Association of Depression and Excessive Daytime Sleepiness among Sleep-Deprived College Freshmen in Northern Taiwan

Background. The aim of this study was to investigate depression and other determinants (sleep-deprived behaviors such as hours spent sleeping, watching television, and on the computer) and their association with excessive daytime sleepiness (EDS) among college freshmen. Methods. Self-administered questionnaires were collected from two colleges in northern Taiwan from July to September 2014. A total of 2643 students (38.7% male; ages ranged 18–23 years; mean age of 18.8 ± 1.2 years) completed an anonymous questionnaire on lifestyle behaviors (including personal habits, sleep duration and quality, and hours spent watching television and on the computer); perception of one’s health, a validated depression scale (Brief Symptom Rating Scale, BSRS-5); insomnia symptoms (the Chinese version of the Athens Insomnia Scale, CAIS); and EDS rated with the Chinese Epworth sleepiness scale (CESS). The data were analyzed using the chi-squared test, t-test, multivariate logistic regression, and multiple linear regression. Results. The prevalence of EDS among college students was approximately 27.1% (717/2643). The risk of EDS was elevated with increasing severity of depression: odds ratio (OR) = 2.8/3.71/5.01 for female, and OR = 3.29/5.07/5.07 for mild/moderate/severe depression for male, respectively (p < 0.05; marginally higher in male severe depression, p = 0.08). If depression score increased by 1 point, CESS score increased by 0.35 point; if time spent on the computer during non-holidays increased by 1 h, CESS score increased by 0.1 point; and for those whose sleep duration increased by 1 h during non-holidays, CESS score decreased by 0.1 point. Conclusions. EDS significantly predicted depression among college freshmen. Using a computer for a long time and less sleep duration during non-holidays contributed to EDS of college freshmen. Youths who experience EDS are recommended to seek assessment for depression symptoms and sleep-deprived behaviors, thus allowing physicians to offer appropriate screening and treatment.