ArticleFrontiers in public health2026
Sleep debt and depressive symptoms among workers: the mediating role of fatigue.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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8 authors.
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Abstract
Introduction: This study examined whether fatigue mediates the association between sleep debt and depressive symptoms among municipal employees in Japan. Methods: This cross-sectional study was conducted as part of the Night in Japan Home Sleep Monitoring Study (NinJaSleep Study) between November 2023 and March 2024 among 1,435 municipal employees in Koka City, Japan. Sleep debt was quantified using the Sleep Debt Index, calculated from self-reported ideal and actual sleep duration. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and fatigue was assessed using the Chalder Fatigue Scale. Mediation analysis was performed using the PROCESS macro (Model 4), adjusting for age, sex, body mass index, and occupation. Indirect effects were estimated using bootstrapping with 5,000 resamples. Results: Sleep debt was significantly associated with higher fatigue scores ( Discussion: Sleep debt is associated with depressive symptoms primarily through increased fatigue. These findings highlight fatigue as a key pathway in linking insufficient sleep to mental health outcomes and underscore the importance of addressing fatigue in workplace mental health strategies.
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