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Fatigue is associated with depression independent of excessive daytime sleepiness in the general population

  • Epidemiology • Original Article
  • Published:
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Abstract

Purpose

This study aimed to investigate sleep problems and comorbid conditions associated with fatigue in the general population.

Methods

The data were obtained from a nationwide cross-sectional survey conducted in 2018. The Fatigue Severity Scale was used to assess fatigue. We examined sleep habits, such as workday sleep duration, chronotype, and free-day catch-up sleep, excessive daytime sleepiness (EDS), depression, and other comorbid conditions. We conducted multiple logistic regression analysis with the presence of fatigue as a dependent variable.

Results

Of 2,493 adults aged 19 to 92 years, 50% men, mean age was 47.9 ± 16.4 years. The average workday sleep duration was 7.1 ± 1.1 h, and the prevalence of fatigue was 31%. After adjusting for potential confounders, fatigue was associated with EDS (odds ratio [OR] 3.751, 95% confidence interval [CI] 2.928–4.805), depression (OR 3.736, 95% CI 2.701–5.169), perceived insufficient sleep (OR 1.516, 95% CI 1.249–1.839), free-day catch-up sleep (OR 1.123, 95% CI 1.020–1.235), less alcohol intake (OR 0.570, 95% CI 0.432–0.752), and physical inactivity (OR 0.737, 95% CI 0.573–0.948). On subgroup analysis, fatigue was additionally associated with short workday sleep duration (OR 0.899, 95% CI 0.810–0.997) in individuals without EDS. However, among those with EDS, only depression (OR 2.842, 95% CI 1.511–5.343) and less alcohol intake (OR 0.476, 95% CI 0.247–0.915) were associated with fatigue.

Conclusion

Fatigue was significantly associated with depression independent of EDS. Further research is warranted to better understand the pathophysiological relationship between fatigue, depression, and sleep.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code availability

Not applicable

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Funding

This work was supported by a grant from the Korean Sleep Research Society and the Soonchunhyang University Research Fund.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Seoul National University Hospital, Seoul, South Korea

    Jun-Sang Sunwoo

  2. Department of Neurology, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, South Korea

    Daeyoung Kim

  3. Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Min Kyung Chu

  4. Department of Neurology, Bundang Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, South Korea

    Chang-Ho Yun

  5. Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, 31 Soonchunhyang 6-gil, Dongnam-gu, Cheonan, 31151, South Korea

    Kwang Ik Yang

Authors
  1. Jun-Sang Sunwoo
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  4. Chang-Ho Yun
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  5. Kwang Ik Yang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Jun-Sang Sunwoo and Kwang Ik Yang. The first draft of the manuscript was written by Jun-Sang Sunwoo and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kwang Ik Yang.

Ethics declarations

Ethics approval

This study protocol was approved by the institutional review board/ethics committee of Seoul National University Bundang Hospital (B-1808–484-303). The study was conducted in accordance with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Consent to participate

Written informed consent was obtained from all participants before enrollment in the study.

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Not applicable

Conflict of interest

The authors declare no competing interests.

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Comment

Important population-based study pointing out that fatigue is significantly associated with depression regardless of excessive daytime sleepiness. The same is true for weekly alcohol consumption. Those who consumed alcohol more than twice a week, surprisingly, had less fatigue. This deserves further investigation by the scientific community.

Darlan Lauricio Matte

Brazil

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Cite this article

Sunwoo, JS., Kim, D., Chu, M.K. et al. Fatigue is associated with depression independent of excessive daytime sleepiness in the general population. Sleep Breath 26, 933–940 (2022). https://doi.org/10.1007/s11325-021-02448-3

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  • DOI: https://doi.org/10.1007/s11325-021-02448-3

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