Interactive effect between sleep and exercise on depressive symptoms in Chinese adolescents

• Published in: Frontiers in psychiatry 2023-07, Vol.14, p.1207243-1207243
• Main Authors: Zou, Shoukang, Deng, Fang, Tan, Wenli, Fu, Yutong, Zhang, Hang, Xu, Hanmei, Tao, Yuanmei, Tang, Xian, Tang, Xiaowei, Xiong, Ping, Huang, Huiping, Huang, Ying, Li, Ling, Yang, Wenjuan, Zeng, Hongping, Liu, Gui, Shen, Xiaosu, Zhao, Hongqin, Chen, Ying, Yao, Kangling, Zhao, Jingyi, Han, Wenwen, Zhou, Jingmiao, Hou, Jianmin, Peng, Shikun, Wang, Yadan, Yang, Yunzhen, Feng, Yi, Chen, Lin, Yang, Xiting, Li, Shuangshuang, Luo, Xue, Wang, Yan, Yin, Li
• Format: Article
• Language: English
• Subjects: adolescent; depressive symptoms; exercise; interactive effect; Psychiatry; sleep
• ISSN: 1664-0640; 1664-0640
• DOI: 10.3389/fpsyt.2023.1207243

The study aimed to investigate the effects of sleep and exercise, individually and jointly, on depressive symptoms in Chinese adolescents. Cluster sampling was used to conduct a cross-sectional, electronic survey among 11,563 students from five primary and high schools in Sichuan Province in Western China. The questionnaire contained custom-designed items concerning sleep and exercise, while it used the Center for Epidemiologic Studies Depression Scale to assess depressive symptoms and the Core Self-Evaluations Scale to assess core self-evaluation. Data were analyzed using descriptive statistics and multivariate linear regression. A total of 10,185 valid questionnaires were collected, corresponding to an effective response rate of 88.1%. Among the respondents in the final analysis, 5,555 (54.5%) were boys and 4,630 (45.5%) were girls, and the average age was 15.20 ± 1.72 years (range, 11-18 years). Only less than half of the respondents (4,914, 48.2%) reported insufficient sleep, while the remainder (5,271, 51.8%) had adequate sleep. Nearly one-quarter (2,250, 22.1%) reported insufficient exercise, while the remainder (7,935, 77.9%) reported adequate exercise. More than half of the respondents (5,681, 55.7%) were from vocational high school, 3,368 (33.1%) were from junior high school, 945 (9.3%) were from senior high school, and 191 (1.9%) were from primary school. The prevalence of depressive symptoms among all respondents was 29.5% (95% CI 28.7%-30.4%). When other variables were controlled, the depression score did not vary significantly with gender ( = -0.244, SE = 0.127, = 0.054), but it decreased by 0.194 points per 1-year increase in age ( = -0.194, SE = 0.037, < 0.001). Students getting adequate sleep had depression scores 2.614 points lower than those getting insufficient sleep ( = -2.614, SE = 0.577, < 0.001), while students who engaged in adequate exercise had depression scores 1.779 points lower than those not exercising enough ( = -1.779, SE = 0.461, < 0.001). The depression score decreased by 0.919 points per 1-point increase in the core self-evaluation score ( = -0.919, SE = 0.008, < 0.001). In regression controlling for gender, age, and core self-evaluation, sleep and exercise were found to be related significantly to influence depressive symptoms ( = 0.821, SE = 0.315, = 0.009). Adequate sleep and adequate exercise are individually associated with milder depressive symptoms in Chinese adolescents. Our results further highlight the need for