Morningness/Eveningness and menstrual symptoms in adolescent females

Influence of chronotype on pain incidence during early adolescence

ABSTRACT

During adolescence major shifts in sleep and circadian systems occur with a notable circadian phase delay. Yet, the circadian influence on pain during early adolescence is largely unknown. Using 2 years of data from the Adolescent Brain Cognitive Development study, we investigated the impact of chronotype on pain incidence, moderate-to-severe pain, and multiregion pain 1 year later in U.S. adolescents. Based on the Munich ChronoType Questionnaire, chronotype was calculated as the midpoint between sleep onset and offset on free days, corrected for sleep debt over the week. Adolescents reported pain presence over the past month, and if present, rated pain intensity (0-10 numerical rating scale; ≥ 4 defined as moderate-to-severe pain) and body site locations (Collaborative Health Outcomes Information Registry Body Map; ≥2 regions defined as multiregion pain). Three-level random intercept logistic regression models were specified for each pain outcome, adjusting for baseline sociodemographic and developmental characteristics. Among 5991 initially pain-free adolescents (mean age 12.0 years, SD 0.7), the mean chronotype was 3:59 am (SD 97 minutes), and the 1-year incidence of pain, moderate-to-severe pain, and multiregion pain was 24.4%, 15.2%, and 13.5%, respectively. Each hour later chronotype at baseline was associated with higher odds of developing any pain (odds ratio [OR] = 1.06, 95% confidence interval [CI] = 1.01, 1.11), moderate-to-severe pain (OR = 1.10, 95% CI = 1.05-1.17), and multiregion pain (OR = 1.08, 95% CI = 1.02-1.14) during 1-year follow-up. In this diverse U.S. adolescent sample, later chronotype predicted higher incidence of new-onset pain.

Instruments to Identify Menstrual Complaints and Their Impact on Adolescents: A Systematic Review

STUDY OBJECTIVE

The aim of this review was to create an overview of available instruments used to evaluate the menstrual complaints of dysmenorrhea and heavy menstrual bleeding (HMB) in adolescents.

METHODS

The search was conducted in PubMed, Web of Science, Embase, and PsycINFO on December 1, 2022. Studies published in English reporting on menstrual complaints among girls aged 10-19 were included. The quality and bias risk was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2.

RESULTS

Of 8994 identified studies, 57 were included. In these studies, 19 instruments were described, of which 8 were validated in adolescents. One was difficult to use in daily practice, 1 had low sensitivity and specificity in the detection of HMB, 2 were validated by face validity, and 2 were not specifically developed to evaluate (the impact of) menstrual complaints. Therefore, only 2 were validated and feasible to measure adolescent menstrual complaints: the Period ImPact and Pain Assessment (PIPPA) and the Adolescent Menstrual Bleeding Questionnaire (aMBQ). Remarkably, the Pictorial Blood Loss Assessment Chart (PBAC) was the most frequently used instrument in adolescents. There was one modified version of the PBAC for adolescents, which had a lower cutoff value for HMB and low sensitivity and specificity.

CONCLUSION

We found that the PIPPA and aMBQ are suitable for assessing menstrual complaints and their impact on daily activities and health-related quality of life in adolescents. The PBAC, which is used frequently in adults, needs to be further assessed specifically for adolescents. In particular, the clinical relevance of the PBAC cutoff value for HMB should be determined for this age group. Considering the different interpretations, experiences, and limited knowledge of menstrual complaints, instruments suitable for adults may not be suitable for adolescents.

Associations of chronotype and insomnia with menstrual problems in newly employed nurses at university hospitals in the Republic of Korea

Background

Dysmenorrhea and menstrual cycle changes occur in women working shifts. Circadian rhythm disruption and sleep disturbances associated with shift work leads to health problems. We identified chronotypes and the occurrence of insomnia among newly employed university hospital nurses and investigated the association of these factors with menstrual problems.

Methods

We conducted pre-placement health examinations for shift workers using self-reported questionnaires between 2018 and 2020. A total of 463 nurses were included in the study. Sociodemographic data, shift work experience, and information on insomnia were collected from health examination data. In addition, details regarding chronotype, dysmenorrhea, irregular and abnormal menstrual cycles, amenorrhea, and contraceptive use were obtained from the questionnaire. Multiple logistic regression analysis was performed to study the association between chronotype, insomnia, and menstrual problems after controlling for age, body mass index, contraceptive use, amenorrhea, and prior shift work.

Results

The prevalence rates of dysmenorrhea, irregular menstrual cycles, and longer menstrual cycles were 23.8%, 14.9%, and 4.1%, respectively. The risk of dysmenorrhea increased in the evening-type (odds ratio [OR]: 3.209; 95% confidence interval [CI]: 1.685-6.113) and those with insomnia (OR: 1.871; 95% CI: 1.074-3.261). Additionally, the risk of an irregular menstrual cycle (OR: 2.698; 95% CI: 1.167-6.237) increased in the evening-type, and the risk of a longer menstrual cycle (OR: 4.008; 95% CI: 1.354-11.864) increased in individuals with insomnia.

Conclusions

Our findings suggest that dysmenorrhea is promoted in the evening-type and insomnia individuals. There may be an increased risk of irregular menstrual cycles among evening-type nurses and an increased risk of longer menstrual cycles among those with insomnia. Therefore, factors such as evening-type and insomnia should be considered for the prevention of menstrual problems in women performing shift work.

Changes in menstrual cycle length and in sleep-wake behaviors during COVID-19 related lockdown in Israel

COVID-19 related lockdowns changed our life. Studies report that young women are more susceptible to lockdown-induced adverse effects and stress. As stress and menstrual cycle are associated, we hypothesized that menstrual cycle length might change during lockdown. We examined menstrual cycle length, and sleep-wake behaviors during lockdown in Israel. Participants were 97 women in their fertile years who used Tempdrop fertility sensor™ to track cycles. Data were collected before, during and after lockdown in Israel. Our main finding is that lockdown was associated with changes in menstrual cycle length of most participants, with either increased of decreased length. Changes were reversed when lockdown was terminated. Sleep duration increased during lockdown but we found no relationship between sleep and menstrual cycle. We suggest these findings contribute to the understanding of the relationship between stress, sleep, and menstrual cycle. Further studies should explore the sources for differential effects in sub-groups of women.

Human fertility and sleep disturbances: A narrative review

INTRODUCTION

Many factors may be hidden behind the global fertility decline observed in Western countries. Alongside the progressively increased age of infertile couples, environmental and behavioural factors, including non-optimal lifestyle habits, should be considered. Among these, sleep disorders have been suggested to be linked to human fertility.

METHODS

This is a narrative review, describing first sleep physiology, its disturbances, and the tools able to quantify sleep dysfunction. Then, we consider all available studies aimed at investigating the connection between sleep disorders and human fertility, providing a comprehensive view on this topic.

RESULTS

Forty-two studies investigating the relationship between sleep habits and human reproduction were included. All the published evidence was grouped according to the aspect of human fertility considered, i.e. i) female reproductive functions, ii) male reproductive functions, iii) natural conception and iv) assisted reproduction. For each of the sub-groups considered, the connection between sleep dysregulation and human fertility was classified according to specific sleep characteristics, such as sleep duration, quality, and habits. In addition, possible physio-pathological mechanisms proposed to support the link between sleep and fertility were summarized.

CONCLUSION

This review summarizes the most relevant findings about the intricate and still largely unknown network of molecular pathways involved in the regulation of circadian homeostasis, to which sleep contributes, essential for reproductive physiology. Thus, many mechanisms seem correlate sleep disorders to reproductive health, such as adrenal activation, circadian dysregulation, and genetic influences. This review highlights the need to properly designed trials on the topic.

Menstrual regularity and bleeding is associated with sleep duration, sleep quality and fatigue in a community sample

Female menstrual health and its relationship with sleep is an understudied subject. The aim of this investigation was to determine the association between the two in a community sample. Data were obtained from n = 579 menstruating females who participated in the Sleep and Health Activity, Diet, Environment, and Socialization (SHADES) study, a community-based sample of adults aged 22-60 years. Participants were asked, "How regular is your period?", with response choices of "very regular", "mostly regular", "fairly regular" and "not regular". They were also asked, "How much bleeding do you usually experience during your period?" Response choices were: "very heavy", "heavy", "medium", "light" or "very light". These were evaluated as ordinal outcomes. Sleep-related predictors included sleep duration (in hr; ≤ 6 [short], 7-9 [normal] and ≥ 9 [long]), Insomnia Severity Index score, Pittsburgh Sleep Quality Index score, Epworth Sleepiness Scale score and Fatigue Severity Scale score. Covariates included age, education, income, race/ethnicity and body mass index. Short sleep duration was associated with heavier bleeding (odds ratio = 1.46, p = 0.026) and greater cycle irregularity (odds ratio = 1.44, p = 0.031) as compared with normal sleep. Higher Pittsburgh Sleep Quality Index score was associated with greater cycle irregularity (odds ratio = 1.05, p = 0.022). Higher Fatigue Severity Scale score was associated with heavier bleeding (odds ratio = 1.02, p = 0.003) and greater cycle irregularity (odds ratio = 1.02, p = 0.008). Long sleep, Insomnia Severity Index and Epworth Sleepiness Scale were not associated with either outcome. These results demonstrate an association between short sleep duration, poor sleep quality, fatigue, stress and depression with heavier bleeding and menstrual cycle irregularity, highlighting the need for further studies to improve treatment options.

The mediating effect of cognitive appraisal on the relationship between sleep habits and the stress response among Japanese female college students

Background

Undergraduate students tend to develop “evening-type” sleep patterns. Recent research has reported that evening-type and irregular sleep habits are related to physical and mental stress responses, particularly in female students. Although the connection between sleep habits and the stress response has been well documented, the mechanism behind this relationship is currently unknown. Using the transactional model as a framework and female students as our target population, we examined whether sleep habits predict the stress response through the mediation of cognitive appraisals of one’s own sleep habits.

Methods

Three hundred twenty-one Japanese female college students participated in this study. Participants completed measures of their sleep habits (sleep patterns and sleep irregularity), cognitive appraisals of their sleep habits (including four subscales: commitment, appraisal of influence, appraisal of threat, and controllability), stress responses (depression and anxiety), and control factors. The reliability and validity of the scales used in this study, except for sleep pattern and sleep irregularity, were confirmed in previous studies.

Results

Multiple-mediation-model analysis indicated that commitment mediates the relationship between sleep pattern and anxiety. Meanwhile, cognitive appraisals, as a whole, were found to have a mediating effect on the relationship between sleep irregularity and depression.

Conclusions

Our study revealed that cognitive appraisals mediated the relationship between sleep habits and the stress response. The findings also suggest that maintaining a low level of commitment might be effective for reducing anxiety, especially considering the difficulty associated with changing lifestyles. The findings of the present study should be useful for health education related to lifestyle.

Impact of sleep on female and male reproductive functions: a systematic review

OBJECTIVE

To evaluate the association of sleep parameters on female and male reproductive functions.

DESIGN

Systematic review.

SETTING

Not applicable.

PATIENT(S)

Female and male individuals, either healthy or infertile.

INTERVENTION(S)

Relevant articles were identified according to the The Preferred Reporting Items for Systematic Reviews and Meta-analyses recommendations in the PubMed and EMBASE databases from January 1, 2000 to June 8, 2020.

MAIN OUTCOME MEASURE(S)

The association between sleep and ovary function, spermatic function, natural fertility, and in vitro fertilization (IVF) outcomes was assessed.

RESULT(S)

A total of 33 studies that looked at the association between sleep and either ovary function (n = 10), spermatic function (n = 12), natural fertility (n = 5), or IVF outcomes (n = 6) were included. Overall, female and male fertility, as well as IVF outcomes may be affected by short sleep duration, evening chronotype, or shift/night work schedules. However, the results were hardly comparable due to the heterogeneous study methodologies used.

CONCLUSION(S)

Sleep may be an original and innovative parameter to consider in the reproduction field. Further investigation is needed to elucidate how sleep and fertility are interrelated and how sleep might constitute a useful modifiable target in infertility management.

Measures of circadian preference in childhood and adolescence: A review

Purpose

To review the psychometric properties of the questionnaires commonly filled in by children and adolescents to measure circadian preference.

Methods

We examined the Morningness-Eveningness Questionnaire for Children and Adolescents (MEQ-CA), the Morningness-Eveningness Scale for Children (MESC) and the Composite Scale of Morningness (CSM). We critically analyzed the reliability, in term of internal consistency (through the Cronbach's alpha) and test-retest reliability (through the correlation coefficient), and the type of validation against external criteria (objective assessment of the sleep/wake cycle, body temperature, hormones and other questionnaires). Fifty studies that reported these data were included in the review: 7 studies used the MEQ-CA, 28 used the MESC and 15 used the CSM.

Results

The percentage of studies reporting at least acceptable levels of internal consistency was high and similar between the three questionnaires. Evidence for test-retest reliability was scant, since only 3 studies were available; it was at least acceptable for the MESC (two studies with a time interval of 1 month), not acceptable for the MEQ-CA (one study with a time interval of 6 months), while no information was available for the CSM. As regards the validation evidence, the MEQ-CA has been validated by the highest number of external criteria (actigraphy, oral body temperature and other questionnaires), followed by the CSM (cortisol sampling and other questionnaires). The MESC has been validated only against self-report measures.

Conclusions

The present state of the art would suggest the use of the MEQ-CA to assess circadian preference in children and adolescents.

Morning chronotype is a protective factor against chemotherapy-induced hot flashes in premenopausal women with breast cancer

PURPOSE

Adjuvant chemotherapy in patients with breast cancer often causes hot flashes, impairing quality of life. However, the chronobiological or psychiatric factors associated with the development of chemotherapy-induced hot flashes (CIHFs) remain undetermined. The purpose of this study was to investigate whether chronotype was associated with the incidence of CIHFs.

METHODS

A total of 119 premenopausal women with non-metastatic breast cancer awaiting adjuvant chemotherapy after surgery without hot flashes were included. The presence of CIHF was defined as having moderate to severe hot flashes, as measured by the subscale of hot flashes in the Menopause Rating Scale, at 4 weeks after the completion of chemotherapy. Chronotype (Morning/Intermediate/Evening) was assessed with the Composite Scale of Morningness before adjuvant chemotherapy. To examine the association between chronotype and CIHF, we built logistic regression models, adjusting for age, body mass index, sleep quality, and radiation therapy.

RESULTS

CIHF occurred in 50.4% of participants. Morning type was inversely associated with CIHF (reference: Intermediate type, odds ratio [OR], 0.37; 95% confidence interval [CI], 0.16-0.94; p = 0.040) in the univariate model, and the association remained significant (OR, 0.37; CI, 0.13-0.96; p = 0.045) after adjusting for age, body mass index, sleep quality, and radiation therapy.

CONCLUSIONS

Morning chronotype is a protective factor against the development of CIHF in patients with breast cancer. Chronotypes should be assessed and considered in the prediction and management of CIHF.

Prevalence and Predictors of Dysmenorrhea, Its Effect, and Coping Mechanisms among Adolescents in Shai Osudoku District, Ghana

Background

Dysmenorrhea has been the most common gynecological problem worldwide. Reports of dysmenorrhea are greatest among individuals in their late teens and 20s and usually declining with age. It has also been reported that dysmenorrhea affects more than 80% of women in the reproductive age. The study objective was to examine the predictors of dysmenorrhea, its effect, and coping mechanisms among adolescents in Shai Osudoku District, Ghana.

Methods

We conducted a cross-sectional study in September and November 2017 in selected schools in Shai Osudoku District, Ghana. We employed self-administered questionnaire to obtain data from adolescents volunteered to participate in the study. We analyzed the data using the SPSS programme IBM version 20. We used the Pearson chi-square test and multiple logistic regression analysis to assess the association between exposure variables and the outcome variable. The odds ratio was reported to establish the risk of dysmenorrhea at a confidence interval of 95%, and statistical significance was assumed at p < 0.05.

Results

The prevalence of dysmenorrhea was 68.1% (95% CI, 65.0–72.0) with one-third recounting their pain as severe. The pain during menstruation negatively influences the daily physical activities (22.5%), school attendance (6.9%), concentration during classes' hours (27.9%), and academic performance (31.1%) of the respondents. Besides, adolescents who do not live with their parent experienced a 53.1% increase in odds of self-reporting dysmenorrhea (AOR, 1.53 (95% CI, 1.02–2.23)). Similarly, respondents who had irregular menstrual cycle experienced a 72.5% increase in odds of self-reporting dysmenorrhea (AOR, 1.73 (95% CI, 1.16–2.57)). Finally, a significant association between irregular menstrual cycle (p < 0.01), not lived with their parent (p < 0.04), and self-reported dysmenorrhea was found.

Conclusion

This study establishes that dysmenorrhea is high among adolescents in Shai Osudoku District which negatively affects the daily activity of majority of them.

Social jetlag and quality of life among nursing students: A cross-sectional study

AIMS

To investigate chronotype categories and social jetlag among nursing students and to identify associations between rhythm asynchrony and participants' physical and psychological health, academic performance and quality of life.

BACKGROUND

Social jetlag refers to the asynchrony between chronotypes and social working hours, resulting in a misalignment of biological and social time. Recent studies have reported possible changes in psychosocial functioning owing to social jetlag. Therefore, the present study investigated chronotypes and the extent of social jetlag among nursing students.

DESIGN

A cross-sectional study was conducted in 2015 with a sample of 346 nursing students in two universities in Korea.

METHODS

Social jetlag and quality of life were measured with the Munich Chronotype Questionnaire and the abbreviated version of the World Health Organization Quality of Life Scale, respectively, in the year 2015. Data analysis was mainly based on a multiple regression to identify social jetlag's influence on students' quality of life.

RESULTS

Average social jetlag was 1 hr - 36 min. Social jetlag was negatively correlated with chronotype, academic performance and quality of life. A multiple regression analysis revealed that social jetlag, a positive emotional state, recovery resilience and depressive symptoms affected students' quality of life. These variables accounted for 41.7% of the variance in quality of life.

CONCLUSIONS

Results suggest that decreases in social jetlag and depressive symptoms, as well as increases in the positive emotional state and recovery resilience, enhance students' quality of life.

More than just sleeping in: a late timing of sleep is associated with health problems and unhealthy behaviours in adolescents

OBJECTIVE

New research suggests that the timing of sleep, or chronotype, affects the mental well-being of adolescents, however evidence of its links to physical health is limited. We investigated the associations between chronotype and various health outcomes and behaviours in a national sample of Canadian adolescents.

METHODS

Data were from the 2014 Canadian Health Behaviour in School-Aged Children survey (29,470 students; ages 10-18). Chronotype was estimated using the midpoint of sleep on weekends, corrected for catch-up sleep. We tested the associations with physical health (headache, stomach ache, back ache, dizziness, overweight, self-rated health) and health behaviours (consumption of fruits, vegetables, sweets, soft drinks, and energy drinks, smoking, physical activity, screen time) using random-effects regressions adjusted for sleep duration and individual, family, and school characteristics.

RESULTS

The average chronotype was 4:11 a.m. for boys and 4:10 for girls. Each 1-h delay in chronotype was associated with more headaches, stomach aches, and back aches [proportional odds ratios (PropORs) 1.08, 1.08, 1.07, respectively (boys), 1.10, 1.10, 1.08, respectively (girls)], and dizziness and worse self-rated health in girls (PropORs 1.10 and 1.09, respectively), but not overweight. A 1-h delay in chronotype also related to daily soft drink consumption [ORs 1.17 (boys), 1.11 (girls)], smoking [ORs 1.23 (boys), 1.37 (girls)], screen time [additional 0.64 h (boys), 0.74 h (girls)], less vegetable consumption in boys (OR 0.96), and daily energy drink consumption in girls (OR 1.42).

CONCLUSION

A later chronotype related to worse physical health and unhealthy behaviours in Canadian adolescents. Studies are needed to clarify the underlying mechanisms.

Psychometric properties of Persian version of Composite Scale of Morningness

BACKGROUND

Morningness-eveningness preference is commonly measured by questionnaires such as the Composite Scale of Morningness (CSM). The purpose of this study is to assess the Persian translation of the CSM and explore its psychometric properties.

METHOD

Participants consisted of 288 students at the University of Bojnord, Iran. Of the participants selected, 47.6% were female, 52.4% were male, and all were aged between 18 and 24 (20.09±1.32). Participants were selected using the stratified random sampling method. The scale was translated into Persian using the parallel translation method. SPSS-22 and AMOS-22 were used for analyses.

RESULTS

Mean CSM scores were 31.43±6.32 in a range of 14-50. Internal reliability, as measured by Cronbach's α, was 0.790, which fits well with previous studies undertaken in many countries. The factor analysis revealed a two-factor structure based on parallel analysis: one factor was labeled as "morning affect" and the other as "self-assessment/activity planning." Also, the confirmatory factor analysis supported the two-factor model fit. Construct validity was also evaluated by the MEQ with the results showing that correlations were comparable to other studies (r=0.76). Results did not show any significant correlation between age (r=0.041; P=0.487) and the CSM scores. According to the results of the t-test, women and men were not significantly different in terms of the CSM scores (t=-0.264; P=0.792).

CONCLUSIONS

The Persian version of the CSM is freely available and can be adopted for behavioral research related to sleep and circadian function and also applied to other Persian-speaking populations.

Fatigue correlates with the decrease in parasympathetic sinus modulation induced by a cognitive challenge

Background

It is known that enhancement of sympathetic nerve activity based on a decrease in parasympathetic nerve activity is associated with fatigue induced by mental tasks lasting more than 30 min. However, to measure autonomic nerve function and assess fatigue levels in both clinical and industrial settings, shorter experimental durations and more sensitive measurement methods are needed. The aim of the present study was to establish an improved method for inducing fatigue and evaluating the association between it and autonomic nerve activity.

Methods

Twenty-eight healthy female college students participated in the study. We used a kana pick-out test (KPT) as a brief verbal cognitive task and recorded electrocardiography (ECG) to measure autonomic nerve activity. The experimental design consisted of a 16-min period of ECG: A pre-task resting state with eyes open for 3 min and eyes closed for 3 min, the 4-min KPT, and a post-task resting state with eyes open for 3 min and eyes closed for 3 min.

Results

Baseline fatigue sensation, measured by a visual analogue scale before the experiment, was associated with the decrease in parasympathetic sinus modulation, as indicated the by ratio of low-frequency component power (LF) to high-frequency component power (HF), during the KPT. The LF/HF ratio during the post-KPT rest with eyes open tended to be greater than the ratio during the KPT and correlated with fatigue sensation. Fatigue sensation was correlated negatively with log-transformed HF, which is an index of parasympathetic sinus modulation, during the post-KPT rest with eyes open.

Conclusions

The methods described here are useful for assessing the association between fatigue sensation and autonomic nerve activity using a brief cognitive test in healthy females.

Relationships among circadian typology, psychological symptoms, and sensation seeking

Recently, attention has been focused on the relationship among circadian typology, psychiatric symptoms, and personality traits. This study analyzes the influence of circadian typology on psychological distress, and the sensation-seeking personality trait. Five hundred seventeen college students (173 males), aged 17 to 30, answered the Composite Scale of Morningness (CSM), the General Health Questionnaire 28-item version (GHQ-28), and the Sensation Seeking Scale-V (SSS-V). The evening-type subjects in our sample scored higher than the neither- and morning- type in the GHQ-28 total score, as well as in the four subscales that composed it (Psychosomatic Symptoms, Anxiety and Insomnia, Social Dysfunction, and Severe Depression) (p<0.02 in all cases). The evening-type subjects also had a larger proportion of psychiatric cases than the other two circadian typologies (p<0.0001 in all cases). Moreover, the evening-type subjects obtained higher scores in the SSS-V total score and in the subscales of Disinhibition and Boredom Susceptibility (p<0.001 in all cases). A positive correlation was observed between the GHQ-28 and the SSS-V total scores in the total sample, but only for the evening-type group (r=0.217; p<0.027). In the evening group, several relations were also found between the subscales of the GHQ-28 and the subscales of the SSS-V (r>0.206; p<0.036). All these data point to a relationship between evening-type subjects and the level of psychological distress and the sensation-seeking personality trait. They also suggest that eveningness could be related to developing psychological distress and personality traits that could, in turn, be related to developing other problems, such as drug consumption.

Menstruation disturbances: prevalence, characteristics, and effects on the activities of daily living among adolescent girls from Brazil

STUDY OBJECTIVE

To determine the prevalence, characteristics and effects on the activities of daily living of menstruation disturbances among adolescent girls.

DESIGN

Descriptive, cross-sectional study.

SETTING

A public school in the city of Petrolina, Brazil.

PARTICIPANTS

218 female adolescents of ages between 12 and 17 years.

MAIN OUTCOME MEASURE

We used a structured questionnaire addressing the socio-demographic and menstrual characteristics of the adolescents. The intensity of menstrual pain and its effect on the activities of daily living were measured using an 11-point numeric rating scale.

RESULTS

The mean age of adolescent girls was 13.7 ± 1.5 years. The menstrual cycles of 67% were regular, while 33% were irregular. Dysmenorrhea had a prevalence of 73%, and school absenteeism was observed among 31% of the adolescents. In addition, 66% of the participants considered that dysmenorrhea affected their activities of daily living. Associations were found between the intensity of pain and the variables: school absenteeism; affected activities of daily living; need to use medications; and between affected activities of daily living and school absenteeism (P < .05).

CONCLUSIONS

Among the menstrual disturbances observed dysmenorrhea stood out due to its high prevalence among adolescents with a negative effect on adolescents' activities of daily living. Early diagnosis and knowledge about menstrual disturbances are essential because in addition to reiterating the importance of implementing health education actions, they also help to choose appropriate treatments, thus minimizing the negative effects of these disturbances on the lives of adolescents.

Morning types are less sensitive to pain than evening types all day long

BACKGROUND

Diurnal variations in pain have been observed in experimental protocols, post-surgery states and pathological conditions. Chronotype is considered to have the most profound effect on diurnal variations, and in addition, previous studies suggest that evening types may be more vulnerable to pain than morning types. This study aimed to examine whether or not morning and evening chronotypes differ in terms of their daily levels and diurnal fluctuations of pain sensitivity.

METHODS

A total of 16 morning-healthy and 15 evening-healthy men were selected using the Morningness-Eveningness Questionnaire and underwent nine measurements during 1 day (between 08:15 and 20:15 h), each consisting of five heat stimuli situated at the ventral side of the wrist.

RESULTS

A marked difference between chronotypes was found, with morning types showing less sensitivity to pain than evening types all day long [M = 50.1; standard error (SE) = 1 and M = 47.2; SE = 1, respectively; pain thresholds in centigrade]. Diurnal variations in pain were not statistically significant.

CONCLUSIONS

The results showed that chronotype could be an important factor determining sensitivity to pain, regardless of time of day.

Night eating patterns and chronotypes: a correlation with binge eating behaviors

This cross-sectional study examined the association between the morningness/eveningness dimension and eating patterns. The sample consists of 100 subjects who were screened at a nutrition clinic and was composed of 77% women; mean age was 39.5 (±11.7) years; and 66% were overweight. Significant bivariate correlations were found between the Morningness-Eveningness Questionnaire (MEQ) total score and the Binge Eating Scale (BES) and the Night Eating Questionnaire (NEQ). The NEQ and BES were also significantly correlated. Body mass index (BMI) was correlated with the NEQ and BES, but it was not a confounding variable as no associations were found between the MEQ and BMI. To control for potential multicollinearity effects among variables, we also used multivariate regression analysis in which the values of the correlation coefficients were adjusted. Only the BES remained statistically associated with the MEQ. In conclusion, these results suggest that the study of chronotype may be an important issue to be considered when characterizing disordered eating. This study serves as an impetus for examining circadian intake patterns in more detail between those with binge eating disorder (BED) and night eating syndrome (NES) to help discern these important nosological questions.

Circadian typology: a comprehensive review

The interest in the systematic study of the circadian typology (CT) is relatively recent and has developed rapidly in the two last decades. All the existing data suggest that this individual difference affects our biological and psychological functioning, not only in health, but also in disease. In the present study, we review the current literature concerning the psychometric properties and validity of CT measures as well as individual, environmental and genetic factors that influence the CT. We present a brief overview of the biological markers that are used to define differences between CT groups (sleep-wake cycle, body temperature, cortisol and melatonin), and we assess the implications for CT and adjustment to shiftwork and jet lag. We also review the differences between CT in terms of cognitive abilities, personality traits and the incidence of psychiatric disorders. When necessary, we have emphasized the methodological limitations that exist today and suggested some future avenues of work in order to overcome these. This is a new field of interest to professionals in many different areas (research, labor, academic and clinical), and this review provides a state of the art discussion to allow professionals to integrate chronobiological aspects of human behavior into their daily practice.

Morningness/eveningness, pubertal timing, and substance use in adolescent girls

The purpose of this study was to examine the associations between Morningness/Eveningness (M/E; a measure of sleep-wake preference) and alcohol, cigarette, and marijuana use as well as the interaction of M/E and pubertal timing. The data represent baseline measures from a longitudinal study examining the association of psychological functioning and smoking with reproductive and bone health in 262 adolescent girls (11-17 years). The primary measures used for this study were pubertal timing (measured by age at menarche), the Morningness/Eveningness scale, and substance use (alcohol, cigarettes, and marijuana). Multiple group path modeling showed that there was a significant interaction between pubertal timing and M/E on cigarette use. The direction of the parameter estimates indicated that for the early and on-time groups, Evening preference was associated with more cigarette use. For the late timing group the association was not significant. The results point to the need to consider sleep preference as a characteristic that may increase risk for substance use in adolescents.