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Cheung FTW, Sit HF, Li X, Chan JWY, Chan NY, Wing YK, Li SX. A Longitudinal Examination between Chronotype and Insomnia in Youths: A Cross-Lagged Panel Analysis. Clocks Sleep 2024; 6:557-567. [PMID: 39449311 PMCID: PMC11503325 DOI: 10.3390/clockssleep6040037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 09/24/2024] [Accepted: 10/01/2024] [Indexed: 10/26/2024] Open
Abstract
Adolescence and young adulthood are transitional periods associated with significant changes and challenges, leading to a heightened vulnerability to sleep disturbances and mental health difficulties. This stage is often associated with an increased preference for eveningness, manifested as a later chronotype. The current study aimed to investigate the directionality of the association between chronotype, based on an individual's sleep-wake behaviour, and insomnia in young people using a two-wave panel design with a 12-month interval. A total of 370 participants aged 15-24 (mean age: 21.0 ± 2.0, 72.7% female) were recruited from local secondary schools and universities. Insomnia symptoms were assessed using the Insomnia Severity Index, while chronotype was measured using the Munich Chronotype Questionnaire. Temporal associations were analysed using a series of cross-lagged panel models. The best fitting and most parsimonious model indicated that a later chronotype at baseline predicts more severe insomnia symptoms at the 12-month follow-up after accounting for autoregressive effects. However, the opposite causal model, where baseline insomnia symptoms predicted the chronotype at the 12-month follow-up, was not supported. These findings suggest that a late chronotype may be a potential risk factor for the development of insomnia in young people, emphasising the importance of considering circadian factors in the prevention and treatment of sleep disturbances among this population.
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Affiliation(s)
- Forrest Tin Wai Cheung
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong; (F.T.W.C.); (H.F.S.); (X.L.)
| | - Hao Fong Sit
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong; (F.T.W.C.); (H.F.S.); (X.L.)
| | - Xiao Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong; (F.T.W.C.); (H.F.S.); (X.L.)
| | - Joey Wing Yan Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; (J.W.Y.C.); (N.Y.C.); (Y.K.W.)
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; (J.W.Y.C.); (N.Y.C.); (Y.K.W.)
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; (J.W.Y.C.); (N.Y.C.); (Y.K.W.)
| | - Shirley Xin Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong; (F.T.W.C.); (H.F.S.); (X.L.)
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
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Feng Y, Xue Q, Yu P, Peng L. The Relationship Between Epidemic Perception and Cyberbullying Behaviors of Chinese Adolescents During the COVID-19 Pandemic: Cross-Sectional Study. JMIR Public Health Surveill 2024; 10:e54066. [PMID: 39356494 PMCID: PMC11463192 DOI: 10.2196/54066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 07/10/2024] [Accepted: 07/11/2024] [Indexed: 10/03/2024] Open
Abstract
Background In response to the COVID-19 outbreak, the government initiated measures for social distancing, leading to a gradual transition of adolescents' social interactions toward web-based platforms. Consequently, web-based behaviors, particularly cyberbullying, have become a prominent concern. Considering that adolescents experience more intense feelings, the widely increased negative emotions and strains perceived from the COVID-19 pandemic may end up engaging in cyberbullying behaviors. In addition, during the COVID-19 pandemic, adolescents experiencing insomnia and negative affect are more prone to diminished self-control, which is associated with cyberbullying behaviors. Objective This study aims to investigate the relationship between epidemic perception and cyberbullying behaviors, while also examining the serial mediating roles of insomnia and negative affect on the relationship between epidemic perception and cyberbullying behaviors. Methods This study presents a large-scale web-based survey conducted during the period of concentrated COVID-19 outbreaks, encompassing 20,000 Chinese adolescents. A total of 274 submitted questionnaires were discarded because of high levels of missing data or their answers were clearly fictitious or inconsistent. The final count of valid participants amounted to 19,726 (10,371 boys, age range: 12-18 years; mean 14.80, SD 1.63 years). The Perceptions of COVID-19 Scale, Negative Affect Scale, Insomnia Scale, and Cyberbullying Behavior Scale were used to assess participants' responses on the Questionnaire Star platform. Results The results show that epidemic perception is positively correlated with cyberbullying behaviors (r=0.13; P<.001), insomnia (r=0.19; P<.001), and negative affect (r=0.25; P<.001). Insomnia is positively correlated with negative affect (r=0.44; P<.001) and cyberbullying behaviors (r=0.30; P<.001). Negative affect is positively correlated with cyberbullying behaviors (r=0.25; P<.001). And insomnia and negative affect play independent mediating and serial mediating roles in epidemic perception and cyberbullying behaviors. Conclusions This study provides additional empirical evidence on the relationship between the perception of COVID-19 pandemic and cyberbullying in adolescents. In addition, the study offers recommendations for implementing interventions targeted at mitigating cyberbullying in adolescents during the COVID-19 pandemic.
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Affiliation(s)
- Yonggang Feng
- Faculty of Education, Shandong Normal University, No.88 Wenhua East Road, Lixia District, Jinan, 250014, China, 86 531-86182177
| | - Qihui Xue
- College of Ethnology and Sociology, South-Central Minzu University, Wuhan, China
| | - Peng Yu
- School of Education Science, Kashi University, Kashi, China
| | - Lanxiang Peng
- Faculty of Education, Shandong Normal University, No.88 Wenhua East Road, Lixia District, Jinan, 250014, China, 86 531-86182177
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Nakajima S, Otsuka Y, Itani O, Kaneko Y, Suzuki M, Kaneita Y. Association between commuting and mental health among Japanese adolescents. Psychiatry Clin Neurosci 2024; 78:588-594. [PMID: 39049611 DOI: 10.1111/pcn.13714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 06/08/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024]
Abstract
AIM Mental health issues in adolescence contribute to various disease burdens later in life and are associated with violence, crime, and suicide. Activities such as sleep, diet, exercise, and time spent using electronic devices are related to declining mental health. However, few studies have examined the association between commuting times to school and mental health. This study tested the hypothesis that high school students' long commuting times are associated with poor mental health. METHOD A cross-sectional study was conducted between October and December 2022 among 2067 students at two private high schools. Survey items included participant information (sex, grade, school), commuting time, mental health status (Patient Health Questionnaire 9 [PHQ-9]: depressive symptoms, and Generalized Anxiety Disorder 7 [GAD-7]: anxiety symptoms), lifestyle factors, and sleep-related factors. RESULTS Data from 1899 high school students were analyzed. The prevalence of depressive and anxiety symptoms was 17.3% and 19.0%, respectively. A commuting time of ≥1 h was significantly associated with depressive symptoms (adjusted odds ratio: 1.60 [95% confidence interval]: 1.14-2.24) and anxiety symptoms (adjusted odds ratio: 1.51 [95% confidence interval]: 1.09-2.10). Sex, grade, use of ≥8 h/day of electronic devices, and chronotype were significantly associated with depressive symptoms, while sex, grade, use of ≥8 h/day of electronic devices, and insomnia were significantly associated with anxiety symptoms. CONCLUSION It is suggested that long commuting times are associated with poor mental health in high school students. Parents and schools should consider commuting time when advising students on school selection to maintain their mental health.
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Affiliation(s)
- Suguru Nakajima
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Yuichiro Otsuka
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Osamu Itani
- Department of Public Health, International University of Health and Welfare, Chiba, Japan
| | - Yoshiyuki Kaneko
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Masahiro Suzuki
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Yoshitaka Kaneita
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
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Chauhan S, Pandey R, Vakani K, Norbury R, Ettinger U, Kumari V. Sleep quality mediates the association between chronotype and mental health in young Indian adults. NPJ MENTAL HEALTH RESEARCH 2024; 3:31. [PMID: 38914742 PMCID: PMC11196584 DOI: 10.1038/s44184-024-00076-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 06/05/2024] [Indexed: 06/26/2024]
Abstract
There is increasing recognition of 'higher preference for eveningness' as a potential independent risk factor for poor mental health. To examine the chronotype-mental health relationship while also quantifying the potential roles of poor sleep quality, relevant personality traits, and childhood trauma, we assessed 282 young adults (18-40 years; 195 females) residing in North India, between January and March 2023 (to control for seasonal variation), using self-report measures of diurnal preference, sleep patterns, mental health (depression, anxiety, and stress), personality traits (extraversion, neuroticism, schizotypy, and impulsivity), and childhood trauma. The results showed a significant association between eveningness and poor mental health but this association was fully mediated by poor sleep quality. Neuroticism, emotional abuse and cognitive disorganisation were correlated with eveningness as well as with poor mental health and sleep quality. Neuroticism and emotional abuse, but not cognitive disorganisation, also had indirect effects on mental health via sleep quality. Our findings highlight the crucial role played by sleep quality in the chronotype-mental health relationship.
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Affiliation(s)
- Satyam Chauhan
- Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
- Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
| | - Rakesh Pandey
- Department of Psychology, Faculty of Social Sciences, Banaras Hindu University, Varanasi, India
| | - Krupa Vakani
- Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
- Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Ray Norbury
- Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
- Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | | | - Veena Kumari
- Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
- Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
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Naufel MF, Pedroso AP, de Souza AP, Boldarine VT, Oyama LM, Lo Turco EG, Hachul H, Ribeiro EB, Telles MM. Targeted Analysis of Plasma Polar Metabolites in Postmenopausal Depression. Metabolites 2024; 14:286. [PMID: 38786763 PMCID: PMC11123176 DOI: 10.3390/metabo14050286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/19/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
Depression will be the disease with the highest incidence worldwide by 2030. Data indicate that postmenopausal women have a higher incidence of mood disorders, and this high vulnerability seems to be related to hormonal changes and weight gain. Although research evaluating the profile of metabolites in mood disorders is advancing, further research, maintaining consistent methodology, is necessary to reach a consensus. Therefore, the objective of the present study was to carry out an exploratory analysis of the plasma polar metabolites of pre- and postmenopausal women to explore whether the profile is affected by depression. The plasma analysis of 50 polar metabolites was carried out in a total of 67 postmenopausal women, aged between 50 and 65 years, either without depression (n = 25) or with depression symptoms (n = 42), which had spontaneous onset of menopause and were not in use of hormone replacement therapy, insulin, or antidepressants; and in 42 healthy premenopausal women (21 without depression and 21 with depression symptoms), aged between 40 and 50 years and who were not in use of contraceptives, insulin, or antidepressants. Ten metabolites were significantly affected by depression symptoms postmenopause, including adenosine (FDR = 3.778 × 10-14), guanosine (FDR = 3.001 × 10-14), proline (FDR = 1.430 × 10-6), citrulline (FDR = 0.0001), lysine (FDR = 0.0004), and carnitine (FDR = 0.0331), which were down-regulated, and dimethylglycine (FDR = 0.0022), glutathione (FDR = 0.0048), creatine (FDR = 0.0286), and methionine (FDR = 0.0484) that were up-regulated. In premenopausal women with depression, oxidized glutathione (FDR = 0.0137) was down-regulated, and dimethylglycine (FDR = 0.0406) and 4-hydroxyproline (FDR = 0.0433) were up-regulated. The present study provided new data concerning the consequences of depression on plasma polar metabolites before and after the establishment of menopause. The results demonstrated that the postmenopausal condition presented more alterations than the premenopausal period and may indicate future measures to treat the disturbances involved in both menopause and depression.
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Affiliation(s)
- Maria Fernanda Naufel
- Department of Physiology, Universidade Federal de São Paulo (UNIFESP-EPM), Rua Botucatu 862, Vila Clementino, São Paulo 04023-062, SP, Brazil; (A.P.P.); (A.P.d.S.); (V.T.B.); (L.M.O.); (M.M.T.)
| | - Amanda Paula Pedroso
- Department of Physiology, Universidade Federal de São Paulo (UNIFESP-EPM), Rua Botucatu 862, Vila Clementino, São Paulo 04023-062, SP, Brazil; (A.P.P.); (A.P.d.S.); (V.T.B.); (L.M.O.); (M.M.T.)
| | - Adriana Pereira de Souza
- Department of Physiology, Universidade Federal de São Paulo (UNIFESP-EPM), Rua Botucatu 862, Vila Clementino, São Paulo 04023-062, SP, Brazil; (A.P.P.); (A.P.d.S.); (V.T.B.); (L.M.O.); (M.M.T.)
| | - Valter Tadeu Boldarine
- Department of Physiology, Universidade Federal de São Paulo (UNIFESP-EPM), Rua Botucatu 862, Vila Clementino, São Paulo 04023-062, SP, Brazil; (A.P.P.); (A.P.d.S.); (V.T.B.); (L.M.O.); (M.M.T.)
| | - Lila Missae Oyama
- Department of Physiology, Universidade Federal de São Paulo (UNIFESP-EPM), Rua Botucatu 862, Vila Clementino, São Paulo 04023-062, SP, Brazil; (A.P.P.); (A.P.d.S.); (V.T.B.); (L.M.O.); (M.M.T.)
| | | | - Helena Hachul
- Department of Psychobiology, UNIFESP-EPM, São Paulo 04023-062, SP, Brazil;
- Department Gynaecology, UNIFESP-EPM, São Paulo 04023-062, SP, Brazil
| | - Eliane Beraldi Ribeiro
- Department of Physiology, Universidade Federal de São Paulo (UNIFESP-EPM), Rua Botucatu 862, Vila Clementino, São Paulo 04023-062, SP, Brazil; (A.P.P.); (A.P.d.S.); (V.T.B.); (L.M.O.); (M.M.T.)
| | - Mônica Marques Telles
- Department of Physiology, Universidade Federal de São Paulo (UNIFESP-EPM), Rua Botucatu 862, Vila Clementino, São Paulo 04023-062, SP, Brazil; (A.P.P.); (A.P.d.S.); (V.T.B.); (L.M.O.); (M.M.T.)
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Mao B, Xie Z, Liu M, Gong Y, Wang H, Yang S, Liao M, Xiao T, Tang S, Wang Y, Yang YD. Associations of chronotype with anxiety, depression and insomnia among general adult population: A cross-sectional study in Hubei, China. J Affect Disord 2024; 351:250-258. [PMID: 38280566 DOI: 10.1016/j.jad.2024.01.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 01/06/2024] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND The relationship between chronotype and anxiety, depression, and insomnia was inconsistent. We aimed to assess the association between chronotype and mental health and the potential moderating effect of age and socioeconomic status (SES). METHODS A multi-stage sampling cross-sectional study with 12,544 adults was conducted. Chronotype, anxiety, depression, and insomnia were investigated by 5-item Morning and Evening, 7-item Generalized Anxiety Disorder, 9-item Patient Health, and the 7-item Insomnia Severity Index Questionnaires. Logistic regression was conducted. RESULTS The predominant chronotype was morning chronotype (69.2 %), followed by 27.6 % intermediate and 3.2 % evening chronotype. The prevalence of anxiety, depression, and insomnia was 0.7 %, 1.9 %, and 9.6 %, respectively. Compared with intermediate chronotype, morning chronotype participants had a lower risk of anxiety (OR = 0.28,95%CI:0.18-0.44), depression (OR = 0.54,95%CI:0.41-0.72) and insomnia (OR = 0.67,95%CI:0.58-0.77), while evening chronotype participants had a higher risk of depression (OR = 1.98,95%CI:1.06-3.71) but not anxiety or insomnia. Interactions between chronotype with age and SES on insomnia (Pinteraction < 0.05) were found. A more profound association between morning chronotype and insomnia was observed in <65 years participants (OR = 0.59,95%CI:0.50-0.71) and those with monthly household income ≥10,000yuan (OR = 0.21,95%CI:0.12-0.35), compared with their counterparts. LIMITATIONS The cross-sectional design limited causal conclusions. Only adults were included; the findings could not be generalized to children. CONCLUSIONS The morning chronotype might be protective for anxiety, depression, and insomnia, while the evening chronotype might be a risk factor for depression. Future studies are needed to assess the efficacy of chronotype-focused intervention for mental health. Insomnia prevention efforts should pay more attention to the elderly and those with lower incomes.
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Affiliation(s)
- Bin Mao
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China
| | - Zhongliang Xie
- Department of Psychiatry, Honghu Mental Health Center, Shimatou Street 126, Honghu, Jingzhou 434021, China
| | - Mengjiao Liu
- School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang 330006, China; Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College, Nanchang University, Nanchang 330006, China
| | - Yue Gong
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China
| | - Huicai Wang
- Department of Psychiatry, Honghu Mental Health Center, Shimatou Street 126, Honghu, Jingzhou 434021, China
| | - Shuwang Yang
- Institute of Chronic Non-Communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Ming Liao
- Department of Psychiatry, Honghu Mental Health Center, Shimatou Street 126, Honghu, Jingzhou 434021, China
| | - Tianli Xiao
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China
| | - Shiming Tang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Ying Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Yi-De Yang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China..
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Li SX, Cheung FTW, Chan NY, Chan JWY, Zhang J, Li AM, Espie CA, Gradisar M, Wing YK. Effects of cognitive behavioural therapy and bright light therapy for insomnia in youths with eveningness: study protocol for a randomised controlled trial. Trials 2024; 25:246. [PMID: 38594725 PMCID: PMC11005158 DOI: 10.1186/s13063-024-08090-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/02/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Insomnia and eveningness are common and often comorbid conditions in youths. While cognitive behavioural therapy for insomnia (CBT-I) has been suggested as a promising intervention, it remains unclear whether it is sufficient to also address circadian issues in youths. In addition, despite that light has been shown to be effective in phase-shifting one's circadian rhythm, there has been limited data on the effects of bright light therapy and its combination with CBT-I on sleep and circadian outcomes in youths. The current protocol outlines a randomised controlled trial that examines the efficacy of CBT-I and CBT-I plus bright light therapy (BLT) in reducing insomnia severity, improving mood symptoms and daytime functioning (e.g. sleepiness, fatigue, cognitive function), and improving subjective and objective sleep and circadian measures compared to a waitlist control group. METHODS We will carry out a randomised controlled trial (RCT) with 150 youths aged 12-24 who meet the criteria of insomnia and eveningness. Participants will be randomised into one of three groups: CBT-I with bright light therapy, CBT-I with placebo light, and waitlist control. Six sessions of CBT-I will be delivered in a group format, while participants will be currently asked to use a portable light device for 30 min daily immediately after awakening throughout the intervention period for bright light therapy. The CBT-I with light therapy group will receive bright constant green light (506 lx) while the CBT-I with placebo light group will receive the modified light device with the LEDs emitting less than 10 lx. All participants will be assessed at baseline and post-treatment, while the two active treatment groups will be additionally followed up at 1 month and 6 months post-intervention. The primary outcome will be insomnia severity, as measured by the Insomnia Severity Index. Secondary outcomes include self-reported mood, circadian, daytime functioning, and quality of life measures, as well as sleep parameters derived from actigraphy and sleep diary and neurocognitive assessments. Objective measures of the circadian phase using dim-light melatonin onset assessment and sleep parameters using polysomnography will also be included as the secondary outcomes. DISCUSSION This study will be the first RCT to directly compare the effects of CBT-I and BLT in youths with insomnia and eveningness. Findings from the study will provide evidence to inform the clinical management of insomnia problems and eveningness in youths. TRIAL REGISTRATION ClinicalTrials.gov NCT04256915. Registered on 5 February 2020.
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Affiliation(s)
- Shirley Xin Li
- Department of Psychology, Sleep Research Clinic and Laboratory, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China.
| | - Forrest Tin Wai Cheung
- Department of Psychology, Sleep Research Clinic and Laboratory, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joey Wing Yan Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medicine University, Guangzhou, Guangdong, China
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Colin A Espie
- Nuffield Department of Clinical Neurosciences and Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
| | - Michael Gradisar
- WINK Sleep Pty Ltd, Adelaide, Australia
- Sleep Cycle AB, Gothenburg, Sweden
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Blouchou A, Chamou V, Eleftheriades C, Poulimeneas D, Kontouli KM, Gkiouras K, Bargiota A, Gkouskou KK, Rigopoulou E, Bogdanos DP, Goulis DG, Grammatikopoulou MG. Beat the Clock: Assessment of Night Eating Syndrome and Circadian Rhythm in a Sample of Greek Adults. Nutrients 2024; 16:187. [PMID: 38257080 PMCID: PMC10818804 DOI: 10.3390/nu16020187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/30/2023] [Accepted: 01/02/2024] [Indexed: 01/24/2024] Open
Abstract
The night eating syndrome (NES) is characterized by excessive food intake during the evening and night hours, with 25% of the daily intake being consumed post-dinner, paired with ep-isodes of nocturnal food intake, at a frequency of more than twice weekly. The NES has been associated with a misaligned circadian rhythm related to a delay in overall food intake, increased energy and fat consumption. The present cross-sectional study aimed to assess NES in a Greek population and evaluate possible links between NES and chronotype. NES was assessed using the Night Eating Questionnaire (NEQ), and circadian rhythm, sleep and mood were evaluated with the Sleep, Circadian Rhythms, and Mood (SCRAM) questionnaire. A total of 533 adults participated in the study. A relatively high prevalence of NES was revealed, with more than 8.1% (NEQ ≥ 30) of the participants reporting experiencing NES symptoms, depending on the NEQ threshold used. Most participants had the intermediate chronotype. NEQ score was positively associated with the morning chronotype, and SCRAM was negatively related to "Good Sleep". Each point increment in the depression score was associated with 6% higher odds of NES. The early identification of NES gains importance in clinical practice, in a collective effort aiming to reduce NES symptomatology and its detrimental health effects.
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Affiliation(s)
- Anastasia Blouchou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Sindos, GR-57400 Thessaloniki, Greece; (A.B.); (V.C.); (C.E.)
| | - Vasiliki Chamou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Sindos, GR-57400 Thessaloniki, Greece; (A.B.); (V.C.); (C.E.)
| | - Christos Eleftheriades
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Sindos, GR-57400 Thessaloniki, Greece; (A.B.); (V.C.); (C.E.)
| | - Dimitrios Poulimeneas
- Department of Nutritional Science and Dietetics, School of Health Sciences, University of the Peloponnese, GR-24100 Kalamata, Greece
| | - Katerina-Maria Kontouli
- Department of Primary Education, School of Education, University of Ioannina, GR-45110 Ioannina, Greece
| | - Konstantinos Gkiouras
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41223 Larissa, Greece
| | - Alexandra Bargiota
- Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, University of Thessaly, Biopolis, GR-41223 Larissa, Greece
| | - Kalliopi K. Gkouskou
- Laboratory of Biology, School of Medicine, National and Kapodistrian University of Athens, GR-11527 Athens, Greece;
- Genosophy, 1 Melissinon and Damvergidon Street, GR-71305 Heraklion, Crete, Greece
| | - Eirini Rigopoulou
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, Larissa University Hospital, Biopolis, GR-41334 Larissa, Greece
- European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Larissa University Hospital, Biopolis, GR-41334 Larissa, Greece
| | - Dimitrios P. Bogdanos
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41223 Larissa, Greece
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
| | - Maria G. Grammatikopoulou
- Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41223 Larissa, Greece
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece
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9
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Cheung FTW, Li X, Hui TK, Chan NY, Chan JW, Wing YK, Li SX. Circadian preference and mental health outcomes in youth: A systematic review and meta-analysis. Sleep Med Rev 2023; 72:101851. [PMID: 37793219 DOI: 10.1016/j.smrv.2023.101851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 07/10/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023]
Abstract
Youth is a vulnerable developmental period associated with an increased preference for eveningness and risk for developing psychopathology. Growing evidence suggests a link between eveningness and poorer mental health outcomes, but the findings in the current literature are inconsistent, and a comprehensive synthesis of evidence in this area remains lacking. This meta-analysis aimed to 1) synthesise the existing evidence on the association between circadian preference and mental health outcomes in youths and 2) explore potential sleep-related factors that may moderate the relationship between circadian preference and mental health outcomes. A systematic search of five electronic databases resulted in 81 observational studies included in the review. Eveningness was found to be significantly associated with general mental health (r = 0.20), mood-related disturbances (r = 0.17), and anxiety problems (r = 0.13). The qualitative review also identified that eveningness was associated with greater risks for psychotic symptoms and maladaptive eating behaviours. These findings highlighted the need to consider circadian preference in the clinical management of youth mental health problems. Further research is needed to examine the efficacy of a circadian-focused intervention in the context of youth mental health.
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Affiliation(s)
- Forrest Tin Wai Cheung
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong.
| | - Xiao Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong
| | - Tsz Kwan Hui
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Joey Wy Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Shirley Xin Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong.
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10
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Cruz-Sanabria F, Violi M, Bazzani A, Bruno S, Massoni L, Bertelloni CA, Dell'Oste V, Frumento P, Faraguna U, Dell'Osso L, Carmassi C. Chronotype is differentially associated with lifetime mood and panic-agoraphobic spectrum symptoms in patients with bipolar disorder and healthy controls. CNS Spectr 2023; 28:726-738. [PMID: 36942635 DOI: 10.1017/s1092852923001207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE Although the association between chronotype and mood disorders has been consistently reported, conversely, attempts to measure the association between chronotype and anxiety symptoms have generated inconsistent results. We aimed at evaluating whether chronotype (assessed through subjective and objective measures) is associated with lifetime mood and panic-agoraphobic spectrum symptoms in healthy controls (HCs) and in patients with bipolar disorder (BD). METHODS Overall, 173 subjects, patients with BD in euthymic phase (n = 76) and HC (n = 97), were evaluated through the reduced Morningness-Eveningness Questionnaire (rMEQ), actigraphy monitoring and mood and panic-agoraphobic spectrum self-report (MOODS-SR and PAS-SR). The discrepancy between objective (actigraphic-based) versus subjective (rMEQ-based) circadian typology was estimated through the Circadian Classification Discrepancy Index (CCDI). RESULTS rMEQ-based evening chronotype (ET) was associated with higher scores in MOODS-SR depressive and rhythmicity and vegetative functions domains in HC and BD.Both ET and morning chronotypes (MT) were associated with higher PAS-SR scores in BD only. Actigraphic-based MT was associated with higher MOODS-SR depressive scores in HC. Likewise, the discrepancy between actigraphic-based and rMEQ-based circadian typology was associated with depressive symptoms in HC only. CONCLUSION Self-reported ET was consistently associated with mood symptoms, while associations with panic-agoraphobic symptoms only emerged in BD and involved both extreme chronotypes. The discrepancy between the preferred circadian typology (rMEQ-based) and the actual one (actigraphic-based) could contribute to depressive symptoms in HC. These results pave the way for interventional studies targeting circadian typology in an attempt to prevent or treat mental health disorders.
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Affiliation(s)
- Francy Cruz-Sanabria
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Miriam Violi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Bazzani
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Simone Bruno
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Leonardo Massoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Valerio Dell'Oste
- Department of Biotechnology Chemistry and Pharmacy, University of Siena, Siena, Italy
| | - Paolo Frumento
- Department of Political Sciences, University of Pisa, Pisa, Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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11
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Sarsembayeva D, Hartman CA, Cardoso Melo RD, Schreuder MJ. Nonlinear associations between insomnia symptoms and circadian preferences in the general population: Symptom-specific and lifespan differences in men and women. Sleep Health 2023:S2352-7218(23)00244-9. [PMID: 38007303 DOI: 10.1016/j.sleh.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 09/26/2023] [Accepted: 10/18/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVES This study investigated (non)linear associations between different eveningness characteristics (bedtime, wake time, morning affect, and peak performance time) and insomnia symptoms (difficulties initiating sleep, difficulties maintaining sleep, and nonrestorative sleep) in a large general population sample. METHODS The data came from digital surveys about insomnia (Minimal Insomnia Scale) and circadian preferences (Children's Chronotype Questionnaire/Composite Scale of Morningness) completed by the Dutch general population (37,389 participants aged 4-91years, 42.4% men) in the Lifelines cohort substudy Comorbid Conditions of ADHD. RESULTS Using generalized additive modeling, we found that different characteristics of eveningness related to insomnia either exponentially (later wake time/peak performance time, worse morning affect) or quadratically (early and late bedtime/midpoint of sleep). While difficulties initiating sleep and nonrestorative sleep were strongly associated with all eveningness characteristics, difficulties maintaining sleep related only to earlier bedtimes. These relationships were similar for men and women but varied partly in shapes and strengths across the lifespan. Additional analyses showed that bedtime and wake time were associated with insomnia symptoms only when their combination would result in an unusually long or short preferred time in bed. CONCLUSION The association between eveningness and insomnia symptoms highly depends on whether eveningness is reflected by daytime performance or sleep-wake time. The pattern and strength of these associations also vary depending on age and insomnia symptom, but less so on sex. Future sleep-related research and policies relying on circadian preferences should account for the nonlinearity, dimension/symptom-related specificity and age-related differences in the association between eveningness and insomnia symptoms.
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Affiliation(s)
- Dina Sarsembayeva
- Interdisciplinary Centre Psychopathology and Emotion Regulation, University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - Catharina A Hartman
- Interdisciplinary Centre Psychopathology and Emotion Regulation, University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Raniere Dener Cardoso Melo
- Interdisciplinary Centre Psychopathology and Emotion Regulation, University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Marieke J Schreuder
- Quantitative Psychology and Individual Differences, Department of Psychology and Education Sciences, KU Leuven, Leuven, Belgium
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12
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Wang Y, Guang Z, Zhang J, Han L, Zhang R, Chen Y, Chen Q, Liu Z, Gao Y, Wu R, Wang S. Effect of Sleep Quality on Anxiety and Depression Symptoms among College Students in China's Xizang Region: The Mediating Effect of Cognitive Emotion Regulation. Behav Sci (Basel) 2023; 13:861. [PMID: 37887511 PMCID: PMC10603987 DOI: 10.3390/bs13100861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND While the exact mechanisms are not fully understood, there are significant links between sleep quality, anxiety, depressive symptoms, and cognitive emotion regulation. This research examines how sleep quality affects anxiety and depressive symptoms, as well as the potential of cognitive emotion regulation strategies (CERS) to moderate the impact of sleep quality on these symptoms. METHODS The Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), the Cognitive Emotion Regulation Questionnaire (CERQ), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder Scale-7 (GAD-7) were all completed online by students from two colleges in China's Xizang region. RESULTS The study included 4325 subjects. The prevalence of poor sleep quality, anxiety symptoms, and depression symptoms was 45.69%, 36.81%, and 51.86%, respectively. We observed significant direct effects on poor sleep and severity of anxiety/depression: c'1 = 0.586 (0. 544-0.628), and c'2 = 0.728 (0.683-0.773). Adaptive CERS only had a mediating effect on the relationship between sleep quality and depression symptoms, with a1b3 = -0.005 (-0.011--0.001). The link between poor sleep quality and the intensity of anxiety and depression was significantly affected by the indirect effects of maladaptive CERS: effect a2b2 = 0.126 (0.106-0.147), and effect a2b4 = 0.145 (0.123-0.167). CONCLUSIONS Individuals who experience poor sleep quality are more likely to have increased levels of anxiety and depression. However, enhancing sleep quality led to a decrease in anxiety and depression levels. Adaptive CERS did not predict anxiety, but they did predict depression. Multiple maladaptive CERS could increase levels of anxiety and depression. To prevent mental stress, it is crucial to examine sleep problems among college students, understand their cognitive strategies, promote the adoption of adaptive CERS, and reduce the reliance on maladaptive CERS.
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Affiliation(s)
- Yingting Wang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Zixuan Guang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Jinjing Zhang
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Lixin Han
- School of Public Health, Xi’an Jiaotong University Health Science Center, No.76 Yanta West Road, Xi’an 710049, China
- Disease Control and Prevention Division, Shaanxi Provincial Health Commission, No.112 Lianhu Road, Xi’an 710003, China
| | - Rongqiang Zhang
- School of Public Health, Shaanxi University of Chinese Medicine, Xianyang 712046, China
| | - Yichun Chen
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Qi Chen
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| | - Zhenjia Liu
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Yuan Gao
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
| | - Ruipeng Wu
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of High Altitude Hypoxia Environment and Life Health, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
| | - Shaokang Wang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Disease of Tibet Autonomous Region, School of Medicine, Xizang Minzu University, Xianyang 712082, China
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China
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13
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Knauert MP, Adekolu O, Xu Z, Deng A, Chu JH, Baldassarri SR, Kushida C, Yaggi HK, Zinchuk A. Morning Chronotype Is Associated with Improved Adherence to Continuous Positive Airway Pressure among Individuals with Obstructive Sleep Apnea. Ann Am Thorac Soc 2023; 20:1182-1191. [PMID: 36917194 PMCID: PMC10405611 DOI: 10.1513/annalsats.202210-885oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/13/2023] [Indexed: 03/16/2023] Open
Abstract
Rationale: Poor adherence limits the effectiveness of continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA). A better understanding of CPAP adherence is needed to develop novel strategies to improve it. Objectives: To determine if the chronotype (morning, evening, or intermediate) of patients with OSA is associated with differences in CPAP adherence. If such an association exists, determine the mechanisms underlying this association. Methods: We performed a secondary analysis of the APPLES (Apnea Positive Pressure Long-term Efficacy Study) clinical trial. We assessed chronotype using the Morningness-Eveningness Questionnaire (MEQ) among participants randomized to the CPAP arm with daily adherence data (n = 469). Evening (MEQ ⩽ 41), intermediate (41 < MEQ < 59), and morning type (MEQ ⩾ 59) categories were the exposures. We modeled daily CPAP use (hours per night) over a 6-month period, using a linear mixed model, adjusted for covariates (e.g., age, sex, marital status). To assess mechanisms of the association, we performed mediation analyses using sleep duration, weekend catch-up sleep, depression, and other factors. Results: Most participants were obese men with severe OSA (body mass index of 32.3 ± 7.3 kg/m2, 65% male, and apnea-hypopnea index 39.8 ± 24.6/h). Participants were 44% morning, 47% intermediate, and 8% evening chronotype. Participants with the morning chronotype reported the shortest sleep duration on weekends (7.3 vs. 7.6 and 7.9 h/night) compared with the intermediate and evening types. Participants with the morning chronotype exhibited a 40-min/night higher CPAP use (P = 0.001) than persons with the intermediate chronotype. This relationship was mildly attenuated (32.8 min/night; P = 0.011) after adjustment for covariates. None of the selected factors (e.g., sleep duration, weekend catch-up sleep) exhibited a significant mediation effect. Conclusions: Morning chronotype is associated with a clinically meaningful increase in CPAP adherence compared with other chronotypes. Mechanisms of this association require further study. Chronotype may be a novel predictor of CPAP adherence. Clinical trial registered with www.clinicaltrials.gov (NCT00051363).
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Affiliation(s)
- Melissa P. Knauert
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Olurotimi Adekolu
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Zhichao Xu
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut
| | - Annan Deng
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut
| | - Jen-hwa Chu
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut
| | - Stephen R. Baldassarri
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Clete Kushida
- Stanford University Sleep Clinic and Center for Human Sleep Research, Redwood City, California; and
| | - H. Klar Yaggi
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
- Clinical Epidemiology Research Center, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut
| | - Andrey Zinchuk
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
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14
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Braund TA, O'Dea B, Bal D, Maston K, Larsen M, Werner-Seidler A, Tillman G, Christensen H. Associations Between Smartphone Keystroke Metadata and Mental Health Symptoms in Adolescents: Findings From the Future Proofing Study. JMIR Ment Health 2023; 10:e44986. [PMID: 37184904 DOI: 10.2196/44986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/24/2023] [Accepted: 03/22/2023] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Mental disorders are prevalent during adolescence. Among the digital phenotypes currently being developed to monitor mental health symptoms, typing behavior is one promising candidate. However, few studies have directly assessed associations between typing behavior and mental health symptom severity, and whether these relationships differs between genders. OBJECTIVE In a cross-sectional analysis of a large cohort, we tested whether various features of typing behavior derived from keystroke metadata were associated with mental health symptoms and whether these relationships differed between genders. METHODS A total of 934 adolescents from the Future Proofing study undertook 2 typing tasks on their smartphones through the Future Proofing app. Common keystroke timing and frequency features were extracted across tasks. Mental health symptoms were assessed using the Patient Health Questionnaire-Adolescent version, the Children's Anxiety Scale-Short Form, the Distress Questionnaire 5, and the Insomnia Severity Index. Bivariate correlations were used to test whether keystroke features were associated with mental health symptoms. The false discovery rates of P values were adjusted to q values. Machine learning models were trained and tested using independent samples (ie, 80% train 20% test) to identify whether keystroke features could be combined to predict mental health symptoms. RESULTS Keystroke timing features showed a weak negative association with mental health symptoms across participants. When split by gender, females showed weak negative relationships between keystroke timing features and mental health symptoms, and weak positive relationships between keystroke frequency features and mental health symptoms. The opposite relationships were found for males (except for dwell). Machine learning models using keystroke features alone did not predict mental health symptoms. CONCLUSIONS Increased mental health symptoms are weakly associated with faster typing, with important gender differences. Keystroke metadata should be collected longitudinally and combined with other digital phenotypes to enhance their clinical relevance. TRIAL REGISTRATION Australian and New Zealand Clinical Trial Registry, ACTRN12619000855123; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377664&isReview=true.
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Affiliation(s)
- Taylor A Braund
- Faculty of Medicine and Health, University of New South Wales, Kensington, Australia
- Black Dog Institute, University of New South Wales, Randwick, Australia
| | - Bridianne O'Dea
- Faculty of Medicine and Health, University of New South Wales, Kensington, Australia
- Black Dog Institute, University of New South Wales, Randwick, Australia
| | - Debopriyo Bal
- Black Dog Institute, University of New South Wales, Randwick, Australia
| | - Kate Maston
- Black Dog Institute, University of New South Wales, Randwick, Australia
| | - Mark Larsen
- Faculty of Medicine and Health, University of New South Wales, Kensington, Australia
- Black Dog Institute, University of New South Wales, Randwick, Australia
| | - Aliza Werner-Seidler
- Faculty of Medicine and Health, University of New South Wales, Kensington, Australia
- Black Dog Institute, University of New South Wales, Randwick, Australia
| | - Gabriel Tillman
- Institute of Health and Wellbeing, Federation University, Ballarat, Australia
| | - Helen Christensen
- Faculty of Medicine and Health, University of New South Wales, Kensington, Australia
- Black Dog Institute, University of New South Wales, Randwick, Australia
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15
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Wang S, Wang H, Deng X, Lei X. Validation of the Munich Chronotype Questionnaire (MCTQ) in Chinese college freshmen based on questionnaires and actigraphy. Chronobiol Int 2023:1-12. [PMID: 37080772 DOI: 10.1080/07420528.2023.2202246] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
The Munich Chronotype Questionnaire (MCTQ) was developed to determine an individual's chronotype, and it provides information about sleep and wake times separately for work and free days. However, the MCTQ has not been effectively verified using a large sample based on multiple questionnaires and actigraphy measures. Three sequential studies were conducted. Study 1 used a large sample (n = 1066) to investigate the chronotype of Chinese college freshmen and assess the validity of the MCTQ compared with the reduced Morningness-Eveningness Questionnaire (rMEQ), actigraphy, and other related questionnaires. Study 2 verified the MCTQ compared with a sleep diary. Study 3 examined the test-retest reliability of the MCTQ at the 2-year follow-up. The results showed that MCTQ parameters were significantly associated with rMEQ scores, the actigraphy-based mid-point of sleep, sleep quality, depression, and trait anxiety. In addition, all MCTQ variables were significantly related to the diary-based sleep mid-point. The test-retest reliability of the mid-point of sleep adjusted for sleep debt (MSFsc) and mid-point of sleep on free days (MSF) was acceptable. These results indicate that the MCTQ is a practical and efficient tool with good reliability. Its further development is important for the accurate assessment of chronotypes and clinical diagnoses of sleep.
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Affiliation(s)
- Shuo Wang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
| | - Haien Wang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
| | - Xinyi Deng
- Department of Psychology, Cornell University, Ithaca, New York, USA
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
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16
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Comas M, Solis Flores A, Lovato N, Miller CB, Bartlett DJ, Grunstein RR, Chapman J, Gordon CJ. The Relationship between Anxiety, Subjective and Objective Sleep, Chronotype and Circadian Rhythms with Depressive Symptoms in Insomnia Disorder. Brain Sci 2023; 13:brainsci13040613. [PMID: 37190578 DOI: 10.3390/brainsci13040613] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 05/17/2023] Open
Abstract
Insomnia is a highly prevalent sleep disorder with strong bidirectional associations with depressive symptoms. The circadian preference for eveningness has been shown to be associated with depressive symptoms in insomnia and other mental health conditions. However, there is a lack of studies in insomnia investigating whether objective measures, such as dim light melatonin onset (DLMO) or polysomnographic (PSG) sleep, are associated with depressive symptoms. Therefore, we investigated the associations between subjective measures (questionnaires assessing anxiety, sleep quality and circadian preference, and sleep diary) and depressive symptoms and whether the addition of objective measures (DLMO, PSG parameters) would strengthen the associations with depressive symptoms. In 115 insomnia disorder patients we found that anxiety was strongly associated with depressive symptoms in a model including circadian preference, dysfunctional beliefs of sleep, and self-reported previous depressive symptoms (R2 = 0.496, p < 0.001). The addition of sleep diary measures did not strengthen the model. We also found that the addition of objective measures (DLMO, PSG parameters) did not improve the subjective associations with depressive symptoms. Our data suggest that objective circadian markers are less important in the prediction of depressive symptoms in insomnia compared to subjective measures.
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Affiliation(s)
- Maria Comas
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, Sydney, NSW 2037, Australia
- Faculty of Medicine and Health, The University of Sydney, Science Rd., Camperdown, NSW 2050, Australia
- Renal Division, Department of Medicine, Faculty of Medicine and Medical Center, University of Freiburg, 79106 Freiburg, Germany
| | - Alejandra Solis Flores
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, Sydney, NSW 2037, Australia
| | - Nicole Lovato
- Flinders Health and Medical Research Institute Sleep Health (Formally Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence), College of Medicine and Public Health, Flinders University of South Australia, Sturt Rd., Bedford Park, Adelaide, SA 5042, Australia
| | - Christopher B Miller
- Big Health Inc., 461 Bush St. #200, San Francisco, CA 94108, USA
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, Level 6, West Wing, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
| | - Delwyn J Bartlett
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, Sydney, NSW 2037, Australia
- Faculty of Medicine and Health, The University of Sydney, Science Rd., Camperdown, NSW 2050, Australia
| | - Ronald R Grunstein
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, Sydney, NSW 2037, Australia
- Faculty of Medicine and Health, The University of Sydney, Science Rd., Camperdown, NSW 2050, Australia
- CRC for Alertness, Safety and Productivity, Melbourne, VIC 3800, Australia
- Collaborative Centre for Cardiometabolic Health in Psychoses, Charles Perkins Centre-Royal Prince Alfred Hospital, Johns Hopkins Dr, Camperdown NSW 2006, Sydney Local Health District, Sydney, NSW 2050, Australia
| | - Julia Chapman
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, Sydney, NSW 2037, Australia
| | - Christopher J Gordon
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, Sydney, NSW 2037, Australia
- Faculty of Medicine and Health, The University of Sydney, Science Rd., Camperdown, NSW 2050, Australia
- CRC for Alertness, Safety and Productivity, Melbourne, VIC 3800, Australia
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17
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Beames JR, Huckvale K, Fujimoto H, Maston K, Batterham PJ, Calear AL, Mackinnon A, Werner-Seidler A, Christensen H. The impact of COVID-19 and bushfires on the mental health of Australian adolescents: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2023; 17:34. [PMID: 36895004 PMCID: PMC9998012 DOI: 10.1186/s13034-023-00583-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND When COVID-19 spread to Australia in January 2020, many communities were already in a state of emergency from the Black Summer bushfires. Studies of adolescent mental health have typically focused on the effects of COVID-19 in isolation. Few studies have examined the impact of COVID-19 and other co-occurring disasters, such as the Black Summer bushfires in Australia, on adolescent mental health. METHODS We conducted a cross-sectional survey to examine the impact of COVID-19 and the Black Summer bushfires on the mental health of Australian adolescents. Participants (N = 5866; mean age 13.61 years) answered self-report questionnaires about COVID-19 diagnosis/quarantine (being diagnosed with and/or quarantined because of COVID-19) and personal exposure to bushfire harm (being physically injured, evacuated from home and/or having possessions destroyed). Validated standardised scales were used to assess depression, psychological distress, anxiety, insomnia, and suicidal ideation. Trauma related to COVID-19 and the bushfires was also assessed. The survey was completed in two large school-based cohorts between October 2020 and November 2021. RESULTS Exposure to COVID-19 diagnosis/quarantine was associated with increased probability of elevated trauma. Exposure to personal harm by the bushfires was associated with increased probability of elevated insomnia, suicidal ideation, and trauma. There were no interactive effects between disasters on adolescent mental health. Effects between personal risk factors and disasters were generally additive or sub-additive. CONCLUSIONS Adolescent mental health responses to community-level disasters are multi-faceted. Complex psychosocial factors associated with mental ill health may be relevant irrespective of disaster. Future research is needed to investigate synergistic effects of disasters on young mental health.
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Affiliation(s)
- Joanne R Beames
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia.
| | - Kit Huckvale
- Centre for Digital Transformation of Health, University of Melbourne, Melbourne, VIC, Australia
| | - Hiroko Fujimoto
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Kate Maston
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Alison L Calear
- Centre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Andrew Mackinnon
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Helen Christensen
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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18
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Swisher V, Tooker M, Qu C, Burgess HJ, Coles ME, Bennett S, Piacentini J, Colwell CS, Ricketts EJ. Sleep Disorders, Sleep Medication Use, and Predictors of Sleep Disturbance in Children with Persistent Tic Disorders. CHILDRENS HEALTH CARE 2023; 53:23-40. [PMID: 38435344 PMCID: PMC10904019 DOI: 10.1080/02739615.2023.2175682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The present study examined rates of sleep disorders and sleep medication use, and predictors of sleep disturbance in children with persistent tic disorders (PTD). Sixty-three parents of children aged 10 to 17 years with PTDs completed an internet survey evaluating sleep patterns and clinical symptoms. Insomnia (19.4%), nightmares (16.1%), and bruxism (13.1%) were the most commonly reported lifetime sleep disorders. Fifty-two percent endorsed current sleep medication use. Higher ADHD severity, overall life impairment, and female sex predicted greater sleep disturbance. Findings suggest the utility of clinical management of co-occurring ADHD and impairment to mitigate sleep disturbance in children with PTDs.
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Affiliation(s)
- Valerie Swisher
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Maya Tooker
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Christine Qu
- Department of Biological Sciences, Columbia University
| | | | | | - Shannon Bennett
- Department of Psychiatry, Weill Cornell Medicine, New York, NY 10065
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Christopher S. Colwell
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Emily J. Ricketts
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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19
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Morningness-Eveningness and Problematic Online Activities. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01017-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Abstract
Online activities and problematic online behaviors have recently emerged as important research topics. However, only a few studies have explored the possible associations between these behaviors and morningness-eveningness. The authors examined whether eveningness predicts these distinct problematic online behaviors differently and directly or via mediators. The associations between eveningness and three different problematic online behaviors (problematic Internet use, problematic online gaming, and problematic social media use) were explored among a large sample of Hungarian young adults (N = 1729, 57.2% female, Mage = 22.01, SDage = 1.97) by using a self-report survey. Depression and the time spent engaging in online activities were assessed as possible mediators. The effects of age and sex were controlled for. Using structural equation modeling, the results supported the association between eveningness and the higher risk for all three problematic online behaviors and highlighted that these associations were mediated by depressive mood and time spent on the activities. In addition, eveningness also predicted PIU directly. Eveningness is a risk factor for problematic online behaviors not only because of the higher amount of time spent on the activities but also because of the worse mood associated with eveningness. The results highlight that it is important to examine the different types of online activity separately and explore the role of diverse risk factors, among them morningness-eveningness.
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20
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Hwang H, Kim KM, Yun CH, Yang KI, Chu MK, Kim WJ. Sleep state of the elderly population in Korea: Nationwide cross-sectional population-based study. Front Neurol 2023; 13:1095404. [PMID: 36698878 PMCID: PMC9868806 DOI: 10.3389/fneur.2022.1095404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Objective Interest in sleep disorders among the elderly, especially those in Korea, has increased. We aimed to describe the overall sleep status of the elderly population in Korea using survey data and to determine the risk factors concerning different aspects of sleep status. Methods We conducted a cross-sectional survey on 271 respondents aged 65-86 years old. We performed multistage clustered random sampling according to the population and socioeconomic distribution of all Korean territories. The survey questionnaire was used to perform a structural assessment of sociodemographic characteristics; medical comorbidities; psychiatric comorbidities; and sleep status, including sleep duration, sleep quality, presence of insomnia, excessive daytime sleepiness, sleep apnea, and restless legs syndrome. Results Approximately 12.5, 22.%, and 51.3% of the elderly population had poor sleep quality, excessive daytime sleepiness, and insomnia, respectively. Hypertension, dyslipidemia, insomnia, anxiety, and depression predicted poor sleep quality. Female sex, insomnia, and sleep apnea predicted excessive daytime sleepiness. Poor sleep quality and depression predicted insomnia. Conclusion A substantial proportion of the elderly Korean population have sleep problems, including poor sleep quality, excessive daytime sleepiness, and insomnia. Sleep status is influenced by various factors, including age, sex, and metabolic and psychiatric comorbidities.
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Affiliation(s)
- Heewon Hwang
- Department of Neurology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea,Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyung Min Kim
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Chang-Ho Yun
- Department of Neurology, Bundang Clinical Neuroscience Institute, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kwang Ik Yang
- Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, South Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Won-Joo Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea,*Correspondence: Won-Joo Kim ✉
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21
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Gruber R, Salamon L, Tauman R, Al-Yagon M. Sleep Disturbances in Adolescents with Attention-Deficit/Hyperactivity Disorder. Nat Sci Sleep 2023; 15:275-286. [PMID: 37113558 PMCID: PMC10126718 DOI: 10.2147/nss.s386435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 01/23/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction Delayed sleep phase syndrome (DSPS) and insomnia disorders are prevalent in adolescents and are comorbid with attention-deficit/hyperactivity disorder (ADHD), but only limited information is available regarding the prevalence of DSPS and insomnia in adolescents with ADHD. Moreover, previous studies comparing objective sleep parameters averaged the findings across all participants of each group (ADHD, control) regardless of each individual's level of reported sleep disturbance. This might have resulted in inconsistency between information obtained by objective and subjective sleep measures in adolescents with ADHD. The objectives of the present study were 1) to compare the prevalence of risk for DSPS and insomnia in adolescents with ADHD and control adolescents in our samples; 2) to compare objectively measured sleep characteristics of adolescents with ADHD and controls while taking into consideration their levels of risk for DSPS or their level of insomnia; and 3) to compare the ADHD symptom levels of adolescents with moderate/high and low risk for DSPS or insomnia. Methods Seventy-three adolescents (37 ADHD, 36 controls) aged 12-15 years participated in a cross-sectional study. Actigraphy was used to characterize objective sleep parameters and parents' or adolescents' reports were used to characterize subjective sleep parameters. Results Of the participants in the ADHD and control groups, 33.33% and 27%, respectively, had moderate/high levels of risk for DSPS. Adolescents in the high-risk group for DSPS had an objectively measured delayed sleep schedule and more variable sleep duration, time in bed, and sleep efficiency compared to adolescents in the low-risk group for DSPS, regardless of their ADHD diagnosis. Adolescents with higher levels of insomnia spent more time in bed and had more variable sleep efficiency compared to adolescents with no insomnia, regardless of their diagnosis. Conclusion The prevalence of moderate/high risk for DSPS was similarly high in adolescents with ADHD and controls. Participants' subjective reports of sleep disturbances were consistent with their objective sleep parameters when the type and level of subjectively defined sleep disturbance were considered. ADHD symptom levels were not different in adolescents with moderate/high or low risk for DSPS or insomnia.
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Affiliation(s)
- Reut Gruber
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Attention, Behaviour and Sleep Lab, Douglas Mental Health University Institute, Montreal, QC, Canada
- Correspondence: Reut Gruber, Department of Psychiatry, McGill University, Montreal, QC, Canada, Email
| | - Liron Salamon
- Department of School Counseling and Special Education, Tel-Aviv University, Tel-Aviv, Israel
| | - Riva Tauman
- Sleep Disorders Center, Tel Aviv Souraski Medical Center, Tel Aviv, Israel
| | - Michal Al-Yagon
- Department of School Counseling and Special Education, Tel-Aviv University, Tel-Aviv, Israel
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22
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Wan ZY, Xiao L, Wang GH. People with passive sleep delay have more severe depression and sleep problems than those with active sleep delays-a cross-sectional study after the COVID-19 pandemic. Heliyon 2022; 8:e11805. [PMID: 36506868 PMCID: PMC9721167 DOI: 10.1016/j.heliyon.2022.e11805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/31/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
Objective This study was designed to investigate the effect of different types of sleep delay in depression and sleep characteristics after the pandemic. Meanwhile, risk factors for depression were also explored. Methods The survey was conducted in Wuhan from March 1 to May 30, 2021, and participants were recruited through a snowball process. A total of 1,583 people with sleep delays responded to the invitation, of which 1,296 were enrolled. Participants filled out a questionnaire including social demographics, sleep characteristics, Social Support Rating Scale (SSRS), Pittsburgh Sleep Quality Index (PSQI) and Patient Health Questionnaire-9 (PHQ-9). Results There were no significant differences in sex, social support and level of education between the two types of sleep delay (p = 0.961, p = 0.110, p = 0.090), but the average age of the passive sleep delay group was higher (p = 0.015). And most people with active sleep delay were caused by the use of electronic devices (73.6%), while most people with passive sleep delay were caused by work or study tasks (73.2%), with a significant difference between the two groups (p < 0.001). People who actively delayed sleep had more regular sleep (p < 0.001), better sleep quality and longer sleep duration (p < 0.001, p < 0.001). In addition, although they delayed sleep more frequently (p < 0.001), they had significantly lower depression degree than people who passively delayed sleep (p < 0.001). Conclusions Passive sleep delays, usually caused by work or study, has higher levels of depression and more adverse sleep behaviors than active sleep delay. The findings help further understand the effects of delayed sleep and provide insight for people with delayed sleep to evaluate their own condition. Future studies are required to standardize and accurately classify sleep delay and further explore it.
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Affiliation(s)
- Zhen-Yu Wan
- Department of Psychiatry, Renmin Hospital of Wuhan University, China,Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, China
| | - Ling Xiao
- Department of Psychiatry, Renmin Hospital of Wuhan University, China,Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, China
| | - Gao-Hua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, China,Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, China,Corresponding author
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23
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Lampinen LA, Zheng S, Taylor JL, Adams RE, Pezzimenti F, Asarnow LD, Bishop SL. Patterns of sleep disturbances and associations with depressive symptoms in autistic young adults. Autism Res 2022; 15:2126-2137. [PMID: 36082844 PMCID: PMC9677950 DOI: 10.1002/aur.2812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 08/19/2022] [Indexed: 12/15/2022]
Abstract
Autistic individuals are at an increased risk for both sleep disturbances and depression. While studies in the general population and in autistic adults have drawn general links between sleep disturbances and mental health, few studies have examined the extent to which specific sleep problems may be implicated in the extremely high rates of depression among autistic adults. This study aimed to describe the patterns of sleep disturbances in autistic young adults, and their associations with depressive symptoms while controlling for relevant demographic factors. A sample of 304 legally independent adults (age 18-35 years old) with a childhood diagnosis of autism spectrum disorder self-reported on their average sleep behaviors during the past week and depressive symptoms on the Beck Depressive Inventory-II. A significant proportion (86.01%) of autistic young adults experienced at least one of the primary sleep disturbances of interest, including short total sleep time (39.59%), poor sleep efficiency (60.07%), and delayed sleep phase (36.18%). Additionally, lower sleep efficiency and delayed sleep phase were both associated with higher depressive symptoms. The associations between sleep and depressive symptoms identified in our study suggest that sleep treatments may hold potential for ameliorating depressive symptoms in autistic adults who also experience sleep problems. Further research using daily sleep diaries and objective measures of sleep behaviors, as well as longitudinal studies, are needed to understand how changes in sleep may relate to changes in depressive symptoms in autistic adults.
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Affiliation(s)
- Linnea A Lampinen
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Shuting Zheng
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Julie Lounds Taylor
- Department of General Pediatrics, Vanderbilt University Medical Center. One Magnolia Circle, Nashville, Tennessee, USA
| | - Ryan E Adams
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Florencia Pezzimenti
- Department of General Pediatrics, Vanderbilt University Medical Center. One Magnolia Circle, Nashville, Tennessee, USA
| | - Lauren D Asarnow
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Somer L Bishop
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
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24
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Anastasiades PG, de Vivo L, Bellesi M, Jones MW. Adolescent sleep and the foundations of prefrontal cortical development and dysfunction. Prog Neurobiol 2022; 218:102338. [PMID: 35963360 PMCID: PMC7616212 DOI: 10.1016/j.pneurobio.2022.102338] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022]
Abstract
Modern life poses many threats to good-quality sleep, challenging brain health across the lifespan. Curtailed or fragmented sleep may be particularly damaging during adolescence, when sleep disruption by delayed chronotypes and societal pressures coincides with our brains preparing for adult life via intense refinement of neural connectivity. These vulnerabilities converge on the prefrontal cortex, one of the last brain regions to mature and a central hub of the limbic-cortical circuits underpinning decision-making, reward processing, social interactions and emotion. Even subtle disruption of prefrontal cortical development during adolescence may therefore have enduring impact. In this review, we integrate synaptic and circuit mechanisms, glial biology, sleep neurophysiology and epidemiology, to frame a hypothesis highlighting the implications of adolescent sleep disruption for the neural circuitry of the prefrontal cortex. Convergent evidence underscores the importance of acknowledging, quantifying and optimizing adolescent sleep's contributions to normative brain development and to lifelong mental health.
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Affiliation(s)
- Paul G Anastasiades
- University of Bristol, Translational Health Sciences, Dorothy Hodgkin Building, Whitson Street, Bristol BS1 3NY, UK
| | - Luisa de Vivo
- University of Bristol, School of Physiology, Pharmacology & Neuroscience, University Walk, Bristol BS8 1TD, UK; University of Camerino, School of Pharmacy, via Gentile III Da Varano, Camerino 62032, Italy
| | - Michele Bellesi
- University of Bristol, School of Physiology, Pharmacology & Neuroscience, University Walk, Bristol BS8 1TD, UK; University of Camerino, School of Bioscience and Veterinary Medicine, via Gentile III Da Varano, Camerino 62032, Italy
| | - Matt W Jones
- University of Bristol, School of Physiology, Pharmacology & Neuroscience, University Walk, Bristol BS8 1TD, UK
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25
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Lucifora C, Grasso GM, Nitsche MA, D'Italia G, Sortino M, Salehinejad MA, Falzone A, Avenanti A, Vicario CM. Enhanced fear acquisition in individuals with evening chronotype. A virtual reality fear conditioning/extinction study. J Affect Disord 2022; 311:344-352. [PMID: 35561887 DOI: 10.1016/j.jad.2022.05.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/09/2022] [Accepted: 05/05/2022] [Indexed: 11/18/2022]
Abstract
Circadian rhythms have received increasing attention within the context of mental disorders. Evening chronotype has been associated with enhanced risk to develop anxiety and post-traumatic stress disorder (PTSD). The classical fear conditioning paradigm is a powerful tool to reveal key mechanisms of anxiety and PTSD. We used this paradigm to study the neurocognitive basis of the association between chronotype and fear responses in healthy humans. 20 participants with evening chronotype and 20 controls (i.e., intermediate chronotype) completed a 2-day Pavlovian fear learning and extinction virtual reality task. Participants received fear conditioning, and extinction learning on day 1. Extinction memory recall was tested on day 2. To address interactions between chronotype and time of day of the fear conditioning, and extinction performance, half of the participants were tested in the morning, and the other half in the evening. Skin conductance response (SCR) and subjective fear ratings were measured as primary outcomes. Chronotype was established via the morningness-eveningness questionnaire (MEQ). We found an overall higher SCR for fear acquisition in participants with the evening chronotype profile, compared to controls. Moreover, the higher the MEQ scores -indicative of less eveningness - the lower the SCR was. No effects of chronotype were found for extinction and extinction recall. The higher vulnerability of the evening chronotype for anxiety and related disorders may thus be explained by enhanced fear acquisition of this group.
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Affiliation(s)
- Chiara Lucifora
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98121 Messina, Italy
| | - Giorgio M Grasso
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98121 Messina, Italy
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Ardeystr. 67, 44139 Dortmund, Germany
| | - Giovanni D'Italia
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98121 Messina, Italy
| | - Mauro Sortino
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98121 Messina, Italy
| | - Mohammad A Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Ardeystr. 67, 44139 Dortmund, Germany
| | - Alessandra Falzone
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98121 Messina, Italy
| | - Alessio Avenanti
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Alma Mater Studiorum - Università di Bologna, Campus di Cesena, 47521 Cesena, Italy; Centro de Investigación en Neuropsicología y Neurociencias Cognitivas, Universidad Católica Del Maule, 346000 Talca, Chile
| | - Carmelo M Vicario
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98121 Messina, Italy.
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26
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Zou H, Zhou H, Yan R, Yao Z, Lu Q. Chronotype, circadian rhythm, and psychiatric disorders: Recent evidence and potential mechanisms. Front Neurosci 2022; 16:811771. [PMID: 36033630 PMCID: PMC9399511 DOI: 10.3389/fnins.2022.811771] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/21/2022] [Indexed: 12/27/2022] Open
Abstract
The circadian rhythm is crucial for physiological and behavioral functions. Chronotype, which represents individual preferences for activity and performance, is associated with human health issues, particularly psychiatric disorders. This narrative review, which focuses on the relationship between chronotype and mental disorders, provides an insight into the potential mechanism. Recent evidence indicates that (1) the evening chronotype is a risk factor for depressive disorders and substance use disorders, whereas the morning chronotype is a protective factor. (2) Evening chronotype individuals with bipolar disorder tend to have more severe symptoms and comorbidities. (3) The evening chronotype is only related to anxiety symptoms. (4) The relationship between chronotype and schizophrenia remains unclear, despite increasing evidence on their link. (5) The evening chronotype is significantly associated with eating disorders, with the majority of studies have focused on binge eating disorders. Furthermore, the underlying mechanisms or influence factors are described in detail, including clock genes, brain characteristics, neuroendocrinology, the light/dark cycle, social factors, psychological factors, and sleep disorders. These findings provide the latest evidence on chronotypes and psychiatric disorders and serve as a valuable reference for researchers.
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Affiliation(s)
- Haowen Zou
- Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hongliang Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Rui Yan
- Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhijian Yao
- Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, China
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27
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Segal SC, Carmona NE. A systematic review of sleep problems in children and adolescents with obsessive compulsive disorder. J Anxiety Disord 2022; 90:102591. [PMID: 35728382 DOI: 10.1016/j.janxdis.2022.102591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 05/15/2022] [Accepted: 06/04/2022] [Indexed: 11/28/2022]
Abstract
There is growing interest in the relationship between obsessive-compulsive disorder (OCD) and sleep problems in youth, including the development of a theoretical model proposing how these disorders maintain each other. The model suggests that OCD symptoms are proposed to interfere with sleep duration (e.g., via increased arousal and delayed bedtime), which compounds OCD symptom severity during the daytime and into the evening, feeding back into the model. Whether the recent influx of research on sleep problems in youth with OCD supports this model is unknown. The primary aim of this systematic review was to characterize sleep problems in youth with OCD and evaluate whether current research supports previous theoretical inferences. Findings across 20 studies revealed a high prevalence of sleep problems among youth with OCD and support a bidirectional relationship. Studies largely did not assess hypothesized relationships proposed by the model; support for the model is therefore preliminary. A secondary aim was to assess the impacts of comorbidity and developmental stage. Findings suggest that in childhood, comorbid anxiety disorders may initially predate sleep problems, but they become mutually maintained over time; the role of comorbid depression appears to increase with age. Limitations, future directions, and clinical implications are discussed.
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Affiliation(s)
- Shira C Segal
- Toronto Metropolitan University, Department of Psychology, 350 Victoria St, Toronto, ON M5B 2K3, Canada.
| | - Nicole E Carmona
- Toronto Metropolitan University, Department of Psychology, 350 Victoria St, Toronto, ON M5B 2K3, Canada.
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28
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Ricketts EJ, Montalbano GE, Burgess HJ, McMakin DL, Coles ME, Piacentini J, Colwell CS. Sleep and chronotype in adults with persistent tic disorders. J Clin Psychol 2022; 78:1516-1539. [PMID: 35150595 DOI: 10.1002/jclp.23323] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 12/22/2021] [Accepted: 01/14/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study examined sleep disorders and sleep medication use rates, nighttime tics, and sleep and chronotype in relation to tic and co-occurring symptoms in adults with persistent tic disorders (PTDs), including Tourette's disorder (TD). METHODS One hundred twenty-five adult internet survey respondents rated sleep history, sleep, chronotype, tic severity, impairment, attention deficit hyperactivity disorder, obsessive-compulsive symptoms, anxiety, depression, and emotional and behavioral dyscontrol. RESULTS Bruxism, insomnia, tic-related difficulty falling asleep, and melatonin use were commonly endorsed. Sleep disturbance correlated with impairment, obsessive-compulsive symptoms, and emotional and behavioral dyscontrol. Eveningness correlated with vocal and total tic severity only in TD. Controlling for age and sex, age, impairment, and obsessive-compulsive symptoms predicted sleep disturbance, and age and tic severity predicted chronotype. CONCLUSIONS Impairment and obsessive-compulsive symptoms play a role in sleep disturbance in adults with PTDs, and may be intervention targets. Eveningness relates to tic severity, which may suggest the utility of interventions to advance chronotype.
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Affiliation(s)
- Emily J Ricketts
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
| | - Gabrielle E Montalbano
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
| | - Helen J Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, Florida, USA.,Department of Neurology, Nicklaus Children's Hospital, Miami, Florida, USA
| | - Meredith E Coles
- Department of Psychology, State University of New York-Binghamton, Binghamton, New York, USA
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
| | - Christopher S Colwell
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
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Cheung FTW, Ho AWY, Chan JWY, Li X, Chan NY, Zhang J, Ho CS, Wing YK, Li SX. Validation of the Chinese version of the Munich Chronotype Questionnaire (MCTQ HK) in Hong Kong Chinese youths. Chronobiol Int 2022; 39:678-689. [PMID: 35086397 DOI: 10.1080/07420528.2022.2025821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Chronotype, referred to as an individual's diurnal preference of timing for rest and activity, can be subjectively measured using the Munich Chronotype Questionnaire (MCTQ). However, the validity of MCTQ has yet to be tested in the youth population. In addition, it remains uncertain if MCTQ is a good measure of chronotype in individuals with insomnia. The current study aimed to validate the Chinese version of MCTQ (MCTQHK) in the youth population and to explore the utility of MCTQHK in individuals with insomnia. The original MCTQ was translated into Chinese language using the translation-back-translation method. Part one of this study included 988 youths who completed a battery of self-report questionnaires online consisting of the MCTQHK and the morningness-eveningness questionnaire (MEQ) for the measures of circadian preference, Insomnia Severity Index (ISI) to assess insomnia symptoms, and Patient Health Questionnaire (PHQ-9) to measure depressive symptoms. Test-retest reliability was examined in 442 participants at one-month follow-up. Of the overall sample, 69 participants were randomly drawn to complete the second part of the study, which included prospective 7-day actigraphy monitoring and a further subset (n = 40) additionally completed a laboratory-based assessment of dim-light melatonin onset (DLMO) as a circadian phase marker. A total of 659 participants with valid responses were finally included in the analyses of the data collected from part one of the study (female = 67.7%; mean age: 20.7 ± 2.02). Results showed that MCTQ parameters, namely the midpoint of sleep on free days (MSF), midpoint of sleep on workdays (MSW), and midpoint of sleep adjusted for sleep debt (MSFsc), were significantly correlated with MEQ score (r = -.514 to -.650, p < .01). Test-retest reliability for MCTQHK was good (intraclass correlation = 0.75 to 0.84). Later MSFsc was significantly associated with greater insomnia and depressive symptoms after controlling for age and sex. All MCTQ parameters showed significant correlations with actigraphy-based midpoint of sleep and circadian rhythm parameters, i.e., acrophase and L5 onset (r = .362 to .619, p < .01), as well as DLMO (r = .393 to .517, p < .05). The associations remained significant after controlling for age. MSFsc derived from MCTQ was significantly correlated with MEQ score in both the healthy sleepers and participants with insomnia (as defined by ISI > 14), r = -.600, p < .001 and r = -.543, p < .001, respectively. The present study demonstrated that MCTQHK is suitable for assessing chronotype with good reliability and validity in Chinese youths and supported the utility of MCTQHK in individuals with insomnia.
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Affiliation(s)
- Forrest Tin Wai Cheung
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong
| | - Amy Wing Yin Ho
- Department of Chemical Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Joey Wing Yan Chan
- Li Chiu Kong Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Xiao Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong
| | - Ngan Yin Chan
- Li Chiu Kong Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Jihui Zhang
- Guang Dong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chung Shun Ho
- Department of Chemical Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Yun Kwok Wing
- Li Chiu Kong Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Shirley Xin Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
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Wang J, Liu S, Guo J, Xiao R, Yu J, Luo X, Xu Y, Zhao Y, Cui Y, Gu Y, Cai L, Zhang B. Chronotypes, Sleep and Mental Distress Among Chinese College Students: A Cross-Sectional Study. Front Psychiatry 2022; 13:883484. [PMID: 35693958 PMCID: PMC9177998 DOI: 10.3389/fpsyt.2022.883484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/05/2022] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the chronotypes and their relationship with sleep disturbances and mental distress among college students. METHODS Students from a university in Guangzhou, China, were recruited through a cross-sectional online survey. Data were collected by self-reported questionnaires including socio-demographics, lifestyles and health conditions, sleep patterns on weekdays and weekends, as well as the reduced Morningness-Eveningness Questionnaire (rMEQ), the Insomnia Severity Index, the Epworth Sleepiness Scale, the Beck Depression Inventory-13, and the Zung Self-Rating Anxiety Scale. Multivariate analyses were performed to examine the associations of chronotypes with sleep compensation, sleep disturbances, and mental distress. RESULTS A total of 1,607 questionnaires were received, among which 1,569 (97.6%) were valid for further analysis. Among these participants [mean age 19.86 ± 1.16 (15-27) years], morning types (M-types), intermediate types (I-types), and evening types (E-types) accounted for 14.9, 71.5, and 13.6%, respectively. The regression analysis revealed that E-types were positively associated with long sleep compensation on weekends (adjusted OR 2.443, 95%CI 1.740-3.429) compared with I-types, while M-types were the opposite (adjusted OR 0.623, 95%CI 0.392-0.990). E-types were also positively correlated with insomnia symptoms (adjusted OR 2.000, 95%CI 1.428-2.801), depressive symptoms (adjusted OR 2.068, 95%CI 1.496-2.858), and anxiety symptoms (adjusted OR 2.188, 95%CI 1.387-3.451). However, no significant association was found between chronotypes and excessive daytime sleepiness. CONCLUSION Our study found that E-types were associated with long sleep compensation on weekends and insomnia, depression, and anxiety symptoms. Our findings emphasized the importance of early recognition and intervention of E-types and their accompanied sleep problems and mental distress.
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Affiliation(s)
- Jiajia Wang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shuai Liu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Junlong Guo
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Rong Xiao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jia Yu
- Department of Psychosomatic Diseases, The Third People's Hospital of Panzhihua, Panzhihua, China
| | - Xian Luo
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yan Xu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuhan Zhao
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yingru Cui
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yue Gu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lidan Cai
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Yang L, Yu S, Zhang L, Peng W, Hu Y, Feng F, Yang J. Gender Differences in Hippocampal/Parahippocampal Functional Connectivity Network in Patients Diagnosed with Chronic Insomnia Disorder. Nat Sci Sleep 2022; 14:1175-1186. [PMID: 35761887 PMCID: PMC9233514 DOI: 10.2147/nss.s355922] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 05/31/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Gender differences in hippocampal and parahippocampal gyrus (HIP/PHG) volumes have been reported in sleep disorders. Therefore, this study investigated the moderating effect of gender on the relationship between chronic insomnia disorder (CID) and the HIP/PHG functional connectivity (FC) network. METHODS For this study, 110 patients diagnosed with CID (43 men and 67 women) and 60 matched good sleep control (GSC) (22 men and 38 women) were recruited. These participants underwent resting-state functional magnetic resonance imaging scans, after which a 2 × 2 (diagnosis × gender) analysis of variance was used to detect the main and interactive effect of insomnia and gender on their HIP/PHG FC networks. RESULTS Although the main effect of insomnia on the HIP FC network was observed in the bilateral cerebellar tonsil, superior frontal gyrus, and the medial orbitofrontal cortex, effects on the PHG FC network were observed in the bilateral HIP and amygdala. In contrast, the main effect of gender on the HIP FC network was observed in the right cerebellum posterior lobe, the dorsolateral prefrontal cortex (DLPFC), and the supplemental motor area. Of note, the interactive effect of both insomnia and gender was observed in FCs between the right HIP and the dorsal anterior cingulate cortex, and then between the right PHG and DLPFC. Moreover, the FC between the right PHG and left DLPFC was positively associated with anxiety scores in the female patients with CID. CONCLUSION Our study identified that gender differences in brain connectivity existed between the HIP/PHG and executive control network in patients diagnosed with CID, these results will eventually extend our understanding of the important role that gender plays in the pathophysiology of CID.
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Affiliation(s)
- Lili Yang
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People's Republic of China
| | - Siyi Yu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People's Republic of China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, People's Republic of China
| | - Leixiao Zhang
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Wei Peng
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People's Republic of China
| | - Youping Hu
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People's Republic of China
| | - Fen Feng
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, People's Republic of China
| | - Jie Yang
- Department of Acupuncture & Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, People's Republic of China
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32
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Possible actions of cannabidiol in obsessive-compulsive disorder by targeting the WNT/β-catenin pathway. Mol Psychiatry 2022; 27:230-248. [PMID: 33837269 DOI: 10.1038/s41380-021-01086-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/13/2021] [Accepted: 03/26/2021] [Indexed: 02/02/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder characterized by recurrent and distinctive obsessions and/or compulsions. The etiologies remain unclear. Recent findings have shown that oxidative stress, inflammation, and glutamatergic pathways play key roles in the causes of OCD. However, first-line therapies include cognitive-behavioral therapy but only 40% of the patients respond to this first-line therapy. Research for new treatment is mandatory. This review focuses on the potential effects of cannabidiol (CBD), as a potential therapeutic strategy, on OCD and some of the presumed mechanisms by which CBD provides its benefit properties. CBD medication downregulates GSK-3β, the main inhibitor of the WNT/β-catenin pathway. The activation of the WNT/β-catenin could be associated with the control of oxidative stress, inflammation, and glutamatergic pathway and circadian rhythms dysregulation in OCD. Future prospective clinical trials could focus on CBD and its different and multiple interactions in OCD.
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33
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Jongte L, Trivedi AK. Chronotype, sleep quality and academic performances among Mizo students. Chronobiol Int 2021; 39:398-408. [PMID: 34794352 DOI: 10.1080/07420528.2021.2002350] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Sleep is an essential component of the daily cycle. Age and puberty-related declines in sleep duration, delays in chronotype, and an increase in social jet lag have been consistently reported. This study examined chronotype and gender-based differences in adolescents' sleep quality, depression level, and academic achievements. Eight hundred fifteen school students (372 male and 443 female) aged 14 to 20 years voluntarily participated in this study. Horne and Östberg Morningness-Eveningness Questionnaire (MEQ) was used to measure their chronotype. Sleep duration, sleep quality, and daytime sleepiness were assessed by the Pediatric Daytime Sleepiness Scale (PDSS) and Epworth Sleepiness Scale (ESS). Pittsburgh's Sleep Quality Index (PSQI) was used to evaluate sleep habits. Cleveland Adolescent Sleepiness Questionnaire (CASQ) was used to measure the sleep pattern of the students. Zung Self-Rating Depression Scale (SDS) was used to assess the level of depression for the students. Our results show neither type of students dominated the population studied but interestingly, in comparison to evening type, morning type individuals were higher among the population. Chronotype-based sleep quality and academic performances were observed, and higher depression levels, poor sleep quality, poor academic performances were observed in evening type compared to neither type and morning type. In contrast to males, females had a poor sleep pattern (CASQ) and a higher depression level (SDS). Altogether, our study shows the effect of chronotype and gender on sleep quality and depression levels among school students.
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34
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Circadian Rhythms in Mood Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1344:153-168. [PMID: 34773231 DOI: 10.1007/978-3-030-81147-1_9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Altered behavioral rhythms are a fundamental diagnostic feature of mood disorders. Patients report worse subjective sleep and objective measures confirm this, implicating a role for circadian rhythm disruptions in mood disorder pathophysiology. Molecular clock gene mutations are associated with increased risk of mood disorder diagnosis and/or severity of symptoms, and mouse models of clock gene mutations have abnormal mood-related behaviors. The mechanism by which circadian rhythms contribute to mood disorders remains unknown, however, circadian rhythms regulate and are regulated by various biological systems that are abnormal in mood disorders and this interaction is theorized to be a key component of mood disorder pathophysiology. A growing body of evidence has begun defining how the interaction of circadian and neurotransmitter systems influences mood and behavior, including the role of current antidepressants and mood stabilizers. Additionally, the hypothalamus-pituitary-adrenal (HPA) axis interacts with both circadian and monoaminergic systems and may facilitate the contribution of environmental stressors to mood disorder pathophysiology. The central role of circadian rhythms in mood disorders has led to the development of chronotherapeutics, which are treatments designed specifically to target circadian rhythm regulators, such as sleep, light, and melatonin, to produce an antidepressant response.
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35
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O'Loughlin J, Casanova F, Jones SE, Hagenaars SP, Beaumont RN, Freathy RM, Watkins ER, Vetter C, Rutter MK, Cain SW, Phillips AJK, Windred DP, Wood AR, Weedon MN, Tyrrell J. Using Mendelian Randomisation methods to understand whether diurnal preference is causally related to mental health. Mol Psychiatry 2021; 26:6305-6316. [PMID: 34099873 PMCID: PMC8760058 DOI: 10.1038/s41380-021-01157-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 12/13/2022]
Abstract
Late diurnal preference has been linked to poorer mental health outcomes, but the understanding of the causal role of diurnal preference on mental health and wellbeing is currently limited. Late diurnal preference is often associated with circadian misalignment (a mismatch between the timing of the endogenous circadian system and behavioural rhythms), so that evening people live more frequently against their internal clock. This study aims to quantify the causal contribution of diurnal preference on mental health outcomes, including anxiety, depression and general wellbeing and test the hypothesis that more misaligned individuals have poorer mental health and wellbeing using an actigraphy-based measure of circadian misalignment. Multiple Mendelian Randomisation (MR) approaches were used to test causal pathways between diurnal preference and seven well-validated mental health and wellbeing outcomes in up to 451,025 individuals. In addition, observational analyses tested the association between a novel, objective measure of behavioural misalignment (Composite Phase Deviation, CPD) and seven mental health and wellbeing outcomes. Using genetic instruments identified in the largest GWAS for diurnal preference, we provide robust evidence that early diurnal preference is protective for depression and improves wellbeing. For example, using one-sample MR, a twofold higher genetic liability of morningness was associated with lower odds of depressive symptoms (OR: 0.92, 95% CI: 0.88, 0.97). It is possible that behavioural factors including circadian misalignment may contribute in the chronotype depression relationship, but further work is needed to confirm these findings.
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Affiliation(s)
- Jessica O'Loughlin
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Francesco Casanova
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Samuel E Jones
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Saskia P Hagenaars
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robin N Beaumont
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Rachel M Freathy
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Edward R Watkins
- Psychology, Mood Disorders Centre, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Céline Vetter
- Circadian and Sleep Epidemiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Martin K Rutter
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.,Manchester Diabetes Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Sean W Cain
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Andrew J K Phillips
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Daniel P Windred
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Andrew R Wood
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Michael N Weedon
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Jessica Tyrrell
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK.
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36
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Chen SJ, Zhang JH, Li SX, Tsang CC, Chan KCC, Au CT, Li AM, Kong APS, Wing YK, Chan NY. The trajectories and associations of eveningness and insomnia with daytime sleepiness, depression and suicidal ideation in adolescents: A 3-year longitudinal study. J Affect Disord 2021; 294:533-542. [PMID: 34330050 DOI: 10.1016/j.jad.2021.07.033] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 06/13/2021] [Accepted: 07/11/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Eveningness and insomnia are highly comorbid and closely related to psychopathology in adolescents. We aimed to prospectively investigate the trajectories and associations of eveningness and insomnia with daytime functioning, depression and suicidal risk in adolescents. METHODS A 3-year longitudinal study was conducted among 414 Chinese adolescents. The associations of eveningness and insomnia with daytime functioning, depression and suicidal ideation were analyzed using logistic regressions. RESULTS The prevalence rates of eveningness were similar at baseline and follow-up (19.3% vs 22.5%; p = 0.27), while the prevalence of insomnia increased at follow-up (29.2% vs 40.8%; p < 0.001). Among those eveningness adolescents (n=80) at baseline, 46.2% remained as stable evening-type at follow-up, and among those insomnia adolescents (n=121) at baseline, 64.5% had persistent insomnia at follow-up. Logistic regressions showed that stable, incident, and resolved eveningness were associated with excessive daytime sleepiness (EDS) at follow-up, while only persistent and incident insomnia increased the risk of EDS. Persistent and incident insomnia, as well as stable eveningness were independently associated with depression at follow-up. Persistent and incident insomnia, but not eveningness, were associated with suicidal ideation. LIMITATIONS The outcome assessments were based on self-reported questionnaires and the sample size is modest. CONCLUSIONS Persistent eveningness and insomnia are significantly associated with greater risks of EDS and depression in adolescents, while both persistent and incident insomnia, but not eveningness, increased the risk of suicidal ideation. These findings underscore the importance of addressing sleep and circadian factors in the management of adolescent mood and daytime functioning.
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Affiliation(s)
- Si-Jing Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ji-Hui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Guangdong Mental Health Center, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Chi Ching Tsang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kate Ching Ching Chan
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chun Ting Au
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Alice Pik Shan Kong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Kim S, Lee HJ. Validation of the 6-item Evening Chronotype Scale (ECS): a modified version of Composite Scale Morningness. Chronobiol Int 2021; 38:1640-1649. [PMID: 34412524 DOI: 10.1080/07420528.2021.1938596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In a previous study comparing two representative chronotype questionnaires to screen for delayed sleep-phase disorder, six items from the simplified language version of Composite Scale of Morningness (CSM) have been found to be useful and effective for screening evening-type person. In this study, we reverse coded the six items from CSM and named them Evening Chronotype Scale (ECS). The primary aim of this study was to examine the psychometric properties, validity, and test-retest reliability of the ECS when administered on mood disorder patients. The secondary aim was to further examine the relationship between circadian preferences and symptoms of mood disorders. The study sample was of 472 mood disorder patients including major depressive disorder, bipolar disorder I, and bipolar disorder II. The 13-item full version CSM and 6-item ECS were externally validated by self-reported sleep time, wake time, sleep latency, depressive symptoms, hypomanic symptoms, quality of life, and impulsivity. Cronbach's alpha was calculated for the internal consistency of the ECS, and the test-retest reliability analysis was also performed. Our results suggest that the ECS is a reliable and valid instrument to assess circadian preference in mood disorder patients. First, the ECS showed moderate to good internal consistency (Cronbach's alpha = 0.727). Also, it showed external validity comparable to that of the 13-item CSM. Participants who were more evening-oriented according to the ECS slept and woke up later, took longer time to fall asleep, showed more depressive and hypomanic symptoms, and showed lower quality of life and higher impulsivity. As circadian rhythm disruption has been shown to affect the regulation of mood symptoms in patients with mood disorders, assessment of circadian preferences may be crucial in clinical settings. We suggest that ECS appears to be an easy-to-use instrument that is reliable and valid.
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Affiliation(s)
- Sojeong Kim
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea.,Chronobiology Institute, Korea University, Seoul, Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea.,Chronobiology Institute, Korea University, Seoul, Korea
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Abstract
Circadian rhythms, present in most phyla across life, are biological oscillations occurring on a daily cycle. Since the discovery of their molecular foundations in model organisms, many inputs that modify this tightly controlled system in humans have been identified. Polygenic variations and environmental factors influence each person's circadian rhythm, contributing to the trait known as chronotype, which manifests as the degree of morning or evening preference in an individual. Despite normal variation in chronotype, much of society operates on a "one size fits all" schedule that can be difficult to adjust to, especially for certain individuals whose endogenous circadian phase is extremely advanced or delayed. This is a public health concern, as phase misalignment in humans is associated with a number of adverse health outcomes. Additionally, modern technology (such as electric lights and computer, tablet, and phone screens that emit blue light) and lifestyles (such as shift or irregular work schedules) are disrupting circadian consistency in an increasing number of people. Though medical and lifestyle interventions can alleviate some of these issues, growing research on endogenous circadian variability and sensitivity suggests that broader social changes may be necessary to minimize the impact of circadian misalignment on health.
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Affiliation(s)
| | | | - Ying-Hui Fu
- Department of Neurology
- Institute for Human Genetics
- Weill Institute for Neurosciences, and
- Kavli Institute for Fundamental Neuroscience, UCSF, San Francisco, California, USA
| | - Louis J. Ptáček
- Department of Neurology
- Institute for Human Genetics
- Weill Institute for Neurosciences, and
- Kavli Institute for Fundamental Neuroscience, UCSF, San Francisco, California, USA
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39
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Putilov AA, Sveshnikov DS, Bakaeva ZV, Yakunina EB, Starshinov YP, Torshin VI, Lahana RP, Budkevich RO, Budkevich EV, Puchkova AN, Dorokhov VB. When early and late risers were left to their own devices: six distinct chronotypes under "lockdown" remained dissimilar on their sleep and health problems. Chronobiol Int 2021; 39:5-11. [PMID: 34372716 DOI: 10.1080/07420528.2021.1964518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Under national "lockdown," the habitual late risers need not wake up early, and, similarly to the early risers, they don't lose much sleep on weekdays. We tested whether, despite a decrease in weekday sleep loss, the difference between distinct chronotypes in health and sleep problems persisted during "lockdown." Two online surveys were conducted from 10th to 20th of May, 2020 and 2021, one of them after 6 non-working weeks and another after 14 working weeks (during and after "lockdown," respectively). Participants were students of the same grade at the same university department (572 and 773, respectively). The self-assessments included the Single-Item Chronotyping (SIC) designed for self-choosing chronotype among several their short descriptions and several questions about general health, mood state, outdoors and physical activity, and sleep concerns. The results suggested that the responses to each of the questions were not randomly distributed over 6 distinct chronotypes. Such a nonrandomness was identified within each of three pairs of these chronotypes, evening vs. morning types (with a rising throughout the day vs. a falling level of alertness, respectively), afternoon vs. napping types (with a peak vs. a dip of alertness in the afternoon, respectively), and vigilant vs. lethargic types (with the levels of alertness being permanently high vs. low, respectively). Morning, afternoon, and vigilant types reported healthier sleep/mood/behavior/habits than three other types. The most and the least healthy sleep/mood/behavior/habits were reported by morning and evening types, respectively. These relationships with health and sleep problems and the frequencies of 6 chronotypes remained unchanged after "lockdown." Such results, in particular, suggested that the association of evening types with poorer health and sleep might not be attributed to a big amount of weekday sleep loss. The accounting for this association might help in designing interventions purposed on reduction of sleep and health problems.
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Affiliation(s)
- Arcady A Putilov
- Research Group for Math-Modeling of Biomedical Systems, Research Institute for Molecular Biology and Biophysics of the Federal Research Centre for Fundamental and Translational Medicine, Novosibirsk, Russia.,Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia
| | - Dmitry S Sveshnikov
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Zarina V Bakaeva
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Elena B Yakunina
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Yuri P Starshinov
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Vladimir I Torshin
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Ravoori Priyamsha Lahana
- Department of Normal Physiology, Medical Institute of the Peoples' Friendship University of Russia, Moscow, Russia
| | - Roman O Budkevich
- Laboratory of Nanobiotechnology and Biophysics, The North-Caucasus Federal University, Stavropol, Russia
| | - Elena V Budkevich
- Laboratory of Nanobiotechnology and Biophysics, The North-Caucasus Federal University, Stavropol, Russia
| | - Alexandra N Puchkova
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia
| | - Vladimir B Dorokhov
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, Moscow, Russia
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40
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Walsh NA, Repa LM, Garland SN. Mindful larks and lonely owls: The relationship between chronotype, mental health, sleep quality, and social support in young adults. J Sleep Res 2021; 31:e13442. [PMID: 34272788 DOI: 10.1111/jsr.13442] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 05/22/2021] [Accepted: 06/22/2021] [Indexed: 01/15/2023]
Abstract
Chronotype is related to mental health, with evening chronotypes being more susceptible to psychological disorders than intermediate and morning types. The present study investigated the relationship between chronotype, mental health, sleep quality, and social support in Canadian young adults. We surveyed 3160 university students aged 18-35 years. Participants completed the Morningness-Eveningness Questionnaire, the Hospital Anxiety and Depression Scale, the Mindful Attention Awareness Scale, the Pittsburgh Sleep Quality Index, and the Medical Outcomes Study - Social Support Survey. We conducted Bonferroni-corrected one-way analyses of covariance with post hoc paired comparisons to determine the relationship between the aforementioned variables, with age and sex as covariates. We further looked at the moderation of social support on the relationship between chronotype and sleep quality. Overall, 55%, 36% and 9% of participants were classified as intermediate, evening and morning types, respectively. There was a significant difference between chronotype on levels of depression, anxiety, and sleep quality, with evening types reporting more severe symptomology than morning-types and intermediate types. Morning types reported greater levels of overall social support and mindfulness. Evening types reported the lowest levels of all types of social support. Social support did not moderate the relationship between chronotype and sleep quality. This study further demonstrates the association between worse psychological well-being and eveningness and between more social support, and mindfulness in morning chronotype young adults. Education and intervention are warranted to help evening chronotypes manage the potential negative features of their circadian rhythm, as well as to cultivate a greater sense of social support and mindfulness.
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Affiliation(s)
- Nyissa A Walsh
- Department of Psychology, Faculty of Science, Memorial University of Newfoundland, St. John's, NF, Canada
| | - Lily M Repa
- Department of Psychology, Faculty of Science, Memorial University of Newfoundland, St. John's, NF, Canada
| | - Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University of Newfoundland, St. John's, NF, Canada
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41
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Ceglarek A, Hubalewska-Mazgaj M, Lewandowska K, Sikora-Wachowicz B, Marek T, Fafrowicz M. Time-of-day effects on objective and subjective short-term memory task performance. Chronobiol Int 2021; 38:1330-1343. [PMID: 34121547 DOI: 10.1080/07420528.2021.1929279] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The time-of-day along with the synchrony effect (better performance at optimal times of the day according to the chronotype) on the cognitive performance has been well established in previous research. This influence is mediated by both circadian and homeostatic processes consistent with the Borbély two-process model. This experiment focused on the objective and subjective performance of the visual short-term memory task requiring holistic processing. Sixty-five young, healthy participants including 40 females were divided into morning and evening types and performed a given task in two sessions - in the morning and in the evening. Type division was made according to the chronotype questionnaire and polymorphism of the PER3 clock gene. The task was a modified version of Deese-Roediger-McDermott paradigm adjusted to study short-term memory, in which visual, abstract stimuli were used. The analysis was based on an exploratory approach investigating the influence of circadian and individual (sex) factors on execution of memory task. Evening types were more accurate in the task compared to morning types, regardless of the part of the day. The time-of-day effect was revealed on objective measures (reaction times for hits and false alarms) and subjective effort put into the performance. The reaction times were slower in the morning unlike the effort that was greater in the evening. The time-of-day × sex interaction was observed in the case of subjective effort: men described the task as more demanding in the evening. The results could be explained by differences in hemispheric dominance depending on the time-of-day. The report provides new patterns of behavioral data analysis, investigating sex aspects and use of self-assessment scales of performance.
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Affiliation(s)
- Anna Ceglarek
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Magdalena Hubalewska-Mazgaj
- Department of Drug Addiction Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Koryna Lewandowska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Barbara Sikora-Wachowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland
| | - Magdalena Fafrowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Krakow, Poland.,Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
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42
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Diurnal preference and depressive symptomatology: a meta-analysis. Sci Rep 2021; 11:12003. [PMID: 34099766 PMCID: PMC8184740 DOI: 10.1038/s41598-021-91205-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/24/2021] [Indexed: 02/05/2023] Open
Abstract
Eveningness, a preference for later sleep and rise times, has been associated with a number of negative outcomes in terms of both physical and mental health. A large body of evidence links eveningness to Major Depressive Disorder (MDD). However, to date, evidence quantifying this association is limited. The current meta-analysis included 43 effect sizes from a total 27,996 participants. Using a random-effects model it was demonstrated that eveningness is associated with a small effect size (Fisher's Z = - 2.4, 95% CI [- 0.27. - 0.21], p < 0.001). Substantial heterogeneity between studies was observed, with meta-regression analyses demonstrating a significant effect of mean age on the association between diurnal preference and depression. There was also evidence of potential publication bias as assessed by visual inspection of funnel plots and Egger's test. The association between diurnal preference and depression is small in magnitude and heterogenous. A better understanding of the mechanistic underpinnings linking diurnal preference to depression and suitably powered prospective studies that allow causal inference are required.
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43
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Li SH, Graham BM, Werner-Seidler A. Gender Differences in Adolescent Sleep Disturbance and Treatment Response to Smartphone App-Delivered Cognitive Behavioral Therapy for Insomnia: Exploratory Study. JMIR Form Res 2021; 5:e22498. [PMID: 33755029 PMCID: PMC8075040 DOI: 10.2196/22498] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/10/2020] [Accepted: 12/19/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Insomnia and sleep disturbance are pervasive and debilitating conditions affecting up to 40% of adolescents. Women and girls are at greater risk of insomnia, yet differences in treatment responsiveness between genders have not been adequately investigated. Additionally, while women report greater symptom severity and burden of illness than men, this discrepancy requires further examination in adolescents. OBJECTIVE The purpose of this study was to examine gender differences in sleep symptom profiles and treatment response in adolescents. METHODS Digital cognitive behavioral therapy for insomnia (CBT-I) treatment responsiveness, as indexed by changes in Insomnia Severity Index (ISI) and Global Pittsburgh Sleep Quality Index (PSQI) scores, was compared in boys and girls (aged 12-16 years; N=49) who participated in a pilot evaluation of the Sleep Ninja smartphone app. Gender differences in self-reported baseline insomnia symptom severity (ISI), sleep quality (PSQI), and sleep characteristics derived from sleep diaries were also examined. RESULTS Compared with boys, we found that girls reported greater symptom severity (P=.04) and nighttime wakefulness (P=.01 and P=.04) and reduced sleep duration (P=.02) and efficiency (P=.03), but not poorer sleep quality (P=.07), more nighttime awakenings (P=.16), or longer time to get to sleep (P=.21). However, gender differences in symptom severity and sleep duration were accounted for by boys being marginally younger in age. Treatment response to CBT-I was equivalent between boys and girls when comparing reductions in symptom severity (P=.32); there was a trend showing gender differences in improvements in sleep quality, but this was not statistically significant (P=.07). CONCLUSIONS These results demonstrate the presence of gender differences in insomnia symptoms and severity in adolescents and suggest further research is required to understand gender differences in insomnia symptom profiles to inform the development of gender-specific digital interventions delivered to adolescents.
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Affiliation(s)
- Sophie H Li
- Black Dog Institute, University of New South Wales, Randwick, Australia
| | - Bronwyn M Graham
- School of Psychology, University of New South Wales, Kensington, Australia
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44
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Höller Y, Gudjónsdottir BE, Valgeirsdóttir SK, Heimisson GT. The effect of age and chronotype on seasonality, sleep problems, and mood. Psychiatry Res 2021; 297:113722. [PMID: 33476898 DOI: 10.1016/j.psychres.2021.113722] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/10/2021] [Indexed: 12/15/2022]
Abstract
Seasonal affective disorder has been associated with sleep problems, young age, and an evening chronotype. A chronotype refers to an individual's preference in the timing of their sleep-wake cycle, as well as the time during the sleep-wake cycle when a person is most alert and energetic. Seasonality refers to season-dependent fluctuations in sleep length, social activity, mood, weight, appetite, and energy level. Evening chronotype is more common in young adults and morning chronotype more common in the elderly. This study aimed to estimate the differential contribution of chronotype and age on seasonality. A sample of n=410 participants were included in the study. The age groups showed significantly different results according to sleep parameters, depression, anxiety, stress, seasonality, and chronotype. The oldest group (>59 years) showed the lowest scores on all of these scales. According to a path analysis, chronotype and age predict propensity for seasonality. However, sleep problems were linked to chronotype but not to age. Older adults seem to be more resistant to seasonal changes that are perceived as a problem than young and middle aged adults. Future studies would benefit from considering cultural aspects and examine seasonality, chronotype, depression, and insomnia in longitudinal designs.
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Affiliation(s)
- Yvonne Höller
- Faculty of Psychology, University of Akureyri, Nordurslod 2, 600 Akureyri, Iceland.
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45
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Sleep-Wake Timings in Adolescence: Chronotype Development and Associations with Adjustment. J Youth Adolesc 2021; 50:628-640. [PMID: 33606125 DOI: 10.1007/s10964-021-01407-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 01/29/2021] [Indexed: 10/22/2022]
Abstract
Adolescent sleep research has focused heavily on duration and quality with less work examining chronotype, defined as individual differences in sleep-wake timings driven by the circadian rhythm. This study filled a gap in the literature by utilizing actigraphy-based sleep estimates in an accelerated longitudinal design in order to better understand the developmental trajectory and individual stability of chronotype during adolescence, as well as the associations between chronotype with risky behaviors, substance use, and depressive symptoms. A total of 329 adolescents (57% female; 21% Asian American, 31% European American, 41% Latino, 7% other ethnicity) provided actigraphy-based estimates of sleep and completed questionnaires at up to three time points, two years apart, beginning at 14-17 years of age. Multilevel modeling revealed a non-linear developmental trend in chronotype whereby eveningness increased from 14 to 19 years of age followed by a trend toward morningness. Individual differences in chronotype exhibited modest stability during adolescent development. Furthermore, greater evening chronotype was associated with more risky behaviors and substance use among males, and more substance use among older adolescents, whereas depressive symptoms were not associated with chronotype. The findings from this study may have practical implications for adolescent behavioral health interventions targeted at reducing risky behaviors and substance use among youth.
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46
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Wang W, Guo Y, Du X, Li W, Wu R, Guo L, Lu C. Associations Between Poor Sleep Quality, Anxiety Symptoms, and Depressive Symptoms Among Chinese Adolescents Before and During COVID-19: A Longitudinal Study. Front Psychiatry 2021; 12:786640. [PMID: 35095601 PMCID: PMC8795609 DOI: 10.3389/fpsyt.2021.786640] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/22/2021] [Indexed: 12/19/2022] Open
Abstract
Since the novel coronavirus disease 2019 (COVID-19) outbreak, adolescents' emerging mental health and behavior issues have been an international public health concern. This longitudinal study aimed to examine the situation of poor sleep quality, anxiety, and depressive symptoms among Chinese adolescents and to explore the associations between them before and during COVID-19. A total of 1,952 middle and high school students as eligible participants at baseline (pre-COVID-19, Wave 1; response rate: 98.79%), 1,831 eligible students were followed up at Wave 2 (October 2019 to December 2019, pre-COVID-19; retention rate: 93.80%), and 1,790 completed the follow-up at Wave 3 (during the COVID-19; retention rate: 97.80%). The mean age of the baseline students was 13.56 (SD: 1.46) years. The differences in anxiety and depressive symptoms between Wave 1, Wave 2, and Wave 3 were not statistically significant. The proportion of students with poor sleep quality increased over time, from Wave 1 (21.0%) to Wave 3 (26.0%, OR = 1.37, 95% CI = 1.17-1.60, P = 0.001) and from Wave 2 (21.9%) to Wave 3 (OR = 1.29, 95% CI = 1.11-1.51, P < 0.001). The cross-lagged generalized linear mixed models revealed that the concurrent and cross-lagged associations of poor sleep quality with anxiety symptoms across the three waves were significant (P < 0.05) and vice versa. Only a marginally significant positive cross-lagged association between poor sleep quality at Wave 2 and depressive symptoms at Wave 3 was found (standardized β estimate = 0.044, SE = 0.022, P = 0.045). Sleep quality was adversely affected during COVID-19, and the bidirectional associations of poor sleep quality with anxiety symptoms could not be neglected.
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Affiliation(s)
- Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Yangfeng Guo
- Department of Prevention and Treatment of Common Diseases Among Students, Health Promotion Center for Primary and Secondary Schools, Guangzhou, China
| | - Xueying Du
- Department of Prevention and Treatment of Common Diseases Among Students, Health Promotion Center for Primary and Secondary Schools, Guangzhou, China
| | - Wenyan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Ruipeng Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
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47
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Brandão LEM, Martikainen T, Merikanto I, Holzinger B, Morin CM, Espie CA, Bolstad CJ, Leger D, Chung F, Plazzi G, Dauvilliers Y, Matsui K, De Gennaro L, Sieminski M, Nadorff MR, Chan NY, Wing YK, Mota-Rolim SA, Inoue Y, Partinen M, Benedict C, Bjorvatn B, Cedernaes J. Social Jetlag Changes During the COVID-19 Pandemic as a Predictor of Insomnia - A Multi-National Survey Study. Nat Sci Sleep 2021; 13:1711-1722. [PMID: 34675720 PMCID: PMC8502537 DOI: 10.2147/nss.s327365] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/12/2021] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Lifestyle and work habits have been drastically altered by restrictions due to the COVID-19 pandemic. Whether the associated changes in sleep timing modulate the risk of suffering from symptoms of insomnia, the most prevalent sleep disorder, is however incompletely understood. Here, we evaluate the association between the early pandemic-associated change in 1) the magnitude of social jetlag (SJL) - ie, the difference between sleep timing on working vs free days - and 2) symptoms of insomnia. PATIENTS AND METHODS A total of 14,968 anonymous participants (mean age: 40 years; 64% females) responded to a standardized internet-based survey distributed across 14 countries. Using logistic multivariate regression, we examined the association between the degree of social jetlag and symptoms of insomnia, controlling for important confounders like social restriction extension, country specific COVID-19 severity and psychological distress, for example. RESULTS In response to the pandemic, participants reported later sleep timing, especially during workdays. Most participants (46%) exhibited a reduction in their SJL, whereas 20% increased it; and 34% reported no change in SJL. Notably, we found that both increased and decreased SJL, as a result of the COVID-19 pandemic, were associated with later sleep midpoint (indicating a later chronotype) as well as more recurrent and moderate-to-severe symptoms of insomnia (about 23-54% higher odds ratio than subjects with unchanged SJL). Primarily those with reduced SJL shifted their bedtimes to a later timepoint, compared with those without changes in SJL. CONCLUSION Our findings offer important insights into how self-reported changes to the stability of sleep/wake timing, as reflected by changes in SJL, can be a critical marker of the risk of experiencing insomnia-related symptoms - even when individuals manage to reduce their social jetlag. These findings emphasize the clinical importance of analyzing sleep-wake regularity.
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Affiliation(s)
| | | | - Ilona Merikanto
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.,Orton Orthopaedic Hospital, Helsinki, Finland
| | - Brigitte Holzinger
- ZK-Schlafcoaching, Medical University Vienna, Vienna, Austria.,Institute for Consciousness and Dream Research, Vienna, Austria
| | - Charles M Morin
- École de Psychologie, Université Laval, Québec, Canada.,Centre d'étude des troubles du sommeil, Université Laval, Québec, Canada.,Centre de recherche CERVO/Brain Research Center, Université Laval, Québec, Canada
| | - Colin A Espie
- Sleep & Circadian Institute, University of Oxford, Oxford, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Courtney J Bolstad
- Department of Psychology, Mississippi State University, Starkville, MS, USA
| | - Damien Leger
- APHP, VIFASOM, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Université de Paris, Paris, France
| | - Frances Chung
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Yves Dauvilliers
- Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier, Montpellier, France
| | - Kentaro Matsui
- National Center of Neurology and Psychiatry National Institute of Mental Health, Department of Clinical Laboratory and Department of Sleep-Wake Disorders, Tokyo, Japan.,Tokyo Women's Medical University, Department of Psychiatry, Tokyo, Japan
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Mariusz Sieminski
- Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Michael R Nadorff
- Department of Psychology, Mississippi State University, Starkville, MS, USA.,Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Sérgio Arthuro Mota-Rolim
- Brain Institute, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Physiology and Behaviour Department, Federal University of Rio Grande do Norte, Natal, RN, Brazil.,Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Markku Partinen
- Helsinki Sleep Clinic, Vitalmed Research Center, Terveystalo Biobank and Research, Helsinki, Finland.,Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland
| | - Christian Benedict
- Sleep Science Laboratory, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Bjorn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Jonathan Cedernaes
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Department of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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48
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Li T, Xie Y, Tao S, Yang Y, Xu H, Zou L, Tao F, Wu X. Chronotype, Sleep, and Depressive Symptoms Among Chinese College Students: A Cross-Sectional Study. Front Neurol 2020; 11:592825. [PMID: 33391156 PMCID: PMC7773835 DOI: 10.3389/fneur.2020.592825] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 11/30/2020] [Indexed: 01/13/2023] Open
Abstract
Objective: To describe the prevalence of chronotype and depressive symptoms among Chinese college students and to examine the association between chronotype and depressive symptoms. Methods: From April to May 2019, a cross-sectional survey was conducted among 1,179 Chinese college students from 2 universities in Anhui and Jiangxi provinces. A total of 1,135 valid questionnaires were collected, the valid response rate was 98.6%. The questionnaire investigated age, gender, major, height, weight, only child status, living place, self-reported family economy, and self-reported study burden. The chronotype was assessed by the Morning and Evening Questionnaire (MEQ). Depressive symptoms and sleep quality were evaluated by the Patient Health Questionnaire 9 (PHQ-9) and the Pittsburgh Sleep Quality Index (PSQI), respectively. A Chi-square test was used to examine the proportion of depressive symptoms among Chinese college students with different demographic characteristics. The generalized linear model was used to analyze the relationships between chronotype and depressive symptoms. Results: The proportion of morning types (M-types), neutral types (N-types), and evening types (E-types) of college students were 18.4, 71.1, and 10.5%, respectively. The proportion of mild depression, moderate depression, and moderate to severe depression of participants were 32.4, 6.0, and 4.2%, respectively. Compared to the M-types, after controlled for age, gender, major, sleep quality, self-reported study burden, father's education level, and self-reported family economy, depressive symptoms were positively correlated with E-types (OR = 2.36, 95% CI: 1.49–3.73). Conclusions: There was a significant association between chronotype and depressive symptoms among Chinese college students. Further longitudinal studies were needed to clarify the causal relationship between chronotype and depressive symptoms.
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Affiliation(s)
- Tingting Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Yang Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Shuman Tao
- Department of Nephrology, The Second Hospital of Anhui Medical University, Hefei, China
| | - Yajuan Yang
- School of Nursing, Anhui Medical University, Hefei, China
| | - Honglv Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Liwei Zou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Xiaoyan Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
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Monteiro RP, Nascimento BS, Monteiro TMC, da Silva PDG, Ferreira AJC. Psychometric Evidence of the 7-Item Generalized Anxiety Disorder Questionnaire in Brazil. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00423-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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50
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Chan NY, Zhang J, Tsang CC, Li AM, Chan JWY, Wing YK, Li SX. The associations of insomnia symptoms and chronotype with daytime sleepiness, mood symptoms and suicide risk in adolescents. Sleep Med 2020; 74:124-131. [DOI: 10.1016/j.sleep.2020.05.035] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 12/22/2022]
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