Association between snoring and depressive symptoms in adolescents

Abstract

While previous studies have suggested that snoring may be associated with depressive symptoms and suicidality in adults and preschool children, there have been no investigations in non-clinical adolescent populations. This study aimed to demonstrate the association between snoring and depressive symptoms/suicidality in adolescents. This survey study recruited 8530 students (grades 7–11) and examined depressive symptoms, suicidality, snoring frequency, daytime sleepiness, sleep duration, and presence of insomnia by questionnaires. Correlation analyses, multiple linear regression analyses and mediation analyses were performed to determine the association between snoring frequency and depressive symptoms/suicidality. The study population included 8080 students (16.73 ± 1.09 years old). Snoring frequency was positively correlated with depressive symptoms and suicidality. Snoring frequency was associated with depressive symptoms and suicidality when adjusted for age and sex, and the association remained significant after additionally adjusting for sleep duration, insomnia, and daytime sleepiness. When depressive symptoms were included as a predictor of suicidality, snoring frequency showed no significant predictive value. Mediation analysis confirmed that depressive symptoms mediate the association between snoring frequency and suicidality. Our findings suggest that self-reported complaints of snoring are associated with increased depressive symptoms and suicidality in adolescents independently of sleep duration, insomnia, and daytime sleepiness, and the connection between snoring and suicidality is mediated by depressive symptoms. These data underscore the importance of identifying snorers among adolescents and screening for depression and suicidal ideation in this population. © 2021 Elsevier Ltd