Sleep duration and its associations with depressive, anxiety, PTSD symptoms, and psychotic-like experiences in young people: a household-based epidemiological study in Hong Kong

Abstract

Sleep deficiency is a major global health threat. While some studies have suggested a J-shaped relationship between sleep duration and adverse health outcomes, the influence of excessive sleep is often attributed to confounding factors, such as depression. It remains unclear whether insufficient and excessive sleep would be similarly or differentially associated with a transdiagnostic range of mental health problems in young people. We collected data from 3210 participants (15–25 years) from a household-based epidemiological youth study in Hong Kong. Using univariate and multivariable logistic regression models, we examined the associations of sleep duration with probable depression, anxiety, post-traumatic stress disorder, and psychotic-like experiences (PLEs), while accounting for an array of confounders. The youth population in Hong Kong reported a mean sleep duration of 7.5 h (SD = 1.6); 35.3% had insufficient sleep (<7h) and 5.5% excessive sleep (≥10 h). After adjustments, insufficient sleep was associated with probable depression (aOR = 1.35, CI = 1.11–1.63) and anxiety (aOR = 1.22, CI = 1.02–1.47). Nonetheless, when selecting young people without physical illness or using psychiatric/sleeping medications, the adjusted associations remained only for probable depression (aOR = 1.43, CI = 1.12–1.83). The effects of insufficient sleep on PLEs were found only in the univariate model and not after adjustments for insomnia and frequent nightmares. No clear association was observed between excessive sleep and all four symptom dimensions. Insufficient sleep may be a simple-to-assess indicator of mental health risks in young people, particularly in terms of depressive symptomatology. Understanding the factors contributing to the lack of sleep and identifying feasible strategies to develop healthier sleep habits among young people will be crucial.