The Association between Physical Activity and Depressive Symptoms in U.S. Adults Is Modulated by Sleep Duration: Gender Disparities
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Background: The aim of this study is to explore the independent and joint associations between physical activity (PA) and sleep duration with depressive symptoms. Methods: We included and analyzed 18,052 participants (age ≥ 20 years) from the cross-sectional National Health and Nutrition Examination Survey (NHANES) conducted between 2007 and 2014. Results: After adjustment, both males and females showed a significant correlation between PA, sleep duration, and depressive symptoms. In the joint association analysis, we found: 1. The interaction between PA and sleep duration was statistically significant in males but not significant in females (P=0.380). 2. Compared to individuals with the lowest PA level and not meeting the National Sleep Foundation's (NSF) guidelines, those with the highest PA level and recommended sleep duration had a 79% decrease in depression risk in males (odds ratio [OR] 0.21, 95% confidence interval [CI] 0.14-0.32) and a 74% decrease in females (OR 0.26, 95% CI 0.20-0.35). 3. In male participants adhering to NSF guidelines, each increase in PA quartile is associated with a 19% reduction in the risk of depression (OR 0.81, 95% CI 0.71-0.92). Conversely, among male participants not adhering to NSF guidelines, there is a 23% decrease in depression risk (OR 0.77, 95% CI 0.69-0.86). For female participants, the respective reductions in depression risk are 20% (OR 0.80, 95% CI 0.73-0.89) and 14% (OR 0.86, 95% CI 0.80-0.93). Conclusion: For males, adherence to recommended sleep duration weakens the relationship between physical activity and depression, while the opposite is observed for females.