Chongqing Center for Disease Control and Prevention, 400042, Chongqing, China.
BMC Psychiatry. 2023 Feb 27;23(1):127. doi: 10.1186/s12888-023-04601-6.
Although there are several cross-sectional and prospective studies on the relationship between sleep duration /insomnia symptoms and depression symptoms, the results of these studies are still not conclusive, and few studies have further analyzed the association between sleep duration and depressive symptoms in adults by gender and age. Thus, this study aimed to investigate the relationship between nocturnal sleep duration and insomnia symptoms with depression symptoms, and further examine whether the association was impacted by age and gender in a large-scale Han Chinese population in southwest China.
A cross-sectional study was performed that included 44,900 participants from 18 districts in southwest China from September 2018 to January 2019. The study comprised 42,242 individuals in the final analysis. Depressive symptoms were investigated using the PHQ-2 questionnaires. Multivariate logistic regression analysis was performed to investigate the relationship between nocturnal sleep duration and insomnia symptoms with depression symptoms as well as the influence of age and gender.
After adjusting for multiple variables, those with nocturnal sleep duration < 7 h had a higher odds ratio for depression (OR:1.47, 95%CI 1.31-1.65) compared to participants whose nocturnal sleep duration was in the range of 7-8 h. Notably, there is a higher association in those aged below 45 years (OR:1.91, 95%CI 1.52-2.41) and in female participants (OR:1.57, 95%CI 1.35-1.82). However, nocturnal sleep duration longer than 9 h was not associated with depression symptoms in either the whole population analysis or the subgroup analysis. Insomniacs had a higher odds ratio for depression(OR:1.87, 95%CI 1.84-2.36, respectively) compared to non-insomniacs. There is a higher association in those aged 45-60 years (OR:2.23, 95%CI 1.82-2.73) and in female participants (OR:2.17, 95%CI 1.84-2.56). Further subgroup analysis by age and gender at the same time showed the association between sleep deprivation and depression was highest among women aged below 45 years, while the association between insomnia and depression was the highest among men aged 45-59 years.
Short nocturnal sleep duration and insomnia symptoms were positively associated with the risk of depressive symptoms among Chinese Han adults aged 30-79 in Southwest China, especially the middle-aged population and females should be more concerned.
尽管有几项关于睡眠时长/失眠症状与抑郁症状之间关系的横断面和前瞻性研究，但这些研究的结果仍不明确，并且很少有研究进一步分析性别和年龄对成年人睡眠时长与抑郁症状之间关系的影响。因此，本研究旨在调查西南地区汉族人群中夜间睡眠时长和失眠症状与抑郁症状之间的关系，并进一步探讨在大规模人群中，年龄和性别是否会影响这种关联。
本研究为横断面研究，于 2018 年 9 月至 2019 年 1 月期间在西南地区的 18 个区招募了 44900 名参与者，最终有 42242 人纳入最终分析。采用 PHQ-2 问卷评估抑郁症状。采用多变量 logistic 回归分析来探讨夜间睡眠时长和失眠症状与抑郁症状之间的关系，以及年龄和性别对其的影响。
调整多个变量后，与夜间睡眠时长为 7-8 小时的参与者相比，夜间睡眠时长<7 小时的参与者发生抑郁的比值比（OR）更高（OR：1.47，95%CI 1.31-1.65）。值得注意的是，在年龄<45 岁的人群（OR：1.91，95%CI 1.52-2.41）和女性参与者（OR：1.57，95%CI 1.35-1.82）中，这种关联更高。然而，在全人群分析或亚组分析中，夜间睡眠时长>9 小时与抑郁症状均无关联。与非失眠者相比，失眠者发生抑郁的比值比（OR）更高（OR：1.87，95%CI 1.84-2.36）。在 45-60 岁年龄组（OR：2.23，95%CI 1.82-2.73）和女性参与者（OR：2.17，95%CI 1.84-2.56）中，这种关联更高。同时按年龄和性别进行亚组分析，结果显示，睡眠不足与抑郁之间的关联在 45 岁以下的女性中最高，而失眠与抑郁之间的关联在 45-59 岁的男性中最高。
在西南地区 30-79 岁的汉族成年人中，较短的夜间睡眠时长和失眠症状与抑郁症状的风险呈正相关，尤其是中年人群和女性应更加关注。
