Background: Sleep and mental health are crucial to elite youth athletes, who face combined pressures of training, competition, school, and social commitments. We examined the association between sleep and depression in elite youth athletes. Methods: We analyzed data of 248 Korean world-class youth athletes (aged 13-19 years). The athletes completed the Pittsburgh Sleep Quality Index (PSQI), the Morningness-Eveningness Questionnaire (MEQ), and the Center for Epidemiologic Studies Depression Scale (CES-D). Results: Overall, 50.4% of the athletes were considered poor sleepers (global PSQI score = 5.5); 23.8% reported depressive symptoms (CES-D score = 16). Depression was 4.26 times (95% confidence interval [CI], 2.00-9.09, p < 0.001) more likely in poor than in good sleepers. Odds of depression were increased with poor subjective sleep quality (odds ratio [OR]: 4.62; 95%CI, 2.10-10.18, p < 0.001), prolonged sleep latency (OR: 2.45: 95% CI, 1.28-4.69, p < 0.01), increased sleep disturbances (OR: 3.98: 95% CI, 1.83-8.63, p < 0.001), and daytime dysfunction (OR: 3.28; 95% CI, 1.67-6.44, p < 0.001). Depressive symptoms were associated with worse sleep, particularly poor subjective sleep quality, prolonged sleep latency, increased sleep disturbances, and increased daytime dysfunction. Conclusions: These results suggest that depressive symptoms are associated with poor sleep in the elite youth athlete population.
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