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Becker SP, Brown A, Langberg JM, Beebe DW. Later ("evening") circadian preference is associated with poorer executive, academic, and attentional functioning in adolescents with and without ADHD. J Child Psychol Psychiatry 2024. [PMID: 39031776 DOI: 10.1111/jcpp.14030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND Adolescents vary considerably in their circadian phase preference; those with greater "eveningness" (also known as "night owls") have later bedtimes, wake times, and peak arousal compared to those with greater "morningness." Prior research suggests that (a) greater eveningness is associated with worse academic, executive, and attentional functioning; and (b) adolescents with attention-deficit/hyperactivity disorder (ADHD) tend to be high in eveningness and to have deficits in these school-related constructs. However, few studies have examined circadian preference alongside two potential confounds-sleep duration and sleep quality-as predictors of daytime functioning, or whether the strength of associations differs across adolescents with and without ADHD. METHODS Participants were 302 adolescents (Mage = 13.17 years; 44.7% female; 81.8% White); approximately half (52%) had ADHD. A multi-method, multi-informant design was used. Specifically, adolescents reported on their circadian preference, school night sleep duration, and sleep quality. Adolescents provided ratings of their academic motivation (intrinsic, extrinsic, and amotivation) and were administered standardized achievement tests in reading and math. Adolescents and parents completed ratings of daily life executive functioning (behavioral, emotion, and cognitive regulation), and they and teachers also provided ratings of ADHD inattentive symptoms. RESULTS Above and beyond sleep duration, sleep quality, and covariates (sex, family income, pubertal development, medication use), greater eveningness was uniquely associated with poorer academic, executive, and attentional functioning across most measures. Sleep quality was uniquely associated with a handful of outcomes, and sleep duration was not significantly uniquely associated with any outcome in the regression analyses. ADHD status did not moderate effects. CONCLUSIONS This study provides compelling evidence that poorer academic, executive, and attentional functioning are more closely associated with greater eveningness than with sleep duration or quality in adolescents. Findings suggest that targeting circadian preference may be important to reduce these problems in adolescents, especially in clinical samples such as ADHD for whom academic, executive, and attentional difficulties are exceptionally common.
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Affiliation(s)
- Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Joshua M Langberg
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, NJ, USA
| | - Dean W Beebe
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Ying ZQ, Li DL, Liang G, Yin ZJ, Li YZ, Ma R, Qin Y, Zheng YJ, Wang P, Pan CW. Reduced Health-Related Quality of Life Due to Mobile Phone Dependence in a Sample of Chinese College Students: The Mediating Role of Chronotype and Sleep Quality. Am J Health Promot 2024:8901171241258375. [PMID: 38831423 DOI: 10.1177/08901171241258375] [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: 06/05/2024]
Abstract
PURPOSE Presenting a chain mediation model to investigate whether mobile phone dependence results in a reduction in health-related quality of life (HRQoL) among Chinese college students, through the mediating effect of chronotype and sleep quality. DESIGN AND SETTING A cross-sectional survey was conducted on students from a Chinese university using a validated structured questionnaire. SAMPLE 2014 freshmen. MEASURES The study measured the students' level of mobile phone dependence using the Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use. Chronotype and sleep quality were measured by the Chinese version of the Morningness-Eveningness Questionnaire (MEQ) and the Pittsburgh Sleep Quality Index (PSQI), respectively. HRQoL was evaluated using the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L), including a descriptive system and a visual analog scale (VAS). ANALYSIS Descriptive statistical analysis, correlation analysis, and mediation analysis. RESULTS Mobile phone dependence had a significant negative effect on HRQoL as indicated by both the EQ-5D-5L index score and EQ-VAS score (P < .001 for both). Additionally, it was found to significantly predict chronotype (MEQ score) (β = -.546, P < .001) and sleep quality (PSQI score) (β = .163, P < .001). Chronotype negatively predict sleep quality (β = -.058, P < .001), and sleep quality was a significant negative predictor of HRQoL (EQ-5D-5L index score, β = -.008, P < .001; EQ-VAS score, β = -1.576, P < .001). CONCLUSION Mobile phone dependence negatively impacts students' HRQoL through chronotype and sleep quality, and there is a chain mediating effect. Students should consider making lifestyle changes to improve their HRQoL and promote health.
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Affiliation(s)
- Zhi-Qi Ying
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Dan-Lin Li
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Gang Liang
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Zhi-Jian Yin
- Department of Ophthalmology, The First Affiliated Hospital of Dali University, Dali, China
| | - Yue-Zu Li
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Rong Ma
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Yu Qin
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Ya-Jie Zheng
- Department of Ophthalmology, The Affiliated Hospital of Yunnan University, Kunming, China
- Department of Ophthalmology, The Second People's Hospital of Yunnan Province, Kunming, China
| | - Pei Wang
- School of Public Health, Fudan University, Shanghai, China
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China
| | - Chen-Wei Pan
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
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Troxel WM, Klein DJ, Dong L, Mousavi Z, Dickerson DL, Johnson CL, Palimaru AI, Brown RA, Rodriguez A, Parker J, Schweigman K, D’Amico EJ. Sleep Problems and Health Outcomes Among Urban American Indian and Alaska Native Adolescents. JAMA Netw Open 2024; 7:e2414735. [PMID: 38833247 PMCID: PMC11151157 DOI: 10.1001/jamanetworkopen.2024.14735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/02/2024] [Indexed: 06/06/2024] Open
Abstract
Importance Adolescent sleep problems are prevalent, particularly among racial and ethnic minority groups, and can increase morbidity. Despite the numerous strengths of their racial and ethnic group, urban American Indian and Alaska Native adolescents face significant health disparities but are rarely included in health research. Understanding how sleep problems are associated with health outcomes among American Indian and Alaska Native adolescents may elucidate novel targets for interventions to promote health equity. Objective To assess whether baseline sleep problems are associated with changes in behavioral and cardiometabolic health outcomes among urban American Indian and Alaska Native adolescents 2 years later. Design, Setting, and Participants American Indian and Alaska Native adolescents were recruited via flyers and community events for an observational cohort study in California. Baseline assessments were conducted among 142 adolescents from March 1, 2018, to March 31, 2020, and follow-ups were conducted among 114 adolescents from December 1, 2020, to June 30, 2022. Exposures Baseline actigraphy-assessed sleep duration and efficiency and self-reported sleep disturbances and social jet lag (absolute value of the difference in sleep midpoint on weekends vs weekdays; indicator of circadian misalignment). Main Outcomes and Measures Main outcome measures included self-reported depression (measured using the Patient Health Questionnaire), anxiety (measured using the Generalized Anxiety Disorder 7-item scale), past year alcohol and cannabis use, body mass index, systolic blood pressure (SBP) and diastolic blood pressure (DBP), waist circumference, and glycosylated hemoglobin (HbA1c). Analyses examined whether baseline sleep was associated with health outcomes at follow-up, controlling for age, sex, and baseline outcome measures. Results The baseline sample included 142 urban American Indian and Alaska Native adolescents (mean [SD] age, 14.0 [1.4] years; 84 girls [59%]), 80% of whom (n = 114; mean [SD] age, 14.1 [1.3] years; 71 girls [62%]) completed follow-ups. Linear or logistic regressions showed significant negative associations between shorter sleep duration and depression (β = -1.21 [95% CI, -2.19 to -0.24]), anxiety (β = -0.89 [95% CI, -1.76 to -0.03]), DBP (β = -2.03 [95% CI, -3.79 to -0.28]), and HbA1c level (β = -0.15 [95% CI, -0.26 to -0.04]) and likelihood of alcohol (odds ratio [OR], 0.57 [95% CI, 0.36-0.91]) and cannabis use (full week: OR, 0.59 [95% CI, 0.35-0.99]) at follow-up. Greater social jet lag was associated with significantly higher SBP (β = 0.06 [95% CI, 0.01-0.11]) at follow-up. Conclusions and Relevance This cohort study found significant associations between poor sleep and adverse changes in health outcomes. Findings highlight the importance of developing culturally responsive interventions that target sleep as a key modifiable risk factor to improve the health of American Indian and Alaska Native adolescents.
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Affiliation(s)
- Wendy M. Troxel
- Behavioral and Policy Sciences, Division of Social and Economic Wellbeing, RAND Corporation, Pittsburgh, Pennsylvania
| | - David J. Klein
- Behavioral and Policy Sciences, Division of Social and Economic Wellbeing, RAND Corporation, Santa Monica, California
| | - Lu Dong
- Behavioral and Policy Sciences, Division of Social and Economic Wellbeing, RAND Corporation, Santa Monica, California
| | - Zahra Mousavi
- Behavioral and Policy Sciences, Division of Social and Economic Wellbeing, RAND Corporation, Santa Monica, California
| | - Daniel L. Dickerson
- UCLA Integrated Substance Abuse Program, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California
| | | | - Alina I. Palimaru
- Behavioral and Policy Sciences, Division of Social and Economic Wellbeing, RAND Corporation, Santa Monica, California
| | - Ryan A. Brown
- Behavioral and Policy Sciences, Division of Social and Economic Wellbeing, RAND Corporation, Santa Monica, California
| | - Anthony Rodriguez
- Behavioral and Policy Sciences, Division of Social and Economic Wellbeing, RAND Corporation, Boston, Massachusetts
| | - Jennifer Parker
- Behavioral and Policy Sciences, Division of Social and Economic Wellbeing, RAND Corporation, Santa Monica, California
| | | | - Elizabeth J. D’Amico
- Behavioral and Policy Sciences, Division of Social and Economic Wellbeing, RAND Corporation, Santa Monica, California
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Ciner OA, Cilli AS, Yazici AB, Bakay H, Gica Ş. The effect of chronotypes on follow-up outcomes of patients with substance use disorder. Sleep Biol Rhythms 2024; 22:247-258. [PMID: 38524170 PMCID: PMC10959913 DOI: 10.1007/s41105-023-00496-8] [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: 06/07/2023] [Accepted: 10/06/2023] [Indexed: 03/26/2024]
Abstract
Substance use disorder (SUD) can have circadian characteristics and individuals with evening chronotype are more prone to addiction. In this study, the effect of chronotypes on the treatment outcomes of SUD was investigated. The study included 66 patients who were diagnosed with SUD according to DSM-5. Two clinical interviews were conducted at 6-month intervals, and remission/relapse status was evaluated at the second interview. The Structured Clinical Interview Form for DSM-IV Axis I Disorders (SCID-I), Addiction Profile Index Practitioner Form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Pittsburg Sleep Quality Index and Morningness-Eveningness Questionnaire (MEQ) were applied to the patients. MEQ scores of relapsed patients were found to be different in terms of eveningness than those in remission (45.62 ± 8.70 versus 49.75 ± 7.60, p = 0.045). As the craving and addiction profile index total scores (addiction severity) increased, eveningness chronotype scores also increased (r = - 0.387 and r = - 0.286, respectively). The mean scores of craving and BDI were higher in relapsed patients compared to those in remission (p = 0.003 and p = 0.015, respectively). Our results suggest that patients with SUD had a lower morningness chronotype than the general population; additionally, more relapsed patients had an eveningness chronotype. Thus, chronotypes may play a role in the onset, prevention, and treatment outcome of SUD.
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Affiliation(s)
- Ozlem Akcay Ciner
- Department of Psychiatry, Duzce Ataturk State Hospital, Duzce, Turkey
| | - Ali Savas Cilli
- Department of Psychiatry, Medical Faculty, Sakarya University, Sakarya, Turkey
| | - Ahmet Bulent Yazici
- Department of Psychiatry, Medical Faculty, Sakarya University, Sakarya, Turkey
| | - Hasan Bakay
- Department of Psychiatry, Meram Medical Faculty, Necmettin Erbakan University, Yunus Emre Mah. Beyşehir Cad. No: 281, Meram, 42090 Konya, Turkey
| | - Şakir Gica
- Department of Psychiatry, Meram Medical Faculty, Necmettin Erbakan University, Yunus Emre Mah. Beyşehir Cad. No: 281, Meram, 42090 Konya, Turkey
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Minz S, Pati AK, Mohapatra M, Pati UC, Sahu P, Acharya PK, Kumari RB, Satpathy R. Patterns in behavioural sleep variables and social jetlag in elderly people of Western Odisha. Chronobiol Int 2024; 41:473-484. [PMID: 38353253 DOI: 10.1080/07420528.2024.2315216] [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: 09/04/2023] [Accepted: 02/01/2024] [Indexed: 02/17/2024]
Abstract
In humans, sleep is an essential physiological process for life and survival. The main objective of the current study is to determine the behavioural sleep patterns and social jetlag in elderly adults. The second objective is to define the relationship among subjective sleep quality, mid-sleep timings, social jetlag, and sunlight exposure. We recruited 945 female and 1047 male participants aged ≥ 60 years from 65 rural villages in the Sambalpur district of Odisha, India. The Munich Chrono Type Questionnaire (MCTQ) is a self-reported questionnaire that measures a person's behavioral sleep variables, including social jetlag and chronotype, whereas the Pittsburgh Sleep Quality Index (PSQI) measures the subjective sleep quality of an individual. We employed MCTQ and PSQI to obtain behavioral sleep variables and subjective sleep quality in the recruited subjects. The behavioral sleep variables were compared using a paired t-test on both work and work-free days. In addition, the behavioral sleep variables as a function of gender were compared using an independent Student's t-test. In the current study, most of the elderly individuals reported both midpoint of sleep on workdays (MSW) and midpoint of sleep on work-free days (MSF) between 00:01-03:00. The averages of mid-sleep timings between workdays and work-free days were not statistically significant. Data on MSFsc (midpoint of sleep on work-free days sleep corrected) indicated that most elderly adults (99.6%) are morning type; they go to bed early and wake up early. The elderly participants from the rural population of Sambalpur district in western Odisha had the least social jetlag and exhibited good subjective sleep quality. It would be worthwhile to find out the determinants of these positive features apropos social jetlag and behavioural sleep patterns.
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Affiliation(s)
- Sarojini Minz
- Center of Excellence, Odisha Center for Geriatrics and Gerontology, Gangadhar Meher University, Sambalpur, India
| | - Atanu Kumar Pati
- Odisha State Higher Education Council, Government of Odisha, Bhubaneswar, India
- School of Comparative Indic Studies and Tribal Sciences, Kalinga Institute of Social Sciences, Bhubaneswar, India
| | - Monalisa Mohapatra
- Center of Excellence, Odisha Center for Geriatrics and Gerontology, Gangadhar Meher University, Sambalpur, India
- School of Chemistry, Gangadhar Meher University, Sambalpur, India
| | - Uma Charan Pati
- School of Economics, Gangadhar Meher University, Sambalpur, India
| | - Pritipadma Sahu
- Center of Excellence, Odisha Center for Geriatrics and Gerontology, Gangadhar Meher University, Sambalpur, India
| | - Pradosh Kumar Acharya
- Center of Excellence, Odisha Center for Geriatrics and Gerontology, Gangadhar Meher University, Sambalpur, India
- School of Botany, Gangadhar Meher University, Sambalpur, India
| | - Rupashree Brahma Kumari
- Center of Excellence, Odisha Center for Geriatrics and Gerontology, Gangadhar Meher University, Sambalpur, India
- School of Pshychology, Gangadhar Meher University, Sambalpur, India
| | - Raghunath Satpathy
- Center of Excellence, Odisha Center for Geriatrics and Gerontology, Gangadhar Meher University, Sambalpur, India
- School of Biotechnology, Gangadhar Meher University, Sambalpur, India
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Poon K, Ho MSH, Tai APL, Leung MK, Chan MCM, Lau WKW. Mediating roles of sleep quality and resilience in the relationships between chronotypes and mental health symptoms. Sci Rep 2024; 14:5874. [PMID: 38467740 PMCID: PMC10928116 DOI: 10.1038/s41598-024-56688-w] [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: 11/23/2023] [Accepted: 03/09/2024] [Indexed: 03/13/2024] Open
Abstract
Sleep and mental health are intrinsically intertwined, but not every individual with problems sleeping develops a mental health disorder. This study examined the association among chronotypes, resilience, sleep quality and mental health symptoms amongst otherwise healthy individuals. Two hundred adults (Mage = 27.75 ± 5.11, 68% female) with no previous diagnosis of mental illness were recruited and filled in a set of questionnaires measuring chronotypes, sleep quality, depression and anxiety symptoms. The findings from the path analysis showed that the morning type had a statistically significant direct effect on a range of sleep quality indices. These included better subjective sleep quality, shortened sleep latency, and fewer daytime dysfunctions, as well as a higher level of resilience. However, it did not significantly affect depression and anxiety symptoms. In addition, the morning type had statistically significant indirect effects on a higher level of resilience and fewer depression and anxiety symptoms through the mediating effect of sleep quality indices. Findings from this study support that morning type is associated with better resilience and psychological health, which is mediated through better sleep quality.
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Affiliation(s)
- Kean Poon
- School of Education, The University of New South Wales, Sydney, Australia
| | - Mimi S H Ho
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong, China
| | - Alan P L Tai
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong, China
| | - Mei-Kei Leung
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, China
| | - Meanne C M Chan
- Wofoo Joseph Lee Consulting and Counselling Psychology Research Centre, Lingnan University of Hong Kong, Room 213, LBY Building, 8 Castle Peak Road, Tuen Mun, Hong Kong, China.
| | - Way K W Lau
- Department of Health Sciences, Hong Kong Metropolitan University, Room F1229, 12/F, 1 Sheung Shing Street, Ho Man Tin, Kowloon, Hong Kong, China.
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Luz CSDS, Fonseca AETPD, Santos JS, Araujo JF, Duarte LL, Moreno CRDC. Association of Meal Timing with Sleep Quality and Anxiety According to Chronotype: A Study of University Students. Clocks Sleep 2024; 6:156-169. [PMID: 38534799 DOI: 10.3390/clockssleep6010011] [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: 12/04/2023] [Revised: 03/03/2024] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
There are several determinants of mental health symptoms, ranging from individual characteristics to social factors. Consistent with patterns in the general population, students with evening characteristics tend to exhibit more anxiety symptoms and poorer sleep quality compared to morning students. Meal timing also appears to affect sleep and may be associated with mental health symptoms. In this context, the aim of the present study was to investigate the association of the timing of the main and last meals of the day with sleep quality and anxiety levels, according to the chronotype of university students. This study was conducted in colleges in São Paulo, Brazil, and involved application of a questionnaire to 162 university students. The questionnaire collected sociodemographic information meal and study times, and included scales assessing eveningness and morningness, sleep quality, and anxiety. Students demonstrating a phase delay in both chronotype and dinner timing exhibited higher levels of anxiety compared to morning-type students. Although no associations were observed between meal timing and sleep quality, sleeping later was associated with poorer sleep quality. The study suggests that evening students and those who eat late at night are more prone to presenting mental health symptoms. More studies are needed to further investigate this association.
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Affiliation(s)
- Cristina Souza da Silva Luz
- Department of Health, Life Cycles, and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | | | - Jefferson Souza Santos
- Department of Health, Life Cycles, and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
- Department of Theory and Foundations of Education, Education Sector, Federal University of Paraná, Curitiba 80230-130, Brazil
| | - John Fontenele Araujo
- Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal 59078-900, Brazil
| | - Leandro Lourenção Duarte
- Department for Health Sciences, Federal University of Recôncavo da Bahia, Cruz das Almas 44380-000, Brazil
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Agostini A, Centofanti S. Normal Sleep in Children and Adolescence. Psychiatr Clin North Am 2024; 47:1-14. [PMID: 38302199 DOI: 10.1016/j.psc.2023.06.001] [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] [Indexed: 02/03/2024]
Abstract
Adequate sleep is essential for healthy development in childhood and adolescence. Healthy sleep contributes to good physical health, immune function, mental health, and academic performance. The regulation and architecture of sleep change greatly across childhood and adolescence, and the ability to obtain sufficient sleep is impacted by a range of factors that change with maturation. This article describes normal sleep across childhood and adolescence and discusses some of the most common barriers to adequate sleep, including early school start times, technology use, and changes to circadian rhythms, and sleep homeostasis across puberty.
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Affiliation(s)
- Alex Agostini
- Sleep and Chronobiology Laboratory, University of South Australia, Adelaide, Australia.
| | - Stephanie Centofanti
- UniSA Online, University of South Australia, University of South Australia Online, L4, Catherine Helen Spence Building, City West Campus, Adelaide, South Australia 5000, Australia
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Morales-Ghinaglia N, He F, Calhoun SL, Vgontzas AN, Liao J, Liao D, Bixler EO, Fernandez-Mendoza J. Circadian misalignment impacts the association of visceral adiposity with metabolic syndrome in adolescents. Sleep 2024; 47:zsad262. [PMID: 37792965 PMCID: PMC10782492 DOI: 10.1093/sleep/zsad262] [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: 08/02/2023] [Revised: 09/08/2023] [Indexed: 10/06/2023] Open
Abstract
STUDY OBJECTIVES Although insufficient sleep is a risk factor for metabolic syndrome (MetS), the circadian timing of sleep (CTS) is also involved in cardiac and metabolic regulation. We examined whether delays and deviations in the sleep midpoint (SM), a measure of CTS, modify the association between visceral adipose tissue (VAT) and MetS in adolescents. METHODS We evaluated 277 adolescents (median 16 years) who had at least 5 nights of at-home actigraphy (ACT), in-lab polysomnography (PSG), dual-energy X-ray absorptiometry (DXA) scan, and MetS score data. Sleep midpoint (SM), sleep irregularity (SI), and social jetlag (SJL) were examined as effect modifiers of the association between VAT and MetS, including waist circumference, blood pressure, insulin resistance, triglycerides, and cholesterol. Linear regression models adjusted for demographics, ACT-sleep duration, ACT-sleep variability, and PSG-apnea-hypopnea index. RESULTS The association between VAT and MetS was significantly stronger (p-values for interactions < 0.001) among adolescents with a schooldays SM later than 4:00 (2.66 [0.30] points increase in MetS score), a SI higher than 1 hour (2.49 [0.30]) or a SJL greater than 1.5 hours (2.15 [0.36]), than in those with an earlier SM (<3:00; 1.76 [0.28]), lower SI (<30 minutes; 0.98 [0.70]), or optimal SJL (<30 minutes; 1.08 [0.45]). CONCLUSIONS A delayed sleep phase, an irregular sleep-wake cycle, and greater social jetlag on schooldays identified adolescents in whom VAT had a stronger association with MetS. Circadian misalignment is a risk factor that enhances the impact of visceral obesity on cardiometabolic morbidity and should be a target of preventative strategies in adolescents.
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Affiliation(s)
- Natasha Morales-Ghinaglia
- Sleep Research and Treatment Center, College of Medicine, Department of Psychiatry and Behavioral Health, Penn State University, Hershey, PA, USA
| | - Fan He
- Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA, USA
| | - Susan L Calhoun
- Sleep Research and Treatment Center, College of Medicine, Department of Psychiatry and Behavioral Health, Penn State University, Hershey, PA, USA
| | - Alexandros N Vgontzas
- Sleep Research and Treatment Center, College of Medicine, Department of Psychiatry and Behavioral Health, Penn State University, Hershey, PA, USA
| | - Jason Liao
- Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA, USA
| | - Duanping Liao
- Department of Public Health Sciences, College of Medicine, Penn State University, Hershey, PA, USA
| | - Edward O Bixler
- Sleep Research and Treatment Center, College of Medicine, Department of Psychiatry and Behavioral Health, Penn State University, Hershey, PA, USA
| | - Julio Fernandez-Mendoza
- Sleep Research and Treatment Center, College of Medicine, Department of Psychiatry and Behavioral Health, Penn State University, Hershey, PA, USA
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10
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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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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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May CP, Hasher L, Healey K. For Whom (and When) the Time Bell Tolls: Chronotypes and the Synchrony Effect. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:1520-1536. [PMID: 37369064 DOI: 10.1177/17456916231178553] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Circadian rhythms are powerful timekeepers that drive physiological and intellectual functioning throughout the day. These rhythms vary across individuals, with morning chronotypes rising and peaking early in the day and evening chronotypes showing a later rise in arousal, with peaks in the afternoon or evening. Chronotype also varies with age from childhood to adolescence to old age. As a result of these differences, the time of day at which people are best at attending, learning, solving analytical problems, making complex decisions, and even behaving ethically varies. Across studies of attention and memory and a range of allied areas, including academic achievement, judgment and decision-making, and neuropsychological assessment, optimal outcomes are found when performance times align with peaks in circadian arousal, a finding known as the synchrony effect. The benefits of performing in synchrony with one's chronotype (and the costs of not doing so) are most robust for individuals with strong morning or evening chronotypes and for tasks that require effortful, analytical processing or the suppression of distracting information. Failure to take the synchrony effect into consideration may be a factor in issues ranging from replication difficulties to school timing to assessing intellectual disabilities and apparent cognitive decline in aging.
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Affiliation(s)
| | - Lynn Hasher
- Rotman Research Institute, Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto
| | - Karl Healey
- Department of Psychology, Michigan State University
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13
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Dolsen EA, Dong L, Harvey AG. Transdiagnostic Sleep and Circadian Intervention for Adolescents Plus Text Messaging: Randomized Controlled Trial 12-month Follow-up. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:750-762. [PMID: 34936528 PMCID: PMC9213566 DOI: 10.1080/15374416.2021.1978295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The Transdiagnostic Sleep and Circadian Intervention for Youth (TranS-C) was developed to improve sleep and circadian functioning in adolescents. This study examined the 12-month effects for TranS-C compared with psychoeducation (PE). We also investigated whether a text messaging intervention can promote maintenance of treatment effects. METHOD At the baseline, adolescents (58% female, average age = 14.8 years) with an eveningness chronotype were randomized to TranS-C (n = 89) or PE (n = 87). At 6-month follow-up, participants were randomized to receive text messages that had repeated treatment information (n = 47), text messages that prompted the recall of treatment information (n = 50), or no text messages (n = 47). RESULTS Relative to PE, TranS-C was associated with a reduced eveningness (b = 2.06, p = .005, d = 0.29) from the baseline to a 12-month follow-up. TranS-C treatment effects, relative to PE, were augmented by receiving text messages, compared to no text messages, for eveningness from baseline to 12-month follow-up (b = 1.38, p = .008, d = 0.28) and from 6- to 12-month follow-up (b = 1.07, p = .046, d = 0.21). Neither TranS-C nor text messages were significantly associated with other primary outcomes. TranS-C and text messages were significantly associated with improvements on selected secondary sleep and health outcomes through follow-up. CONCLUSIONS For adolescents with an eveningness chronotype, improved sleep and circadian functioning on selected outcomes were maintained over 12 months for TranS-C compared with PE. Text messages boosted the effects of TranS-C through 12-month follow-up.
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Affiliation(s)
- Emily A. Dolsen
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
- Mental Illness Research Education and Clinical Centers, San Francisco VA Healthcare System. San Francisco, CA, USA
| | - Lu Dong
- RAND Corporation, Santa Monica, CA, USA
| | - Allison G. Harvey
- Department of Psychology, University of California, Berkeley, CA, Berkeley, CA, USA
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14
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Crowley R, Javadi AH, Tamminen J. Better alignment between circadian preference and sleep and work timings during COVID-19 did not benefit work engagement at home. Chronobiol Int 2023; 40:1361-1374. [PMID: 37840270 DOI: 10.1080/07420528.2023.2258954] [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: 04/26/2023] [Accepted: 09/09/2023] [Indexed: 10/17/2023]
Abstract
Modern society is structured around early routines which cause evening types to suffer from health and performance detriments associated with sleep times being misaligned with biological needs (circadian preference). Given that COVID-19 lockdowns were less constrained by social schedules, the current study explores whether temporal behaviours became better aligned with biological needs, and whether these changes benefited work engagement. 406 UK participants reported circadian preference and pre-lockdown and lockdown sleep times, work times, and work engagement. Results found that sleep health improved under lockdown measures in terms of increased sleep duration and reduced social jetlag, and sleep and work times became better aligned with circadian preferences. The most circadian-misaligned participants - students and young adults - exhibited the largest changes to sleep and work habits. However, work engagement decreased more in participants with improved social jetlag and delayed work habits, which is surprising given that these temporal changes reflect improved circadian alignment. We discuss potential moderators including poor sleep quality, non-engaging work-from-home environments, and mental health. These findings have implications for encouraging flexible educational and employment schedules post-COVID-19 to satisfy the common drive to improve circadian alignment, but future work must determine the moderating factors that impair work engagement during remote work.
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Affiliation(s)
- Rebecca Crowley
- Department of Psychology, Royal Holloway, University of London, Egham, UK
| | | | - Jakke Tamminen
- Department of Psychology, Royal Holloway, University of London, Egham, UK
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15
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Conway A, Miller AL. Social jetlag longitudinally predicts internalizing and externalizing behavior for adolescent females, but not males. Chronobiol Int 2023; 40:1404-1418. [PMID: 37814409 DOI: 10.1080/07420528.2023.2265480] [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: 12/09/2021] [Accepted: 09/26/2023] [Indexed: 10/11/2023]
Abstract
Biological changes contribute to preferences for later bed and wake times during adolescence, yet the social constraints of school start times necessitate early wake times. This often results in social jetlag (i.e. misalignment between preferred sleep timing on weekends and school days). We examined whether social jetlag predicts adolescent internalizing and externalizing behavior over time and/or whether associations differ based on sex. We used data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development Study (n = 767) to test whether social jetlag at 6th grade (ages 12-13 years) predicted internalizing and externalizing behavior at age 15 years and whether child sex moderated associations. Controlling for internalizing and externalizing behavior at 6th grade (ages 12-13 years), results were that social jetlag at 6th grade (ages 12-13 years) predicted more internalizing and externalizing behaviors at age 15 for females, but not males. These findings show that social jetlag during early adolescence confers risk for internalizing and externalizing behavior in females at mid-adolescence. Greater attention should be placed on identifying and addressing social jetlag in adolescent females.
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Affiliation(s)
- Anne Conway
- Social Work, University of Tennessee, Knoxville, Knoxville, Tennessee, USA
- Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Alison L Miller
- Public Health, University of Michigan, Ann Abor, Michigan, USA
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16
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İpar N. The effect of circadian preference and sleep disturbances on depression in children 6 to 12 years of age. Chronobiol Int 2023; 40:1375-1386. [PMID: 37781873 DOI: 10.1080/07420528.2023.2262577] [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: 01/19/2023] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
Circadian rhythm and sleep disruption have been associated with depressive symptoms in children. This study was conducted to determine sleep disturbances and circadian preferences and their possible associations with depression in healthy children 6 to 12 years of age. A total of 111 healthy children (mean age 7.5 years; 62.2% male) were included. Sleep disturbances and depression were determined by the Sleep Disturbance Scale for Children (SDSC) and the Children's Depression Inventory (CDI), respectively. Circadian preference was evaluated by the Morningness - Eveningness Stability Scale improved (MESSi). SDSC was correlated with CDI (r = 0.396, p < 0.001). Morning affect was inversely correlated with CDI (r = -0.405, p < 0.001), SDSC (r = -0.348, p < 0.001), and three subdimensions of SDSC, i.e. disorders of initiating and maintaining sleep (DIMS, r = -0.317, p = 0.001), disorders of arousal (DA, r = -0.375, p < 0.001) and disorders of excessive somnolence (DOES, r = -0.303, p = 0.001). Distinctness was inversely correlated with CDI (r = -0.402, p < 0.001) and SDSC (r = -0.274, p < 0.001). Increased use of electronic devices was associated with higher CDI (p = 0.003), while decreased duration of physical activity with higher SDSC (p = 0.017). Our findings support the recommendations addressing sleep and circadian preferences as lifestyle modifications in reducing depression in children.
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Affiliation(s)
- Necla İpar
- Department of Pediatrics, Koc University School of Medicine, İstanbul, Türkiye
- Institute of Health Sciences, Social Pediatrics PhD Program, Marmara University, İstanbul, Türkiye
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17
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Stager LM, Thompson-Phillips K, Morgan CH, Watson CS, Grant M, Fobian AD. The Impact of Longitudinal Patterns of Adolescent Sleep Duration on Adult C-Reactive Protein (CRP), Waist-To-Height Ratio, and Body Mass Index (BMI) Among Black and White Individuals. J Adolesc Health 2023; 73:776-783. [PMID: 37395694 PMCID: PMC10524665 DOI: 10.1016/j.jadohealth.2023.05.018] [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] [Received: 12/08/2022] [Revised: 04/05/2023] [Accepted: 05/14/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE To assess the impact of longitudinal adolescent sleep duration on adult C-reactive protein (CRP), waist-to-height ratio (WtHR), and body mass index (BMI) by race. METHODS Participants (N = 2,399; Mage = 15.7; 40.2% male; 79.2% White, 20.8% Black; Grades 7-12 at Wave I) from the Add Health database provided self-reported sleep duration in Waves I-IV. During Wave V, CRP, WtHR, and BMI were objectively measured. Trajectory analysis was performed using a group-based modeling approach. Chi-square test determined racial differences between groups. General linear models determined relationships between trajectory group, race, and group/race interaction with Wave V CRP, WtHR, and BMI. RESULTS Three sleep trajectories emerged: Group 1 "shortest" (24.4%), Group 2 "stable recommended" (67.6%), and Group 3 "varied" (8%). Black individuals and older individuals were more likely to be in Group 1 compared with Group 2. Regardless of race, individuals with patterns of sleep duration increasing to above what is recommended across waves (Group 3) had elevated CRP. Individuals with stable patterns of adequate sleep (Group 2) had lower WtHR. Black individuals with consistently stable patterns of adequate sleep duration had lower BMI compared to those with low sleep duration. DISCUSSION Black individuals were more likely to obtain chronically short sleep during the transition from adolescence to adulthood, highlighting a significant health disparity. Poor longitudinal sleep predicted elevated CRP and WtHR. Sleep only impacted BMI for Black individuals. This may relate to racial differences in BMI measurement.
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Affiliation(s)
- Lindsay M Stager
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kathryn Thompson-Phillips
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama; Children's Behavioral Health, Children's of Alabama, Birmingham, Alabama
| | - Casie H Morgan
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Caroline S Watson
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Merida Grant
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Aaron D Fobian
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama.
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18
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Liebig L, Bergmann A, Voigt K, Balogh E, Birkas B, Faubl N, Kraft T, Schöniger K, Riemenschneider H. Screen time and sleep among medical students in Germany. Sci Rep 2023; 13:15462. [PMID: 37726327 PMCID: PMC10509232 DOI: 10.1038/s41598-023-42039-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023] Open
Abstract
Medical students are a vulnerable group for harmful health behaviours due to academic stress. Increased screen time is associated with adverse health behaviour, particularly delayed bedtime, shorter sleep duration and poorer sleep quality. This possible relationship has not yet been examined among medical students in Europe. Medical students at the Technical University of Dresden were invited to participate in an online questionnaire based cross-sectional study. To analyse correlations between screen time and sleep parameters, correlation coefficients, linear regression and mixed-model analysis were calculated. 415 students (average age 24 years, 70% female) were included in the analysis. The students reported an average of 7 h screen time per day and 7.25 h sleep duration per night. Approximately 23% (n = 97) reported sleeping less than 7 h per night and 25% (n = 105) reported fairly to very poor sleep quality. Students who reported more screen time for leisure went to bed significantly later (r = 0.213, p < 0.001). Students who spent more screen time for study/work tended to sleep shorter (r = - 0.108, p < 0.015). There was no significant association between screen time and sleep quality (p = 0.103). The results show a need for educational interventions to promote healthy sleep behaviour and to limit screen time.
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Affiliation(s)
- Lukas Liebig
- Department of General Practice, Medical Clinic 3, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Antje Bergmann
- Department of General Practice, Medical Clinic 3, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Karen Voigt
- Department of General Practice, Medical Clinic 3, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Erika Balogh
- Department of Public Health Medicine, University of Pécs Medical School, Pecs, Hungary
| | - Béla Birkas
- Department of Behavioral Sciences, University of Pécs Medical School, Pecs, Hungary
| | - Nora Faubl
- Department of Behavioral Sciences, University of Pécs Medical School, Pecs, Hungary
| | - Theresa Kraft
- Institute for Medical Informatics and Biometry (IMB), Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Konrad Schöniger
- Department of Biological and Clinical Psychology, Institute of Psychology, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - Henna Riemenschneider
- Department of General Practice, Medical Clinic 3, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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19
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Vidueira VF, Booth JN, Saunders DH, Sproule J, Turner AP. Circadian preference and physical and cognitive performance in adolescence: A scoping review. Chronobiol Int 2023; 40:1296-1331. [PMID: 37781788 DOI: 10.1080/07420528.2023.2256901] [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: 12/16/2022] [Accepted: 09/02/2023] [Indexed: 10/03/2023]
Abstract
Adolescence is a crucial period of development which coincides with changes in circadian rhythmicity. This may augment the impact of circadian preference on performance in this group. We aimed to scope the literature available on chronotypes and their effect on physical and mental aspects of performance in adolescents. Studies were identified by systematically searching bibliographical databases and grey literature. The Morningness-Eveningness Questionnaire was the most frequently reported tool for circadian preference assessment. Academic achievement was the most prevailing outcome, with evidence suggesting that morning type adolescents tend to outperform evening types, yet the results vary depending on multiple factors. Performance in tests of intelligence and executive functions was generally better at optimal times of the day (synchrony effect). Physical performance was examined in 8 studies, with very heterogeneous outcomes. Although the associations between circadian preference and performance in adolescents are evident in some areas, there are many factors that may be involved in the relationship and require further investigation. This review highlights the assessment of physical performance in relation to chronotypes, the multidimensional assessment of circadian preference, and the need for longitudinal studies as priorities for further research.Protocol: OSF Registration - Public registration, DOI: 10.17605/OSF.IO/UCA3Z.
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Affiliation(s)
- Vanessa F Vidueira
- Moray House School of Education and Sport, Institute for Sport, Physical Education and Health Sciences (ISPEHS), University of Edinburgh, Edinburgh, UK
| | - Josie N Booth
- Moray House School of Education and Sport, Institute for Education, Community and Society (IECS), University of Edinburgh, Edinburgh, UK
| | - David H Saunders
- Moray House School of Education and Sport, Institute for Sport, Physical Education and Health Sciences (ISPEHS), University of Edinburgh, Edinburgh, UK
| | - John Sproule
- Moray House School of Education and Sport, Institute for Sport, Physical Education and Health Sciences (ISPEHS), University of Edinburgh, Edinburgh, UK
| | - Anthony P Turner
- Moray House School of Education and Sport, Institute for Sport, Physical Education and Health Sciences (ISPEHS), Human Performance Science Research Group, University of Edinburgh, Edinburgh, UK
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20
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Jung HN, Suh D, Jeong WC, Ryu J, Kim YM, Yoon S, Kim H. Associations of chronotype and insomnia with menstrual problems in newly employed nurses at university hospitals in the Republic of Korea. Ann Occup Environ Med 2023; 35:e30. [PMID: 37701482 PMCID: PMC10493377 DOI: 10.35371/aoem.2023.35.e30] [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: 02/16/2023] [Revised: 06/06/2023] [Accepted: 06/30/2023] [Indexed: 09/14/2023] Open
Abstract
Background Dysmenorrhea and menstrual cycle changes occur in women working shifts. Circadian rhythm disruption and sleep disturbances associated with shift work leads to health problems. We identified chronotypes and the occurrence of insomnia among newly employed university hospital nurses and investigated the association of these factors with menstrual problems. Methods We conducted pre-placement health examinations for shift workers using self-reported questionnaires between 2018 and 2020. A total of 463 nurses were included in the study. Sociodemographic data, shift work experience, and information on insomnia were collected from health examination data. In addition, details regarding chronotype, dysmenorrhea, irregular and abnormal menstrual cycles, amenorrhea, and contraceptive use were obtained from the questionnaire. Multiple logistic regression analysis was performed to study the association between chronotype, insomnia, and menstrual problems after controlling for age, body mass index, contraceptive use, amenorrhea, and prior shift work. Results The prevalence rates of dysmenorrhea, irregular menstrual cycles, and longer menstrual cycles were 23.8%, 14.9%, and 4.1%, respectively. The risk of dysmenorrhea increased in the evening-type (odds ratio [OR]: 3.209; 95% confidence interval [CI]: 1.685-6.113) and those with insomnia (OR: 1.871; 95% CI: 1.074-3.261). Additionally, the risk of an irregular menstrual cycle (OR: 2.698; 95% CI: 1.167-6.237) increased in the evening-type, and the risk of a longer menstrual cycle (OR: 4.008; 95% CI: 1.354-11.864) increased in individuals with insomnia. Conclusions Our findings suggest that dysmenorrhea is promoted in the evening-type and insomnia individuals. There may be an increased risk of irregular menstrual cycles among evening-type nurses and an increased risk of longer menstrual cycles among those with insomnia. Therefore, factors such as evening-type and insomnia should be considered for the prevention of menstrual problems in women performing shift work.
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Affiliation(s)
- Han-Na Jung
- Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Dongwhan Suh
- Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Woo Chul Jeong
- Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Jia Ryu
- Department of Occupational and Environmental Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Korea
| | - Yu-Mi Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Korea
- School of Public Health, Hanyang University, Seoul, Korea
| | - Seohyun Yoon
- Ewha Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Korea
| | - Hyunjoo Kim
- Department of Occupational and Environmental Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea
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21
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Richardson CE, Magson NR, Oar EL, Fardouly J, Johnco CJ, Freeman JYA, Rapee RM. A longitudinal investigation of sleep hygiene as a mediator linking parental warmth with adolescent sleep. Sleep 2023; 46:zsac267. [PMID: 36346339 PMCID: PMC10334483 DOI: 10.1093/sleep/zsac267] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/02/2022] [Indexed: 07/20/2023] Open
Abstract
STUDY OBJECTIVES Parental warmth in adolescence protects sleep in early adulthood, yet the nature, directions, and mechanisms of this association across adolescence are unknown. This study examined parental warmth, adolescent sleep hygiene and sleep outcomes (morning/eveningness, school night sleep duration, and daytime sleepiness) across five annual waves, spanning four years, using a cross-lagged panel design. METHODS Adolescents and one primary caregiver (96% mothers) completed questionnaires assessing parental warmth (child- and parent-report) and adolescent sleep hygiene and sleep (child-report), across five annual waves: Wave 1 (N = 531, Mage = 11.18, SD = 0.56, 51% male), Wave 2 (N = 504, Mage = 12.19, SD = 0.53, 52% male), Wave 3 (N = 478, Mage = 13.19, SD = 0.53, 52% male), Wave 4 (N = 440, Mage = 14.76, SD = 0.47, 51% male), and Wave 5 (N = 422, Mage = 15.75, SD = 0.49, 51% male). RESULTS Greater child-reported parental warmth was indirectly associated with better adolescent sleep (greater morningness, longer school night sleep duration, less sleepiness) through healthier sleep hygiene. The inverse was also often observed. Warmth had a direct relationship with sleep duration and sleepiness, independent of sleep hygiene. Parent-reported parental warmth did not predict, nor was predicted by child-reported adolescent sleep. CONCLUSIONS Parental warmth may protect against developmental changes in adolescent sleep, partially by improving sleep hygiene practices. Similarly, inadequate adolescent sleep may negatively impact parental warmth via deteriorating sleep hygiene. Sleep hygiene emerged as a key mechanism for protecting adolescent sleep and parent-child relationships.
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Affiliation(s)
- Cele E Richardson
- Corresponding author: Cele Richardson, University of Western Australia, M304, 35 Stirling Highway, Perth, WA 6009, Australa.
| | - Natasha R Magson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Ella L Oar
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Jasmine Fardouly
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
- Department of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Carly J Johnco
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Justin Y A Freeman
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
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22
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Choo YS, Hong SW, Koo GE, Han SH. The eveningness chronotype is associated with nightmare distress and dream recall: a cross-sectional study. Sleep Biol Rhythms 2023; 21:329-335. [PMID: 38469083 PMCID: PMC10899907 DOI: 10.1007/s41105-023-00449-1] [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: 08/29/2022] [Accepted: 01/18/2023] [Indexed: 02/07/2023]
Abstract
Dreaming may be affected by sleep behavior; however, evidence of the effect of chronotypes on dreaming is limited. We investigated sleep patterns, dream recall, and nightmare distress according to chronotypes. This cross-sectional study retrospectively enrolled adult participants (age > 18 years) who visited a sleep laboratory between 2016 and 2021 and underwent standard polysomnography (PSG) and completed a self-reported questionnaire. Patients with major sleep disorders were excluded. Chronotypes and dreaming components were assessed using the Korean version of the morningness-eveningness questionnaire and a nine-item dreaming questionnaire (nightmare distress and dream recall), respectively. Among healthy participants without major sleep disorders, the eveningness chronotype correlated with better dream recall than the morningness and intermediate chronotypes. Participants with the eveningness chronotype were younger and more likely to be unmarried than those with the other chronotypes. No significant chronotype-based difference was observed in the subjective measurements of sleep quality, insomnia, daytime sleepiness, depression, and anxiety or in respiration and movement events on PSG. In multivariate linear regression analysis, the chronotypes were independently related to nightmare distress (b = - 0.296; p = 0.002) and dream recall (b = - 0.334; p = 0.002). The apnea-hypopnea index was associated with nightmare distress (b = - 0.209; p = 0.029) and dream recall (b = - 0.189; p = 0.044). Depression was positively correlated with nightmare distress (b = 0.450; p = 0.002). Dream recall was best in the eveningness group among healthy adults. Greater eveningness was associated with higher nightmare distress and better dream recall. Further research is needed to understand the role of chronotypes in dreaming.
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Affiliation(s)
- Yi-Seul Choo
- Department of Neurology, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea
| | - Sang wook Hong
- Department of Neurology, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea
| | - Ga eun Koo
- Department of Neurology, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea
| | - Su-Hyun Han
- Department of Neurology, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea
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da Costa Lopes L, Rollemberg Poyares DL, Tufik S, La Banca de Oliveira S, Ribeiro da Silva Vallim J, Kiyomi Ota V, Melaragno MI, Ohayon M, Berlim de Mello C. The effect of brain-derived neurotrophic factor Val66Met polymorphism on adolescent activity and rest rhythms, circadian preferences and attentional performance. Sleep Med 2023; 104:64-72. [PMID: 36898188 DOI: 10.1016/j.sleep.2023.02.017] [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: 10/24/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Variations in circadian regulating mechanisms generate different individual preferences in respect of sleep and activity timing, which are known as chronotypes. In this sense, specifically during adolescence, there is a greater tendency for an eveningness chronotype. One factor that has been shown to have an impact on circadian rhythm patterns, as well as on some aspects of cognitive function, is the relatively common Val66Met (rs6265) polymorphism in the human brain-derived neurotrophic factor gene. OBJECTIVE This study aimed to evaluate the effect of the BDNF Val66Met polymorphism on the performance of adolescents in attentional tests, circadian preferences and activity-rest rhythm. METHODS 85 healthy high school students completed the Morningness-Eveningness Questionnaire to assess their circadian preferences; were evaluated using the Psychological Battery for Attention Assessment; and were categorized as carriers and non-carriers of the rs6265 polymorphism using the TaqMan rt-PCR technique. A subsample of 42 students had their activity/rest rhythm recorded by actigraphy for nine days from which sleep parameters were estimated. RESULTS Circadian preference did not affect attentional performance (p > 0.1), but the time that the students attended school had an impact on all types of attention with morning shift students scoring higher, regardless of chronotype (p < 0.05). The presence of the BDNF Val66Met polymorphism was associated only with alternate attention performance (p < 0.05). Regarding actigraphy evaluation, the carriers of the polymorphism demonstrated significantly higher total time in bed, total sleep time, social jetlag, and earlier sleep onset. CONCLUSIONS The results indicate some degree of adaptation in the students' attentional performance, according to their school schedules. The presence of BDNF polymorphism demonstrated a counterintuitive impact on attentional performance, comparing to previous findings. The findings reinforce the effect of genetic traits on sleep-wake rhythm parameters, when objectively evaluated.
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Affiliation(s)
- Luísa da Costa Lopes
- Department of Psychobiology, Escola Paulista de Medicina (EPM), Federal University of São Paulo, Rua Botucatu, 862, Edifício Ciências Biomédicas, 1° Andar Vila Clementino, São Paulo, SP, 04724-000, Brazil
| | - Dalva Lucia Rollemberg Poyares
- Department of Psychobiology, Escola Paulista de Medicina (EPM), Federal University of São Paulo, Rua Botucatu, 862, Edifício Ciências Biomédicas, 1° Andar Vila Clementino, São Paulo, SP, 04724-000, Brazil
| | - Sergio Tufik
- Department of Psychobiology, Escola Paulista de Medicina (EPM), Federal University of São Paulo, Rua Botucatu, 862, Edifício Ciências Biomédicas, 1° Andar Vila Clementino, São Paulo, SP, 04724-000, Brazil
| | - Sophia La Banca de Oliveira
- Department of Psychobiology, Escola Paulista de Medicina (EPM), Federal University of São Paulo, Rua Botucatu, 862, Edifício Ciências Biomédicas, 1° Andar Vila Clementino, São Paulo, SP, 04724-000, Brazil
| | - Julia Ribeiro da Silva Vallim
- Department of Psychobiology, Escola Paulista de Medicina (EPM), Federal University of São Paulo, Rua Botucatu, 862, Edifício Ciências Biomédicas, 1° Andar Vila Clementino, São Paulo, SP, 04724-000, Brazil
| | - Vanessa Kiyomi Ota
- Department of Morphology and Genetics, Genetics Division, Escola Paulista de Medicina (EPM), Federal University of São Paulo, Rua Botucatu, 740, Edifício Leitão da Cunha, 1 andar, São Paulo, SP, 04023-900, Brazil
| | - Maria Isabel Melaragno
- Department of Morphology and Genetics, Genetics Division, Escola Paulista de Medicina (EPM), Federal University of São Paulo, Rua Botucatu, 740, Edifício Leitão da Cunha, 1 andar, São Paulo, SP, 04023-900, Brazil
| | - Maurice Ohayon
- Stanford Sleep Epidemiology Research Center, School of Medicine, Stanford University - Stanford, CA, USA
| | - Claudia Berlim de Mello
- Department of Psychobiology, Escola Paulista de Medicina (EPM), Federal University of São Paulo, Rua Botucatu, 862, Edifício Ciências Biomédicas, 1° Andar Vila Clementino, São Paulo, SP, 04724-000, Brazil.
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24
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Quasi-causal associations between chronotype and post-traumatic stress disorder symptoms: A twin study. Sleep Health 2023; 9:218-227. [PMID: 36775751 DOI: 10.1016/j.sleh.2023.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE The evening ("night owl") chronotype is associated with greater severity and lifetime prevalence of post-traumatic stress disorder (PTSD) symptoms compared to morning or intermediate chronotypes. This twin study investigated the gene-environment relationships between chronotype, recent PTSD symptoms, and lifetime intrusive symptoms. METHODS We used the reduced Horne-Östberg Morningness-Eveningness Questionnaire (rMEQ) to assess chronotype in a sample of 3777 same-sex adult twin pairs raised together (70.4% monozygotic, 29.6% dizygotic) in the community-based Washington State Twin Registry. PTSD symptoms were reported on the Impact of Events Scale (IES) and a single item for lifetime experience of intrusive symptoms after a stressful or traumatic event. RESULTS Genetic influences accounted for 50% of chronotype variance, 30% of IES score variance, and 14% of lifetime intrusive symptom variance. Bivariate twin models showed a phenotypic association (bp) between evening chronotype and more severe PTSD symptoms (bp = -0.16, SE = 0.02, p < .001) that remained significant even after adjusting for shared genetic and environmental influences (bp = -0.10, SE = 0.04, p = .009), as well as age, sex, and self-reported sleep duration (bp = -0.11, SE = 0.04, p = .004). An association was found between evening chronotype and lifetime intrusive symptoms (bp = -0.11, SE = 0.03, p < .001) that was no longer significant after adjusting for shared genetic and environmental influences (bp = 0.04, SE = 0.06, p = .558). CONCLUSIONS Our results suggest a "quasi-causal" relationship between evening chronotype and PTSD symptoms that is not purely attributable to genetic or shared environmental factors. Evening chronotype may increase vulnerability to pathologic stress responses in the setting of circadian misalignment, providing potential avenues of prevention and treatment using chronobiological strategies.
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Badri M, Alkhaili M, Aldhaheri H, Yang G, Albahar M, Alrashdi A. From good sleep to health and to quality of life – a path analysis of determinants of sleep quality of working adults in Abu Dhabi. SLEEP SCIENCE AND PRACTICE 2023. [DOI: 10.1186/s41606-023-00083-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Abstract
Background
Sleep quality has significant impacts on many aspects of quality of life. Therefore, identifying the association of sleep quality with that quality of life domains could lead to deeper insights for social policymakers and professionals to enhance their understanding of the lives of Abu Dhabi working adults. This research focuses on sleep quality among working people in Abu Dhabi. The direct and indirect associations of sleep quality with various quality-of-life domains such as income and housing, physical and mental health, sport and activities, eating habits and obesity, work-life balance, online hours, and social connections are investigated and discussed.
Methods
Data were drawn from 36,515 full-time employees in both public, and private sectors, obtained from the third Abu Dhabi Quality of Life (QoL) survey aimed to cover all community members using online platforms. Informed by international research on sleep quality, preliminary investigation using correlation analysis and simple regression identified many well-being variables deemed necessary for inclusion in the path model. Path analysis was then performed.
Results
The final path model produced excellent fit measures. The significant variables directly associated with sleep quality included sleeping hours, social connection, satisfaction with income, satisfaction with residence, subjective physical and mental health, income satisfaction, satisfaction with the surrounding environment, frequency of eating healthy food, work-life balance, and online time. In addition, most variables recorded an indirect association to sleep quality through subjective health.
Conclusions
The importance of multidimensional linkages between many well-being factors influencing sleep quality and subjective health is underscored.
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Crowley SJ, Velez SL, Killen LG, Cvengros JA, Fogg LF, Eastman CI. Extending weeknight sleep of delayed adolescents using weekend morning bright light and evening time management. Sleep 2023; 46:zsac202. [PMID: 36006948 PMCID: PMC9832518 DOI: 10.1093/sleep/zsac202] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/13/2022] [Indexed: 01/14/2023] Open
Abstract
STUDY OBJECTIVES Shift sleep onset earlier and extend school-night sleep duration of adolescents. METHODS Forty-six adolescents (14.5-17.9 years; 24 females) with habitual short sleep (≤7 h) and late bedtimes (≥23:00) on school nights slept as usual for 2 weeks (baseline). Then, there were three weekends and two sets of five weekdays in between. Circadian phase (Dim Light Melatonin Onset, DLMO) was measured in the laboratory on the first and third weekend. On weekdays, the "Intervention" group gradually advanced school-night bedtime (1 h earlier than baseline during week 1; 2 h earlier than baseline during week 2). Individualized evening time management plans ("Sleep RouTeen") were developed to facilitate earlier bedtimes. On the second weekend, Intervention participants received bright light (~6000 lux; 2.5 h) on both mornings. A control group completed the first and third weekend but not the second. They slept as usual and had no evening time management plan. Weekday sleep onset time and duration were derived from actigraphy. RESULTS Dim light melatonin onset (DLMO) advanced more in the Intervention (0.6 ± 0.8 h) compared to the Control (-0.1 ± 0.8 h) group. By week 2, the Intervention group fell asleep 1.5 ± 0.7 h earlier and sleep duration increased by 1.2 ± 0.7 h; sleep did not systematically change in the Control group. CONCLUSIONS This multi-pronged circadian-based intervention effectively increased school-night sleep duration for adolescents reporting chronic sleep restriction. Adolescents with early circadian phases may only need a time management plan, whereas those with later phases probably need both time management and morning bright light. CLINICAL TRIALS Teen School-Night Sleep Extension: An Intervention Targeting the Circadian System (#NCT04087603): https://clinicaltrials.gov/ct2/show/NCT04087603.
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Affiliation(s)
- Stephanie J Crowley
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago IL, USA
| | - Sabrina L Velez
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago IL, USA
| | - Logan G Killen
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago IL, USA
| | - Jamie A Cvengros
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago IL, USA
| | - Louis F Fogg
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago IL, USA
| | - Charmane I Eastman
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago IL, USA
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27
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Fredrick JW, Cook TE, Langberg JM, Becker SP. Prospective association between evening circadian preference and academic functioning in adolescents: the role of daytime sleepiness. J Child Psychol Psychiatry 2023; 64:175-184. [PMID: 35953260 PMCID: PMC10087522 DOI: 10.1111/jcpp.13683] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is growing evidence for the role of circadian factors in adolescents' sleep and academic adjustment, with greater evening preference being linked to poorer academic functioning. However, studies have yet to evaluate this association prospectively in adolescence, nor have studies examined daytime sleepiness as a putative mechanism linking evening preference to poor academic functioning. The current study used a multi-informant design to test the prospective association of evening circadian preference, daytime sleepiness, and academic functioning (e.g., global academic impairment and grades) across 2 years in adolescence. As evening circadian preference, sleepiness, and academic problems are elevated in adolescents with ADHD, we used a sample enriched for adolescents with ADHD and explored whether ADHD moderated effects. METHOD Participants were 302 adolescents (Mage = 13.17 years; 44.7% female; 81.8% White; 52% with ADHD). In the fall of eighth grade, adolescents reported on their circadian preference, and in the fall of ninth grade, adolescents and parents completed ratings of daytime sleepiness. In the middle of 10th grade, parents and teachers reported on adolescents' academic impairment and at the end of 10th grade, adolescents' grade point average (GPA) was obtained from school records. RESULTS Above and beyond covariates (e.g., adolescent sex, ADHD status, medication, sleep duration) and baseline academic impairment, greater self-reported evening preference in 8th grade predicted increased parent ratings of academic impairment in 10th grade indirectly via adolescent and parent ratings of daytime sleepiness in 9th grade. Furthermore, evening preference in 8th grade predicted greater teacher ratings of academic impairment and lower average GPA in 10th grade via parent ratings of daytime sleepiness in 9th grade, controlling for covariates and baseline GPA. ADHD status did not moderate indirect effects. CONCLUSION Findings underscore daytime sleepiness as a possible intervening mechanism linking evening preference to poor academic functioning across adolescence. Intervention studies are needed to evaluate whether targeting circadian preference and sleepiness improves academic functioning in adolescents.
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Affiliation(s)
- Joseph W Fredrick
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Taryn E Cook
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Joshua M Langberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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28
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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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Nouri A, Panjeh S, Cogo-Moreira H, Pompeia S. Factors that influence morningness-eveningness and daytime sleepiness: A cross-cultural comparison of Iranian and Brazilian adolescents. Chronobiol Int 2022; 40:162-173. [PMID: 36530145 DOI: 10.1080/07420528.2022.2157735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
As adolescents get older, they become more evening oriented and, because they are usually expected to wake early to attend school, they often present daytime sleepiness, which is associated with negative outcomes. It is still unclear if this is similar cross-culturally. Here, we studied morningness-eveningness and daytime sleepiness in early adolescence from two different developing nations (Brazil and Iran). A total sample of 697 Iranian and Brazilian early adolescents (9- to 15-year-old; 358 boys) from Tehran, Iran, and São Paulo, Brazil, varying in age and parental schooling (a proxy of socioeconomic status: SES) completed the Morningness-Eveningness Scale for Children (MESC) and the Pediatric Daytime Sleepiness Scale (PDSS) and reported their total sleep time on school nights. They also filled in the Pubertal Developmental Scale to determine their pubertal status. A negligible cross-cultural difference in morningness-eveningness was found, indicating that Brazilians showed a slight circadian-phase delay compared with Iranians throughout all tested ages. There was also seen a very slight increase in phase delay as early adolescents aged, indicative of more eveningness. However, there were no country differences in daytime sleepiness once total sleep time during school nights was controlled for, which was the only factor that affects PDSS scores.
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Affiliation(s)
- Ali Nouri
- Division of Curriculum and Pedagogy, Department of Education Studies, Faculty of Humanities, Malayer University, Malayer, Iran
| | - Sareh Panjeh
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Hugo Cogo-Moreira
- Department of Education, ICT and Learning, Østfold University College, Østfold, Norway
| | - Sabine Pompeia
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Zhang K, Guhn M, Conklin AI. Association between social jetlag and sugar-sweetened beverages (SSBs) in adolescents in Western Canada. Eur J Public Health 2022; 33:287-292. [PMID: 36478224 PMCID: PMC10066488 DOI: 10.1093/eurpub/ckac177] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
Sleep debt is linked to poor health behaviours, and adolescents may be especially vulnerable to deficit from the mismatch of their late chronotype with socially determined sleep timing. We aimed to investigate the potential association between social jetlag and sugar-sweetened beverages (SSBs) consumption among adolescents.
Methods
Cross-sectional data from 1031 adolescents (13–18 years) who participated in the population-based British Columbia Adolescent Substance Use Survey in 2012. Regression analysis using interaction terms estimated the associations between social jetlag (using self-reported weekday/weekends sleep times) and odds of SSB intake in girls and boys.
Results
On average, adolescents reported 1.59 (SD 0.73) hours of social jetlag, but girls had significantly more social jetlag (1.64) than boys (1.52). Most adolescents (84%) reported consuming SSBs, and significantly more boys (87%) than girls (81%); median SSB intake in boys was 1–2 times per week and in girls less than once per week. Significant differences in girls consuming any SSB were seen across levels of social jetlag. The odds of any SSB intake were significantly higher in adolescents with social jetlag between 1 and 2 h [odds ratio (OR): 1.6 (1.14–2.38)] and over 2 h [OR 1.87 (1.11–3.14)], compared with 1 h or less; associations were stronger and only significant in girls.
Conclusions
This study is the first to show social jetlag is a common sleep deficit that is associated with SSB intake in adolescents, particularly among teen girls.
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Affiliation(s)
- Kexin Zhang
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, University of British Columbia , Vancouver, BC, Canada
| | - Martin Guhn
- School of Population and Public Health, Faculty of Medicine, University of British Columbia , Vancouver, BC, Canada
| | - Annalijn I Conklin
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, University of British Columbia , Vancouver, BC, Canada
- Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia , Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, Providence Health Research Institute , Vancouver, BC, Canada
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31
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Gao M, Li X, Lee CY, Ma H, Chen T, Zhang S, Chiang YC. Sleep duration and depression among adolescents: Mediation effect of collective integration. Front Psychol 2022; 13:1015089. [PMID: 36518962 PMCID: PMC9744325 DOI: 10.3389/fpsyg.2022.1015089] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/02/2022] [Indexed: 11/10/2023] Open
Abstract
Adolescence is a time of dramatic physical and mental change when adolescents are extremely vulnerable to various mental health problems. Depression and poor sleep duration are increasingly common among adolescents. This study is mainly aimed to verify the important mediating role of collective integration on sleep duration and depression and examine the interrelationship between sleep duration and depression in adolescents longitudinally. The data were obtained from the Wave 1 (in 2013-2014) and Wave 2 (in 2014-2015) longitudinal surveys of China Education Panel Survey (CEPS). The analytic sample in the present study included 8,829 seventh-grade students aged about 14 years (51.50% boys and 48.50% girls). A structural equation modeling (SEM) was used to investigate parent-child/teacher factors affecting adolescent sleep duration and depression, and Monte Carlo resampling with R was employed to confirm the significance of the mediation effects of collective integration. An autoregressive cross-lagged model was employed to analyze the interrelationship between adolescent sleep duration and depression. The findings were as follows. Firstly, collective integration strongly mediated the relationships among academic self-efficacy, parental involvement, teacher praise/criticism, sleep duration, and depression. Secondly, sleep duration and depression were found to have enduring effects and have effects on each other. Thirdly, parental involvement and teacher praise were positively associated with sleep quality and negatively associated with depression. Teacher criticism was negatively associated with sleep quality and positively associated with depression. Compared with teacher praise, teacher criticism has stronger effects on youth sleep duration and depression. In conclusion, improving sleep problems and depression in adolescents as early as possible can stop the persistent and long-term consequences of these problems. Increasing teacher praise, decreasing teacher criticism, and increasing adolescents' collective integration were effective ways to improve adolescents' sleep duration and mediate depression.
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Affiliation(s)
- Min Gao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Xian Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Chun-Yang Lee
- School of International Business, Xiamen University Tan Kah Kee College, Zhangzhou, China
| | - Honghao Ma
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | | | - Yi-Chen Chiang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
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Garbazza C, Hackethal S, Migliore E, D'Agostino A, Serrati C, Fanti V, Riccardi S, Baiardi S, Cicolin A, Borgwardt S, Mondini S, Cirignotta F, Cajochen C, Manconi M. Influence of chronotype on the incidence and severity of perinatal depression in the "Life-ON" study. J Affect Disord 2022; 317:245-255. [PMID: 36055526 DOI: 10.1016/j.jad.2022.08.064] [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: 10/04/2021] [Revised: 05/10/2022] [Accepted: 08/21/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Perinatal depression (PND) is a severe complication of pregnancy, but there are no established risk factors predicting the disease. Evening chronotype has been associated with unhealthy lifestyle habits and adverse outcomes during pregnancy. In this study, we aimed to clarify whether chronotype can predict symptoms and/or occurrence of PND. METHODS Two hundred ninety-nine women were followed-up from the first trimester of pregnancy until 6 months postpartum. Chronotype was assessed at baseline using the MEQ, while mood was repeatedly assessed by depression rating scales (EPDS, HDRS, MADRS). The influence of time and chronotype on EPDS, HDRS and MADRS, was estimated by constructing multilevel linear mixed regression models. A Cox proportional-hazard regression model was built to evaluate the association between chronotype and incidence of depression. RESULTS Chronotype modulated PND symptom severity depending on time of assessment, with evening chronotypes having a higher risk for developing PND symptoms, as assessed by EPDS, at postpartum visits V4 (5-12 days) and V5 (19-26 days). These also had less healthy lifestyle habits and were more likely to suffer from gestational diabetes mellitus and undergo cesarean delivery as compared to other chronotypes. LIMITATIONS Only a minority of women were classified as evening chronotypes. The long follow-up phase of the study led to missing data. CONCLUSIONS Pregnant evening chronotypes show unhealthy lifestyle habits and sociodemographic characteristics commonly associated with a higher risk for PND. They also have a higher risk of developing PND symptoms in the first month after delivery. Chronotype should therefore be routinely assessed during pregnancy to identify women potentially at risk for developing PND.
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Affiliation(s)
- Corrado Garbazza
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland; Centre for Chronobiology, University of Basel, Basel, Switzerland; Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.
| | - Sandra Hackethal
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland
| | - Enrica Migliore
- Clinical Epidemiology Unit, University Hospital Città Della Salute e Della Scienza di Torino, Turin, Italy; Cancer Epidemiology Unit, University Hospital Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Armando D'Agostino
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Chiara Serrati
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Valentina Fanti
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Silvia Riccardi
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland
| | - Simone Baiardi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; Department of Experimental, Diagnostics, and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Alessandro Cicolin
- Sleep Medicine Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland; Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Susanna Mondini
- Neurology Unit, Sant'Orsola-Malpighi University Hospital, Bologna, Italy
| | | | - Christian Cajochen
- Centre for Chronobiology, University of Basel, Basel, Switzerland; Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Mauro Manconi
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
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Troxel WM, Rodriguez A, Seelam R, Dong L, Perez LG, Tucker JS, Siconolfi D, D'Amico EJ. A latent class approach to understanding longitudinal sleep health and the association with alcohol and cannabis use during late adolescence and emerging adulthood. Addict Behav 2022; 134:107417. [PMID: 35853405 PMCID: PMC10431952 DOI: 10.1016/j.addbeh.2022.107417] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/14/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Sleep is a multi-dimensional health behavior associated with elevated risk of substance use. This is the first study to utilize a latent class approach to characterize sleep health across multiple dimensions and across time from late adolescence to emerging adulthood, and to examine associations with alcohol and cannabis use trajectories. METHODS The sample included 2995 emerging adults (mean ages = 18 to 24 years across six waves of data collection; 54% female) who provided data on sleep dimensions (quality, duration, and social jetlag) and frequency and consequences of alcohol and cannabis use. Longitudinal latent class analysis (LLCA) models characterized participants according to the three sleep dimensions. Latent growth models examined trajectories of frequency and consequences of alcohol or cannabis use over time among emergent sleep classes, with and without controlling for covariates. RESULTS LLCA models identified four sleep classes: good sleepers (n = 451; 15.2%); untroubled poor sleepers (n = 1024; 34.2%); troubled, moderately good sleepers (n = 1056; 35.3%); and suboptimal sleepers (n = 460; 15.4%). Good sleepers reported significantly lower levels of alcohol or cannabis use and consequences, and less of an increase in alcohol consequences as compared to suboptimal sleepers. CONCLUSIONS Persistent poor sleep health was associated with higher levels of alcohol and cannabis use and consequences, and greater increases in alcohol-related consequences during the transition from late adolescence to emerging adulthood. Findings have important clinical implications, highlighting that addressing multi-dimensional sleep health may be an important, novel target of intervention to reduce substance use frequency and consequences.
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Affiliation(s)
- Wendy M Troxel
- RAND Corporation, Behavioral and Policy Sciences, 4501 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
| | - Anthony Rodriguez
- RAND Corporation, Behavioral and Policy Sciences, 20 Park Plaza #920, Boston, MA 02116, USA.
| | - Rachana Seelam
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
| | - Lu Dong
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
| | - Lilian G Perez
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
| | - Joan S Tucker
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
| | - Daniel Siconolfi
- RAND Corporation, Behavioral and Policy Sciences, 4501 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
| | - Elizabeth J D'Amico
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
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Sleep Modulates Alcohol Toxicity in Drosophila. Int J Mol Sci 2022; 23:ijms232012091. [PMID: 36292943 PMCID: PMC9603330 DOI: 10.3390/ijms232012091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 11/19/2022] Open
Abstract
Alcohol abuse is a significant public health problem. While considerable research has shown that alcohol use affects sleep, little is known about the role of sleep deprivation in alcohol toxicity. We investigated sleep as a factor modulating alcohol toxicity using Drosophila melanogaster, a model for studies of sleep, alcohol, and aging. Following 24 h of sleep deprivation using a paradigm that similarly affects males and females and induces rebound sleep, flies were given binge-like alcohol exposures. Sleep deprivation increased mortality, with no sex-dependent differences. Sleep deprivation also abolished functional tolerance measured at 24 h after the initial alcohol exposure, although there was no effect on alcohol absorbance or clearance. We investigated the effect of chronic sleep deprivation using mutants with decreased sleep, insomniac and insulin-like peptide 2, finding increased alcohol mortality. Furthermore, we investigated whether pharmacologically inducing sleep prior to alcohol exposure using the GABAA-receptor agonist 4,5,6,7-tetrahydroisoxazolo(5,4-c)pyridin-3-ol (THIP) mitigated the effects of alcohol toxicity on middle-aged flies, flies with environmentally disrupted circadian clocks, and flies with short sleep. Pharmacologically increasing sleep prior to alcohol exposure decreased alcohol-induced mortality. Thus, sleep prior to binge-like alcohol exposure affects alcohol-induced mortality, even in vulnerable groups such as aging flies and those with circadian dysfunction.
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Faaland P, Vedaa Ø, Langsrud K, Sivertsen B, Lydersen S, Vestergaard CL, Kjørstad K, Vethe D, Ritterband LM, Harvey AG, Stiles TC, Scott J, Kallestad H. Digital cognitive behaviour therapy for insomnia (dCBT-I): Chronotype moderation on intervention outcomes. J Sleep Res 2022; 31:e13572. [PMID: 35224810 PMCID: PMC9787033 DOI: 10.1111/jsr.13572] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 12/30/2022]
Abstract
Using data from 1721 participants in a community-based randomized control trial of digital cognitive behavioural therapy for insomnia compared with patient education, we employed linear mixed modelling analyses to examine whether chronotype moderated the benefits of digital cognitive behavioural therapy for insomnia on self-reported levels of insomnia severity, fatigue and psychological distress. Baseline self-ratings on the reduced version of the Horne-Östberg Morningness-Eveningness Questionnaire were used to categorize the sample into three chronotypes: morning type (n = 345; 20%); intermediate type (n = 843; 49%); and evening type (n = 524; 30%). Insomnia Severity Index, Chalder Fatigue Questionnaire, and Hospital Anxiety and Depression Scale were assessed pre- and post-intervention (9 weeks). For individuals with self-reported morning or intermediate chronotypes, digital cognitive behavioural therapy for insomnia was superior to patient education on all ratings (Insomnia Severity Index, Chalder Fatigue Questionnaire, and Hospital Anxiety and Depression Scale) at follow-up (p-values ≤ 0.05). For individuals with self-reported evening chronotype, digital cognitive behavioural therapy for insomnia was superior to patient education for Insomnia Severity Index and Chalder Fatigue Questionnaire, but not on the Hospital Anxiety and Depression Scale (p = 0.139). There were significant differences in the treatment effects between the three chronotypes on the Insomnia Severity Index (p = 0.023) estimated difference between evening and morning type of -1.70, 95% confidence interval: -2.96 to -0.45, p = 0.008, and estimated difference between evening and intermediate type -1.53, 95% confidence interval: -3.04 to -0.03, p = 0.046. There were no significant differences in the treatment effects between the three chronotypes on the Chalder Fatigue Questionnaire (p = 0.488) or the Hospital Anxiety and Depression Scale (p = 0.536). We conclude that self-reported chronotype moderates the effects of digital cognitive behavioural therapy for insomnia on insomnia severity, but not on psychological distress or fatigue.
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Affiliation(s)
- Patrick Faaland
- Department of Mental HealthNorwegian University of Science and TechnologyTrondheimNorway,St Olavs University Hospital, ØstmarkaTrondheimNorway
| | - Øystein Vedaa
- Department of Mental HealthNorwegian University of Science and TechnologyTrondheimNorway,Department of Health PromotionNorwegian Institute of Public HealthBergenNorway,Voss District Psychiatric HospitalNKS BjørkeliVossNorway,Department of Research and DevelopmentSt Olavs University HospitalTrondheimNorway
| | - Knut Langsrud
- St Olavs University Hospital, ØstmarkaTrondheimNorway
| | - Børge Sivertsen
- Department of Mental HealthNorwegian University of Science and TechnologyTrondheimNorway,Department of Health PromotionNorwegian Institute of Public HealthBergenNorway,Department of Research and InnovationFonna Health TrustHaugesundNorway
| | - Stian Lydersen
- Department of Mental HealthRegional Centre for Child and Youth Mental Health and Child WelfareNorwegian University of Science and TechnologyTrondheimNorway
| | - Cecilie L. Vestergaard
- Department of Mental HealthNorwegian University of Science and TechnologyTrondheimNorway,St Olavs University Hospital, ØstmarkaTrondheimNorway
| | - Kaia Kjørstad
- Department of Mental HealthNorwegian University of Science and TechnologyTrondheimNorway,St Olavs University Hospital, ØstmarkaTrondheimNorway
| | - Daniel Vethe
- Department of Mental HealthNorwegian University of Science and TechnologyTrondheimNorway,St Olavs University Hospital, ØstmarkaTrondheimNorway
| | - Lee M. Ritterband
- Center for Behavioral Health and TechnologyDepartment of Psychiatry and Neurobehavioral SciencesUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - Allison G. Harvey
- Department of PsychologyUniversity of CaliforniaBerkeleyCaliforniaUSA
| | - Tore C. Stiles
- Department of PsychologyNorwegian University of Science and TechnologyNorway
| | - Jan Scott
- Department of Mental HealthNorwegian University of Science and TechnologyTrondheimNorway,University of NewcastleNewcastleUK
| | - Håvard Kallestad
- Department of Mental HealthNorwegian University of Science and TechnologyTrondheimNorway,St Olavs University Hospital, ØstmarkaTrondheimNorway
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36
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Yang YTC, Chang HY, Hsu CY, Lin CY, Zeitzer JM. Chinese translation and validation of the adolescent sleep wake scale. SLEEP SCIENCE AND PRACTICE 2022. [DOI: 10.1186/s41606-022-00078-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Inadequate sleep is a problem for teens world-wide. Identifying the biological and cultural factors that underlie this phenomenon is dependent on tools that can accurately query sleep-related behaviors. While there are many sleep-related questionnaires available in English, there are a paucity of validated Chinese language versions. As such, it was the purpose of this study to translate the Adolescent Sleep Wake Scale into Chinese and to provide a preliminary validation of this questionnaire.
Methods
We used a dual forward translation-back translation approach to translate the Adolescent Sleep Wake Scale into Chinese. We then tested the sensitivity, specificity, and internal consistency of the translated questionnaire using 517 adolescents from Taiwan. Preliminary criterion validity was examined through comparison with a measure of chronotype, with the a priori assumption that evening chronotypes would have worse sleep-related behavior.
Results
Internal consistency for both the overall scale (α = .86) and five subscales (α’s > .81) were good. These five subscales explained 62.6% of the total variance. Confirmatory Factory Analysis indicated a good fit of the data. The overall scale and each of the subscales also showed the expected relationship with chronotype, with worse sleep-related behavior in evening-types.
Conclusion
Our Chinese translation of the Adolescent Sleep Wake Scale is valid and has preliminary criterion validity. This can be a useful tool to explore sleep quality among Chinese-speaking adolescents as well as cross-cultural aspects of sleep behavior between Chinese- and English-speaking adolescents.
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Zhao Q, Wang K, Kiss O, Yuksel D, de Zambotti M, Clark DB, Goldston DB, Nooner KB, Brown SA, Tapert SF, Thompson WK, Nagel BJ, Pfefferbaum A, Sullivan EV, Pohl KM, Baker FC. Earlier Bedtime and Effective Coping Skills Predict a Return to Low-Risk of Depression in Young Adults during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610300. [PMID: 36011934 PMCID: PMC9408272 DOI: 10.3390/ijerph191610300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/13/2022] [Accepted: 08/15/2022] [Indexed: 05/24/2023]
Abstract
To determine the persistent effects of the pandemic on mental health in young adults, we categorized depressive symptom trajectories and sought factors that promoted a reduction in depressive symptoms in high-risk individuals. Specifically, longitudinal analysis investigated changes in the risk for depression before and during the pandemic until December 2021 in 399 young adults (57% female; age range: 22.8 ± 2.6 years) in the United States (U.S.) participating in the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) study. The Center for Epidemiologic Studies Depression Scale (CES-D-10) was administered multiple times before and during the pandemic. A score ≥10 identified individuals at high-risk for depression. Self-reported sleep behavior, substance use, and coping skills at the start of the pandemic were assessed as predictors for returning to low-risk levels while controlling for demographic factors. The analysis identified four trajectory groups regarding depression risk, with 38% being at low-risk pre-pandemic through 2021, 14% showing persistent high-risk pre-pandemic through 2021, and the remainder converting to high-risk either in June 2020 (30%) or later (18%). Of those who became high-risk in June 2020, 51% were no longer at high-risk in 2021. Logistic regression revealed that earlier bedtime and, for the older participants (mid to late twenties), better coping skills were associated with this declining risk. Results indicate divergence in trajectories of depressive symptoms, with a considerable number of young adults developing persistent depressive symptoms. Healthy sleep behavior and specific coping skills have the potential to promote remittance from depressive symptoms in the context of the pandemic.
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Affiliation(s)
- Qingyu Zhao
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA
| | - Kevin Wang
- Department of Computer Science, Stanford University, Stanford, CA 94305, USA
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Dilara Yuksel
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | | | - Duncan B. Clark
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - David B. Goldston
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27708, USA
| | - Kate B. Nooner
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC 28403, USA
| | - Sandra A. Brown
- Department of Psychiatry, University of California, San Diego, CA 92093, USA
| | - Susan F. Tapert
- Department of Psychiatry, University of California, San Diego, CA 92093, USA
| | - Wesley K. Thompson
- Population Neuroscience and Genetics Lab, University of California, San Diego, CA 92093, USA
- Department of Radiology, University of California, San Diego, CA 92093, USA
| | - Bonnie J. Nagel
- Departments of Psychiatry and Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239, USA
| | - Adolf Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Edith V. Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Kilian M. Pohl
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
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Maskevich S, Shen L, Drummond SPA, Bei B. What time do you plan to sleep tonight? An intense longitudinal study of adolescent daily sleep self-regulation via planning and its associations with sleep opportunity. J Child Psychol Psychiatry 2022; 63:900-911. [PMID: 34811748 DOI: 10.1111/jcpp.13540] [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] [Accepted: 10/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Most adolescents are sleep deprived on school days, yet how they self-regulate their sleep-wake behaviours is poorly understood. Using ecological momentary assessment, this intense longitudinal study explored patterns of adolescents' daily bedtime and risetime planning and execution, and whether these behaviours predicted sleep opportunity. METHODS Every afternoon, for 2 school weeks and the subsequent 2 vacation weeks, 205 (54.1% female, 64.4% non-White) adolescents from year 10 to 12 (M ± SDage = 16.9 ± 0.9) reported their plans for bedtime (BT) that evening, and for risetimes (RT) the following day. Actual daily sleep was measured via actigraphy and sleep diary. RESULTS Some adolescents never planned bedtime (school 19.5%, non-school 53.2%) or risetime (school 1.5%, non-school 24.4%). More adolescents planned consistently (≥75% of days) on school (BT = 29.9%, RT = 61.3%) compared to non-school nights (BT = 3.5%, RT = 2.5%). On average, adolescents went to bed later than planned, with longer delays on non-school (71 min) compared to school nights (46 min). Of those who executed their plans within ≤15 min, more did it consistently (≥75% of days) on school (BT = 40.9%, RT = 67.7%) than on non-school nights/days (BT = 29.7%, RT = 58.6%). Mixed effects models utilizing daily data, controlling for sex, race, and study day, showed that bedtime planning predicted longer time in bed (TIB; p < .01) on school and shorter TIB on non-school nights (p < .01); and greater delay in actual (compared to planned) BT predicted shorter TIB (p < .001). CONCLUSIONS Adolescents may require support during the transition from parent-controlled to autonomous sleep self-regulation. Bedtime planning on school nights and going to bed as planned are two modifiable sleep regulatory behaviours that are protective and potential therapeutic targets for increasing sleep opportunity in adolescents.
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Affiliation(s)
- Svetlana Maskevich
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Lin Shen
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Sean P A Drummond
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Bei Bei
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
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McManimen SL, Ross K, Wong MM. The Moderating Role of Stress Response on the Relationship Between Subjective Sleep Quality and Suicide Ideation in Adolescence. Arch Suicide Res 2022; 26:1423-1435. [PMID: 33999779 DOI: 10.1080/13811118.2021.1922106] [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] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Problems sleeping and stress are known to contribute to the development of suicide ideation. However, it is unclear how these risk factors interact longitudinally. The purpose of this study was to determine the impact of problems sleeping on the development of suicide ideation in adolescence one year later and how the relationship changes with the addition of stress as a moderator. METHOD Data were collected from 153 adolescents (M age = 12.8, SD = 1.6) over three years as part of a larger study. Participants completed the MINI-Kid and Youth Self-Report, which were used to assess for suicidality. The Stress scale of the YSR was used to measure stress. Participants also completed the Adolescent Sleep Wake Scale, which was used to assess their perceptions of their sleep quality. RESULTS Logistic moderation analyses demonstrated a significant interaction between ASWS and YSR Stress in the prediction of suicide ideation one year later, Wald χ2(1)=4.57, OR = 0.68, p < 0.05. Results demonstrated higher odds of endorsing SI as stress increased when sleep quality was poor (OR = 21.51) compared to when sleep quality was high (OR = 4.03), suggesting that adequate sleep may act as a protective factor against suicide ideation. CONCLUSIONS The results are indicative of long-term consequences of sleep on adolescent mental health, particularly when faced with high levels of stress. These results may have significant clinical implications for suicide prevention efforts as this relationship may help identify at-risk adolescents prior to the initial experience of suicide ideation.
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Prakash P, Vismaya K, Mahesh DS, Prabhu P. Effect of diurnal changes on dichotic listening in younger adults with normal hearing. J Otol 2022; 17:191-196. [PMID: 36249927 PMCID: PMC9547108 DOI: 10.1016/j.joto.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/25/2022] [Accepted: 06/12/2022] [Indexed: 11/30/2022] Open
Abstract
Background Diurnal changes can be defined as the time of the day over an individual's performance level for different activities that involve physical and mental tasks. Objective The current study aimed to evaluate the effect of diurnal changes in scores obtained for the Dichotic Consonant-Vowel paradigm by young adults with normal hearing sensitivity. Method Based on the ‘Morningness-Eveningness questionnaire’ given by Horne & Ostberg, the subjects were divided into moderately-morning, intermediate and moderately-evening categories. The Dichotic Consonant-Vowel tests were performed during morning and evening, and the right ear, left ear and double correct scores were compared between morning and evening for each category. Results There was significant diurnal changes noted for moderately morning and evening categories, where morning-type individuals performed better during morning and evening-type individuals performed better during the evening. The scores of intermediate individuals remained unchanged between morning and evening test results. Conclusion Diurnal change is a phenomenon associated with an individual's biological clock mechanism. Hence, attention and inhibitory controls aid them in carrying out tasks that require sufficient physical and mental efforts. The current study suggests that clinicians and researchers consider diurnal changes as an extraneous variable that could affect the reliability of the Dichotic Consonant-Vowel test results.
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Langenberg SCN, Kocevska D, Luik AI. The multidimensionality of sleep in population‐based samples: a narrative review. J Sleep Res 2022; 31:e13608. [PMID: 35429087 PMCID: PMC9339471 DOI: 10.1111/jsr.13608] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 12/03/2022]
Abstract
The identification of optimal sleep duration recommendations for the general population has long been an important goal on the public health agenda, as both short and long sleep duration have been linked to unfavourable health outcomes. Yet, sleep is more than duration alone and can be described across multiple domains, such as timing, regularity, satisfaction, alertness, and efficiency. We reviewed observational population‐based studies that examined differences in age, sex, and origin across multiple dimensions of sleep. Reviewed literature suggests an increasing prevalence of insomnia symptoms, shorter and less deep sleep in old age. Overall, women report poorer sleep quality than men despite objective measures revealing shorter and more fragmented sleep in men. Minorities generally have poorer quantity and quality of sleep, but multi‐ethnic studies have reported mixed results regarding the subjective experience of sleep. In sum, effects of age, sex and origin differ across sleep dimensions, thereby suggesting that the multidimensionality of sleep and how these different aspects interact should be studied across individuals. Studies should include both self‐reported measures and objective assessments in diverse population‐based samples, as both aspects are important to understand sleep health in the general population. Data‐driven descriptions could provide researchers and clinicians with insights into how well individuals are sleeping and offer concrete targets for promotion of sleep health across the population.
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Affiliation(s)
| | - Desana Kocevska
- Department of Epidemiology Erasmus MC University Medical Center Rotterdam the Netherlands
- Department of Sleep and Cognition Netherlands Institute for Neuroscience Amsterdam the Netherlands
| | - Annemarie I. Luik
- Department of Epidemiology Erasmus MC University Medical Center Rotterdam the Netherlands
- Department of Child and Adolescent Psychiatry/Psychology Erasmus MC University Medical Center Rotterdam the Netherlands
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Balcı Ö, Çalışkan M. Investigation of the relationship between chronotype, learning style and academic achievement of university students during distance education in the pandemic period. Chronobiol Int 2022; 39:858-871. [PMID: 35176946 DOI: 10.1080/07420528.2022.2041658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The purpose of this study was to investigate the relationship between chronotype, learning style, and academic achievement. The study sample consisted of 1884 volunteer undergraduate students from 58 different universities across Turkey. The data were collected online during distance education because of the Covid-19 pandemic. Turkish version of Morningness-Eveningness Questionnaire (MEQ) and Big16 Learning Modality Inventory were used for data collection. The correlation between chronotype and cumulative grade point average (CGPA) scores was analyzed using Spearman's rho, and differences among the chronotypes were analyzed with Kruskal-Wallis test. Chi-square tests with pairwise z-test were used to analyze the relationships between the participants' learning style preferences and chronotypes. Also, ANCOVA analyses were performed to evaluate the interactions of gender × chronotype and gender × learning style on CGPA scores. The results revealed that participants' preference for visual and auditory styles differed by chronotype. Visual learning style was more dominant among morning (M) types, while auditory style was more dominant among evening (E) types. However, the most preferred learning style was visual, followed by auditory and kinesthetic styles for all chronotypes. No relationship was found between chronotype and academic achievement. The CGPA scores of the participants with kinesthetic learning style were lower than the participants with auditory and visual learning styles. The female participants had higher CGPA score than males. However, the CGPA scores did not differ for both male and female participants with different chronotype and learning style preferences. From the results, we suggest that academic achievement can be enhanced by consideration of students' learning style preferences for all chronotypes.
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Affiliation(s)
- Özgül Balcı
- School of Foreign Languages, Necmettin Erbakan University, Konya, Turkey
| | - Muhittin Çalışkan
- Ahmet Keleşoğlu Faculty of Education, Necmettin Erbakan University, Konya, Turkey
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Marciano L, Camerini AL, Schulz PJ. Neuroticism and internet addiction: What is next? A systematic conceptual review. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111260] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Francisco AP, Cunha AMD, Tonon AC, Scop M, Mathur S, Caropreso L, Frey BN, Hidalgo MP. Adaptation and validation of the Mood Rhythm Instrument for use in Brazilian adolescents. BRAZILIAN JOURNAL OF PSYCHIATRY 2022; 44:264-270. [PMID: 35081211 PMCID: PMC9169486 DOI: 10.1590/1516-4446-2021-2092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 09/05/2021] [Indexed: 12/03/2022]
Abstract
Objective: Adapt and validate the Mood Rhythm Instrument (MRhI), a self-reported questionnaire that assesses self-perceived rhythmicity of mood-related symptoms in adults, into a version that assesses and evaluates perceived mood-related symptoms in adolescents (MRhI-Y). Methods: Adaptation of the Brazilian Portuguese version of the MRhI for an adolescent population followed three steps: review by consultants, analysis by experts, and pilot testing through a visual analogue scale (VAS). The final questionnaire (MRhI-Y) was applied to 171 adolescents aged 12-17 years. Internal consistency was calculated using Cronbach’s alpha and McDonald’s omega. The psychometric properties of the MRhI-Y were evaluated using exploratory factor analysis (EFA). Results: The MRhI-Y was designed to use wording more appropriate for adolescents than that of the MRhI. Expert agreement about item quality ranged between 82 and 100%. Adolescents’ VAS ratings indicated good comprehension of the items. Cronbach’s alpha and McDonalds’ omega coefficients were 0.71 and 0.74. The EFA resulted in a three-factor solution (affective, cognitive, and somatic). Younger adolescents (ages 12 to 13) reported lower rhythmicity scores than older groups (ages 14 to 15 and 16 to 17), even controlling for chronotype. Conclusions: The Brazilian Portuguese version of the MRhI-Y presented adequate comprehension by adolescents and good internal consistency. The MRhI-Y is a promising tool to improve our understanding of the underlying characteristics of mood fluctuation in adolescence.
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Affiliation(s)
- Ana Paula Francisco
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; UFRGS, Brazil
| | - Ana Maria Delgado Cunha
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; UFRGS, Brazil
| | - Andre Comiran Tonon
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; UFRGS, Brazil
| | - Marina Scop
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; UFRGS, Brazil
| | | | - Luisa Caropreso
- McMaster University, Canada; Mood Disorders Program, Women's Health Concerns Clinic, St. Joseph’s Healthcare, Canada
| | - Benicio Noronha Frey
- McMaster University, Canada; Mood Disorders Program, Women's Health Concerns Clinic, St. Joseph’s Healthcare, Canada
| | - Maria Paz Hidalgo
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; UFRGS, Brazil
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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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Too Jittery to Sleep? Temporal Associations of Actigraphic Sleep and Caffeine in Adolescents. Nutrients 2021; 14:nu14010031. [PMID: 35010906 PMCID: PMC8746933 DOI: 10.3390/nu14010031] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 11/17/2022] Open
Abstract
Caffeine consumption has been linked to poor sleep health in adolescents, but it is unknown whether poor sleep predicts caffeine consumption, and/or whether caffeine consumption predicts poor sleep, particularly when sleep is measured objectively. Data were collected from a micro-longitudinal sub-study of the age 15 wave of the Fragile Families and Child Wellbeing Study (n = 589). Adolescents wore an actigraphy device and completed daily surveys for ~1 week. Daily surveys assessed subjective sleep quality and caffeinated beverage consumption (0 = no caffeine, 1 = any caffeine). Separate mixed models assessed whether actigraphy-measured sleep duration, timing, maintenance efficiency, and subjective quality predicted next-day caffeinated beverage consumption within and between adolescents. Variability (standard deviation) of sleep duration and timing, sleep regularity index, and social jetlag were tested as additional between-person predictors. Lagged models tested whether daily caffeinated beverage consumption predicted sleep that night (n = 458). Adolescents with more variable sleep duration and midpoint had higher average odds of consuming caffeinated beverages compared to others. After adolescents consumed ≥1 caffeinated beverage, they had later sleep onset that night and wake time the next morning than usual versus when they did not consume caffeine. Curbing caffeinated beverage consumption may aid in the maintenance of regular sleep schedules and advance sleep timing in adolescents.
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Küçükturan AG, Horzum MB, Korkmaz G, Üngören Y. Investigating the relationship between personality, chronotype, computer game addiction, and sleep quality of high school students: A structural equation modelling approach. Chronobiol Int 2021; 39:590-601. [PMID: 34906014 DOI: 10.1080/07420528.2021.2013252] [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: 10/19/2022]
Abstract
This study examines the relationship between high school students' age, gender, personality, computer game addiction, chronotype, and sleep quality using structural equation modelling. For this purpose, the study was planned according to the correlational research design, one of the most common quantitative research methods. The sample of the study consisted of 922 students who accepted to participate and completed the scales. Of the 922 high school students in the sample, 528 were girls, and 394 were boys. In the study, the Computer Game Addiction Scale for Adolescents, Sleep Quality Scale, Composite Scale of Morningness (CSM), and Big Five Inventory were used to measure the variables. Among the variables involved, personality traits, such as consciousness, neuroticism, and openness to experience, were significantly related with morningness-eveningness. Besides, gender and being evening or morning types were found to be significantly related with game addiction. However, sleep quality was predicted by computer game addiction and morningness-eveningness. It was found that the fit indices of the model have an acceptable and good fit in explaining the variables.
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Affiliation(s)
- Ayşe Güler Küçükturan
- Faculty of Education, Department of Early Childhood Education, Sakarya University, Sakarya Üniversitesi Eğitim Fakültesi Hendek Kampüsü, Hendek, Sakarya
| | - Mehmet Barış Horzum
- Education Faculty, Computer and Instructional Technology Department, Sakarya University, Eğitim Fakültesi, Hendek/Sakarya, Türkiye
| | - Gözde Korkmaz
- Faculty of Education, Department of Early Childhood Education, Sakarya University, Sakarya Üniversitesi Eğitim Fakültesi Hendek Kampüsü, Hendek, Sakarya
| | - Yasin Üngören
- Education Faculty, Computer and Instructional Technology Department, Sakarya University, Eğitim Fakültesi, Hendek/Sakarya, Türkiye
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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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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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Cabanel N, Schmidt AM, Fockenberg S, Brückmann K, Müller MJ, Kundermann B, Haag A. Circadian preference and sleep quality in healthy controls and psychiatric inpatients with major depressive disorder - An actigraphy study incorporating morning and evening mood assessments. Chronobiol Int 2021; 39:249-260. [PMID: 34724857 DOI: 10.1080/07420528.2021.1994583] [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: 10/19/2022]
Abstract
Major depressive disorder (MDD) is frequently accompanied by sleep disturbance. Regarding diurnal preference (chronotype), sleep problems and low mood have been associated with evening orientation. Considering diurnal preference, we investigated subjective restorative value of sleep and actigraphy sleep parameters together with mood assessments twice a day, i.e. in the morning and evening, during weekdays and weekends in MDD psychiatric inpatients and healthy controls (HCs). The restorative value of sleep was higher during the weekend in HC, and bedtimes and risetimes were delayed during the weekend compared to weekdays in HC and MDD. Morning mood affected subjective sleep ratings in both groups, while association with symptom severity (BDI) in MDD remained insignificant. In HC, better evening mood was associated with later bedtimes. Regarding the chronotype in HC, evening orientation was associated with relatively low restorative value of sleep during weekdays, and morning orientation was associated with relatively higher actigraphy sleep efficiency during weekdays compared to weekend. In MDD, an association of evening orientation with later rise times could be observed, while no chronotype dependent effect emerged regarding the restorative value of sleep or sleep efficiency. Our results emphasize that research on sleep in MDD should incorporate weekdays as well as weekends, chronotype assessment, and measures of morning and evening mood, as these can be associated with ratings of the subjective restorative value of sleep (i.e. in our study, better morning mood was associated with higher restorative values), but also with behavioral sleep parameters (i.e. in our study, more positive evening mood was associated with later bedtimes). Potentially, the restorative value of sleep in MDD evening types can be improved by maintaining a regular sleep schedule, which needs to be investigated in an experimental design.
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Affiliation(s)
- Nicole Cabanel
- Vitos Clinic for Psychiatry and Psychotherapy Giessen, Giessen, Germany.,Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | | | | | - Konstantin Brückmann
- Vitos Clinic for Psychiatry and Psychotherapy Giessen, Giessen, Germany.,Faculty of Medicine, Justus-Liebig University Giessen, Giessen, Germany
| | - Matthias J Müller
- Faculty of Medicine, Justus-Liebig University Giessen, Giessen, Germany.,Oberberg Group, Berlin, Germany
| | - Bernd Kundermann
- Vitos Clinic for Psychiatry and Psychotherapy Giessen, Giessen, Germany.,Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Anja Haag
- Vitos Clinic for Psychiatry and Psychotherapy Marburg, Marburg, Germany
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