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Pigazzani F, Dyar KA, Morant SV, Vetter C, Rogers A, Flynn RW, Rorie DA, Mackenzie IS, Cappuccio FP, Manfredini R, MacDonald TM. Effect of timed dosing of usual antihypertensives according to patient chronotype on cardiovascular outcomes: the Chronotype sub-study cohort of the Treatment in Morning versus Evening (TIME) study. EClinicalMedicine 2024; 72:102633. [PMID: 38774676 PMCID: PMC11106533 DOI: 10.1016/j.eclinm.2024.102633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/24/2024] Open
Abstract
Background Timing drug administration to endogenous circadian rhythms may enhance treatment efficacy. In the Chronotype sub-study of the Treatment in Morning versus Evening (TIME) clinical trial we examined whether timing of usual antihypertensive medications according to patient chronotype (a behavioural marker of personal circadian rhythm) may influence clinical cardiovascular outcomes. Methods This was a cohort sub-study of TIME, a prospective, randomised, open-label, blinded-endpoint, UK clinical trial of morning versus evening dosing of usual antihypertensive medications and cardiovascular outcomes. On August 3rd, 2020, all active TIME participants were invited to complete a validated chronotype questionnaire. Chronotype was quantitatively assessed as the mid sleep time on free days corrected for sleep debt on workdays (MSFsc). We analysed associations between chronotype and antihypertensive dosing time and explored their combined effect on cardiovascular outcomes (a composite endpoint of hospitalisation for non-fatal myocardial infarction (MI) or non-fatal stroke, and single components) using proportional hazard time-to-event models adjusted for baseline covariates. These were used to specifically test for interactions between dosing time and chronotype. Findings Between August 3, 2020, and March 31, 2021, 5358 TIME participants completed the online questionnaire. 2778 were previously randomised to morning dosing and 2580 to evening dosing of their usual antihypertensives. Chronotype was symmetrically distributed around a median MSFsc of 3:07 am. The composite endpoint increased for later MSFsc (later chronotype) dosed in the morning but not in those dosed in the evening (hazard ratios 1.46 [95% CI 1.14-1.86] and 0.96 [95% CI 0.70-1.30] per hour of MSFsc, respectively; interaction p = 0.036). Later chronotype was associated with increased risk of hospitalisation for non-fatal MI in the morning dosing group, and reduced risk in the evening dosing group (hazard ratios 1.62 [95% CI 1.18-2.22] and 0.66 [95% CI 0.44-1.00] per hour of MSFsc, respectively; interaction p < 0.001). No interaction between chronotype and antihypertensive dosing time was observed for stroke events. Interpretation Alignment of dosing time of usual antihypertensives with personal chronotype could lower the incidence of non-fatal MI compared to a 'misaligned' dosing time regimen. Future studies are warranted to establish whether synchronizing administration time of antihypertensive therapy with individual chronotype reduces risk of MI. Funding The TIME study was funded by the British Heart Foundation (CS/14/1/30659) with support from the British and Irish Hypertension Society.
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Affiliation(s)
- Filippo Pigazzani
- MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, UK
| | - Kenneth A. Dyar
- Metabolic Physiology, Institute for Diabetes and Cancer, Helmholtz Munich, German Research Center for Environmental Health, and German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Steve V. Morant
- MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, UK
| | | | - Amy Rogers
- MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, UK
| | - Robert W.V. Flynn
- MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, UK
| | - David A. Rorie
- MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, UK
| | - Isla S. Mackenzie
- MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, UK
| | - Francesco P. Cappuccio
- University of Warwick, Warwick Medical School, Sleep Health & Society Programme, Coventry, UK
| | - Roberto Manfredini
- University Strategic Center for Studies on Gender Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Thomas M. MacDonald
- MEMO Research, Division of Molecular and Clinical Medicine, University of Dundee, UK
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2
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Rodríguez Ferrante G, Leone MJ. Solar clock and school start time effects on adolescents' chronotype and sleep: A review of a gap in the literature. J Sleep Res 2024; 33:e13974. [PMID: 37370220 DOI: 10.1111/jsr.13974] [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] [Received: 01/09/2023] [Revised: 05/11/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023]
Abstract
Circadian rhythms are entrained by external factors such as sunlight and social cues, but also depend on internal factors such as age. Adolescents exhibit late chronotypes, but worldwide school starts early in the morning leading to unhealthy sleep habits. Several studies reported that adolescents benefit from later school start times. However, the effect of later school start time on different outcomes varies between studies, and most previous literature only takes into consideration the social clock (i.e. local time of school starting time) but not the solar clock (e.g. the distance between school start time and sunrise). Thus, there is an important gap in the literature: when assessing the effect of a school start time on chronotype and sleep of adolescents at different locations and/or seasons, the solar clock might differ and, consistently, the obtained results. For example, the earliest school start time for adolescents has been suggested to be 08:30 hours, but this school start time might correspond to different solar times at different times of the year, longitudes and latitudes. Here, we describe the available literature comparing different school start times, considering important factors such as geographic position, nationality, and the local school start time and its distance to sunrise. Then, we described and contrasted the relative role of both social and solar clocks on the chronotype and sleep of adolescents. As a whole, we point and discuss a gap in literature, suggesting that both clocks are relevant when addressing the effect of school start time on adolescents' chronotype and sleep.
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Affiliation(s)
- Guadalupe Rodríguez Ferrante
- Laboratorio de Neurociencia, Universidad Torcuato Di Tella, CONICET, Buenos Aires, Argentina
- Laboratorio de Cronobiología, Departamento de Ciencia y Tecnología, Universidad Nacional de Quilmes, CONICET, Buenos Aires, Argentina
| | - María Juliana Leone
- Laboratorio de Neurociencia, Universidad Torcuato Di Tella, CONICET, Buenos Aires, Argentina
- Área de Educación, Escuela de Gobierno, Universidad Torcuato Di Tella, Buenos Aires, Argentina
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3
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Sletten TL, Weaver MD, Foster RG, Gozal D, Klerman EB, Rajaratnam SMW, Roenneberg T, Takahashi JS, Turek FW, Vitiello MV, Young MW, Czeisler CA. The importance of sleep regularity: a consensus statement of the National Sleep Foundation sleep timing and variability panel. Sleep Health 2023; 9:801-820. [PMID: 37684151 DOI: 10.1016/j.sleh.2023.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE To develop and present consensus findings of the National Sleep Foundation sleep timing and variability panel regarding the impact of sleep timing variability on health and performance. METHODS The National Sleep Foundation assembled a panel of sleep and circadian experts to evaluate the scientific evidence and conduct a formal consensus and voting procedure. A systematic literature review was conducted using the NIH National Library of Medicine PubMed database, and panelists voted on the appropriateness of 3 questions using a modified Delphi RAND/UCLA Appropriateness Method with 2 rounds of voting. RESULTS The literature search and panel review identified 63 full text publications to inform consensus voting. Panelists achieved consensus on each question: (1) is daily regularity in sleep timing important for (a) health or (b) performance? and (2) when sleep is of insufficient duration during the week (or work days), is catch-up sleep on weekends (or non-work days) important for health? Based on the evidence currently available, panelists agreed to an affirmative response to all 3 questions. CONCLUSIONS Consistency of sleep onset and offset timing is important for health, safety, and performance. Nonetheless, when insufficient sleep is obtained during the week/work days, weekend/non-work day catch-up sleep may be beneficial.
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Affiliation(s)
- Tracey L Sletten
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Matthew D Weaver
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Russell G Foster
- Sleep & Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - David Gozal
- Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, USA
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Till Roenneberg
- Institutes for Occupational, Social, and Environmental Medicine and Medical Psychology, LMU Munich, Munich, Germany
| | - Joseph S Takahashi
- Department of Neuroscience, The University of Texas Southwestern Medical Center, Dallas, Texas, USA; Howard Hughes Medical Institute, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Fred W Turek
- Center for Sleep and Circadian Biology, Department of Neurobiology, Northwestern University, Evanston, Illinois, USA
| | - Michael V Vitiello
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Michael W Young
- Laboratory of Genetics, The Rockefeller University, New York City, New York, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.
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4
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Sogawa R, Ono F, Terao M, Nagano S, Kawabe J, Node K, Akashi M. Correlation Analysis Between Time Awareness and Morningness-Eveningness Preference. J Circadian Rhythms 2023; 21:2. [PMID: 37842163 PMCID: PMC10573578 DOI: 10.5334/jcr.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 09/20/2023] [Indexed: 10/17/2023] Open
Abstract
The circadian clock is adjusted by light inputs via the retinohypothalamic tract. Because environmental light is controllable for modern humans at the individual's preference although under social schedules, individual differences in time-related psychology and behavior may be associated with morningness-eveningness preference (M-E preference). To examine this hypothesis, we used the Time Management Scale and Time Anxiety Scale to quantify time-related psychology and behavior. These scales aim to evaluate "awareness of effective time management and utilization" and "anxiety about uncontrollable time schedule and unexpected time-related outcome", respectively. According to our correlation analysis using mid-sleep time as a marker for M-E preference, we obtained results supporting our hypothesis in the correlation between the M-E preference values and the Time Management Scale scores, with larger "time estimation" and "taking each moment as it comes" scores associated with more morningness and eveningness, respectively. Considering that modern humans likely become night owls under artificial light conditions, it appears plausible that lower awareness of time management leads to more eveningness.
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Affiliation(s)
- Reimi Sogawa
- Department of Clinical Genetics and Genomic Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama, Japan
| | - Fuminori Ono
- Faculty of Education, Yamaguchi University, 1677-1 Yoshida, Yamaguchi, Yamaguchi, Japan
- The Research Institute for Time Studies, Yamaguchi University, 1677-1 Yoshida, Yamaguchi, Yamaguchi, Japan
| | - Masahiko Terao
- The Research Institute for Time Studies, Yamaguchi University, 1677-1 Yoshida, Yamaguchi, Yamaguchi, Japan
| | - Shunta Nagano
- Faculty of Education, Yamaguchi University, 1677-1 Yoshida, Yamaguchi, Yamaguchi, Japan
| | - Junko Kawabe
- The Research Institute for Time Studies, Yamaguchi University, 1677-1 Yoshida, Yamaguchi, Yamaguchi, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, Saga, Japan
| | - Makoto Akashi
- The Research Institute for Time Studies, Yamaguchi University, 1677-1 Yoshida, Yamaguchi, Yamaguchi, Japan
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5
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Zakharov IM, Ismatullina VI, Kolyasnikov PV, Marakshina JA, Malykh AS, Tabueva AO, Adamovich TV, Lobaskova MM, Malykh SB. An Independent Evaluation of the Psychometric Properties of the Russian Version of the Pediatric Daytime Sleepiness Scale (PDSS). PSYCHOLOGY IN RUSSIA: STATE OF ART 2023; 16:206-221. [PMID: 38024570 PMCID: PMC10659232 DOI: 10.11621/pir.2023.0314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background The quality of sleep significantly impacts children's day-to-day performance, with at least 20% reporting issues with sleepiness. Valid tools for assessing the quality of sleep are needed. Objective In this study, we assessed the psychometric properties of the Russian version of the Pediatric Daytime Sleepiness Scale (PDSS). The initial adaptation of the PDSS was conducted on a sample from the Arctic regions of Russia. This location may have influenced the scale's generalizability due to variations in natural daylight across different areas of the country. Design To rectify this, we gathered a comprehensive, geographically diverse sample from Russia. This combined dataset comprised 3772 participants between 10 to 18 years of age, from nine different regions of Russia. Results We confirmed the unifactorial structure of the PDSS, which showed no regional effects. The psychometric analysis indicated that one item from the 8item PDSS could be removed, thereby improving the scale's model fit. We also observed gender and age impacts on sleep quality: boys reported fewer sleep-related issues than girls, and younger children reported fewer problems than older children. Conclusion This study validates the usefulness and reliability of the Russian version of the PDSS, thereby enhancing its general applicability. Furthermore, we replicated previously reported age and sex effects on the sleep quality of school-aged children.
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Affiliation(s)
- Ilya M Zakharov
- Ural Federal University named after the first President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | | | - Pavel V Kolyasnikov
- Ural Federal University named after the first President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | | | - Artem S Malykh
- Ural Federal University named after the first President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | - Anna O Tabueva
- Ural Federal University named after the first President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | | | - Marina M Lobaskova
- Ural Federal University named after the first President of Russia B.N. Yeltsin, Yekaterinburg, Russia
| | - Sergey B Malykh
- Psychological Institute of Russian Academy of Education, Moscow, Russia
- Lomonosov Moscow State University, Russia
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Gubin D, Vetoshkin A, Shurkevich N, Gapon L, Borisenkov M, Cornelissen G, Weinert D. Chronotype and lipid metabolism in Arctic Sojourn Workers. Chronobiol Int 2023; 40:1198-1208. [PMID: 37700623 DOI: 10.1080/07420528.2023.2256839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 06/13/2023] [Accepted: 09/02/2023] [Indexed: 09/14/2023]
Abstract
This study relates answers to the Munich Chronotype Questionnaire (MCTQ) and Pittsburgh Sleep Quality Index (PSQI) from Arctic Sojourn Workers (ASW) of Yamburg Settlement, 68° Latitude North, 75° Longitude East (n = 180; mean age ± SD; range: 49.2 ± 7.8; 25-66 y; 45% women) to Arctic Sojourn Work Experience (ASWE), age and health status. Chronotype, Mid Sleep on Free Days sleep corrected (MSFsc) and sleep characteristics of ASW were compared to those of age-matched Tyumen Residents (TR, n = 270; mean age ± SD; range: 48.4 ± 8.4; 25-69 y; 48% women), 57° Latitude North, 65° Longitude East. ASW have earlier MSFsc than TR (70 min in men, p < 0.0001, and 45 min in women, p < 0.0001). Unlike TR, their MSFsc was not associated with age (r = 0.037; p = 0.627) and was linked to a larger Social Jet Lag (+21 min in men; p = 0.003, and +18 min in women; p = 0.003). These differences were not due to outdoor light exposure (OLE): OLE on work (OLEw) or free (OLEf) days was not significantly different between ASW and TR in men and was significantly less in ASW than in TR women (OLEw: -31 min; p < 0.001; OLEf: -24 min; p = 0.036). ASWE, but not age, was associated with compromised lipid metabolism in men. After accounting for multiple testing, when corrected for age and sex, higher triglycerides to high-density lipoprotein ratio, TG/HDL correlated with ASWE (r = 0.271, p < 0.05). In men, greater SJL was associated with lower HDL (r = -0.204; p = 0.043). Worse proxies of metabolic health were related to unfavorable components of the Pittsburgh Sleep Quality Index in ASW. Higher OLE on free days was associated with lower systolic (b = -0.210; p < 0.05) and diastolic (b = -0.240; p < 0.05) blood pressure.
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Affiliation(s)
- Denis Gubin
- Laboratory for Chronobiology and Chronomedicine, Research Institute of Biomedicine and Biomedical Technologies, Medical University, Tyumen, Russia
- Department of Biology, Medical University, Tyumen, Russia
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - Alexander Vetoshkin
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
- Medical Unit, Gazprom Dobycha Yamburg LLC, Novy Urengoy, Russia
| | - Nina Shurkevich
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - Ludmila Gapon
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
| | - Mikhail Borisenkov
- Institute of Physiology of Komi Science Centre of the Ural Branch of the Russian Academy of Sciences, Syktyvkar, Russia
| | - Germaine Cornelissen
- Halberg Chronobiology Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Dietmar Weinert
- Institute of Biology/Zoology, Martin Luther University, Halle-Wittenberg, Halle, Germany
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Siraji MA, Spitschan M, Kalavally V, Haque S. Light exposure behaviors predict mood, memory and sleep quality. Sci Rep 2023; 13:12425. [PMID: 37528146 PMCID: PMC10394000 DOI: 10.1038/s41598-023-39636-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 07/28/2023] [Indexed: 08/03/2023] Open
Abstract
Ample research has shown that light influences our emotions, cognition, and sleep quality. However, little work has examined whether different light exposure-related behaviors, such as daytime exposure to electric light and nighttime usage of gadgets, especially before sleep, influence sleep quality and cognition. Three-hundred-and-one Malaysian adults (MeanAge±SD = 28 ± 9) completed the Light Exposure Behavior Assessment tool that measured five light exposure behaviors. They also completed the Morningness-Eveningness Questionnaire, Positive and Negative Affect Schedule, Pittsburgh Sleep Quality Index, and single items assessing trouble in memory and concentration. A partial least square structural equation model, showing 72.72% predictive power, revealed that less use of wearable blue filters outdoors during the day and more within one hour before sleep predicted early peak time (direct effect = -0.25). Increased time spent outdoors predicted a positive affect (direct effect = 0.33) and a circadian phase advancement (direct effect: rising time = 0.14, peak time = 0.20, retiring time = 0.17). Increased use of mobile phone before sleep predicted a circadian phase delay (direct effect: retiring time = -0.25; rising time = -0.23; peak time = -0.22; morning affect = -0.12), reduced sleep quality (direct effect = 0.13), and increased trouble in memory and concentration (total effect = 0.20 and 0.23, respectively). Increased use of tunable, LED, or dawn-simulating electric light in the morning and daytime predicted a circadian phase advancement (direct effect: peak time = 0.15, morning affect = 0.14, retiring time = 0.15) and good sleep quality (direct effect = -0.16). The results provide valuable insights into developing a healthy light diet to promote health and wellness.
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Affiliation(s)
- Mushfiqul Anwar Siraji
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences and Intelligent Lighting Laboratory, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - Manuel Spitschan
- Max Planck Institute for Biological Cybernetics, Translational Sensory & Circadian Neuroscience, Tübingen, Germany
- Department of Sport and Health Sciences (TUM SG), Technical University of Munich, Munich, Germany
| | - Vineetha Kalavally
- Department of Electrical and Computer Systems Engineering and Intelligent Lighting Laboratory, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia
| | - Shamsul Haque
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences and Intelligent Lighting Laboratory, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia.
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Ujma PP, Horváth CG, Bódizs R. Daily rhythms, light exposure and social jetlag correlate with demographic characteristics and health in a nationally representative survey. Sci Rep 2023; 13:12287. [PMID: 37516741 PMCID: PMC10387097 DOI: 10.1038/s41598-023-39011-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/18/2023] [Indexed: 07/31/2023] Open
Abstract
The timing of daily activity in humans have been associated with various demographic and health-related factors, but the possibly complex patterns of confounding and interaction between these has not been systematically explored. We use data from Hungarostudy 2021, a nationally representative survey of 7000 Hungarian adults to assess the relationship between self-reported chronotype, social jetlag (using the Munich Chronotype Questionnaire), demographic variables and self-reported health and demographic variables, including ethnic minority membership. Supporting the validity of self-reports, participants with later chronotypes reported the lowest daytime sleepiness at a later clock time. We found that older age, female sex, a more eastward and southward geographical position, residence in a smaller settlement, less education and income, religiousness and cohabiting with small children were associated with an earlier chronotype. Younger age, higher education and income, and cohabiting with small children were associated with increased social jetlag. Of the 48 health-related variables surveyed, the relationship with both chronotype and social jetlag were mostly accounted for by age, sex, and socioeconomic effects, but we identified alcohol consumption, smoking, and physical activity as predictors of both social jetlag and chronotype, while a number of disorders were either positively or negatively associated with chronotype and social jetlag. Our findings from a large, nationally representative sample indicate that both biological and social factors influence chronotype and identified both demographic and health-related variables as risk factors for social jetlag. Our results, however, do not support a causal relationship between light exposure and mental health.
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Affiliation(s)
- Péter P Ujma
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.
| | - Csenge G Horváth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Róbert Bódizs
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
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9
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Jankowski KS, Díaz-Morales JF, Vollmer C. Chronotype, Time of Day, and Performance on Intelligence Tests in the School Setting. J Intell 2023; 11:jintelligence11010013. [PMID: 36662143 PMCID: PMC9862939 DOI: 10.3390/jintelligence11010013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/28/2022] [Accepted: 01/08/2023] [Indexed: 01/12/2023] Open
Abstract
Research suggests the existence of an association between chronotype and intellectual performance, but the nature of this link remains unclear. Studies conducted in a laboratory setting point to the synchrony effect (better performance at a person's preferred time of day) for fluid intelligence, but not for crystallized intelligence, whereas studies that have analyzed students' grades suggest that the effect exists for both. In the present study, we aimed to verify the synchrony effect by applying direct measures of crystallized intelligence, fluid intelligence, and subjective sleepiness-alertness in a sample of high school students during their morning or afternoon class. The results revealed a synchrony effect for crystallized, but not for fluid intelligence. During morning class, students with a morning chronotype performed better than evening chronotypes on a test of crystallized intelligence, whereas during afternoon class there was no difference between chronotypes. The association resulted from decreased performance during morning class in evening chronotypes that improved during afternoon class and constant performance in morning chronotypes. These effects were independent of sleepiness-alertness levels. The results suggest that individual differences between chronotypes may be important for tasks performed during morning classes, but not during afternoon ones, and that performance across school days may depend on time of day in evening chronotypes.
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Affiliation(s)
- Konrad S. Jankowski
- Department of Psychology, University of Warsaw, 00-183 Warsaw, Poland
- Correspondence:
| | - Juan Francisco Díaz-Morales
- Department of Social Psychology, Work and Individual Differences, Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain
| | - Christian Vollmer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6020 Innsbruck, Austria
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Abstract
PURPOSE OF REVIEW We discuss the relationship between sleep and circadian factors with cardiovascular disease (CVD) risk, including physiologic, behavioral, and psychological mechanisms along this pathway. RECENT FINDINGS The relationship between short and long sleep duration, as well as insomnia, with CVD risk is well-established. Recent work has highlighted how other sleep factors, such as sleep regularity (i.e., consistency of sleep timing), multidimensional sleep health, and circadian factors like chronotype and social jetlag, relate to CVD risk. Sleep-focused interventions (e.g., cognitive behavioral therapy for insomnia and sleep extension) may be effective to reduce CVD risk and disease burden. Sleep is increasingly recognized as an integral component of cardiovascular health. This was underscored by the recent inclusion of sleep duration as a health behavior in the American Heart Association's Life's Essential 8 for defining optimal cardiovascular health.
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Affiliation(s)
- Joseph Belloir
- School of Nursing, Columbia University, New York, NY, USA
| | - Nour Makarem
- Department of Epidemiology, Mailman School of Public Health Columbia University Irving Medical Center, New York, NY, USA
| | - Ari Shechter
- Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Irving Medical Center, 622 West 168th Street, 9th Floor, New York, NY, 10032, USA.
- Center of Excellence for Sleep & Circadian Research, Columbia University Irving Medical Center, New York, NY, USA.
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11
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Ohashi M, Lee SI, Eto T, Uotsu N, Tarumizu C, Matsuoka S, Yasuo S, Higuchi S. Intake of l-serine before bedtime prevents the delay of the circadian phase in real life. J Physiol Anthropol 2022; 41:31. [PMID: 36028887 PMCID: PMC9413878 DOI: 10.1186/s40101-022-00306-z] [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: 03/14/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
Background It has been shown in laboratory experiments using human subjects that ingestion of the non-essential amino acid l-serine before bedtime enhances the advance of circadian phase induced by light exposure the next morning. In the present study, we tested the effect of ingestion of l-serine before bedtime on circadian phase in real life and whether its effect depends on the initial circadian phase. Methods The subjects were 33 healthy male and female university students and they were divided into an l-serine group (n = 16) and a placebo group (n = 17). This study was conducted in a double-blind manner in autumn and winter. After a baseline period for 1 week, the subjects took 3.0 g of l-serine or a placebo 30 min before bedtime for 2 weeks. Saliva was collected twice a week at home every hour under a dim light condition from 20:00 to 1 h after habitual bedtime. Dim light melatonin onset (DLMO) was used as an index of phase of the circadian rhythm. Results DLMO after intervention was significantly delayed compared to the baseline DLMO in the placebo group (p = 0.02) but not in the l-serine group. There was a significant difference in the amount of changes in DLMO between the two groups (p = 0.04). There were no significant changes in sleeping habits after intervention in the two groups. There were significant positive correlations between advance of DLMO and DLMO before intervention in the l-serine group (r = 0.53, p < 0.05) and the placebo group (r = 0.69, p < 0.01). There was no significant difference in the slopes of regression lines between the two groups (p = 0.71), but the intercept in the l-serine group was significantly higher than that in the placebo group (p < 0.01). The levels of light exposure were not significantly different between the two groups. Conclusions Our findings suggest that intake of l-serine before bedtime for multiple days might attenuate the circadian phase delay in the real world and that this effect does not depend on the initial circadian phase. Trial registration This study is registered with University Hospital Medical Information Network in Japan (UMIN000024435. Registered on October 17, 2016).
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Roenneberg T, Foster RG, Klerman EB. The circadian system, sleep, and the health/disease balance: a conceptual review. J Sleep Res 2022; 31:e13621. [PMID: 35670313 PMCID: PMC9352354 DOI: 10.1111/jsr.13621] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/08/2022] [Accepted: 04/10/2022] [Indexed: 11/30/2022]
Abstract
The field of "circadian medicine" is a recent addition to chronobiology and sleep research efforts. It represents a logical step arising from the increasing insights into the circadian system and its interactions with life in urbanised societies; applying these insights to the health/disease balance at home and in the medical practice (outpatient) and clinic (inpatient). Despite its fast expansion and proliferating research efforts, circadian medicine lacks a formal framework to categorise the many observations describing interactions among the circadian system, sleep, and the health/disease balance. A good framework allows us to categorise observations and then assign them to one or more components with hypothesised interactions. Such assignments can lead to experiments that document causal (rather than correlational) relationships and move from describing observations to discovering mechanisms. This review details such a proposed formal framework for circadian medicine and will hopefully trigger discussion among our colleagues, so that the framework can be improved and expanded. As the basis of the framework for circadian medicine, we define "circadian health" and how it links to general health. We then define interactions among the circadian system, sleep, and the health/disease balance and put the framework into the context of the literature with examples from six domains of health/disease balance: fertility, cancer, immune system, mental health, cardiovascular, and metabolism.
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Affiliation(s)
- Till Roenneberg
- Institute of Medical Psychology and Institute for Occupational, Social and Environmental Medicine, Munich, Germany
| | - Russell G Foster
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, New Biochemistry Building, University of Oxford, Oxford, UK
| | - Elizabeth B Klerman
- Department of Neurology, Massachusetts General Hospital, Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
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13
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Sexton-Radek K, Luna L. University Student Sleep Quality: Some Health Insights regarding Light Exposure. Health (London) 2022. [DOI: 10.4236/health.2022.143029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Kayaba M, Matsushita T, Katayama N, Inoue Y, Sasai-Sakuma T. Sleep-wake rhythm and its association with lifestyle, health-related quality of life and academic performance among Japanese nursing students: a cross-sectional study. BMC Nurs 2021; 20:225. [PMID: 34749734 PMCID: PMC8576865 DOI: 10.1186/s12912-021-00748-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 10/22/2021] [Indexed: 11/12/2022] Open
Abstract
Background Young adults are likely to have activities and go to bed late at night due to their age-dependent delayed endogenous circadian clock. The purpose of the present study was to clarify sleep–wake rhythm and its association with lifestyle, health-related quality of life, and academic performance among nursing students. Methods Self-reported questionnaires were distributed to undergraduate nursing students at six universities in Japan. Sleep–wake rhythm was assessed using the morningness-eveningness questionnaire. A quantitative design using the generalized linear mixed effect model was utilized to identify the factors related to the evening type among female nursing students (n = 447). Results About 18% of the participants were identified as the evening type. Evening type was associated with living alone, part-time job, and club activity. Sleep duration on weekdays was shorter, meal time duration was the shortest, and the percentages of students who skipped meals and those who gained body weight were higher in the evening type than in the morning type and intermediate type. Mental health-related quality of life was lower in the intermediate type and evening type than in the morning type, while there was no difference in physical health-related quality of life among these groups. The percentages of the nursing students who have experienced absence, tardiness, falling asleep during class, and/or interference with academic achievement were higher in the evening type than in other groups. Conclusions The present study has important implications for nursing students’ biological characteristics and lifestyle, which are associated with their health-related quality of life and academic performance. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00748-3.
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Affiliation(s)
- Momoko Kayaba
- Department of Somnology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. .,Japan Somnology Center, Institute of Neuropsychiatry, 5-10-10, Yoyogi, Shibuya-ku, Tokyo, 151-0053, Japan.
| | - Toshiko Matsushita
- Department of Nursing, Graduate School of Medicine, Yokohama City University, Fukuura 3-9, Yokohama Kanazawa-ku, Kanagawa, 236-0004, Japan
| | - Noriko Katayama
- Graduate School of Health Sciences, Shonan University of Medical Sciences, Kamishinano 16-48, Yokohama Totsuka-ku, Kanagawa, 244-0806, Japan
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.,Japan Somnology Center, Institute of Neuropsychiatry, 5-10-10, Yoyogi, Shibuya-ku, Tokyo, 151-0053, Japan
| | - Taeko Sasai-Sakuma
- Department of Somnology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.,Japan Somnology Center, Institute of Neuropsychiatry, 5-10-10, Yoyogi, Shibuya-ku, Tokyo, 151-0053, Japan.,Department of Clinical Laboratory Science, Faculty of Medical Technology, Teikyo University, Kaga 2-11-1, Itabashi-ku, Tokyo, 173-8605, Japan
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15
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Ujma PP, Kirkegaard EOW. The overlapping geography of cognitive ability and chronotype. Psych J 2021; 10:834-846. [PMID: 34423580 DOI: 10.1002/pchj.477] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/28/2021] [Accepted: 07/01/2021] [Indexed: 11/07/2022]
Abstract
Chronotype and cognitive ability are two human phenotypes with an uneven geographic distribution due to both selective migration and causal environmental effects. In our study, we aimed to examine the relationship between geographic variables, cognitive ability and chronotype. We used a large anonymized sample (n = 25,700, mostly from the USA, UK, Canada and Australia) of dating site users to estimate chronotype and cognitive ability from questionnaire responses using item response theory. We matched each user to geographic coordinates and city size using the reported locations and geographic databases. In line with previous research we found that male sex, younger age, residence in a more populous locale, higher cognitive ability and more westward position within the same time zone were associated with later chronotype. Male sex, younger age, residence in a more populous locale, later chronotype and higher latitude were associated with higher cognitive ability, but the effect of population on chronotype and latitude on cognitive ability was only present in the USA. The relationship between age and chronotype was stronger in males, and the relationship between chronotype and cognitive ability was stronger in males and in older participants. Population density had an independent association with cognitive ability, but not chronotype. Our results confirm the uneven geographic distribution of chronotype and cognitive ability. These findings generalize across countries, but they are moderated by age and sex, suggesting both biological and cultural effects.
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Affiliation(s)
- Péter Przemyslaw Ujma
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
- National Institute of Clinical Neuroscience, Budapest, Hungary
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16
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Mendoza J. Nighttime Light Hurts Mammalian Physiology: What Diurnal Rodent Models Are Telling Us. Clocks Sleep 2021; 3:236-250. [PMID: 33915800 PMCID: PMC8167723 DOI: 10.3390/clockssleep3020014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/16/2021] [Accepted: 03/15/2021] [Indexed: 01/24/2023] Open
Abstract
Natural sunlight permits organisms to synchronize their physiology to the external world. However, in current times, natural sunlight has been replaced by artificial light in both day and nighttime. While in the daytime, indoor artificial light is of lower intensity than natural sunlight, leading to a weak entrainment signal for our internal biological clock, at night the exposure to artificial light perturbs the body clock and sleep. Although electric light at night allows us "to live in darkness", our current lifestyle facilitates nighttime exposure to light by the use, or abuse, of electronic devices (e.g., smartphones). The chronic exposure to light at nighttime has been correlated to mood alterations, metabolic dysfunctions, and poor cognition. To decipher the brain mechanisms underlying these alterations, fundamental research has been conducted using animal models, principally of nocturnal nature (e.g., mice). Nevertheless, because of the diurnal nature of human physiology, it is also important to find and propose diurnal animal models for the study of the light effects in circadian biology. The present review provides an overview of the effects of light at nighttime on physiology and behavior in diurnal mammals, including humans. Knowing how the brain reacts to artificial light exposure, using diurnal rodent models, is fundamental for the development of new strategies in human health based in circadian biology.
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Affiliation(s)
- Jorge Mendoza
- Institute of Cellular and Integrative Neuroscience CNRS UPR3212, University of Strasburg, 8 allée du Général Rouvillois, 67000 Strasbourg, France
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Teoh AN, Kaur S, Mohd Shukri NH, Shafie SR, Ahmad Bustami N, Takahashi M, Lim PJ, Shibata S. Psychological state during pregnancy is associated with sleep quality: preliminary findings from MY-CARE cohort study. Chronobiol Int 2021; 38:959-970. [PMID: 33779445 DOI: 10.1080/07420528.2021.1902338] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Psychological distress during pregnancy may increase the risk of adverse maternal and infant outcomes. Past studies have demonstrated the association between circadian disturbances with psychological health. However, the roles of chronotype and social jetlag on psychological state during pregnancy are yet to be identified. We aimed to examine the psychological state in pregnant women and its relations to chronotype, social jetlag (SJL), sleep quality and cortisol rhythm. The current study included a subsample of participants from an ongoing cohort study. A total of 179 primigravidas (mean age 28.4 ± 4.0 years) were recruited. Chronotype and sleep quality during the second trimester were assessed using the Morning-Eveningness Questionnaire (MEQ) and Pittsburgh Sleep Quality Index (PSQI), respectively. SJL was calculated based on the difference between mid-sleep on workdays and free days. Psychological state of participants was evaluated using the Depression, Anxiety, and Stress Scale-21 (DASS-21). Subsamples (n = 70) provided salivary samples at 5 time points over a 24 h period during the second trimester for cortisol assay. A higher proportion of pregnant women experienced moderate to severe anxiety symptoms (n = 77, 43.0%), followed by depressive (n = 17, 9.5%) and stress (n = 14, 7.8%) symptoms. No association was observed between chronotype and psychological distress during pregnancy. There was no significant difference in cortisol rhythms in relation to psychological distress. SJL and sleep quality were significantly associated with stress symptoms among pregnant women in the second trimester. Poor sleep quality, particularly daytime dysfunction (β = 0.37, p = .006) and sleep disturbances (β = 0.23, p = .047), were significantly associated with psychological distress (depressive, anxiety and stress symptoms) during the second trimester. The findings suggest that sleep is a potential modifiable lifestyle factor that can be targeted to improve psychological health among pregnant women.
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Affiliation(s)
- Ai Ni Teoh
- Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Satvinder Kaur
- Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Nurul Husna Mohd Shukri
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Siti Raihanah Shafie
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Normina Ahmad Bustami
- School of Healthy Aging, Medical Aesthetics and Regenerative Medicine, Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
| | - Masaki Takahashi
- Institute for Liberal Arts, Tokyo Institute of Technology, Tokyo, Japan
| | - Pei Jean Lim
- Waseda Bioscience Research Institute in Singapore, Waseda University, Helios, Singapore
| | - Shigenobu Shibata
- Department of Electrical Engineering and Biosciences, School of Advanced Engineering and Sciences, Waseda University, Tokyo, Japan
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18
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Kim KM, Han SM, Heo K, Kim WJ, Chu MK. Sex differences in the association between chronotype and risk of depression. Sci Rep 2020; 10:18512. [PMID: 33116223 PMCID: PMC7595163 DOI: 10.1038/s41598-020-75724-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/20/2020] [Indexed: 12/31/2022] Open
Abstract
Information on sex differences in the association between chronotype and depression is scarce. We aimed to investigate these differences using data from the Korea National Health and Nutrition Examination Survey in 2016. Chronotypes were categorised based on mid-sleep time on free days corrected by sleep debt accumulated on workdays (MSFsc): early type, < mean MSFsc - 1 standard deviation (SD); intermediate type, between mean MSFsc - 1 SD and MSFsc + 1 SD; and late type, > mean MSFsc + 1 SD. A Patient Health Questionnaire-9 score of ≥ 10 indicated depression. Among 5550 non-shift working adults aged 19-80 years, the prevalence rates of depression in the early, intermediate, and late chronotype groups were 7.4%, 4.5%, and 9.3%, respectively. Women with late chronotype (odds ratio [OR] = 2.9, 95% confidence interval [CI] = 1.8-4.7) showed a higher risk of depression than women with intermediate chronotype after adjusting for covariates. Women with early chronotype did not show a significant difference in depression risk (OR = 1.3, 95% CI = 0.9-2.0). In conclusion, late chronotype is associated with an increased risk of depression in women but not in men. Early chronotype is not associated with depression in women or men.
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Affiliation(s)
- Kyung Min Kim
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Seung Min Han
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Kyoung Heo
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Won-Joo Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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19
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Foster RG, Hughes S, Peirson SN. Circadian Photoentrainment in Mice and Humans. BIOLOGY 2020; 9:biology9070180. [PMID: 32708259 PMCID: PMC7408241 DOI: 10.3390/biology9070180] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/03/2020] [Accepted: 07/05/2020] [Indexed: 12/26/2022]
Abstract
Light around twilight provides the primary entrainment signal for circadian rhythms. Here we review the mechanisms and responses of the mouse and human circadian systems to light. Both utilize a network of photosensitive retinal ganglion cells (pRGCs) expressing the photopigment melanopsin (OPN4). In both species action spectra and functional expression of OPN4 in vitro show that melanopsin has a λmax close to 480 nm. Anatomical findings demonstrate that there are multiple pRGC sub-types, with some evidence in mice, but little in humans, regarding their roles in regulating physiology and behavior. Studies in mice, non-human primates and humans, show that rods and cones project to and can modulate the light responses of pRGCs. Such an integration of signals enables the rods to detect dim light, the cones to detect higher light intensities and the integration of intermittent light exposure, whilst melanopsin measures bright light over extended periods of time. Although photoreceptor mechanisms are similar, sensitivity thresholds differ markedly between mice and humans. Mice can entrain to light at approximately 1 lux for a few minutes, whilst humans require light at high irradiance (>100’s lux) and of a long duration (>30 min). The basis for this difference remains unclear. As our retinal light exposure is highly dynamic, and because photoreceptor interactions are complex and difficult to model, attempts to develop evidence-based lighting to enhance human circadian entrainment are very challenging. A way forward will be to define human circadian responses to artificial and natural light in the “real world” where light intensity, duration, spectral quality, time of day, light history and age can each be assessed.
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20
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Papaconstantinou E, Quick V, Vogel E, Coffey S, Miller A, Zitzelsberger H. Exploring Relationships of Sleep Duration with Eating and Physical Activity Behaviors among Canadian University Students. Clocks Sleep 2020; 2:194-207. [PMID: 33089200 PMCID: PMC7445828 DOI: 10.3390/clockssleep2020016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/22/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Students pursuing postsecondary education are a population described as vulnerable for sleep problems, poor dietary habits, weight gain, and reduced physical activity. The primary goal of this study was to examine relationships of sleep behaviors with eating and physical activity behaviors in a sample of undergraduate health sciences students. METHODS Using a cross-sectional design, undergraduate health sciences students in a small Canadian university were recruited to complete an on-line questionnaire about their sleep, eating, and physical activity behaviors using valid and reliable instruments. Key sociodemographic characteristics and self-reported height and weight data were also captured. RESULTS The participants (n = 245) were on average 23 years of age, female (86%), and the majority were full-time students (92%). The mean BMI was within a healthy range (mean 24.58 SD 5.55) with the majority reporting low physical activity levels (65%). Despite self-reports of very or fairly good (65%) sleep quality in the past month, the mean global sleep scores (scores > 5, mean 7.4, SD 3.3) indicated poor overall sleep quality. Poorer sleep quality was associated with higher BMIs (r = 0.265, p < 0.001). CONCLUSIONS The findings highlight the need to expand the scope of on-campus wellness programs to promote healthy sleep habits in a vulnerable university population.
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Affiliation(s)
- Efrosini Papaconstantinou
- University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, ON L1G 0C5, Canada; (E.V.); (S.C.); (A.M.); (H.Z.)
| | - Virginia Quick
- Rutgers University, School of Environmental and Biological Sciences, New Brunswick, NJ 08901, USA;
| | - Ellen Vogel
- University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, ON L1G 0C5, Canada; (E.V.); (S.C.); (A.M.); (H.Z.)
| | - Sue Coffey
- University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, ON L1G 0C5, Canada; (E.V.); (S.C.); (A.M.); (H.Z.)
| | - Andrea Miller
- University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, ON L1G 0C5, Canada; (E.V.); (S.C.); (A.M.); (H.Z.)
| | - Hilde Zitzelsberger
- University of Ontario Institute of Technology, Faculty of Health Sciences, Oshawa, ON L1G 0C5, Canada; (E.V.); (S.C.); (A.M.); (H.Z.)
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21
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Estevan I, Silva A, Vetter C, Tassino B. Short Sleep Duration and Extremely Delayed Chronotypes in Uruguayan Youth: The Role of School Start Times and Social Constraints. J Biol Rhythms 2020; 35:391-404. [DOI: 10.1177/0748730420927601] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
During adolescence, biological, psychosocial, and contextual factors converge in a “perfect storm” and have been put forward to explain the delay in chronotype observed at this age and the prevalence of disrupted sleep. This study provides evidence to support that chronotype and sleep patterns (particularly sleep duration) are socially constrained and to identify novel significant social predictors. Uruguayan public school activities are arranged in up to 4 shifts, creating a natural experiment to examine the effect of school timing on questionnaire-based assessments of sleep and chronotype. In this study, 268 high school students (15-18 years old) who attended school either on morning (0730 to 1130 h) or afternoon shifts (1130 h to 1530 h) responded to an adapted School Sleep Habits Survey. Students attending afternoon shifts had later chronotypes (a 1.5-h later midpoint of sleep on free days adjusted for sleep debt) than those attending the morning shift. Besides shift, evening social activities (including dinner time) were further identified as key predictors of late chronotypes, whereas age and gender were not. Sleep on school days was overall advanced and reduced with respect to weekends, and these effects were stronger in morning-shift students. Weekend sleep duration was similar between shifts, which probably caused the prevalence of reduced sleep durations (average weekly sleep duration, SDweek <8 h) to be higher in morning-shift students (almost 80%) than in afternoon-shift ones (34%). Reduced sleep duration was significantly higher in morning-shift students. In addition, age, chronotype, and dinner time became relevant determinants of sleep deficit only in the morning-shift students. Besides the important social constraint of early school start time, this is the first study to confirm the significance of other types of social pressures on both adolescents’ chronotype and sleep deficit, which can be useful as potential new targets for effective policies to protect adolescent sleep.
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Affiliation(s)
- Ignacio Estevan
- Programa de Neuropsicología y Neurobiología, Facultad de Psicología, Universidad de la República, Uruguay
| | - Ana Silva
- Laboratorio de Neurociencias, Facultad de Ciencias, Universidad de la República, Uruguay
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Bettina Tassino
- Sección Etología, Facultad de Ciencias, Universidad de la República, Uruguay
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Šmotek M, Fárková E, Manková D, Kopřivová J. Evening and night exposure to screens of media devices and its association with subjectively perceived sleep: Should "light hygiene" be given more attention? Sleep Health 2020; 6:498-505. [PMID: 32197951 DOI: 10.1016/j.sleh.2019.11.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/18/2019] [Accepted: 11/22/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of the study was to examine subjective sleep quality in a population of healthy volunteers and its association with evening and night light exposure to screens of media devices. METHODS A total of 693 participants (mean age 31.2±11.4 years, 159 men, and 538 women) completed an online questionnaire battery consisting of several sleep-related questionnaires: PSQI, FSS, MCTQ, MEQ, and added questions assessing the timing and character the evening and night exposure to electronical devices (TV, PC, tablets, and phones), and the use of various filters blocking short-wavelength light. RESULTS Statistical analyses show that longer cumulative exposure to screen light in the evening was associated with greater sleep inertia in the morning (P = .019, η2=0.141) and longer sleep latency on workdays P = .038, η2=0.135). Furthermore, exposure to screen light 1.5 h before sleep or during night awakenings was also associated with a decreased chance to wake up before alarm clock (P = .003, d=0.30), larger social jet lag (P < .001, d=0.15), more daytime dysfunction (P < .001, d=0.40), decreased subjective sleep quality (P = .024, d=0.16), and more fatigue (P < .001, d=0.52). A statistical trend for an increase in duration of sleep on weekdays (P = .058, d=0.23) was also found in participants using blue-light filters in the evening hours. DISCUSSION Our results are in line with other studies that converge to show the negative association of evening and night exposure to short-wavelength light on subjective and objective sleep parameters. Results suggest that light hygiene in general population should be given more attention not only in the context of clinical sleep medicine but also in the realm of public health.
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Affiliation(s)
- Michal Šmotek
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Eva Fárková
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Denisa Manková
- National Institute of Mental Health, Klecany, Czech Republic
| | - Jana Kopřivová
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic
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Münch M, Wirz-Justice A, Brown SA, Kantermann T, Martiny K, Stefani O, Vetter C, Wright KP, Wulff K, Skene DJ. The Role of Daylight for Humans: Gaps in Current Knowledge. Clocks Sleep 2020; 2:61-85. [PMID: 33089192 PMCID: PMC7445840 DOI: 10.3390/clockssleep2010008] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/21/2020] [Indexed: 01/04/2023] Open
Abstract
Daylight stems solely from direct, scattered and reflected sunlight, and undergoes dynamic changes in irradiance and spectral power composition due to latitude, time of day, time of year and the nature of the physical environment (reflections, buildings and vegetation). Humans and their ancestors evolved under these natural day/night cycles over millions of years. Electric light, a relatively recent invention, interacts and competes with the natural light-dark cycle to impact human biology. What are the consequences of living in industrialised urban areas with much less daylight and more use of electric light, throughout the day (and at night), on general health and quality of life? In this workshop report, we have classified key gaps of knowledge in daylight research into three main groups: (I) uncertainty as to daylight quantity and quality needed for "optimal" physiological and psychological functioning, (II) lack of consensus on practical measurement and assessment methods and tools for monitoring real (day) light exposure across multiple time scales, and (III) insufficient integration and exchange of daylight knowledge bases from different disciplines. Crucial short and long-term objectives to fill these gaps are proposed.
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Affiliation(s)
- Mirjam Münch
- Sleep/Wake Research Centre, Massey University Wellington, Wellington 6021, New Zealand
| | - Anna Wirz-Justice
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, 4002 Basel, Switzerland; (A.W.-J.); (O.S.)
- Transfaculty Research Platform Molecular and Cognitive Neurosciences (MCN), University of Basel, 4002 Basel, Switzerland
| | - Steven A. Brown
- Chronobiology and Sleep Research Group, Institute of Pharmacology and Toxicology, University of Zürich, 8057 Zürich, Switzerland;
| | - Thomas Kantermann
- Faculty for Health and Social Affairs, University of Applied Sciences for Economics and Management (FOM), 45141 Essen, Germany;
- SynOpus, 44789 Bochum, Germany
| | - Klaus Martiny
- Psychiatric Center Copenhagen, University of Copenhagen, Rigshospitalet, 2100 Copenhagen, Denmark;
| | - Oliver Stefani
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, 4002 Basel, Switzerland; (A.W.-J.); (O.S.)
- Transfaculty Research Platform Molecular and Cognitive Neurosciences (MCN), University of Basel, 4002 Basel, Switzerland
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA; (C.V.); (K.P.W.J.)
| | - Kenneth P. Wright
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA; (C.V.); (K.P.W.J.)
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado, Aurora, CO 80045, USA
| | - Katharina Wulff
- Departments of Radiation Sciences and Molecular Biology, Umeå University, 901 87 Umeå, Sweden;
- Wallenberg Centre for Molecular Medicine (WCMM), Umeå University, 901 87 Umeå, Sweden
| | - Debra J. Skene
- Chronobiology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK;
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24
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Shochat T, Santhi N, Herer P, Flavell SA, Skeldon AC, Dijk DJ. Sleep Timing in Late Autumn and Late Spring Associates With Light Exposure Rather Than Sun Time in College Students. Front Neurosci 2019; 13:882. [PMID: 31555073 PMCID: PMC6724614 DOI: 10.3389/fnins.2019.00882] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 08/07/2019] [Indexed: 12/11/2022] Open
Abstract
Timing of the human sleep-wake cycle is determined by social constraints, biological processes (sleep homeostasis and circadian rhythmicity) and environmental factors, particularly natural and electrical light exposure. To what extent seasonal changes in the light-dark cycle affect sleep timing and how this varies between weekdays and weekends has not been firmly established. We examined sleep and activity patterns during weekdays and weekends in late autumn (standard time, ST) and late spring (daylight saving time, DST), and expressed their timing in relation to three environmental reference points: clock-time, solar noon (SN) which occurs one clock hour later during DST than ST, and the midpoint of accumulated light exposure (50% LE). Observed sleep timing data were compared to simulated data from a mathematical model for the effects of light on the circadian and homeostatic regulation of sleep. A total of 715 days of sleep timing and light exposure were recorded in 19 undergraduates in a repeated-measures observational study. During each three-week assessment, light and activity were monitored, and self-reported bed and wake times were collected. Light exposure was higher in spring than in autumn. 50% LE did not vary across season, but occurred later on weekends compared to weekdays. Relative to clock-time, bedtime, wake-time, mid-sleep, and midpoint of activity were later on weekends but did not differ across seasons. Relative to SN, sleep and activity measures were earlier in spring than in autumn. Relative to 50% LE, only wake-time and mid-sleep were later on weekends, with no seasonal differences. Individual differences in mid-sleep did not correlate with SN but correlated with 50% LE. Individuals with different habitual bedtimes responded similarly to seasonal changes. Model simulations showed that light exposure patterns are sufficient to explain sleep timing in spring but less so in autumn. The findings indicate that during autumn and spring, the timing of sleep associates with actual light exposure rather than sun time as indexed by SN.
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Affiliation(s)
- Tamar Shochat
- Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Nayantara Santhi
- Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Paula Herer
- Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Sapphira A. Flavell
- Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Anne C. Skeldon
- Department of Mathematics, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, United Kingdom
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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25
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Lansdall-Welfare T, Lightman S, Cristianini N. Seasonal variation in antidepressant prescriptions, environmental light and web queries for seasonal affective disorder. Br J Psychiatry 2019; 215:481-484. [PMID: 30924435 DOI: 10.1192/bjp.2019.40] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The state of an individual's mental health depends on many factors. Determination of the importance of any particular factor within a population needs access to unbiased data. We used publicly available data-sets to investigate, at a population level, how surrogates of mental health covary with light exposure. We found strong seasonal patterns of antidepressant prescriptions, which show stronger correlations with day length than levels of solar energy. Levels of depression in a population can therefore be determined by proxy indicators such as web query logs. Furthermore, these proxies for depression correlate with day length rather than solar energy.Declaration of interestNone.
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Affiliation(s)
| | - Stafford Lightman
- Professor of Medicine,Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology,University of Bristol,UK
| | - Nello Cristianini
- Professor of Artificial Intelligence,Intelligent Systems Laboratory,University of Bristol,UK
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26
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Randler C, Kolomeichuk SN, Morozov AV, Petrashova DA, Pozharskaya VV, Martynova AA, Korostovtseva LS, Bochkarev MV, Sviryaev YV, Polouektov MG, Drake C. Psychometric properties of the Russian version of the Pediatric Daytime Sleepiness Scale (PDSS). Heliyon 2019; 5:e02134. [PMID: 31372567 PMCID: PMC6661285 DOI: 10.1016/j.heliyon.2019.e02134] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 03/27/2019] [Accepted: 07/18/2019] [Indexed: 12/20/2022] Open
Abstract
Insufficient sleep could severely impair both cognitive and learning skills. More prominent changes are found in children and adolescents. Tools used to estimate sleepiness in the adult population are commonly inappropriate for children. The objective of our study was to provide a reliable instrument to measure excessive sleepiness for upcoming studies in Russian-speaking children, applying the Russian version of Pediatric Daytime Sleepiness Scale (PDSS). The following tasks were resolved in our study: translation, validation, and analysis of psychometric properties of the Russian adaptation of the PDSS by standard tests. After the semantic validation of the instrument through a multi-stage translation process we checked its psychometric validation. A total of 552 students, consisting of N = 285 for the exploratory factor analysis (EFA), N = 267 for the confirmatory factor analysis (CFA) and N = 204 for test-retest analysis of public elementary schools located in Northern Russia completed the PDSS and Munich Chronotype Questionnaire to estimate sleep parameters in the classroom during the lessons. Response rate was 90%; excluded cases contained no data. Further, 204 of our participants completed the PDSS in a 3 months interval to check the test-retest reliability. Internal consistency was measured by Cronbach's alpha coefficients and CFA was used to test factorial validity of the tool. Concurrent validity and test-retest reliability were assessed via intra-class coefficient. Internal consistency of the PDSS scale was high (Cronbach's α = 0.8). The construct validity of the PDSS was supported by CFA (factor loadings were from 0.438 to 0.727) and the test-retest reliability demonstrated by the intra-class coefficient was 0.70. The total PDSS score was independent of sex. The mean total value of PDSS was 11.95 ± 6.24. Higher scores on PDSS were negatively correlated with sleep duration. Thus, the construct validity of the instrument remains valid and could be used for Russian-speaking youth samples in the evaluation of daytime sleepiness. It could be useful in future applications by sleep scientists and health practitioners.
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Affiliation(s)
- C Randler
- University of Tuebingen, Department of Biology, Auf der Morgenstelle 24, D-72076 Tübingen, Germany
| | - S N Kolomeichuk
- Laboratory of Genetics, Institute of Biology of the Karelian Science Center of the Russian Academy of Sciences, Petrozavodsk, Russia.,Kola Science Center of the Russian Academy of Sciences, Apatity, Murmansk Region, Russia
| | - A V Morozov
- Laboratory of Ecological Physiology of Animals, Institute of Biology of the Karelian Science Center of the Russian Academy of Sciences, Petrozavodsk, Russia
| | - D A Petrashova
- Kola Science Center of the Russian Academy of Sciences, Apatity, Murmansk Region, Russia
| | - V V Pozharskaya
- Kola Science Center of the Russian Academy of Sciences, Apatity, Murmansk Region, Russia
| | - A A Martynova
- Kola Science Center of the Russian Academy of Sciences, Apatity, Murmansk Region, Russia
| | | | - M V Bochkarev
- Almazov National Medical Research Center, Saint-Petersburg, Russia
| | - Y V Sviryaev
- Almazov National Medical Research Center, Saint-Petersburg, Russia
| | | | - C Drake
- Henry Ford Hospital Sleep Disorders and Research Center, Detroit, MI, USA
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