Anxiety symptomatology, sex and chronotype: The mediational effect of diurnal sleepiness

Circadian preference and mental health outcomes in youth: A systematic review and meta-analysis

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.

Impact of the COVID-19 pandemic on psychological distress and biological rhythm in China’s general population: A path analysis model

Objective

When facing major emergency public accidents, men and women may react differently. Our research aimed to assess the influence of gender difference on social support, information preference, biological rhythm, psychological distress, and the possible interaction among these factors during the COVID-19 pandemic.

Methods

In this cross-sectional study, 3,237 respondents aged 12 years and older finished the online survey. Levels of social support, information preference, biological rhythm, and psychological distress were assessed using validated scales. A path analysis was conducted to explore possible associations among these variables.

Results

The path analysis indicated that women with high levels of social support had a lower possibility of biological rhythm disorders and lower levels of somatization symptoms of psychological distress during the COVID-19 pandemic. The influence of social support on somatization symptoms was exerted via biological rhythm. Women tended to believe both negative and positive information, while men preferred more extreme information.

Conclusion

Our results highlighted gender difference in study variables during the COVID-19 pandemic and the importance of social support in alleviating psychological distress and biological rhythm disorders. Moreover, we confirmed that information preference differed significantly by somatization symptoms of psychological distress, suggesting extra efforts to provide more individualized epidemic information. Longitudinal research is required to further explore casual inferences.

Sleepiness, sleep duration, and human social activity: An investigation into bidirectionality using longitudinal time-use data

Daytime sleepiness impairs cognitive ability, but recent evidence suggests it is also an important driver of human motivation and behavior. We aimed to investigate the relationship between sleepiness and a behavior strongly associated with better health: social activity. We additionally aimed to investigate whether a key driver of sleepiness, sleep duration, had a similar relationship with social activity. For these questions, we considered bidirectionality, time of day, and differences between workdays and days off. Over 3 wk, 641 working adults logged their behavior every 30 min, completed a sleepiness scale every 3 h, and filled a sleep diary every morning (rendering >292,000 activity and >70,000 sleepiness datapoints). Using generalized additive mixed-effect models, we analyzed potential nonlinear relationships between sleepiness/sleep duration and social activity. Greater sleepiness predicted a substantial decrease in the probability of social activity (odds ratio 95% CI = 0.34 to 0.35 for days off), as well as a decreased duration of such activity when it did occur. These associations appear especially robust on days off and in the evenings. Social duration moderated the typical time-of-day pattern of sleepiness, with, for example, extended evening socializing associated with lower sleepiness. Sleep duration did not robustly predict next-day social activity. However, extensive social activity (>5 h) predicted up to 30 min shorter subsequent sleep duration. These results indicate that sleepiness is a strong predictor of voluntary decreases in social contact. It is possible that bouts of sleepiness lead to social withdrawal and loneliness, both risk factors for mental and physical ill health.

Symptom Cluster of ICU Nurses Treating COVID-19 Pneumonia Patients in Wuhan, China

BACKGROUND

In treating highly infectious coronavirus disease-19 (COVID-19) pneumonia, intensive care unit (ICU) nurses face a high risk of developing somatic symptom disorder (SSD).The symptom clusters in one population may show overlaps and involvements, a phenomenon that should be deliberately resolved to improve the management efficiency.

OBJECTIVES

The present study aims to investigate the symptoms and causes of SSD of ICU nurses treating COVID-19 pneumonia. The research results are expected to provide evidence for the establishment of a better management strategy.

METHODS

This study enrolled a total of 140 ICU nurses who were selected by Jiangsu Province Hospital to work in Wuhan (the epicenter of the COVID-19 epidemic in China) on February 3, 2020. A questionnaire, Somatic symptom disorders for ICU nurses in Wuhan No. 1 Hospital, was designed based on the International Classification of Functioning, Disability and Health. Exploratory factor analysis was performed to cluster the symptoms and logistic regression analysis to find the risk factors of the symptoms.

RESULTS

Five major symptoms were chest discomfort and palpitation (31.4%), dyspnea (30.7%), nausea (21.4%), headache (19.3%), and dizziness (17.9%). In exploratory factor analysis, the symptoms were classified into three clusters: Cluster A of breathing and sleep disturbances (dizziness, sleepiness, and dyspnea); Cluster B of gastrointestinal complaints and pain (nausea and headache), and Cluster C of general symptoms (xerostomia, fatigue, as well as chest discomfort and palpitation). In Cluster A, urine/feces splash, sex, and sputum splash were independent predictive factors. In Cluster B, fall of protective glasses and urine/feces splash were independent predictive factors. In Cluster C, urine/feces splash and urine/feces clearance were independent predictive factors.

CONCLUSION

The ICU nurses in Wuhan showed varying and overlapping SSDs. These SSDs could be classified into three symptom clusters. Based on the characteristics of their SSDs, specific interventions could be implemented to safeguard the health of ICU nurses.

Temporal associations between morningness/eveningness, problematic social media use, psychological distress and daytime sleepiness: Mediated roles of sleep quality and insomnia among young adults

The extant literature has suggested relationships between an individual's chronotype (in relation to morningness/eveningness) and several outcomes, including addictive disorders, psychological distress and daytime sleepiness. Moreover, sleep quality has been proposed to be a mediator in the aforementioned relationships. Consequently, the aim of the present study was to investigate the complex relationship between morningness/eveningness, problematic social media use, psychological distress and daytime sleepiness, with the potential mediators of sleep quality and insomnia. All participants (N = 1,791 [30.1% males]; mean age = 27.2 years, SD = 10.1) completed a battery of psychometric scales, including a reduced version of the Morningness-Eveningness Questionnaire (at baseline), the Pittsburgh Sleep Quality Index and Insomnia Severity Index (1 month after baseline assessment), the Bergen Social Media Addiction Scale, the Hospital Anxiety and Depression Scale, and the Epworth Sleepiness Scale (2 months after baseline assessment). The impacts of morningness-eveningness on problematic social media use, anxiety, depression and daytime sleepiness were found in the mediation models. Furthermore, the mediated effects of insomnia and sleep quality were observed. The present study's results emphasize the importance of promoting healthy sleep habits and sleep hygiene behaviours, and that of early detection of sleep problems among individuals who have the eveningness chronotype, because this would significantly improve their health outcomes.

Quality of leadership and presenteeism in health professions education and research: a test of a recovery-based process model with cognitive irritation and impaired sleep as mediators

Presenteeism (PRES) includes working while feeling ill and constrained in performance. Compared with absence from work, PRES generates significantly higher cost estimates. Health problems and PRES are related to leadership quality. Hence, research on corporate health management needs to explore why leadership problems (LP) correspond to more frequent PRES.This study tests recovery after work as an underlying process with cognitive irritation (COGIRR) and sleep problems (SP) as simultaneous mediators and explores three mediation pathways (path one: LP→COGIRR→PRES; path two: LP→SP→PRES; and path three: LP→COGIRR→SP→PRES). Out of 293 employees of a university's school of health professions in German-speaking Switzerland, 211 completed a questionnaire. LP and PRES were found to be positively related (r(211) = .22, p < .01). The tests of mediation yielded no significant results for path one and two, but the third mediation path LP→COGIRR→SP→PRES was positive and differed significantly from zero (B = 0.83, CI95 = 0.33 to 1.69). According to our results, a recovery-based mediation model fits the empirical self-report data best. These results suggest that occupational health interventions should improve leadership quality to promote recovery after work in order to increase health and productivity by reduced PRES.

Mismatch between perceived family and individual chronotype and their association with sleep-wake patterns

While social zeitgebers are known to shape diurnal preference, little research has been devoted to determining the contribution of the familiar group chronotype as social zeitgeber on individual circadian rhythms and sleep-wake patterns in adult subjects. The current study aimed to examine the matching between perceived family chronotype and individual chronotype and their relationship with sleep-wake patterns on weekdays and weekends, diurnal subjective somnolence, and substance consumption. Nine hundred and forty-two Colombian adults completed the Composite Scale of Morningness, the Epworth Sleepiness Scale, and responded to a questionnaire about circadian preferences of their family nucleus. We found evidence of a mismatch between perceived family and individual chronotype, mainly for morning-type individuals (Cohen's Kappa = -0.231; p < 0.001). This mismatch was associated with diurnal subjective somnolence (β = 0.073; p < 0.001) and specific sleep-wake patterns (p < 0.01). In addition, subjects with evening-type families showed higher caffeine and alcohol consumption (p < 0.001). To our knowledge, this is the first study to assess and report the mismatching between perceived family and individual chronotypes, and it adds to the existing body of knowledge regarding the influence of social zeitgebers on circadian rhythms. This is particularly relevant since mismatching between circadian physiology and environmental cues have been shown to lead to diverse pathologies.