Wanxin Wang1, Xueying Du2, Yangfeng Guo2, Wenyan Li1, Sheng Zhang1, Weihong Zhang3, Roger S McIntyre4, Jocelyn K Tamura4, Lan Guo5, Ciyong Lu6. 1. Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China. 2. Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, 510080, China. 3. International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University. 4. Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada. 5. Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China. Electronic address: guolan3@mail.sysu.edu.cn. 6. Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China. Electronic address: luciyong@mail.sysu.edu.cn.
Abstract
OBJECTIVES: Relatively few studies have explored the inter-relationship between screen time (ST), sleep duration and depressive symptoms. The study herein sought to determine (1) the relationships between ST, sleep duration and depressive symptoms among Chinese adolescents; (2) whether sleep duration mediates the relationships between ST and depressive symptoms. METHODS: 1st grade students (n=1,976) from ten high schools in Guangzhou, China were invited through cluster sampling between January and April 2019. Self-reported ST with electronic devices and Internet, sleep duration, and The Center for Epidemiology Scale for Depression (CES-D) score were collected. Generalized mixed linear models and mediation analyses were conducted. RESULTS: There were 1,956 self-reported questionnaires received (response rate: 98.99%). Approximately 25% (471/1,929 for Internet use, 399/1,928 for electronic device) of the total sample reported ST >2 hours/day. Approximately 8.9% (169/1,894) reported a CES-D score >28. Longer ST with electronic devices (estimate=0.52, 95%CI: 0.24~0.80), Internet usage (estimate=0.82, 95%CI: 0.53~1.11) were positively associated with depressive symptoms, while less sleep (estimate=-1.85, 95%CI: -2.27~-1.43) was negatively associated with depressive symptoms. There is significant indirect effect of electronic device usage on depressive symptoms through sleep duration (indirect effect=0.08, 95%CI: 0.01~0.15). LIMITATIONS: This study only included school students from Guangzhou. Causal relationship cannot be inferred by this cross-sectional design. CONCLUSIONS: ST and sleep duration were significantly associated with depressive symptoms severity. The indirect effect of sleep duration suggests a possible mechanism of the association between ST and depressive symptoms. Future interventions to manage depressive symptoms should target sleep time and decrease ST among adolescents.
OBJECTIVES: Relatively few studies have explored the inter-relationship between screen time (ST), sleep duration and depressive symptoms. The study herein sought to determine (1) the relationships between ST, sleep duration and depressive symptoms among Chinese adolescents; (2) whether sleep duration mediates the relationships between ST and depressive symptoms. METHODS: 1st grade students (n=1,976) from ten high schools in Guangzhou, China were invited through cluster sampling between January and April 2019. Self-reported ST with electronic devices and Internet, sleep duration, and The Center for Epidemiology Scale for Depression (CES-D) score were collected. Generalized mixed linear models and mediation analyses were conducted. RESULTS: There were 1,956 self-reported questionnaires received (response rate: 98.99%). Approximately 25% (471/1,929 for Internet use, 399/1,928 for electronic device) of the total sample reported ST >2 hours/day. Approximately 8.9% (169/1,894) reported a CES-D score >28. Longer ST with electronic devices (estimate=0.52, 95%CI: 0.24~0.80), Internet usage (estimate=0.82, 95%CI: 0.53~1.11) were positively associated with depressive symptoms, while less sleep (estimate=-1.85, 95%CI: -2.27~-1.43) was negatively associated with depressive symptoms. There is significant indirect effect of electronic device usage on depressive symptoms through sleep duration (indirect effect=0.08, 95%CI: 0.01~0.15). LIMITATIONS: This study only included school students from Guangzhou. Causal relationship cannot be inferred by this cross-sectional design. CONCLUSIONS: ST and sleep duration were significantly associated with depressive symptoms severity. The indirect effect of sleep duration suggests a possible mechanism of the association between ST and depressive symptoms. Future interventions to manage depressive symptoms should target sleep time and decrease ST among adolescents.
Authors: Tong Zhou; Gang Cheng; Xihong Wu; Rui Li; Chao Li; Gang Tian; Simin He; Yan Yan Journal: Int J Environ Res Public Health Date: 2021-06-06 Impact factor: 3.390