Prospective associations between heterogeneous sleep profiles and depressive symptoms in adolescents: The mediating role of coping styles

Introduction: Extant literature has linked sleep disturbance to depressive symptoms. However, the coexistence of naturally occurring sleep profiles among adolescents and the prospective associations between sleep profiles and depressive symptoms remain poorly understood. This study aims to uncover sleep patterns in Chinese adolescents based on a comprehensive set of sleep features (e.g., latency, daytime dysfunction, etc.) derived from the Pittsburg Sleep Quality Index (PSQI) and investigate the relationship between these profiles and subsequent depressive symptoms mediated by positive and negative coping styles. Methods: Five thousand five hundred five adolescents from Shandong province, China, enrolled (M_age = 16.83 years; 49.9% girls) in a two-wave longitudinal study (T1 in August 2023; T2 in February 2024). Latent class analysis (LCA) was conducted to identify adolescent sleep patterns. Mediation and sensitivity analyses were used to examine prospective associations between sleep patterns, coping styles, and depressive symptoms. Results: Four qualitatively distinct sleep profiles emerged: Healthy Sleepers (18.9%), Latency but Functioning Sleepers (13.6%), Efficient but Dysfunctional Sleepers (57.5%), and Medicated Maladaptive Sleepers (10.0%). Using the Healthy Sleepers as a reference group, Latency but Functional Sleepers, Efficient but Dysfunctional Sleepers, and Medicated Maladaptive Sleepers all predicted subsequent depressive symptoms through positive coping styles rather than negative coping styles. The relative indirect effects were 0.19, 0.19, and 0.32, respectively. Conclusions: The study underscored that adolescents exhibit distinct sleep patterns, and specific sleep profiles may be prospectively associated with depressive symptoms mediated by positive coping styles.