Abstract
<title>Abstract</title> <p>Background The rapid rise in popularity of esports has brought increased attention to the unique mental health challenges faced by esports players, yet research in this area remains in its infancy. Early research suggests a substantial mental health burden and has examined associations between esports-specific stressors, mental health and sleep disturbances. However, much of this work has relied traditional methodologies, providing limited insight into how affective, psychosocial, sleep-related, and esports-specific indicators are organised within this competitive performance environment. Methods To address this gap, we developed a bespoke 17-item questionnaire tailored for Directed Acyclic Graph (DAG) network analysis, providing a powerful methodological approach for mapping the conditional dependency structure of complex multivariate systems such as mental health. Results A total of 1025 esports players from over 60 countries completed the survey. Depressed mood emerged as a structurally prominent source node within the network, suggesting an organizing upstream role. Mental fatigue occupied an important position between affective variables and sleep/fatigue indicators. Additionally, its high prevalence and counterintuitive upstream position towards sleep indicators, suggests that it may warrant closer examination in future research on training load, recovery, and sleep in esports. Emotion control and a sense of autonomy formed a structural connection between upstream affective distress and downstream esports-specific indicators such as esports-related stress. Game-related thought preoccupation, a core feature of gaming disorder, emerged as a downstream sink node, consistent with the possibility that it represents a compound indicator of broader upstream psychosocial strain, rather than an organising feature itself. Conclusions Collectively, these findings provide an exploratory map of how mental health-relevant indicators were organised in this performance environment, and generate concrete, testable hypotheses for future longitudinal, experimental, and intervention research.</p>