Depressive symptoms, sleep-wake features, and insomnia among female students: The role of rumination

Depression symptoms are prevalent among nursing students, especially those in Asia. This study assessed the association between rumination and depression symptoms among female nursing students ( N = 148) and the chain mediation role of sleep-wake indexes and insomnia symptoms. The data were collected from a battery of questionnaires and consecutive 7-day actigraphy data for analyzing sleep-wake indexes. About 54.1% of the participants had either mild or moderate depression symptoms. Most students (89.2%) had a delayed circadian phase, and circadian activity rhythm (CAR) was not ideal. The path mediation model underwent analysis using the PROCESS macros. The results showed that rumination in students is directly positively correlated with depressive symptoms ( b = 4.831). Moreover, the association between rumination and depressive symptoms is sequent (moderating effect = 0.12, 95% CI [0.017, 0.410]). The proposed model in this study provides a foundation for improving educational programs on sleep hygiene and promoting mental wellness.