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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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Çinar B, Gica Ş, Çelikkiran P, Kara A, Yeşilkaya UH, Karamustafalioğlu N. Eveningness chronotype influences social functioning by deteriorating depressive symptoms in remitted patients with schizophrenia. Chronobiol Int 2024; 41:847-858. [PMID: 38752353 DOI: 10.1080/07420528.2024.2353859] [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: 09/10/2023] [Accepted: 05/01/2024] [Indexed: 06/12/2024]
Abstract
Sleep and circadian rhythm disruption (SCRD) is common in schizophrenia patients, who also typically experience impaired social functioning. While various factors influence social functioning in schizophrenia, the specific impact of sleep and circadian rhythm disruption remains unclear. This study aimed to investigate the connection between chronotype and social functioning in remitted schizophrenia patients, examining the mediating roles of depression and sleep quality. The study included 185 patients diagnosed with schizophrenia based on DSM-5 criteria. After categorizing the patients into morningness, eveningness, or intermediate chronotypes using the Morningness-Eveningness Questionnaire(MEQ), they were assessed with the Positive and Negative Syndrome Scale(PANSS), Calgary Depression Scale for Schizophrenia(CDSS), Personal and Social Performance Scale(PSPS) and Pittsburgh Sleep Quality Index(PSQI). The eveningness chronotype group showed higher CDSS and PSQI scores and lower PWBS and PSPS-Total scores than the other groups (p < 0.05). A hierarchical linear regression model assessed MEQ, PSQI, and CDSS scores' effects on PSPS total scores. MEQ scores' significance diminished when CDSS scores were included. Eveningness chronotype, particularly with increased depressive symptoms, negatively impacts social functioning in remitted schizophrenia patients.These findings contribute to the understudied area of chronotype in schizophrenia and its impact on social functioning, including its interaction with sleep..
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Affiliation(s)
- Bilge Çinar
- Department of Psychiatry, Ardahan State Hospital, Ardahan, Turkiye
| | - Şakir Gica
- Department of Psychiatry, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkiye
| | - Pinar Çelikkiran
- Department of Psychiatry, Bakirkoy Dr. Mazhar Osman Clinic of Psychiatry and Neurology, Istanbul, Turkiye
| | - Aysu Kara
- Department of Psychiatry, Van State Training and Research Hospital, Van, Turkiye
| | - Umit Haluk Yeşilkaya
- Department of Psychiatry, Bakirkoy Dr. Mazhar Osman Clinic of Psychiatry and Neurology, Istanbul, Turkiye
- Regenerative and Restorative Medicine Research Center (REMER), Institute for Health Sciences and Technologies (SABITA), İstanbul Medipol University, İstanbul, Turkiye
- Schizophrenia and Bipolar Disorder Program, McLean Hospital, Harvard Medical School, Belmont, Massachusetts, USA
| | - Nesrin Karamustafalioğlu
- Department of Psychiatry, Bakirkoy Dr. Mazhar Osman Clinic of Psychiatry and Neurology, Istanbul, Turkiye
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Mao B, Xie Z, Liu M, Gong Y, Wang H, Yang S, Liao M, Xiao T, Tang S, Wang Y, Yang YD. Associations of chronotype with anxiety, depression and insomnia among general adult population: A cross-sectional study in Hubei, China. J Affect Disord 2024; 351:250-258. [PMID: 38280566 DOI: 10.1016/j.jad.2024.01.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 01/06/2024] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND The relationship between chronotype and anxiety, depression, and insomnia was inconsistent. We aimed to assess the association between chronotype and mental health and the potential moderating effect of age and socioeconomic status (SES). METHODS A multi-stage sampling cross-sectional study with 12,544 adults was conducted. Chronotype, anxiety, depression, and insomnia were investigated by 5-item Morning and Evening, 7-item Generalized Anxiety Disorder, 9-item Patient Health, and the 7-item Insomnia Severity Index Questionnaires. Logistic regression was conducted. RESULTS The predominant chronotype was morning chronotype (69.2 %), followed by 27.6 % intermediate and 3.2 % evening chronotype. The prevalence of anxiety, depression, and insomnia was 0.7 %, 1.9 %, and 9.6 %, respectively. Compared with intermediate chronotype, morning chronotype participants had a lower risk of anxiety (OR = 0.28,95%CI:0.18-0.44), depression (OR = 0.54,95%CI:0.41-0.72) and insomnia (OR = 0.67,95%CI:0.58-0.77), while evening chronotype participants had a higher risk of depression (OR = 1.98,95%CI:1.06-3.71) but not anxiety or insomnia. Interactions between chronotype with age and SES on insomnia (Pinteraction < 0.05) were found. A more profound association between morning chronotype and insomnia was observed in <65 years participants (OR = 0.59,95%CI:0.50-0.71) and those with monthly household income ≥10,000yuan (OR = 0.21,95%CI:0.12-0.35), compared with their counterparts. LIMITATIONS The cross-sectional design limited causal conclusions. Only adults were included; the findings could not be generalized to children. CONCLUSIONS The morning chronotype might be protective for anxiety, depression, and insomnia, while the evening chronotype might be a risk factor for depression. Future studies are needed to assess the efficacy of chronotype-focused intervention for mental health. Insomnia prevention efforts should pay more attention to the elderly and those with lower incomes.
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Affiliation(s)
- Bin Mao
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China
| | - Zhongliang Xie
- Department of Psychiatry, Honghu Mental Health Center, Shimatou Street 126, Honghu, Jingzhou 434021, China
| | - Mengjiao Liu
- School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang 330006, China; Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College, Nanchang University, Nanchang 330006, China
| | - Yue Gong
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China
| | - Huicai Wang
- Department of Psychiatry, Honghu Mental Health Center, Shimatou Street 126, Honghu, Jingzhou 434021, China
| | - Shuwang Yang
- Institute of Chronic Non-Communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Ming Liao
- Department of Psychiatry, Honghu Mental Health Center, Shimatou Street 126, Honghu, Jingzhou 434021, China
| | - Tianli Xiao
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China
| | - Shiming Tang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Ying Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Yi-De Yang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China..
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Li SX, Cheung FTW, Chan NY, Chan JWY, Zhang J, Li AM, Espie CA, Gradisar M, Wing YK. Effects of cognitive behavioural therapy and bright light therapy for insomnia in youths with eveningness: study protocol for a randomised controlled trial. Trials 2024; 25:246. [PMID: 38594725 PMCID: PMC11005158 DOI: 10.1186/s13063-024-08090-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/02/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Insomnia and eveningness are common and often comorbid conditions in youths. While cognitive behavioural therapy for insomnia (CBT-I) has been suggested as a promising intervention, it remains unclear whether it is sufficient to also address circadian issues in youths. In addition, despite that light has been shown to be effective in phase-shifting one's circadian rhythm, there has been limited data on the effects of bright light therapy and its combination with CBT-I on sleep and circadian outcomes in youths. The current protocol outlines a randomised controlled trial that examines the efficacy of CBT-I and CBT-I plus bright light therapy (BLT) in reducing insomnia severity, improving mood symptoms and daytime functioning (e.g. sleepiness, fatigue, cognitive function), and improving subjective and objective sleep and circadian measures compared to a waitlist control group. METHODS We will carry out a randomised controlled trial (RCT) with 150 youths aged 12-24 who meet the criteria of insomnia and eveningness. Participants will be randomised into one of three groups: CBT-I with bright light therapy, CBT-I with placebo light, and waitlist control. Six sessions of CBT-I will be delivered in a group format, while participants will be currently asked to use a portable light device for 30 min daily immediately after awakening throughout the intervention period for bright light therapy. The CBT-I with light therapy group will receive bright constant green light (506 lx) while the CBT-I with placebo light group will receive the modified light device with the LEDs emitting less than 10 lx. All participants will be assessed at baseline and post-treatment, while the two active treatment groups will be additionally followed up at 1 month and 6 months post-intervention. The primary outcome will be insomnia severity, as measured by the Insomnia Severity Index. Secondary outcomes include self-reported mood, circadian, daytime functioning, and quality of life measures, as well as sleep parameters derived from actigraphy and sleep diary and neurocognitive assessments. Objective measures of the circadian phase using dim-light melatonin onset assessment and sleep parameters using polysomnography will also be included as the secondary outcomes. DISCUSSION This study will be the first RCT to directly compare the effects of CBT-I and BLT in youths with insomnia and eveningness. Findings from the study will provide evidence to inform the clinical management of insomnia problems and eveningness in youths. TRIAL REGISTRATION ClinicalTrials.gov NCT04256915. Registered on 5 February 2020.
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Affiliation(s)
- Shirley Xin Li
- Department of Psychology, Sleep Research Clinic and Laboratory, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China.
| | - Forrest Tin Wai Cheung
- Department of Psychology, Sleep Research Clinic and Laboratory, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joey Wing Yan Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medicine University, Guangzhou, Guangdong, China
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Colin A Espie
- Nuffield Department of Clinical Neurosciences and Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
| | - Michael Gradisar
- WINK Sleep Pty Ltd, Adelaide, Australia
- Sleep Cycle AB, Gothenburg, Sweden
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Magnani L, Aguglia A, Alexander J, Maiorano A, Richard-Lepouriel H, Iancau SP, Amerio A, Parise A, Serafini G, Amore M, Nguyen KD, Costanza A. Evening Chronotype and Suicide: Exploring Neuroinflammation and Psychopathological Dimensions as Possible Bridging Factors-A Narrative Review. Brain Sci 2023; 14:30. [PMID: 38248245 PMCID: PMC10813318 DOI: 10.3390/brainsci14010030] [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: 12/10/2023] [Revised: 12/21/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
A chronotype is generally defined as the variability of the phase angle of entrainment, while the latter reflects the relationship between the timing of a certain rhythm (e.g., the sleep-wake cycle) and the timing of an external temporal cue. Individuals can be placed on a spectrum from "morning types" (M types) to "evening types" (E types). E-chronotype has been proposed as a transdiagnostic risk factor for psychiatric conditions, and it has been associated with psychopathological dimensions. Eveningness seems to be correlated with both suicidal ideation (SI) and suicidal behavior (SB) through several possible mediating factors. Immunological alterations have also been linked to later chronotypes and SI/SB. This narrative review aims to summarize the evidence supporting the possible association between chronotypes and suicide and the eventual mediating role of neuroinflammation and several psychopathological dimensions. A search of the literature (2003-2023) was conducted using various databases: PUBMED, EMBASE, Scopus, UpToDate, PsycINFO, and Cochrane Library. English-language articles were collected and screened for eligibility. Despite the apparent absence of a direct correlation between E-chronotype and suicidality, E-chronotype promotes a chain of effects that could be involved in an increased risk of SB, in which with neuroinflammation possibly plays an intriguing role and some psychopathological dimensions may stand out.
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Affiliation(s)
- Luca Magnani
- Department of Psychiatry, San Maurizio Hospital, 39100 Bolzano, Italy;
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Polyclinic Hospital San Martino, 16132 Genoa, Italy
| | - Jacques Alexander
- Department of Psychiatry, Geneva University Hospital (HUG), 1205 Geneva, Switzerland; (J.A.); (A.M.)
| | - Alessandra Maiorano
- Department of Psychiatry, Geneva University Hospital (HUG), 1205 Geneva, Switzerland; (J.A.); (A.M.)
| | - Hélène Richard-Lepouriel
- Department of Psychiatry, Mood Disorder Unit, Psychiatric Specialties Service, Geneva University Hospital (HUG), 1205 Geneva, Switzerland;
| | - Sidonia Paula Iancau
- Residence School in Psychiatry, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University, 00185 Rome, Italy;
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Polyclinic Hospital San Martino, 16132 Genoa, Italy
| | - Alberto Parise
- Geriatric-Rehabilitation Department, University Hospital of Parma, 43126 Parma, Italy;
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Polyclinic Hospital San Martino, 16132 Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Polyclinic Hospital San Martino, 16132 Genoa, Italy
| | - Khoa D. Nguyen
- Chinese University of Hong Kong, Hong Kong SAR, China;
- Tranquis Therapeutics, Palo Alto, CA 94303, USA
| | - Alessandra Costanza
- Department of Psychiatry, Geneva University Hospital (HUG), 1205 Geneva, Switzerland; (J.A.); (A.M.)
- Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), 6900 Lugano, Switzerland
- Department of Psychiatry, Faculty of Medicine, Geneva University (UNIGE), 1205 Geneva, Switzerland
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Blum DJ, Hernandez B, Zeitzer JM. Early time-restricted eating advances sleep in late sleepers: a pilot randomized controlled trial. J Clin Sleep Med 2023; 19:2097-2106. [PMID: 37559551 PMCID: PMC10692922 DOI: 10.5664/jcsm.10754] [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: 05/05/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023]
Abstract
STUDY OBJECTIVES This study evaluated the effects of early time-restricted eating (eTRE) on shifting the timing of sleep among late sleepers. Primary outcomes included actigraphy- and sleep diary-derived sleep onset, midsleep phase, and wake time with total sleep time as a secondary outcome. METHODS Fifteen healthy adults with habitual late sleep timing were randomized to receive either eTRE or sleep and nutrition hygiene (control) via a single 30-minute synchronous video session. Participants completed an initial 1-week baseline phase followed by a 2-week intervention phase. Measures included continuous sleep monitoring and sleep and nutrition diaries. RESULTS Linear mixed-effects modeling demonstrated that eTRE significantly advanced sleep timing compared with controls. Self-reported sleep onset (56.1 [95% confidence interval: 20.5, 91.7] minutes), midpoint (19.5 [7.2, 31.9] minutes), and offset (42.2 [2.9, 81.5] minutes) each moved earlier in eTRE as compared with controls. Similarly, objectively determined sleep onset (66.5 [29.6, 103.4] minutes), midpoint (21.9 [9.1, 34.7] minutes), and offset (39.3 [1.3, 77.3] minutes) each moved earlier in eTRE as compared with controls. Total sleep time showed a nonsignificant increase in the eTRE group as compared with controls. CONCLUSIONS Late sleepers who were instructed in a single session about eTRE significantly advanced their sleep timing, especially sleep onset. eTRE shows potential as a clinical strategy for advancing sleep timing in late sleepers. CLINICAL TRIAL REGISTRATION Registry: Chinese Clinical Trial Registry; Name: FAST Asleep: It's All About Timing; URL: https://www.chictr.org.cn/showproj.html?proj=122504; Identifier: ChiCTR2100043691. CITATION Blum DJ, Hernandez B, Zeitzer JM. Early time-restricted eating advances sleep in late sleepers: a pilot randomized controlled trial. J Clin Sleep Med. 2023;19(12):2097-2106.
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Affiliation(s)
- Daniel Jin Blum
- Department of Arts and Sciences, NYU Shanghai, Shanghai, China
- Department of Psychiatry and Behavioral Sciences, Stanford Center for Sleep Sciences and Medicine, Stanford University, Stanford, California
| | - Beatriz Hernandez
- Department of Psychiatry and Behavioral Sciences, Stanford Center for Sleep Sciences and Medicine, Stanford University, Stanford, California
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, California
| | - Jamie M. Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford Center for Sleep Sciences and Medicine, Stanford University, Stanford, California
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, California
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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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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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Reis DJ, Yen P, Tizenberg B, Gottipati A, Postolache SY, De Riggs D, Nance M, Dagdag A, Plater L, Federline A, Grassmeyer R, Dagdag A, Akram F, Ozorio Dutra SV, Gragnoli C, RachBeisel JA, Volkov J, Bahraini NH, Stiller JW, Brenner LA, Postolache TT. Longitude-based time zone partitions and rates of suicide. J Affect Disord 2023; 339:933-942. [PMID: 37481129 PMCID: PMC10870927 DOI: 10.1016/j.jad.2023.07.080] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/19/2023] [Accepted: 07/14/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Increasing evidence suggests that conditions with decreased morning and increased evening light exposure, including shift work, daylight-saving time, and eveningness, are associated with elevated mortality and suicide risk. Given that the alignment between the astronomical, biological, and social time varies across a time zone, with later-shifted daylight exposure in the western partition, we hypothesized that western time zone partitions would have higher suicide rates than eastern partitions. METHODS United States (U.S.) county-level suicide and demographic data, from 2010 to 2018, were obtained from a Centers for Disease Control database. Using longitude and latitude, counties were sorted into the western, middle, or eastern partition of their respective time zones, as well as the northern and southern halves of the U.S. Linear regressions were used to estimate the associations between suicide rates and time zone partitions, adjusting for gender, race, ethnicity, age group, and unemployment rates. RESULTS Data were available for 2872 counties. Across the U.S., western partitions had statistically significantly higher rates of suicide compared to eastern partitions and averaged up to two additional yearly deaths per 100,000 people (p < .001). LIMITATIONS Ecological design and limited adjustment for socioeconomic factors. CONCLUSIONS To our knowledge, this is the first study of the relationship between longitude-based time zone partitions and suicide. The results were consistent with the hypothesized elevated suicide rates in the western partitions, and concordant with previous reports on cancer mortality and transportation fatalities. The next step is to retest the hypothesis with individual-level data, accounting for latitude, photoperiodic changes, daylight-saving time, geoclimatic variables, physical and mental health indicators, as well as socioeconomic adversity and protection.
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Affiliation(s)
- Daniel J Reis
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Poyu Yen
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Boris Tizenberg
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Anurag Gottipati
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sonia Y Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Demitria De Riggs
- VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center, Baltimore, MD, USA
| | - Morgan Nance
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alexandra Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Lynn Plater
- VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center, Baltimore, MD, USA
| | - Amanda Federline
- VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center, Baltimore, MD, USA
| | - Riley Grassmeyer
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Faisal Akram
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA; Psychiatry Residency Training, Saint Elizabeth's Hospital, Department of Behavioral Health, Washington, DC, USA
| | | | - Claudia Gragnoli
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA; Division of Endocrinology, Department of Medicine, Creighton University School of Medicine, Omaha, NE, USA
| | - Jill A RachBeisel
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Janna Volkov
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA; Psychiatry Residency Training, Saint Elizabeth's Hospital, Department of Behavioral Health, Washington, DC, USA
| | - Nazanin H Bahraini
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John W Stiller
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA; Saint Elizabeth's Hospital, Neurology Consultation Service, Washington, DC, USA; Maryland State Athletic Commission, Baltimore, MD, USA
| | - Lisa A Brenner
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Denver, CO, USA
| | - Teodor T Postolache
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA; Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA; VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center, Baltimore, MD, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Denver, CO, USA
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10
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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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11
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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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12
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Rigó A, Tóth-Király I, Magi A, Eisinger A, Demetrovics Z, Urbán R. Sensation seeking, drinking motives, and going out mediate the link between eveningness and alcohol use and problems in adolescence. Chronobiol Int 2023; 40:1187-1197. [PMID: 37722395 DOI: 10.1080/07420528.2023.2256396] [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: 08/22/2022] [Accepted: 09/01/2023] [Indexed: 09/20/2023]
Abstract
The present study was aimed at obtaining a more comprehensive understanding of the possible mediating factors in the morningness-eveningness → alcohol consumption relation. We explored the role of mediators such as sensation seeking, the frequency of going out in the evenings, and drinking motives. We tested the proposed mediation model via structural equation modeling based on cross-sectional research conducted among Hungarian adolescents and young adults (N = 1695, 42.5% male, Mage = 18.98, SDage = 1.89). The outcomes included the frequency of alcohol consumption and problematic drinking. Both alcohol consumption and problematic drinking were predicted in similar directions and magnitudes by sensation seeking, "going out," and coping drinking motives. However, eveningness still had a significant direct effect on alcohol consumption and problematic drinking after we controlled for sensation seeking, going out, and drinking motives. For problematic drinking, the possible role of drinking motives seems to be higher and more complex than it is for alcohol consumption. The mediators, such as sensation seeking, the amount of time spent out in the evenings, and drinking motives, can explain the eveningness → alcohol consumption relationship and should be targeted for alcohol prevention programs among evening-type adolescents.
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Affiliation(s)
- Adrien Rigó
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - István Tóth-Király
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Canada
| | - Anna Magi
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Andrea Eisinger
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar
| | - Róbert Urbán
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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13
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Futenma K, Takaesu Y, Komada Y, Shimura A, Okajima I, Matsui K, Tanioka K, Inoue Y. Delayed sleep-wake phase disorder and its related sleep behaviors in the young generation. Front Psychiatry 2023; 14:1174719. [PMID: 37275982 PMCID: PMC10235460 DOI: 10.3389/fpsyt.2023.1174719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/08/2023] [Indexed: 06/07/2023] Open
Abstract
Delayed sleep-wake phase disorder (DSWPD) is a sleep disorder in which the habitual sleep-wake timing is delayed, resulting in difficulty in falling asleep and waking up at the desired time. Patients with DSWPD frequently experience fatigue, impaired concentration, sleep deprivation during weekdays, and problems of absenteeism, which may be further complicated by depressive symptoms. DSWPD is typically prevalent during adolescence and young adulthood. Although there are no studies comparing internationally, the prevalence of DSWPD is estimated to be approximately 3% with little racial differences between Caucasians and Asians. The presence of this disorder is associated with various physiological, genetic and psychological as well as behavioral factors. Furthermore, social factors are also involved in the mechanism of DSWPD. Recently, delayed sleep phase and prolonged sleep duration in the young generation have been reported during the period of COVID-19 pandemic-related behavioral restrictions. This phenomenon raises a concern about the risk of a mismatch between their sleep-wake phase and social life that may lead to the development of DSWPD after the removal of these restrictions. Although the typical feature of DSWPD is a delay in circadian rhythms, individuals with DSWPD without having misalignment of objectively measured circadian rhythm markers account for approximately 40% of the cases, wherein the psychological and behavioral characteristics of young people, such as truancy and academic or social troubles, are largely involved in the mechanism of this disorder. Recent studies have shown that DSWPD is frequently comorbid with psychiatric disorders, particularly mood and neurodevelopmental disorders, both of which have a bidirectional association with the pathophysiology of DSWPD. Additionally, patients with DSWPD have a strong tendency toward neuroticism and anxiety, which may result in the aggravation of insomnia symptoms. Therefore, future studies should address the effectiveness of cognitive-behavioral approaches in addition to chronobiological approaches in the treatment of DSWPD.
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Affiliation(s)
- Kunihiro Futenma
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Yoshikazu Takaesu
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Yoko Komada
- Institute for Liberal Arts, Tokyo Institute of Technology, Tokyo, Japan
| | - Akiyoshi Shimura
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Isa Okajima
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo, Japan
| | - Kentaro Matsui
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kosuke Tanioka
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Yuichi Inoue
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
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14
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Morningness-Eveningness and Problematic Online Activities. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01017-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Abstract
Online activities and problematic online behaviors have recently emerged as important research topics. However, only a few studies have explored the possible associations between these behaviors and morningness-eveningness. The authors examined whether eveningness predicts these distinct problematic online behaviors differently and directly or via mediators. The associations between eveningness and three different problematic online behaviors (problematic Internet use, problematic online gaming, and problematic social media use) were explored among a large sample of Hungarian young adults (N = 1729, 57.2% female, Mage = 22.01, SDage = 1.97) by using a self-report survey. Depression and the time spent engaging in online activities were assessed as possible mediators. The effects of age and sex were controlled for. Using structural equation modeling, the results supported the association between eveningness and the higher risk for all three problematic online behaviors and highlighted that these associations were mediated by depressive mood and time spent on the activities. In addition, eveningness also predicted PIU directly. Eveningness is a risk factor for problematic online behaviors not only because of the higher amount of time spent on the activities but also because of the worse mood associated with eveningness. The results highlight that it is important to examine the different types of online activity separately and explore the role of diverse risk factors, among them morningness-eveningness.
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15
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Francisco AP, Tonon AC, Amando GR, Hidalgo MP. Self-perceived rhythmicity in affective and cognitive functions is related to psychiatric symptoms in adolescents. Chronobiol Int 2022; 40:103-113. [PMID: 36377323 DOI: 10.1080/07420528.2022.2147078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this study was to evaluate the relationship between self-perceived rhythms measured using the Mood Rhythm Instrument for adolescents (MRhI-Y) and depressive and psychiatric symptoms measured with the Children's Depressive Instrument (CDI) and the Strengths and Difficulties Questionnaire (SDQ). In this study, 186 adolescents were recruited in Rio Grande do Sul, Brazil. We performed a Spearman correlation analysis to evaluate the relationships between quantitative variables. All variables that had a statistically significant correlation were included in ANOVA multiple regression models. The dependent variables in the multiple regression analyses were CDI score and total and emotional scores on the SDQ. We found that only Cognitive self-perceived rhythmicity contributed significantly to the first multiple regression with CDI as the outcome variable. The second regression with SDQ Emotional score as the outcome variable showed that female sex, age, and self-perceived affective rhythmicity contributed significantly to the model. The third regression with SDQ total score as the outcome variable showed that chronotype, self-perceived cognitive symptoms, and affective rhythmicity contributed significantly to the model. In conclusion, we found that lower self-perceived rhythmicity in cognitive factors and higher self-perceived rhythmicity in affective factors were related to presence and intensity of psychiatric and depressive symptoms.
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Affiliation(s)
- Ana Paula Francisco
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andre Comiran Tonon
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Guilherme Rodriguez Amando
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Paz Hidalgo
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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16
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Borisenkov MF, Popov SV, Smirnov VV, Dorogina OI, Pechеrkina AA, Symaniuk EE. Later school start time is associated with better academic performance, sleep-wake rhythm characteristics, and eating behavior. Chronobiol Int 2022; 39:1444-1453. [PMID: 36043490 DOI: 10.1080/07420528.2022.2117050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
There are numerous studies which show that an early school start time has a negative impact on the sleep, well-being, and academic performance of students. There is not enough information on the association between school start time and eating disorders, however: the disruption of the circadian rhythm is known to be a risk factor for eating disorders. The aim of this study is to analyze the relationship between school start time (SST) and the sleep, well-being, academic performance, and eating behavior of children and adolescents. The study was conducted in April and May 2021 in two regions of Russia: the Komi Republic and Yekaterinburg. The online study involved the anonymous and voluntary participation of 6571 students in grades 6-11 (mean age: 14.5 ± 1.6 years, 60.1% female), who have morning classes. All participants were divided into three groups according to SST: 08:00 (n = 3661), 08:30 (n = 2020), and 09:00 (n = 890). Each participant of the study indicated their place of residence, SST, age, sex, height, weight, academic performance, and filled out the Munich Chronotype Questionnaire, the Zung Self-Rating Depression Scale, and the Yale Food Addiction Scale for Children. As a result of multiple regression analysis, it was shown that schoolchildren with SST of 09:00 wake up at a later time on school days (B = 0.432; ΔR2 = 0.039), sleep more (B = 0.293; ΔR2 = 0.004), have less pronounced social jetlag (B = -0.223; ΔR2 = 0.005) and sleep loss (B = -0.292; ΔR2 = 0.005), and higher academic performance (B = 0.113; ΔR2 = 0.003) than schoolchildren with SST of 08:00. As a result of logistic regression analysis, it was found that the frequency of the detection of food addiction is ~30% lower in schoolchildren with SST of 09:00 (OR = 0.690; 95% CI = 0.485-0.981) than in their peers with SST of 08:00. Thus, an overly early SST in Russia has a negative impact on the sleep function, academic performance, and eating behavior of children and adolescents.
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Affiliation(s)
- Mikhail F Borisenkov
- Department of Molecular Immunology and Biotechnology, Institute of Physiology of Komi Science Centre of the Ural Branch of the Russian Academy of Sciences, Syktyvkar, Russia
| | - Sergey V Popov
- Department of Molecular Immunology and Biotechnology, Institute of Physiology of Komi Science Centre of the Ural Branch of the Russian Academy of Sciences, Syktyvkar, Russia
| | - Vasily V Smirnov
- Department of Molecular Immunology and Biotechnology, Institute of Physiology of Komi Science Centre of the Ural Branch of the Russian Academy of Sciences, Syktyvkar, Russia
| | - Olga I Dorogina
- Uranl Institute of Humanity, Ural Federal University, Yekaterinburg, Russia
| | - Anna A Pechеrkina
- Uranl Institute of Humanity, Ural Federal University, Yekaterinburg, Russia
| | - Elvira E Symaniuk
- Uranl Institute of Humanity, Ural Federal University, Yekaterinburg, Russia
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17
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Zou H, Zhou H, Yan R, Yao Z, Lu Q. Chronotype, circadian rhythm, and psychiatric disorders: Recent evidence and potential mechanisms. Front Neurosci 2022; 16:811771. [PMID: 36033630 PMCID: PMC9399511 DOI: 10.3389/fnins.2022.811771] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/21/2022] [Indexed: 12/27/2022] Open
Abstract
The circadian rhythm is crucial for physiological and behavioral functions. Chronotype, which represents individual preferences for activity and performance, is associated with human health issues, particularly psychiatric disorders. This narrative review, which focuses on the relationship between chronotype and mental disorders, provides an insight into the potential mechanism. Recent evidence indicates that (1) the evening chronotype is a risk factor for depressive disorders and substance use disorders, whereas the morning chronotype is a protective factor. (2) Evening chronotype individuals with bipolar disorder tend to have more severe symptoms and comorbidities. (3) The evening chronotype is only related to anxiety symptoms. (4) The relationship between chronotype and schizophrenia remains unclear, despite increasing evidence on their link. (5) The evening chronotype is significantly associated with eating disorders, with the majority of studies have focused on binge eating disorders. Furthermore, the underlying mechanisms or influence factors are described in detail, including clock genes, brain characteristics, neuroendocrinology, the light/dark cycle, social factors, psychological factors, and sleep disorders. These findings provide the latest evidence on chronotypes and psychiatric disorders and serve as a valuable reference for researchers.
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Affiliation(s)
- Haowen Zou
- Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hongliang Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Rui Yan
- Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhijian Yao
- Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, China
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18
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Burgess HJ, Rizvydeen M, Kikyo F, Kebbeh N, Tan M, Roecklein KA, Hasler BP, King AC, Cao D. Sleep and circadian differences between light and heavy adult alcohol drinkers. Alcohol Clin Exp Res 2022; 46:1181-1191. [PMID: 35908247 PMCID: PMC9357170 DOI: 10.1111/acer.14872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 12/01/2022]
Abstract
Background Numerous studies have reported that eveningness is associated with increased alcohol consumption. However, biological markers of circadian timing, such as dim light melatonin onset (DLMO) and circadian photoreceptor responsivity (post‐illumination pupil response, PIPR), have rarely been assessed in the context of habitual alcohol consumption. This study aimed to examine sleep, circadian timing, and photoreceptor responsivity in adult alcohol drinkers. Methods Participants (21 to 45 years) included 28 light and 50 heavy drinkers. The 8‐day study consisted of a week of adlib sleep monitored with wrist actigraphy, followed by a 9‐h laboratory session with a photoreceptor responsivity and circadian phase assessment. Results The heavy drinkers obtained on average 28 more minutes of sleep (p = 0.002) and reported more eveningness than the light drinkers (p = 0.029). There was a trend for a shorter DLMO‐midsleep interval (p = 0.059) in the heavy drinkers, reflecting a tendency for them to sleep at an earlier circadian phase. The PIPR in the heavy drinkers was significantly smaller than in the light drinkers (p = 0.032), suggesting reduced circadian photoreceptor responsivity in the heavy drinkers. A larger PIPR was significantly associated with a later DLMO in the light drinkers (r = 0.44, p = 0.019), but this relationship was absent in the heavy drinkers (r = −0.01, p = 0.94). Conclusions These results are consistent with earlier reports of more eveningness and a shorter DLMO‐midsleep interval being associated with heavier alcohol drinking. The novel finding of reduced circadian photoreceptor responsivity in heavy drinkers is consistent with prior rodent studies. Future studies should explore the impact of habitual alcohol consumption on other measures of circadian photoreceptor responsivity.
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Affiliation(s)
- Helen J Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Muneer Rizvydeen
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Fumitaka Kikyo
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Nema Kebbeh
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Michael Tan
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kathryn A Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrea C King
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Dingcai Cao
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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19
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Lan Z, Pau K, Md Yusof H, Huang X. The Effect of Emotion Regulation on Non-Suicidal Self-Injury Among Adolescents: The Mediating Roles of Sleep, Exercise, and Social Support. Psychol Res Behav Manag 2022; 15:1451-1463. [PMID: 35698565 PMCID: PMC9188465 DOI: 10.2147/prbm.s363433] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/26/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To explore the relationship between adolescents’ emotion regulation ability and non-suicidal self-injury (NSSI) behavior and the role of sleep, exercise, and social support in this relationship. Methods A total of 2573 adolescents were investigated with the Cognitive Emotion Regulation Scale, the Social Support Scale for Children and Adolescents, the Ottawa Self-Injury Questionnaire, and the Self-Made Living Condition Questionnaire, and path analysis was conducted based on the structural equation model (SEM). Results 1) There was a significant correlation between emotion regulation ability and NSSI behavior; 2) sleep and social support played a mediating role between emotion regulation ability and NSSI behavior; and 3) sleep modulated the direct effect of negative emotion regulation ability on NSSI, while exercise modulated the direct effect of positive emotion regulation ability on NSSI, which indicated that sleep and exercise could effectively alleviate NSSI behavior caused by the lack of emotion regulation in adolescents.
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Affiliation(s)
- Zhensong Lan
- School of Public Administrations, Hechi University, Hechi, Guangxi, 546300, People’s Republic of China
- National Child Development Research Centre, Sultan Idris Education University, Tanjong Malim Perak, 35900, Malaysia
| | - Kee Pau
- Department of Psychology and Counseling, Faculty of Human Development, Sultan Idris Education University, Tanjong Malim Perak, 35900, Malaysia
- Correspondence: Kee Pau, Director of Counseling Center, Bangunan Bitarasiswa, Tingkat Bawah, Kampus Sultan Abdul Jalil Shah Universiti Pendidikan Sultan Idris, Tanjong Malim Perak, 35900, Malaysia, Tel +60 167228023, Email
| | - Hapsah Md Yusof
- Department of Psychology and Counseling, Faculty of Human Development, Sultan Idris Education University, Tanjong Malim Perak, 35900, Malaysia
| | - Xuefang Huang
- College of Humanities & Social Sciences, Huazhong Agricultural University, Wuhan, Hubei, 430070, People’s Republic of China
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20
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Kuula L, Halonen R, Lipsanen J, Pesonen AK. Adolescent circadian patterns link with psychiatric problems: A multimodal approach. J Psychiatr Res 2022; 150:219-226. [PMID: 35397335 DOI: 10.1016/j.jpsychires.2022.03.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/04/2022] [Accepted: 03/31/2022] [Indexed: 11/20/2022]
Abstract
Circadian rhythms orchestrate brain function and mental wellbeing. We compared circadian patterns derived from continuous measurements of body temperature, sleep actigraphy and self-reported circadian preference in relation to different psychiatric disorders. 342 adolescents (70% females) aged 17.4y underwent M.I.N.I. psychiatric interviews, wore Ibutton 1922L skin temperature loggers (n = 281; 3 days), completed one-week GeneActiv Original actigraphy measurements (n = 306) and responded to Morningness-Eveningness Questionnaire (MEQ; n = 330). We derived circadian period length and amplitude from the temperature loggers. Actigraphy measures included sleep duration, midpoint, efficiency, and irregularity as well as Delayed Sleep Phase (DSP) characteristics (bedtime after 1 a.m. 3 times/week). M.I.N.I. psychiatric interviews suggested that 36% of participants had one or more psychiatric problem, with 21% suffering from comorbidity. Severe depression was associated with longer circadian period (p = 0.002). Suicidality was associated with later midpoint (p = 0.007) and more irregular sleep (p = 0.007). Those with agoraphobia slept longer (p = 0.013). Manic episodes and psychotic disorders were associated with irregular sleep (p-values <0.02). DSP was related to suicidality (p = 0.026), panic disorder (p = 0.022), and greater comorbidity (p = 0.026). Preference for eveningness was similarly related to higher prevalence of Generalized Anxiety Disorder (p = 0.014), social anxiety (p = 0.03), agoraphobia (p = 0.026), panic disorder (p = 0.004), suicidality (p = 0.018), severe depression (p < 0.001), and comorbidity (p < 0.001). Deviations in circadian rhythms were widely associated with psychiatric problems, whereas sleep duration was not. Especially suicidality linked with several markers of circadian disruption: later sleep midpoint, irregular sleep, and DSP characteristics. Longer circadian period length was associated with severe depression.
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Affiliation(s)
- Liisa Kuula
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland.
| | - Risto Halonen
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anu-Katriina Pesonen
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland
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21
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Molinaro D, Fabbri M, Salluzzo KM, Spagnoli P. The role of circadian typology in the relationship between perfectionism and workaholism. Chronobiol Int 2022; 39:1156-1166. [PMID: 35603492 DOI: 10.1080/07420528.2022.2079518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Workaholism is a work-related addiction, and the study of its antecedents has a strong individual and social impact. Several studies reported high trait perfectionism in individuals exhibiting workaholism. Although the relationship between perfectionism and workaholism is quite consistent in the literature, it is not yet clear which biological underlying mechanisms might explain this relationship. From a chronopsychological perspective, it has been widely demonstrated that evening-type individuals are more prone to develop addictive behaviour. In the present study, we investigated, for the first time, the role of circadian typology in the relationship between perfectionistic concerns and workaholism. A group of Italian workers (N = 369; 60.70% females; mean age of 38.60 years) took part in a survey. Participants filled in the Bergen Work Addiction Scale (for workaholism), the Morningness-Eveningness Questionnaire (for circadian typology), and the Short Almost-Perfect Scale (for perfectionism). In addition to age, we controlled for workload using the Job Content Questionnaire. Beyond the confirmation of the relationship between perfectionism and workaholism, we found that in high perfectionistic individuals, evening-types reported higher score in Bergen Work Addiction Scale. Based on these findings, limitations and suggestions for future research are discussed.
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Affiliation(s)
- Danila Molinaro
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Marco Fabbri
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Klara May Salluzzo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Paola Spagnoli
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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22
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Paciello LM, Quante M, Weidenauer C, Rueschman M, Nieratschker V, Poets CF, Randler C. Validity of chronotype questionnaires in adolescents: Correlations with actigraphy. J Sleep Res 2022; 31:e13576. [PMID: 35246881 DOI: 10.1111/jsr.13576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/14/2022] [Accepted: 02/16/2022] [Indexed: 01/26/2023]
Abstract
There are only a few validated chronotype and morningness-eveningness questionnaires for adolescents. We evaluated three such questionnaires, namely Morningness-Eveningness Stability Scale improved; reduced Morningness-Eveningness Questionnaire for Children and Adolescents; and Composite Scale of Morningness in adolescents against actigraphy. Fifty-five healthy 13- to 16-year-old adolescents completed the Morningness-Eveningness Stability Scale improved, reduced Morningness-Eveningness Questionnaire for Children and Adolescents, Composite Scale of Morningness, and Pediatric Daytime Sleepiness Scale, and provided a 7-day actigraphy and sleep diary recording about their sleep-wake patterns. We examined the correlations between sleep-wake and activity parameters, and the questionnaires. The influence of age and sex on chronotype classification was studied using uni- and multivariate analyses. All three chronotype questionnaires showed good internal consistency and convergent validity. Spearman correlations reflected less daytime sleepiness, earlier sleep times, midpoints of sleep, and acrophase in morning-oriented participants. Evening-oriented participants had more sleepiness and later respective sleep-wake times. Chronotype classification differed significantly between questionnaires. The Composite Scale of Morningness classified more participants as morning types when compared with the reduced Morningness-Eveningness Questionnaire for Children and Adolescents (12 versus 7, respectively), and fewer adolescents as evening types (5 versus 9, respectively). Age and sex had no significant influence on questionnaire scores. The Morningness-Eveningness Stability Scale improved, reduced Morningness-Eveningness Questionnaire for Children and Adolescents, and Composite Scale of Morningness are valid instruments to determine circadian preference in adolescents; however, chronotype classification from the Composite Scale of Morningness and reduced Morningness-Eveningness Questionnaire for Children and Adolescents cannot be used interchangeably.
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Affiliation(s)
- Leonie M Paciello
- Department of Neonatology, University of Tuebingen, Tuebingen, Germany
| | - Mirja Quante
- Department of Neonatology, University of Tuebingen, Tuebingen, Germany
| | - Corina Weidenauer
- LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany
| | - Michael Rueschman
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Massachusetts, USA
| | - Vanessa Nieratschker
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Christian F Poets
- Department of Neonatology, University of Tuebingen, Tuebingen, Germany
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23
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Goldstein TR, Franzen PL. A Comprehensive Review of the Literature on Sleep Difficulties and Suicidality in Youth to Inform an Integrative Developmental Model and Future Directions. CURRENT SLEEP MEDICINE REPORTS 2022; 8:1-19. [PMID: 36274826 PMCID: PMC9586157 DOI: 10.1007/s40675-022-00222-9] [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] [Accepted: 02/17/2022] [Indexed: 12/16/2022]
Abstract
Purpose of Review Suicide is currently the second leading cause of death among youth. Identification of modifiable near-term risk factors can inform suicide prevention strategies. One promising, readily assessed factor is sleep. We critically review the literature on sleep and suicidal thoughts and behaviors among youth. Recent Findings Most studies examining the youth sleep-suicidality relationship are from epidemiological samples in which both sleep problems and suicidality were assessed over variable timeframes using limited items from scales not designed to measure these constructs. Nonetheless, these data overwhelmingly support an association between suicidality and a range of sleep difficulties (e.g., insomnia, short/long sleep, weekend oversleep), above and beyond depressive symptoms. Limited studies include clinical samples or prospective designs. We review potential mechanisms and present a developmentally-informed integrative model. Summary Literature supports a clear association between sleep difficulties and youth suicidality. Future directions include prospective longitudinal studies and targeted prevention efforts.
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Affiliation(s)
- Tina R Goldstein
- Western Psychiatric Hospital and the Center for Sleep and Circadian Science, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Peter L Franzen
- Western Psychiatric Hospital and the Center for Sleep and Circadian Science, University of Pittsburgh School of Medicine, Pittsburgh, PA
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24
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Cheung FTW, Ho AWY, Chan JWY, Li X, Chan NY, Zhang J, Ho CS, Wing YK, Li SX. Validation of the Chinese version of the Munich Chronotype Questionnaire (MCTQ HK) in Hong Kong Chinese youths. Chronobiol Int 2022; 39:678-689. [PMID: 35086397 DOI: 10.1080/07420528.2022.2025821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Chronotype, referred to as an individual's diurnal preference of timing for rest and activity, can be subjectively measured using the Munich Chronotype Questionnaire (MCTQ). However, the validity of MCTQ has yet to be tested in the youth population. In addition, it remains uncertain if MCTQ is a good measure of chronotype in individuals with insomnia. The current study aimed to validate the Chinese version of MCTQ (MCTQHK) in the youth population and to explore the utility of MCTQHK in individuals with insomnia. The original MCTQ was translated into Chinese language using the translation-back-translation method. Part one of this study included 988 youths who completed a battery of self-report questionnaires online consisting of the MCTQHK and the morningness-eveningness questionnaire (MEQ) for the measures of circadian preference, Insomnia Severity Index (ISI) to assess insomnia symptoms, and Patient Health Questionnaire (PHQ-9) to measure depressive symptoms. Test-retest reliability was examined in 442 participants at one-month follow-up. Of the overall sample, 69 participants were randomly drawn to complete the second part of the study, which included prospective 7-day actigraphy monitoring and a further subset (n = 40) additionally completed a laboratory-based assessment of dim-light melatonin onset (DLMO) as a circadian phase marker. A total of 659 participants with valid responses were finally included in the analyses of the data collected from part one of the study (female = 67.7%; mean age: 20.7 ± 2.02). Results showed that MCTQ parameters, namely the midpoint of sleep on free days (MSF), midpoint of sleep on workdays (MSW), and midpoint of sleep adjusted for sleep debt (MSFsc), were significantly correlated with MEQ score (r = -.514 to -.650, p < .01). Test-retest reliability for MCTQHK was good (intraclass correlation = 0.75 to 0.84). Later MSFsc was significantly associated with greater insomnia and depressive symptoms after controlling for age and sex. All MCTQ parameters showed significant correlations with actigraphy-based midpoint of sleep and circadian rhythm parameters, i.e., acrophase and L5 onset (r = .362 to .619, p < .01), as well as DLMO (r = .393 to .517, p < .05). The associations remained significant after controlling for age. MSFsc derived from MCTQ was significantly correlated with MEQ score in both the healthy sleepers and participants with insomnia (as defined by ISI > 14), r = -.600, p < .001 and r = -.543, p < .001, respectively. The present study demonstrated that MCTQHK is suitable for assessing chronotype with good reliability and validity in Chinese youths and supported the utility of MCTQHK in individuals with insomnia.
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Affiliation(s)
- Forrest Tin Wai Cheung
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong
| | - Amy Wing Yin Ho
- Department of Chemical Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Joey Wing Yan Chan
- Li Chiu Kong Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Xiao Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong
| | - Ngan Yin Chan
- Li Chiu Kong Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Jihui Zhang
- Guang Dong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chung Shun Ho
- Department of Chemical Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Yun Kwok Wing
- Li Chiu Kong Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Shirley Xin Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
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25
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Jiang J, Wang D, Scherffius A, Chen D, Ma Z, Chen Z, Zhang Y, Yu Q, Fan F. The Association Between Morningness-Eveningness Preference, Depression, Anxiety and Insomnia Among Chinese Textile Workers With or Without Shift Work. Front Psychiatry 2022; 13:915476. [PMID: 35845469 PMCID: PMC9279731 DOI: 10.3389/fpsyt.2022.915476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Circadian preference and mental health disorders are closely related to insomnia. This study aimed to evaluate insomnia symptoms in textile factory workers with different work schedules, and to investigate the association between insomnia, morningness-eveningness preference, anxiety, and depression. METHODS A total of 3,883 textile workers were assessed using the 3-items of Pittsburg Sleep Quality Index, Composite Scale of Morningness, Beck Anxiety Inventory, Center for Epidemiologic Studies-Depression Scale, and socio-demographic questionnaires. RESULTS The prevalence rate of insomnia in textile workers was 16.7% (N = 646), with 49.8% (N = 322) were shift workers. Among shift workers (N = 1,833), 9.5% had difficulty initiating sleep, and almost 9.0% suffered from early morning awakening, a rate significantly higher than among daytime workers. Logistics regressions revealed that work schedule was insignificantly associated with insomnia. Depression (OR = 1.034, 95% CI = 1.022-1.046) and anxiety (OR = 1.031, 95% CI = 1.018-1.043) positively predicted insomnia, whereas morningness preference (OR = 0.977, 95% CI = 0.960-0.995) decreased the likelihood of insomnia. Furthermore, mediation analysis showed that both anxiety and depression independently mediated the association between circadian preferences and insomnia in textile workers with or without shift work. CONCLUSION This study highlighted the insomnia, depression, and anxiety of textile factory workers in a Chinese textile factory. To improve insomnia symptoms, interventions to promote morningness circadian preference and reduce depressive and anxious symptoms among workers are encouraged.
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Affiliation(s)
- Jiaqi Jiang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Andrew Scherffius
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, United States
| | - Dingxuan Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Zihao Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Yifan Zhang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Qian Yu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
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26
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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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27
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Gonsalvez I, Li JJ, Stevens C, Chen JA, Liu CH. Preexisting Depression and Daytime Sleepiness in Women and Men. Behav Sleep Med 2022; 20:380-392. [PMID: 34003712 PMCID: PMC8599528 DOI: 10.1080/15402002.2021.1924720] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Sleep problems can persist following the treatment of depression and remission of symptoms. The extent to which having a previous history of depression may be associated with current daytime sleepiness is largely unknown. METHODS Data were obtained from the spring 2017 American College Health Association-National College Health Assessment (ACHA-NCHA) survey (92 institutions) which assessed self-reported health in U.S. college students (n = 41,670). Among the sample, 93.5% were 18-24 year of age, and 69.6% women. Logistic regression estimated the association between reported prior lifetime diagnosis of depression and daytime sleepiness from the past 7 days, while adjusting for depressive symptoms and antidepressant use from the past year. Unadjusted and adjusted logistic regression models stratified by gender were performed. RESULTS Among those who reported problems with sleepiness, 31.6% women and 19.4% men had a preexisting depression diagnosis. Individuals with preexisting depression were more likely than those without this diagnosis to report sleepiness problems (women: OR = 1.4, CI = 1.3-1.6, p < .001; men: OR = 1.2, CI = 1.0-1.4, p < .01). However, this association differed significantly by gender, with women with a preexisting depression diagnosis having a 13.0% greater likelihood of sleepiness compared to men. CONCLUSIONS Those with a preexisting depression diagnosis, and specifically women, may be at risk for daytime sleepiness even in the absence of current depressive mood-related symptoms. Given that many individuals are at risk for daytime sleepiness, mental health initiatives, including those on college campuses, should incorporate sleep hygiene within their programming.
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Affiliation(s)
- Irene Gonsalvez
- Department of Psychiatry, St. Elizabeth’s Medical Center, Brighton, MA, USA,Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Justin A. Chen
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cindy H. Liu
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Harvard Medical School, Boston, MA, USA,Department of Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Corresponding Author: Cindy H. Liu, PhD, Tel: 617-525-4131
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28
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The effect of the transdiagnostic sleep and circadian intervention (TranS-C) on actigraphic estimates of sleep and rest-activity rhythms in adolescents with an evening circadian preference. Sleep Health 2021; 8:191-194. [PMID: 34924346 DOI: 10.1016/j.sleh.2021.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/18/2021] [Accepted: 10/09/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND This study evaluates whether the Transdiagnostic Sleep and Circadian Intervention for Youth (TranS-C) improves objective sleep and rest-activity rhythms in a sample of youth with an evening circadian preference (ECP). METHODS Youth with an ECP aged 10-18 years were randomized to receive 6 sessions of TranS-C (n = 60) or Psychoeducation (PE; n = 58). For one week prior to beginning treatment and within 2 weeks of completing treatment, participants wore an actiwatch to assess objective sleep and rest-activity rhythms. RESULTS Among TranS-C participants, there were significant pre-post improvements in weeknight total sleep time (TST), weekend TST, and weeknight-weekend discrepancy in TST and sleep offset time. These changes were not significant in PE. There was no significant treatment by time interactions for the sleep or rest-activity outcomes. CONCLUSIONS For youth with an ECP, TranS-C improves select objective sleep but not rest-activity outcomes, though compared to PE, these benefits did not reach statistical significance.
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29
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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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Circadian Rhythms in Mood Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1344:153-168. [PMID: 34773231 DOI: 10.1007/978-3-030-81147-1_9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Altered behavioral rhythms are a fundamental diagnostic feature of mood disorders. Patients report worse subjective sleep and objective measures confirm this, implicating a role for circadian rhythm disruptions in mood disorder pathophysiology. Molecular clock gene mutations are associated with increased risk of mood disorder diagnosis and/or severity of symptoms, and mouse models of clock gene mutations have abnormal mood-related behaviors. The mechanism by which circadian rhythms contribute to mood disorders remains unknown, however, circadian rhythms regulate and are regulated by various biological systems that are abnormal in mood disorders and this interaction is theorized to be a key component of mood disorder pathophysiology. A growing body of evidence has begun defining how the interaction of circadian and neurotransmitter systems influences mood and behavior, including the role of current antidepressants and mood stabilizers. Additionally, the hypothalamus-pituitary-adrenal (HPA) axis interacts with both circadian and monoaminergic systems and may facilitate the contribution of environmental stressors to mood disorder pathophysiology. The central role of circadian rhythms in mood disorders has led to the development of chronotherapeutics, which are treatments designed specifically to target circadian rhythm regulators, such as sleep, light, and melatonin, to produce an antidepressant response.
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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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Sun W, Kwok NTT, Chan NY, Chan JWY, Zhang J, Chan KCC, Li SX. Associations of circadian factors with insomnia symptoms and emotional and behavioral problems among school-age children. J Clin Sleep Med 2021; 17:2107-2114. [PMID: 34606443 DOI: 10.5664/jcsm.9346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To examine the associations of circadian characteristics (ie, chronotype and social jetlag) with insomnia symptoms and emotional and behavioral problems among school-age children. METHODS A total of 620 primary school children (medianage = 10.06, standard deviation = 1.16, 58.7% boys) were recruited and assessed by a set of parent-report questionnaires, including Children's Sleep Habit Questionnaire for measuring sleep-wake patterns and insomnia symptoms (bedtime resistance, sleep onset delay, and night waking), Children's Chronotype Questionnaire for assessing the child's chronotype preference, and Strength and Difficulties Questionnaire for assessing emotional and behavioral problems. Linear regression models were applied to examine the associations of chronotype and social jetlag with insomnia symptoms and mental health outcomes, in which age, sex, family income, and average sleep duration were entered as covariates. RESULTS Evening chronotype was significantly associated with bedtime resistance and sleep onset delay, while social jetlag was not related to insomnia symptoms. Evening chronotype was also significantly associated with externalizing symptoms after controlling for potential confounders. CONCLUSIONS Evening chronotype, but not social jetlag, was the risk factor for insomnia symptoms, and evening chronotype was further associated with increased behavioral problems in school-age children. Our findings underscored the roles of circadian factors in relation to sleep and mental health problems in this young population. CITATION Sun W, Kwok NTT, Chan NY, et al. Associations of circadian factors with insomnia symptoms and emotional and behavioral problems among school-age children. J Clin Sleep Med. 2021;17(10):2107-2114.
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Affiliation(s)
- Wanqi Sun
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (SAR).,Department of Psychiatry, Shanghai Mental Health Center, People's Republic of China
| | - Natasha Tung Ting Kwok
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (SAR)
| | - Ngan Yin Chan
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (SAR).,Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin Hong Kong SAR
| | - Joey Wing Yan Chan
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin Hong Kong SAR
| | - Jihui Zhang
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin Hong Kong SAR.,Guang Dong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Kate Ching-Ching Chan
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Shirley Xin Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region (SAR).,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR
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Richardson C, Magson N, Fardouly J, Oar E, Johnco C, Rapee R. A longitudinal investigation of sleep and technology use in early adolescence: does parental control of technology use protect adolescent sleep? Sleep Med 2021; 84:368-379. [PMID: 34247125 DOI: 10.1016/j.sleep.2021.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE A bi-directional relationship between technology use and adolescent sleep is likely, yet findings are mixed, and it is not known whether parental control of technology use can protect sleep. The current study examined bi-directionality between technology use on school nights and morning/eveningness, sleep duration and daytime sleepiness in early adolescents. We also examined whether time spent using technology mediated the relationship between parental control of technology and adolescent sleep. METHODS Adolescents and their primary caregiver (96% mothers) completed questionnaire measures of sleep, technology use and parental control across three, annual waves: Wave 1 (N = 528, Mage = 11.18, SD = 0.56, range = 10-12, 51% male), Wave 2 (N = 502, Mage = 12.19, SD = 0.53, 52% male) and Wave 3 (N = 478, Mage = 13.19, SD = 0.53, 52% male). RESULTS When examining the direct relationship between sleep and technology use, cross-lagged panel models showed that time spent using technology predicted shorter sleep duration and greater daytime sleepiness in adolescence, and evening diurnal preference and shorter sleep duration contributed to increased technology use over time. The relationship between technology use and sleep duration was bi-directional. Time spent using technology and adolescent sleep predicted, yet were not predicted by, parental control of technology use. CONCLUSIONS While normative changes in sleep (eg, increased eveningness) may promote increased technology use, technology use may further impinge upon sleep. Results suggest it may be pertinent to instead find creative ways in which adolescents themselves can mitigate their risk of inadequate sleep.
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Affiliation(s)
- C Richardson
- Centre for Sleep Science, School of Psychological Science, University of Western Australia, Perth, WA, Australia; Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia.
| | - N Magson
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - J Fardouly
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - E Oar
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - C Johnco
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - R Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
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Bradford DRR, Biello SM, Russell K. Insomnia symptoms mediate the association between eveningness and suicidal ideation, defeat, entrapment, and psychological distress in students. Chronobiol Int 2021; 38:1397-1408. [PMID: 34100311 DOI: 10.1080/07420528.2021.1931274] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Chronotype describes a person's general preference for mornings, evenings, or neither. It is typically conceptualized as a continuous unidimensional spectrum from morningness to eveningness. Eveningness is associated with poorer outcomes across a myriad of physical and mental health outcomes. This preference for later sleep and wake times is associated with increased risk of depression, anxiety, and suicidal ideation in both clinical and community samples. However, the mechanisms underlying the negative consequences of this preference for evenings are not fully understood. Previous research has found that sleep disturbances may act as a mediator of this relationship. The present study aimed to explore the associations between chronotype and affective outcomes in a sample of students. Additionally, it aimed to investigate the potential role of insomnia as a mediator within these relationships. Participants (n = 190) completed an anonymous self-report survey of validated measures online which assessed chronotype, insomnia symptoms, and a range of affective outcomes (defeat, entrapment, suicide risk, stress, and depressive and anxious symptomology). Eveningness was associated with more severe or frequent experiences of these outcomes, with participants that demonstrated a preference for eveningness more likely to report poorer affective functioning and increased psychological distress. Mediation analysis found the relationship between chronotype and these outcome measures was completely or partially mediated by insomnia symptom severity measured by the validated Sleep Condition Indicator insomnia scale. Taken together, these findings add further evidence for the negative consequences of increased eveningness. Additionally, our results show that chronotype and sleep disturbances should be considered when assessing mental well-being. Implementing appropriate sleep-related behavior change or schedule alterations can offer a tool for mitigation or prevention of psychological distress in students that report a preference for later sleep and wake times.
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Michelini G, Palumbo IM, DeYoung CG, Latzman RD, Kotov R. Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience. Clin Psychol Rev 2021; 86:102025. [PMID: 33798996 PMCID: PMC8165014 DOI: 10.1016/j.cpr.2021.102025] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 12/14/2022]
Abstract
The Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) represent major dimensional frameworks proposing two alternative approaches to accelerate progress in the way psychopathology is studied, classified, and treated. RDoC is a research framework rooted in neuroscience aiming to further the understanding of transdiagnostic biobehavioral systems underlying psychopathology and ultimately inform future classifications. HiTOP is a dimensional classification system, derived from the observed covariation among symptoms of psychopathology and maladaptive traits, which seeks to provide more informative research and treatment targets (i.e., dimensional constructs and clinical assessments) than traditional diagnostic categories. This article argues that the complementary strengths of RDoC and HiTOP can be leveraged in order to achieve their respective goals. RDoC's biobehavioral framework may help elucidate the underpinnings of the clinical dimensions included in HiTOP, whereas HiTOP may provide psychometrically robust clinical targets for RDoC-informed research. We present a comprehensive mapping between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors) based on narrative review of the empirical literature. The resulting RDoC-HiTOP interface sheds light on the biobehavioral correlates of clinical dimensions and provides a broad set of dimensional clinical targets for etiological and neuroscientific research. We conclude with future directions and practical recommendations for using this interface to advance clinical neuroscience and psychiatric nosology. Ultimately, we envision that this RDoC-HiTOP interface has the potential to inform the development of a unified, dimensional, and biobehaviorally-grounded psychiatric nosology.
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Affiliation(s)
- Giorgia Michelini
- Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024, United States of America.
| | - Isabella M Palumbo
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, United States of America
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY 11790, United States of America
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A daily diary study of sleep chronotype among Mexican-origin adolescents and parents: Implications for adolescent behavioral health. Dev Psychopathol 2021; 33:313-322. [PMID: 32308171 DOI: 10.1017/s0954579419001780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The current study used daily assessments of sleep to examine stability and change in sleep chronotype in adolescents and their parents. The study assessed adolescent sleep chronotype according to age, gender, and parent chronotype, and evaluated its associations with emotional and behavioral problems in youth. Participants included of 417 Mexican American adolescents (Mage = 16.0 years, Range = 13.9-20.0) and 403 caregivers, who reported bed and wake times daily for 2 consecutive weeks at two time points spaced 1 year apart. In addition, adolescents completed established self-report questionnaires of emotional and behavioral problems. Chronotype was computed as the midsleep point from bed to wake time on free days, correcting for sleep debt accumulated across scheduled days. Multilevel modeling showed a curvilinear association between adolescent age and chronotype, with a peak eveningness observed between ages 16 to 17. Adolescent and parent chronotypes were contemporaneously correlated, but each was only moderately stable over the 1-year period. Later adolescent chronotype was contemporaneously associated with more substance use in all adolescents. Individual development and the family context shape sleep chronotype in adolescents and parents. Sleep chronotype is implicated in adolescent behavioral health.
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Gasperetti CE, Dolsen EA, Harvey AG. The influence of intensity and timing of daily light exposure on subjective and objective sleep in adolescents with an evening circadian preference. Sleep Med 2021; 79:166-174. [PMID: 33262011 PMCID: PMC7925365 DOI: 10.1016/j.sleep.2020.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 11/19/2022]
Abstract
STUDY OBJECTIVES The aim of the present study is to examine the relationship between light and sleep, in adolescents with an evening circadian preference. METHODS For a period of seven days, ninety-nine adolescents wore a wrist actigraph to assess light exposure and objective sleep and completed a sleep diary to assess subjective sleep. RESULTS Lower average light intensity across the preceding 24 h was associated with a later sleep onset (p < 0.01) and a later next-day sleep offset (p < 0.05). A later time of last exposure to more than 10 lux was associated with a later sleep onset (p < 0.001) and a shorter objective total sleep time (p < 0.001), as well as a later bedtime (p < 0.001) and a shorter subjective total sleep time (p < 0.001). Furthermore, exploratory analyses found that lower average early morning light exposure (between 4 and 9 AM) was associated with later sleep onset (p < 0.05), a later next-day sleep offset (p < 0.05), and a later next-day waketime (p < 0.01), lower average afternoon light exposure (between 2 and 7 PM) was associated with a later next-day sleep offset (p < 0.05), and lower average evening light exposure (between 7 PM and 12 AM) was associated with longer subjective total sleep time (p < 0.01). CONCLUSION This study highlights the importance of light exposure, particularly the timing of light exposure, for establishing healthy patterns of sleep among adolescents with a propensity for a delayed bedtime and waketime. These findings provide additional evidence for targeting light exposure when designing interventions to improve adolescent sleep.
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Affiliation(s)
| | - Emily A Dolsen
- Department of Psychology, University of California, Berkeley, United States
| | - Allison G Harvey
- Department of Psychology, University of California, Berkeley, United States.
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Tamura EK, Oliveira-Silva KS, Ferreira-Moraes FA, Marinho EAV, Guerrero-Vargas NN. Circadian rhythms and substance use disorders: A bidirectional relationship. Pharmacol Biochem Behav 2021; 201:173105. [PMID: 33444601 DOI: 10.1016/j.pbb.2021.173105] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/03/2021] [Accepted: 01/04/2021] [Indexed: 01/23/2023]
Abstract
The circadian system organizes circadian rhythms (biological cycles that occur around 24 h) that couple environmental cues (zeitgebers) with internal functions of the organism. The misalignment between circadian rhythms and external cues is known as chronodisruption and contributes to the development of mental, metabolic and other disorders, including cancer, cardiovascular diseases and addictive disorders. Drug addiction represents a global public health concern and affects the health and well-being of individuals, families and communities. In this manuscript, we reviewed evidence indicating a bidirectional relationship between the circadian system and the development of addictive disorders. We provide information on the interaction between the circadian system and drug addiction for each drug or drug class (alcohol, cannabis, hallucinogens, psychostimulants and opioids). We also describe evidence showing that drug use follows a circadian pattern, which changes with the progression of addiction. Furthermore, clock gene expression is also altered during the development of drug addiction in many brain areas related to drug reward, drug seeking and relapse. The regulation of the glutamatergic and dopaminergic neurocircuitry by clock genes is postulated to be the main circadian mechanism underlying the escalation of drug addiction. The bidirectional interaction between the circadian system and drug addiction seems to be mediated by the effects caused by each drug or class of drugs of abuse. These studies provide new insights on the development of successful strategies aimed at restoring/stabilizing circadian rhythms to reduce the risk for addiction development and relapse.
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Affiliation(s)
- Eduardo K Tamura
- Department of Health Sciences, Universidade Estadual de Santa Cruz, BR-415, Rodovia Ilhéus- Itabuna, Km-16, Salobrinho, Ilhéus, Bahia 45662-000, Brazil.
| | - Kallyane S Oliveira-Silva
- Department of Health Sciences, Universidade Estadual de Santa Cruz, BR-415, Rodovia Ilhéus- Itabuna, Km-16, Salobrinho, Ilhéus, Bahia 45662-000, Brazil
| | - Felipe A Ferreira-Moraes
- Department of Health Sciences, Universidade Estadual de Santa Cruz, BR-415, Rodovia Ilhéus- Itabuna, Km-16, Salobrinho, Ilhéus, Bahia 45662-000, Brazil
| | - Eduardo A V Marinho
- Department of Health Sciences, Universidade Estadual de Santa Cruz, BR-415, Rodovia Ilhéus- Itabuna, Km-16, Salobrinho, Ilhéus, Bahia 45662-000, Brazil
| | - Natalí N Guerrero-Vargas
- Department of Anatomy, Faculty of Medicine, Universidad Nacional Autonóma de México, Av Universidad 3000, Ciudad Universitaria, México City 04510, Mexico
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Carciofo R. Morning affect, eveningness, and amplitude of diurnal variation: associations with parent adult-child relationships, and adult attachment style. Chronobiol Int 2021; 38:501-508. [PMID: 33397163 DOI: 10.1080/07420528.2020.1866002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Eveningness, as opposed to other chronotypes, in childhood and adolescence is associated with more parental conflicts, such as regarding bed and rising times, which might adversely influence future relationships with parents, and adult attachments. The current survey of 524 Chinese university students (mean = 20.05 and range 18-36 years of age) investigated whether eveningness shows these adverse associations. Morning affect and amplitude distinctness facets of circadian functioning were also assessed. It was found that eveningness is not related to adults' perception of current parental relationships, or to adult attachment security, but low morning affect and stronger amplitude distinctness were associated with perception of more fatherly control, less regard for parents, and more attachment insecurity, and these were related to poorer wellbeing. These findings indicate that components of circadian functioning are related to the quality of adult relationships. Further research is needed to confirm these findings and establish explanatory mechanisms for these associations.
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Affiliation(s)
- Richard Carciofo
- Department of Health and Environmental Sciences, Xi'an Jiaotong-Liverpool University, Suzhou, China
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Esaki Y, Obayashi K, Saeki K, Fujita K, Iwata N, Kitajima T. Higher prevalence of intentional self-harm in bipolar disorder with evening chronotype: A finding from the APPLE cohort study. J Affect Disord 2020; 277:727-732. [PMID: 32919293 DOI: 10.1016/j.jad.2020.08.068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 06/07/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Patients with bipolar disorder (BD) frequently self-harm, and this is strongly associated with subsequent suicide. This study investigated the association between chronotype and intentional self-harm in patients with BD. METHODS Two-hundred and five outpatients with BD participated in this cross-sectional study. Each participant's chronotype was evaluated using the Morningness-Eveningness Questionnaire, dividing the scores into three types: evening, 16-41 points; intermediate, 42-58 points; and morning, 59-86 points. Intentional self-harm over the past year were self-reported by questionnaire. Propensity score for evening chronotype was estimated from age, sex, socioeconomic factors, mood symptoms, total sleep time, age at the onset of BD, psychiatric inpatient history, family history of suicide, psychiatric comorbidity, and use of lithium. RESULTS Thirty-six (18%) of the 205 participants reported self-harm. A substantially higher proportion of the evening chronotype group self-harmed compared to the other groups (evening, 37%; intermediate, 13%; morning 10%). In multivariable analysis adjusted for propensity score, the odds ratio (OR) for self-harming significantly increased from morning to intermediate to evening chronotype (ORs: morning, 1.00; intermediate, 1.56; evening, 3.61; P for trend = 0.038). LIMITATIONS This study was a cross-sectional and small sample size. CONCLUSIONS Although a third factors, such as personality disorder or disrupted circadian rhythm, may have influenced, these findings suggest association between chronotype and intentional self-harm in BD patients.
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Affiliation(s)
- Yuichi Esaki
- Department of Psychiatry, Okehazama Hospital, Aichi, Japan; Department of Psychiatry, Fujita Health University School of Medicine, Aichi, Japan.
| | - Kenji Obayashi
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Keigo Saeki
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Kiyoshi Fujita
- Department of Psychiatry, Okehazama Hospital, Aichi, Japan; The Neuroscience Research Center, Aichi, Japan
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Aichi, Japan
| | - Tsuyoshi Kitajima
- Department of Psychiatry, Fujita Health University School of Medicine, Aichi, Japan
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Chan NY, Zhang J, Tsang CC, Li AM, Chan JWY, Wing YK, Li SX. The associations of insomnia symptoms and chronotype with daytime sleepiness, mood symptoms and suicide risk in adolescents. Sleep Med 2020; 74:124-131. [DOI: 10.1016/j.sleep.2020.05.035] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 12/22/2022]
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Yang YT, Kaplan KA, Zeitzer JM. A comparison of sleep, depressive symptoms, and parental perceptions between U.S. and Taiwan adolescents with self-reported sleep problems. ACTA ACUST UNITED AC 2020; 1:zpaa004. [PMID: 33345187 PMCID: PMC7731573 DOI: 10.1093/sleepadvances/zpaa004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/20/2020] [Indexed: 12/13/2022]
Abstract
Study Objectives Inadequate sleep is pervasive among teens worldwide, resulting in daytime sleepiness and, in some cases, depressive symptoms. In addition to their own behavioral choices, parent perceptions may also play a role in adolescent sleep. This study conducted a preliminary evaluation of the antecedents and consequences of sleep factors among adolescents in the United States and Taiwan. Methods Participants were adolescents with self-reported sleep concerns from academically similar schools in Taiwan (n = 548) and northern California, United States (n = 128). Questionnaires on sleep and mood were administered to both the teens and parents. Results While Taiwanese students’ self-reported sleep behavior was generally better than U.S. students (p < .01), Taiwanese students had higher overall self-reported sleepiness (p < .01). Furthermore, Taiwanese parents reported teen sleep durations of 6.53 ± .827 hours per night during the week (with 45% perceiving this as sufficient), while U.S. parents reported teen sleep durations of 7.22 ± .930 hours (with 27% perceiving this as sufficient). Adolescents in both cohorts had high levels of symptoms consistent with depression (Taiwan: 70%, United States: 62%), which was associated with shorter sleep times for both cohorts and evening chronotype in the Taiwanese, but not U.S., adolescents. Conclusions Some differences exist between Taiwanese and U.S. adolescents, with generally better sleep and less sleepiness reported among students in the United States, and Taiwanese students’ sleep influenced more strongly by chronotype. Furthermore, Taiwanese parents reported less concern about their child’s insufficient sleep, despite the fact that inadequate sleep is strongly associated with depressive symptoms for both cohorts.
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Affiliation(s)
- Ya-Ting Yang
- Institute of Education, National Cheng Kung University, Tainan City, Taiwan, ROC.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
| | - Katherine A Kaplan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
| | - Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA.,Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA
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Chung JS, Choi E, Lee AR, Kim SY, Lee K, Kim BN, Park S, Jung KI, Lee SY, Park MH. The difference in sleep, depression, anxiety, and Internet addiction between Korean adolescents with different circadian preference. Indian J Psychiatry 2020; 62:524-530. [PMID: 33678833 PMCID: PMC7909031 DOI: 10.4103/psychiatry.indianjpsychiatry_254_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/23/2019] [Accepted: 06/10/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Compared to adults, adolescents tend to prefer evening times developmentally. The orientation toward evening times is associated with behavioral and emotional problems. Thus, this study examined the association of circadian preference with sleep-related variables, depression, anxiety, and Internet addiction in Korean adolescents. MATERIALS AND METHODS Participants completed the questionnaires measuring sleep pattern, sleep problem, depression, anxiety, and Internet addiction. RESULTS Among 765 students (age range: 13-17 years), 211 students (N male= 134) were allocated into morning types (MT) and 258 adolescents (N male= 147) were allocated into evening types (ET) based on scores of the Morningness-Eveningness Scale. Adolescents without circadian preference (N = 296) were defined as neither type (NT). ET, compared to MT and NT, woke up later in the weekend, showed delays in bedtimes, and spent shorter time sleeping. They also reported a higher level of daytime sleepiness, insomnia, and depression than NT. However, the group difference in wake time on school days was not significant, and adolescents showed mild insomnia regardless of their circadian preference. Although smartphone using time in the weekend was significantly different between groups, group difference in Internet addiction was significant only when gender was adjusted. CONCLUSION Circadian preference was associated with sleep patterns and sleep problems in Korean adolescents. ET showed significantly different sleep patterns compared to MT and NT. ET not only reported a higher level of daytime sleepiness and insomnia but also more depressive symptoms compared to NT. These findings suggest that the uniqueness of adolescence and environmental factors seemed to influence the association of circadian preference with mental problem.
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Affiliation(s)
- Jun-Soo Chung
- Department of Psychiatry, The Catholic University of Korea St. Vincent's Hospital, Gyeonggi-do, Republic of Korea
| | - Eunhye Choi
- Department of Psychiatry, The Catholic University of Korea Eunpyeong St. Mary's Hospital, Seoul, Republic of Korea
| | - Ah Reum Lee
- Department of Psychiatry, The Catholic University of Korea Eunpyeong St. Mary's Hospital, Seoul, Republic of Korea
| | - Shin-Young Kim
- Department of Psychiatry, The Catholic University of Korea Eunpyeong St. Mary's Hospital, Seoul, Republic of Korea
| | - Kina Lee
- Department of Psychiatry, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bung-Nyun Kim
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Subin Park
- Department of Research Planning, National Center for Mental Health, Seoul, Republic of Korea
| | - Kyu-In Jung
- Department of Psychiatry, The Catholic University of Korea Eunpyeong St. Mary's Hospital, Seoul, Republic of Korea
| | - Seung-Yup Lee
- Department of Psychiatry, The Catholic University of Korea Eunpyeong St. Mary's Hospital, Seoul, Republic of Korea
| | - Min-Hyeon Park
- Department of Psychiatry, The Catholic University of Korea Eunpyeong St. Mary's Hospital, Seoul, Republic of Korea
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44
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Dong L, Fine ER, Michie S, Zhou Q, Mullin AC, Alvarado-Martinez CG, Hilmoe HE, Tran M, Harvey AG. Open trial of the Parent Behavior Change Intervention (PBC-I): Study protocol. Health Psychol 2020; 39:785-795. [PMID: 32833480 DOI: 10.1037/hea0000873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Parents have profound impacts on adolescents' health behaviors. Yet parents receive minimal training in the elements of conversations that optimally inspire their children toward engaging in healthy behaviors. The current study examines a novel interpersonal target: parent-adolescent conversations about adolescent health behavior change. Derived from advances in the science of behavior change, the Parent Behavior Change Intervention (PBC-I) contains conversational elements (e.g., behavior change techniques, positive communication strategies) hypothesized to reduce parent-adolescent coercion and conflict and facilitate upward spirals of healthy behavior change in adolescents. METHOD/DESIGN The first phase of the study involves the development of the PBC-I in a small case series (N = 12 dyads). The second phase involves an open trial of the PBC-I (N = 36 dyads). Adolescents will receive six 50-min sessions of the Transdiagnostic Sleep and Circadian Intervention to improve sleep while their parents receive six50-min sessions of the PBC-I. Parent-adolescent dyads will be assessed before and after the intervention. The primary analysis will examine whether postintervention use of behavior change techniques and positive communication strategies by parents is higher than preintervention use and whether increased use by parents predicts more positive conversational behaviors, less parent-adolescent conflict, higher adolescent motivation for change, and improved adolescent sleep. DISCUSSION This research provides an initial test of the hypothesis that improving the parent-adolescent conversation will improve adolescent sleep health behavior. While sleep-related health behaviors are the focus of this study, the research is designed to be relevant to a broad range of health behavior change in young people. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Lu Dong
- Department of Psychology, University of California, Berkeley
| | - Eve R Fine
- Department of Psychology, University of California, Berkeley
| | - Susan Michie
- Centre for Behaviour Change, University College London
| | - Qing Zhou
- Department of Psychology, University of California, Berkeley
| | - Alice C Mullin
- Department of Psychology, University of California, Berkeley
| | | | | | - Melanie Tran
- Department of Psychology, University of California, Berkeley
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Taylor BJ, Bowman MA, Brindle A, Hasler BP, Roecklein KA, Krafty RT, Matthews KA, Hall MH. Evening chronotype, alcohol use disorder severity, and emotion regulation in college students. Chronobiol Int 2020; 37:1725-1735. [PMID: 32791860 PMCID: PMC10080672 DOI: 10.1080/07420528.2020.1800028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The evening chronotype is strongly associated with greater alcohol use, though mechanisms underlying this association are not well understood. The current study evaluated emotion regulation as a potential mechanism linking evening chronotype and alcohol use. Participants were 81 undergraduate students. Chronotype was assessed using the Composite Scale of Morningness (CSM). Alcohol use disorder severity was assessed using the Alcohol Use Disorder Identification Test (AUDIT). Participants recorded daily sleep patterns using an online diary for seven days. Participants then completed a standardized laboratory emotion regulation task. Self-reported affect, high-frequency heart rate variability (HF-HRV), and pre-ejection period (PEP) were measured throughout the task. Sleep duration on non-free days (defined as days when sleep was restricted by morning obligations such as work or school) was evaluated as a moderator. Thirty-one evening chronotypes (CSM scores ≤ 26) were compared to 50 non-evening chronotypes (CSM scores >26). Evening chronotypes reported significantly greater symptoms of alcohol use disorder (F = 4.399, p = .039). In the full sample, emotion regulation was successful for altering affective but not autonomic reactivity to emotional stimuli. There were no chronotype differences in self-reported affect, HF-HRV, or PEP during the emotion regulation task. Longer sleep duration on non-free days was associated with increased HF-HRV during negative emotion regulation among non-evening chronotypes. Moderated mediation revealed that emotion regulation did not mediate the association between evening chronotype and alcohol use, irrespective of sleep duration on non-free days. This study is consistent with the literature on chronotype and substance use, demonstrating that undergraduate evening chronotypes endorse greater severity of alcohol use disorder. Given that emotion regulation did not successfully alter autonomic reactivity to emotional stimuli, emotion regulation as a potential mechanism linking chronotype and alcohol use remains inconclusive. Longer sleep duration appears to be protective for non-evening chronotypes in terms of parasympathetic control during the regulation of negative emotions.
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Affiliation(s)
- Briana J Taylor
- Department of Psychology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA.,Center for Psychiatric Research, Maine Medical Center , Portland, Maine, USA
| | - Marissa A Bowman
- Department of Psychology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA
| | - Alicia Brindle
- Department of Psychology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania, USA
| | - Kathryn A Roecklein
- Department of Psychology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA
| | - Robert T Krafty
- Department of Biostatistics, University of Pittsburgh , Pittsburgh, Pennsylvania, USA
| | - Karen A Matthews
- Department of Psychology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA.,Department of Psychiatry, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania, USA
| | - Martica H Hall
- Department of Psychology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA.,Department of Psychiatry, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania, USA
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46
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Kurnaz S, Kandeger A. Do chronotype differences and night eating syndrome affect dental health? Int J Dent Hyg 2020; 18:378-383. [PMID: 32654415 DOI: 10.1111/idh.12457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 03/14/2020] [Accepted: 06/24/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Our aim in this study was to examine the effect of chronotype differences and night eating syndrome on dental health parameters such as the decay-missing-filled teeth (DMFT) index, the severity of the periodontal disease and the number of endodontically treated teeth in patients admitted to the dental clinic. METHODS The participants, 210 patients, filled out a package of psychological tools, including the Morningness-Eveningness Questionnaire (MEQ), the Night Eating Questionnaire (NEQ) and the Insomnia Severity Index (ISI). Afterwards, the DMFT index scores, the severity of the periodontal disease and the number of endodontically treated teeth of patients were recorded simultaneously with a routine dental examination. RESULTS Findings show that the ISI and NEQ scores were significantly higher in the evening-type individuals (E-types) than in the morning-type individuals, and there was no significant difference between the chronotypes in terms of the number of endodontically treated teeth and the DMFT scores. In ordinal regression analyses, not brushing teeth (OR 7.94, CI 6.40-9.85), increased number of decayed teeth (OR 1.16, CI 1.13-1.19) and decreased MEQ scores (OR 0.95, CI 0.94-0.95) were statistically significant predictors for periodontal disease. CONCLUSION Although there was no correlation between chronotype differences and the DMFT index, and the number of endodontically treated teeth, E-types had a higher risk of periodontal disease severity.
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Affiliation(s)
- Safa Kurnaz
- Department of Endodontics, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Turkey
| | - Ali Kandeger
- Department of Psychiatry, Faculty of Medicine, Selcuk University, Konya, Turkey
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Lin CY, Imani V, Griffiths MD, Broström A, Nygårdh A, Demetrovics Z, Pakpour AH. Temporal associations between morningness/eveningness, problematic social media use, psychological distress and daytime sleepiness: Mediated roles of sleep quality and insomnia among young adults. J Sleep Res 2020; 30:e13076. [PMID: 32406567 DOI: 10.1111/jsr.13076] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/03/2020] [Accepted: 04/27/2020] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- Chung-Ying Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Vida Imani
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mark D Griffiths
- Psychology Department, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Annette Nygårdh
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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48
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Measures of circadian preference in childhood and adolescence: A review. Eur Psychiatry 2020; 30:576-82. [DOI: 10.1016/j.eurpsy.2015.01.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 01/05/2015] [Accepted: 01/11/2015] [Indexed: 02/06/2023] Open
Abstract
AbstractPurposeTo review the psychometric properties of the questionnaires commonly filled in by children and adolescents to measure circadian preference.MethodsWe examined the Morningness-Eveningness Questionnaire for Children and Adolescents (MEQ-CA), the Morningness-Eveningness Scale for Children (MESC) and the Composite Scale of Morningness (CSM). We critically analyzed the reliability, in term of internal consistency (through the Cronbach's alpha) and test-retest reliability (through the correlation coefficient), and the type of validation against external criteria (objective assessment of the sleep/wake cycle, body temperature, hormones and other questionnaires). Fifty studies that reported these data were included in the review: 7 studies used the MEQ-CA, 28 used the MESC and 15 used the CSM.ResultsThe percentage of studies reporting at least acceptable levels of internal consistency was high and similar between the three questionnaires. Evidence for test-retest reliability was scant, since only 3 studies were available; it was at least acceptable for the MESC (two studies with a time interval of 1 month), not acceptable for the MEQ-CA (one study with a time interval of 6 months), while no information was available for the CSM. As regards the validation evidence, the MEQ-CA has been validated by the highest number of external criteria (actigraphy, oral body temperature and other questionnaires), followed by the CSM (cortisol sampling and other questionnaires). The MESC has been validated only against self-report measures.ConclusionsThe present state of the art would suggest the use of the MEQ-CA to assess circadian preference in children and adolescents.
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49
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Ojio Y, Kishi A, Sasaki T, Togo F. Association of depressive symptoms with habitual sleep duration and sleep timing in junior high school students. Chronobiol Int 2020; 37:877-886. [DOI: 10.1080/07420528.2020.1746796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Yasutaka Ojio
- Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Meguro-ku, Tokyo, Japan
| | - Akifumi Kishi
- Educational Physiology Laboratory, Graduate School of Education, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tsukasa Sasaki
- Laboratory of Health Education, Graduate School of Education, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Fumiharu Togo
- Educational Physiology Laboratory, Graduate School of Education, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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50
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Bin-Hasan S, Kapur K, Rakesh K, Owens J. School start time change and motor vehicle crashes in adolescent drivers. J Clin Sleep Med 2020; 16:371-376. [PMID: 31992393 DOI: 10.5664/jcsm.8208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The aim of this study was to examine the association between a 50-minute delay (7:20 am to 8:10 am) in high school start times in Fairfax County (FC) Virginia and changes in rates of adolescent motor vehicle crashes. Crash rates in FC were also compared to those in the rest of the state during the same time period. METHODS Virginia Department of Motor Vehicles crash data in drivers age 16 to 18 years old between September and June of each year in FC versus the rest of the state were compared in the combined 2-year periods preceding (2013-2014 and 2014-2015; T1) and following (2015-2016 and 2016-2017; T2) school start time change in the fall of 2015. RESULTS The crash rate per 1000 in 16- to 18-year-old licensed drivers in FC during T1 was significantly higher compared to T2, 31.63 versus 29.59 accidents per 1,000 (95% confidence interval, 1.0-1.14, odds ratio 1.07, P = .03). In contrast, adolescent crash rates in the rest of Virginia were not statistically significantly different at T1 versus T2. With regard to subtypes of crashes, there was a trend toward significance in distraction-related crashes per 1,000 in FC at T1 compared to T2 at 7.01 versus 6.13 (95% confidence interval, 0.99-1.31, odds ratio 1.14, P = .05), but were not significantly different in the remainder of the state. CONCLUSIONS The results of this study suggest that school start time delay is associated with decreased adolescent motor vehicle crash risk, with significant implications for public health and safety.
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Affiliation(s)
| | - Kush Kapur
- Boston Children's Hospital, Boston, Massachusetts
| | | | - Judith Owens
- Boston Children's Hospital, Boston, Massachusetts
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