Sleep behavior and depression: Findings from the China Kadoorie Biobank of 0.5 million Chinese adults

Sun, Xiaoyan; Zheng, Bang; Lv, Jun; Guo, Yu; Zheng, Bin; Yang, Ling; Chen, Yiping; Fu, Zhenwang; Guo, Hong; Liang, Peng; Chen, Zhengming; Chen, Junshi; Li, Liming; Yu, Canqing

doi:10.1016/j.jad.2017.12.058

Cited by 54 publications

(40 citation statements)

References 37 publications

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“…Moreover, whilst one quarter indicated insomnia symptoms in the clinical range, the prevalence of sleep-disorders other than insomnia remained low (< 5%). These prevalence rates are comparable with previous research reporting high levels of depressive and/or insomnia symptoms in American university students and [19,20] appear to be markedly higher than point prevalence rates established amongst the general population [21,22].…”

Section: Discussionsupporting

confidence: 87%

The Relationship between Depression and Insomnia Symptoms Amongst a Sample of UK University Students

Akram

Gardani

et al. 2019

Sleep Med Res

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BRIEF COMMUNICATION Research exploring the relationship between mental health difficulties and insomnia amongst students in the UK remains limited. This study further examined the extent of potential relationships between insomnia, anxiety and depression symptoms amongst university students in the UK. A sample of 487 students from four northern universities completed The Insomnia Severity Index, SLEEP-50, and Hospital Anxiety and Depression Scales. Approximately one fifth of students experienced mild to severe levels of depressive symptoms, and two thirds reported anxious symptoms. One quarter of students indicated insomnia symptoms in the clinical range, however the prevalence of sleep-disorders other than insomnia remained low (< 5%). Finally, symptoms of insomnia and apnoea were significantly related to depression, after controlling for co-morbid anxiety. The current outcomes highlight the high prevalence of depressive and insomnia symptoms amongst university students in the UK. Considering the relationship between insomnia and depression, student-focused mental health services should explore the possibility of treating insomnia to circumvent depression.

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Section: Discussionsupporting

confidence: 87%

The Relationship between Depression and Insomnia Symptoms Amongst a Sample of UK University Students

Akram

Gardani

et al. 2019

Sleep Med Res

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“…Moreover, because of the healthy volunteer effect, participants in the present study might be healthier than the general population, physically or mentally. Another potential reason for this discrepancy might be that the present study covered an older population (30–79 years old) than the typical onset age of depression (15–30 years old) [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies generally regarded the function of daytime napping as the reflection of daytime dysfunction and OSA [ 22 , 27 , 55 ]. However, the association between daytime napping and depression still remained significant after controlling sleep-related factors in the present study, indicating other existing mechanisms of daytime napping.…”

Section: Discussionmentioning

confidence: 99%

The relationship between depression, daytime napping, daytime dysfunction, and snoring in 0.5 million Chinese populations: exploring the effects of socio-economic status and age

et al. 2018

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BackgroundDaytime napping has been postulated as both a protective and a risk factor for depression in previous studies. In addition to these conflicting results, research gaps also exist with regard to controlling confounding bias between daytime napping and depression and examining the potential association within the Chinese population. To facilitate the prevention and diagnosis of depression, this study aims to provide insight into the association of daytime napping and depression in 0.5 million Chinese adults by fully controlling confounders, and further examine the modifying effects of socio-economic status (SES) and age.MethodsData were drawn from the baseline of a Chinese cohort study of 0.5 million adults. Depressive status was measured by the Composite International Diagnostic Inventory (CIDI). Logistic regression models were used to examine the association between depression and daytime napping adjusted for SES, sleep-related factors, lifestyle factors and related diseases. Further stratified analyses were conducted to identify the modifying effects of socio-economic status and age.ResultsThe odds ratio of depression by daytime napping was 1.15 (95% CI: 1.01–1.31) in females and 1.42 (95% CI: 1.18–1.71) in males. Factors including living in a rural area (OR = 1.31, 95% CI: 1.13–1.52), receiving less education (OR = 1.42, 95% CI: 1.22–1.66), getting married (OR = 1.24, 95% CI: 1.10–1.40) and being 45–65 years old (OR = 1.29, 95% CI: 1.12–1.49) had a modifying effect on daytime napping and depression that could strengthen the association.ConclusionsA significantly positive association was found between depression and daytime napping, as well as daytime dysfunction, snoring and both shorter and longer sleep duration. Lower SES and age could possibly modify the association. Further clinical or epidemiological studies are needed to investigate the mechanism and facilitate the prevention of depression.

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“…Deriving sleep behaviors from the EHR allowed us to quantify associations with a broad range of clinically-defined phenotypes. The association between long weekend sleep and depression is supported by questionnaire-based studies (Sun et al 2018) , however, long weekday sleep duration unexpectedly shows very strong associations with clusters of mental health and neurological conditions. One possible explanation for the differences between PheWAS analyses for sleep duration on weekdays and weekends is that long sleep duration on weekends stems from accumulating sleep debt during the week, while abnormal sleep patterns on weekdays may occur despite social and societal constraints and have a deeper clinical basis.…”

Section: Discussionmentioning

confidence: 81%

Pulling the covers in electronic health records for an association study with self-reported sleep behaviors

Rhoades

Bastarache

Denny

et al. 2018

Preprint

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The electronic health record (EHR) contains rich histories of clinical care, but has not traditionally been mined for information related to sleep habits. Here we performed a retrospective EHR study and derived a cohort of 3,652 individuals with self-reported sleep behaviors, documented from visits to the sleep clinic. These individuals were obese (mean body mass index 33.6 kg/m 2 ) and had a high prevalence of sleep apnea (60.5%), however we found sleep behaviors largely concordant with prior prospective cohort studies. In our cohort, average wake time was one hour later and average sleep duration was 40 minutes longer on weekends than on weekdays (p<1·10 -12 ). Sleep duration also varied considerably as a function of age, and tended to be longer in females and in whites. Additionally, through phenome-wide association analyses, we found an association of long weekend sleep with depression, and an unexpectedly large number of associations of long weekday sleep with mental health and neurological disorders (q<0.05). We then sought to replicate previously published genetic associations with morning/evening preference on a subset of our cohort with extant genotyping data (n=555). While those findings did not replicate in our cohort, a polymorphism (rs3754214) in high linkage disequilibrium with a previously published polymorphism near TARS2 was associated with long sleep duration (p<0.01). Collectively, our results highlight the potential of the EHR for uncovering the correlates of human sleep in real-world populations.

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Sleep behavior and depression: Findings from the China Kadoorie Biobank of 0.5 million Chinese adults

Abstract: Abnormal sleep duration and sleep disturbances were associated with depression. The associations were stronger for abnormal sleep duration accompanied with sleep disturbances, especially for a long duration. More attention should be paid on these persons in clinical practice.

Cited by 54 publications

References 37 publications

The Relationship between Depression and Insomnia Symptoms Amongst a Sample of UK University Students

The Relationship between Depression and Insomnia Symptoms Amongst a Sample of UK University Students

The relationship between depression, daytime napping, daytime dysfunction, and snoring in 0.5 million Chinese populations: exploring the effects of socio-economic status and age

Pulling the covers in electronic health records for an association study with self-reported sleep behaviors

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