Associations of weekend compensatory sleep and weekday sleep duration with psychotic-like experiences among Chinese adolescents

Objective: Insufficient sleep on weekdays among adolescents and its negative effects on mental health is a concerning public health issue. This study examined the relationship between weekday sleep duration, weekend compensatory sleep (WCS), and psychotic-like experiences (PLEs) in a large sample of Chinese adolescents.

Methods: A total of 39,731 junior high school students were recruited in this cross-sectional study. A self-report questionnaire was used to assess sleep duration, social-demographical characteristics, anxiety and depressive symptoms, and PLEs. Logistic regression and stratified analysis were performed to explore the associations between WCS and PLEs.

Results: The prevalence of current PLEs was 12.4 % in this study. The average weekday sleep duration among adolescents was 7.7 ± 1.0 h. 93.2 % of participants reported WCS, with an average duration of 1.8 ± 1.6 h. WCS was significantly associated with a lower risk of PLEs (OR = 0.79, 95 % CI: 0.70-0.90). Moreover, 0-2 h of WCS was linked to a reduced risk of PLEs, regardless of whether students with weekday sleep duration <8 h (OR = 0.74, 95 % CI: 0.61-0.91) or ≥8 h (OR = 0.69, 95 % CI: 0.57-0.82). However, the significant role of WCS >2 h against PLEs was observed only among adolescents with weekday sleep duration <8 h (OR = 0.79, 95 % CI: 0.65-0.97).

Conclusion: WCS was associated with a lower risk of PLEs in adolescents, particularly those with insufficient weekday sleep. These findings highlight the importance of sufficient sleep and the potential benefits of compensatory sleep on adolescents' mental health.