Association of chronotype, social jetlag, sleep duration and depressive symptoms in Chinese college students

Objectives: To describe the prevalence of depressive symptoms among Chinese college students and examine the relationship between sleep and circadian rhythm disruption (SCRD) indicators (chronotype, social jetlag, sleep duration) and depressive symptoms. Methods: From April to May 2019, the College Student Behavior and Health Cohort Study was conducted among Chinese college students from 2 universities in Anhui and Jiangxi provinces. The current study used data from the third follow-up study. Questionnaire content includes socio-demographic and lifestyle information. Social jetlag and sleep duration were calculated by answering the question about sleep time. Chronotype was assessed by the Morning and Evening Questionnaire (MEQ-5). Depressive symptoms were evaluated by the Patient Health Questionnaire 9 (PHQ-9). A Chi-square test was used to examine the proportion depressive symptoms. Multi-nomial logistic regression model were used to explore the associations of circadian rhythm indicators with depressive symptoms.Results: The prevalence of mild depression, moderate and above depression was 18.8 % and 6.9 %. Evening types (E-types) and short sleep duration were significantly associated with depression. Stratified analysis indicated that E-types and social jetlag >= 2 h were associated with mild depression (OR = 5.67, 95 % CI: 1.83-17.51), as well as stratified analysis indicated that E-types and sleep duration<8 h were associated with mild depression (OR 5.10, 95 % CI: 1.88-13.87). Conclusions: The findings suggest that depressive symptoms are more severe when multiple SCRD indicators are out of whack. The intervention programs of depressive symptoms should consider the context of the multidi-mensional aspects of Chinese college student sleep.