Long-term outdoor artificial light at night and psychological symptoms among Chinese adolescents: Findings from a national school-based survey.

BACKGROUND

Outdoor artificial light at night (ALAN) may affect mental health, but evidence on its association with psychological symptoms and potential pathways among Chinese adolescents remains limited.

METHODS

We analyzed data from 39,547 adolescents aged 12-17 years from a national school-based survey conducted in 43 cities across 26 provincial-level administrative regions of China. Outdoor ALAN exposure was estimated using 3-year average satellite-derived ALAN data within a 500 m buffer around each school. Psychological symptoms and their subdimensions were assessed using the Multidimensional Sub-health Questionnaire of Adolescents. Mixed-effects logistic regression models estimated odds ratios (ORs) per interquartile range (IQR) increase in ALAN exposure. Restricted cubic splines (RCS) examined exposure-response patterns, and exploratory mediation analyses evaluated the potential mediating roles of sleep duration, overweight/obesity, and abdominal obesity.

RESULTS

The prevalence of psychological symptoms was 20.27%. Each IQR increase in ALAN exposure was associated with higher odds of psychological symptoms (OR = 1.27, 95% CI: 1.05, 1.54), emotional symptoms (OR = 1.27, 95% CI: 1.06, 1.52), behavioral symptoms (OR = 1.23, 95% CI: 1.02, 1.48), and social adaptation difficulties (OR = 1.25, 95% CI: 1.03, 1.50). The RCS curve suggested that the odds of psychological symptoms became significantly elevated above approximately 38.16 nW/cm2/sr. Sleep duration may partially explain this association, accounting for 50.0% of the total effect, whereas overweight/obesity and abdominal obesity did not show significant mediating effects.

CONCLUSION

Higher outdoor ALAN exposure was associated with greater odds of psychological symptoms among Chinese adolescents, and insufficient sleep may partly explain this association.