Preschool children's sleep duration and parental depressive symptoms in western China: role of children's mental health and socioeconomic factors.

Background: Preschool children's insufficient sleep is a public health concern in underdeveloped western China, yet its association with parental depressive symptoms remains unclear, particularly whether this relationship varies by socioeconomic context. This study aims to examine this association, explore whether child mental health may partly account for it, and identify vulnerable subgroups. Methods: This cross-sectional study recruited 21,366 parent-child dyads from 189 preschools in western China. Parent-reported children's sleep duration was categorized into three groups: 10-13 h/d (reference), 8-9 h/d, and <8 h/d. Parental depressive symptoms and children's mental health outcomes (total difficulties) were assessed using the Center for Epidemiological Studies Depression Scale (CES-D) and the Strengths and Difficulties Questionnaire (SDQ), respectively. Multivariable logistic regression was used to examine the association between children's sleep duration and parental depressive symptoms, and subgroup analyses were performed to assess effect modification by demographic and socioeconomic factors. Indirect effect analysis was conducted to determine the extent to which children's total difficulties account for this association. Results: In fully adjusted model, a clear graded relationship was observed that parents of children sleeping 8-9 h/d had 43% higher odds of elevated parental depressive symptoms (OR = 1.43, 95% CI: 1.30-1.56, Conclusion: Shorter sleep duration in preschool children is associated with an increased risk of parental depressive symptoms, and this association is partially accounted for by children's mental health. Future high-quality cohort studies are needed to explore this topic in greater detail.