Independent and Nonlinear Associations of Sedentary Time and Weekday Sleep Duration with Depressive Symptoms among U.S. Adults: NHANES 2021-2023

Abstract

This study uses the data of National Health and Nutrition Examination Survey to investigate how sedentary time and weekday sleep duration are related to depressive symptoms among U.S. adults and its potential effect modification on the sedentary time–depressive symptoms association were also assessed. A total of 4,449 participants aged 20 years and above who took part in NHANES 2021–2023 were included. A PHQ-9 score of ≥10 was used to identify more pronounced depressive symptoms. Survey-weighted regression models were used for the analyses. For every one weighted SD increase in sedentary time, the odds of more pronounced depressive symptoms were 15.0% higher (OR = 1.150, 95% CI: 1.028–1.286). Compared with 7–9 hours of weekday sleep, short sleep was associated with higher odds of depressive symptoms (OR=1.772, 95% CI: 1.395-2.250). A U-shaped association was observed between sleep duration and depressive symptoms, with a model-estimated nadir of approximately 8.4 hours. No significant effect modification by weekday sleep duration was observed. Longer sedentary time and shorter weekday sleep duration were associated with more pronounced depressive symptoms. It still needs more longitudinal studies to establish the temporal sequence of these relationships.