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<p>Depression is a growing mental health concern, especially among adolescents. It has been documented that excessive daytime sleepiness (EDS) is negatively associated with depression, but the mediating mechanisms underlying the relationship remain unclear. Based on the existing research on fatigue and cognitive deficits, this study constructed a chain mediation model to test whether they mediated the association between EDS and depression among adolescents. A total of 50,072 valid questionnaires were collected among Chinese adolescents (aged 12–18 years, mean ± SD: 15.69 ± 1.57; 23497 males and 26575 females). Data on EDS, fatigue, depression, and cognitive deficits were collected using the Chinese Adolescent Daytime Sleepiness Scale (CADSS), the Fatigue Severity Scale (FSS), the Perceived Deficits Questionnaire for Depression-5-items (PDQ-5-D), and the Patient Health Questionnaire-9 (PHQ-9). The results revealed significantly positive associations between each pair of EDS, fatigue, cognitive deficits, and depression. Furthermore, after controlling for adolescents’ gender, grade, primary caregivers, and place of residence, the mediation analysis confirmed a direct association between EDS and depression, and revealed that EDS could indirectly affect depression through three pathways: the mediation of fatigue, the mediation of cognitive deficits, and the chain mediation of fatigue and cognitive deficits. These findings indicate that fatigue and cognitive deficits could mediate the association between EDS and depression among adolescents. Therefore, it is important to identify adolescents with EDS early and provide intervention especially focusing on alleviating fatigue and improving cognitive deficits to potentially reduce the risk of depression.</p>

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Association between excessive daytime sleepiness and depression among Chinese adolescents: the chain mediating effect of fatigue and cognitive deficits

  • 期刊论文

  • 发表日期：

    2026年1月30日

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  • Wenjie Liu,
  • Yue Yu,
  • Wenkai Zheng,
  • Weijie Song,
  • Yanran Fu,
  • Yufei Di,
  • Shuting Li,
  • Zhaofan Liu,
  • Leilei Wang,
  • Xingjie Yang,
  • Chundi Wang,
  • Hu Deng

摘要

Depression is a growing mental health concern, especially among adolescents. It has been documented that excessive daytime sleepiness (EDS) is negatively associated with depression, but the mediating mechanisms underlying the relationship remain unclear. Based on the existing research on fatigue and cognitive deficits, this study constructed a chain mediation model to test whether they mediated the association between EDS and depression among adolescents. A total of 50,072 valid questionnaires were collected among Chinese adolescents (aged 12–18 years, mean ± SD: 15.69 ± 1.57; 23497 males and 26575 females). Data on EDS, fatigue, depression, and cognitive deficits were collected using the Chinese Adolescent Daytime Sleepiness Scale (CADSS), the Fatigue Severity Scale (FSS), the Perceived Deficits Questionnaire for Depression-5-items (PDQ-5-D), and the Patient Health Questionnaire-9 (PHQ-9). The results revealed significantly positive associations between each pair of EDS, fatigue, cognitive deficits, and depression. Furthermore, after controlling for adolescents’ gender, grade, primary caregivers, and place of residence, the mediation analysis confirmed a direct association between EDS and depression, and revealed that EDS could indirectly affect depression through three pathways: the mediation of fatigue, the mediation of cognitive deficits, and the chain mediation of fatigue and cognitive deficits. These findings indicate that fatigue and cognitive deficits could mediate the association between EDS and depression among adolescents. Therefore, it is important to identify adolescents with EDS early and provide intervention especially focusing on alleviating fatigue and improving cognitive deficits to potentially reduce the risk of depression.