Interaction between health literacy and sleep quality on depressive symptoms among middle school students

Objective To investigate the association between health literacy,sleep quality and depressive symptoms among middle school students.Methods Data were collected from a middle school in Shenyang by questionnaire survey,including demographic information,Chinese Adolescent Interactive Health Literacy Questionnaire(CAIHLQ),Pittsburgh Sleep Quality Index and self-rating depressive scale.Results The score of CAIHLQ was(106.49± 19.87).Junior school students and those from high socioeconomic status(SES) families had significantly higher health literacy scores.The detection rate of sleep disorder was 18.3% and depressive symptoms was 20.9%.Students from low SES families had significantly higher rate of sleep disorder(27.0%) and depressive symptoms(36.5%) than those higher family SES students(P<0.05).Multiple Logistic regression analyses showed that students with sleep disorder and lower health literacy had the highest risks of depressive symptoms,which indicated a dose-response relationship(P<0.05).Conclusion Students with sleep disorder and low health literacy have high risk of depressive symptoms.Health literacy improvement might help to reduce the risk of depressive symptoms.