study provided additional evidence demonstrating the presence of interaction between evening-type and insomnia symptoms, which can lead to a higher risk of depressive symptoms. Our findings argue the need for addressing both sleep and circadian factors in the management of depressive symptoms in young people.

Keywords: Additive interaction; Chronotypes; Depressive symptoms; Insomnia symptoms; Young people.