Sleep irregularity and depression among U.S. adults: An accelerometer-based cross-sectional study in NHANES

To investigate the association between accelerometer-based sleep regularity and depression, and to explore whether meeting sleep duration recommendations modifies the effects of irregular sleep patterns.

In this cross-sectional study, data were analyzed from 7402 adults who participated in the 2011-2014 NHANES and wore accelerometers. Sleep regularity patterns were quantified via the Sleep Regularity Index, and participants were classified as regular, moderately irregular, or irregular sleepers. Depressive symptoms were evaluated with the PHQ-9. Survey-weighted logistic regression, survey-weighted restricted cubic splines, and survey-weighted linear regression were employed to estimate the association between sleep regularity patterns and depression risk, with sleep duration further examined in this relationship.

Adults with irregular sleep patterns (OR 2.65; 95% CI 1.74-4.03) exhibited a higher odds of depression compared with those with regular sleep patterns. A dose-response analysis, which treated the Sleep Regularity Index as a continuous variable, indicated a linear relationship between Sleep Regularity Index and depression. Notably, individuals with irregular sleep patterns faced a higher odds of depression (OR 2.68; 95% CI 1.59-4.53) even when they met the recommended sleep duration guidelines. However, no significant multiplicative interaction (P = .727) or additive interaction (RERI -0.31; 95% CI -1.27 to 0.65) was observed between sleep regularity and sleep duration in relation to depression risk.

Irregular sleep patterns were associated with an elevated odds of depression, even when adults met the recommended sleep durations. Evidence-based interventions designed to enhance sleep regularity could be integrated as potential strategies for the prevention and treatment of depression.