Association Between Weekend Catch-Up Sleep and Depression: Evidence From the 2017–2018 National Health and Nutrition Examination Survey

Weekend catch-up sleep (CUS) has been associated with certain health benefits; however, there is a paucity of research regarding the correlation between CUS and depression in adults. This study aimed to investigate the association between weekend CUS and depressive symptoms in a nationally representative adult population. We analyzed data from the 2017-2018 National Health and Nutrition Examination Survey. Depression was assessed using the Patient Health Questionnaire-9, with a score ≥10 indicating clinically significant depressive symptoms. CUS duration was categorized into four groups: CUS≤0 h, 0 h<CUS≤1 h, 1 h<CUS≤2 h, and CUS>2 h. Multivariable logistic regression models adjusted for sociodemographic factors, health behaviors, and comorbidities were employed to examine associations. Out of 4,450 eligible participants, 2,169 (48.7%), 943 (21.2%), 641 (14.4%), and 697 (15.7%) had weekend CUS durations of ≤0, 0 to 1, 1 to 2, and >2 h, respectively. The prevalence of depression was found to be 9.59%, 7.74%, 7.18%, and 8.75%, respectively, in these groups. Adjusted for multiple variables, the odds ratios (ORs) for depression were 0.89 (95% confidence interval [CI] 0.54-1.48), 0.71 (95% CI 0.37-1.37), and 0.97 (95% CI 0.57-1.65) for individuals with 0 h<CUS≤1 h, 1 h<CUS≤2 h, and CUS>2 h, respectively, in comparison to those with CUS≤0 h. However, subgroup analyses suggested a potential protective effect of CUS (>2 h) against depression in individuals with weekday sleep duration <6 h (OR=0.47, 95% CI 0.27-0.83). Weekend CUS was not associated with depression risk in the general adult population. The observed protective effect in sleep-restricted individuals warrants further investigation through prospective studies to evaluate potential causal relationships.