Independent and joint associations of chronotype and social jetlag with depressive symptoms in adults with overweight and obesity: Evidence from NHANES (2017–2023)

This study aimed to examine the independent and joint associations of chronotype and social jetlag with depression among adults with overweight and obesity. Data from the National Health and Nutrition Examination Survey (NHANES) among US adults were used. Sleep was assessed through the Sleep Disorders Questionnaire, and depressive symptoms via the Patient Health Questionnaire. Body mass index was calculated from objectively measured height and weight. Generalised additive models and multi-level modelling were employed. A total of 5,816 adults (mean age: 45.0 ± 12.9 y; 47.5% male) with overweight or obesity were included in this analysis. Independently, evening chronotypes showed higher depression scores and odds compared with morning type. Moderate and high social jetlag were associated with lower depression scores and reduced depression odds compared to low social jetlag. Joint analyses revealed that among individuals with neutral and evening chronotypes across the week, those experiencing moderate social jetlag had lower odds of depressive symptoms compared to those with low social jetlag (neutral type: odds ratio OR = 0.63; 95% confidence interval CI: 0.41, 0.99; evening type: OR = 0.53; 95% CI: 0.37, 0.74). These associations varied between weekday and weekend chronotypes. Moderate social jetlag demonstrated protective effects against depression in adults with overweight and obesity, particularly among evening chronotypes across the week, morning types on weekdays, and neutral and evening types on weekends. These findings suggest that sleep schedule flexibility between weekdays and weekends, potentially reflecting weekend catch-up sleep, may mitigate depression risk in this population, especially for individuals with evening preferences.