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Lahoud C, Merhi G, Kahwaji GJ, Lahoud R, Hallit S, Fekih-Romdhane F, Mattar H. Depression, Anxiety and Poor Sleep Quality are Associated with Chronotype and Financial Wellness in University Students. Psychol Rep 2024:332941241251457. [PMID: 38755110 DOI: 10.1177/00332941241251457] [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: 05/18/2024]
Abstract
Background: Evidence suggests the importance of a person's chronotype in predicting various aspects of an individual's physical and mental health. While the effect of depression on sleep is well established, the impact of a person's specific sleep timing and chronotype on the prevalence of both depression and anxiety has yet to be fully understood, especially among university students, vulnerable to mental health problems. In addition, other factors also seem to influence the occurrence of depression and anxiety among students as well as their quality of sleep, one of which being the students' financial wellness. The objective was to evaluate the association between chronotype and the severity and prevalence of depression among Lebanese university students, while also taking into account the possible connection between chronotype and financial wellness and both anxiety and sleep quality. Methods: This cross-sectional study was conducted between December 2021 and February 2022; 330 Lebanese university students was included (mean age 21.75 ± 2.43; 67.3% females). Results: The majority of the Lebanese university students in our sample were found to have an intermediate typology (63.0%), followed by the evening typology, which appeared to constitute 28.2% of the sample, while only 8.8% possessed a morning typology. In this study, having an intermediate or evening typology compared to a morning one was significantly associated with higher depression and worse sleep quality. In addition, having an evening chronotype compared to a morningness propensity was significantly associated with more anxiety. Conclusion: This study found a positive association between an evening typology (chronotype) and higher depression and anxiety and poorer quality of sleep. Although preliminary and based on cross-sectional data, this research could help provide a better understanding of the different chronotypes among university students, and of the possible increased susceptibility of some of these typologies (i.e., evening-type) to mental health problems.
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Affiliation(s)
- Christele Lahoud
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Georges Merhi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Georges-Junior Kahwaji
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Rachele Lahoud
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Hanna Mattar
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Department of Neurology, Notre-Dame des Secours University Hospital, Byblos, Lebanon
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Luz CSDS, Fonseca AETPD, Santos JS, Araujo JF, Duarte LL, Moreno CRDC. Association of Meal Timing with Sleep Quality and Anxiety According to Chronotype: A Study of University Students. Clocks Sleep 2024; 6:156-169. [PMID: 38534799 DOI: 10.3390/clockssleep6010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/03/2024] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
There are several determinants of mental health symptoms, ranging from individual characteristics to social factors. Consistent with patterns in the general population, students with evening characteristics tend to exhibit more anxiety symptoms and poorer sleep quality compared to morning students. Meal timing also appears to affect sleep and may be associated with mental health symptoms. In this context, the aim of the present study was to investigate the association of the timing of the main and last meals of the day with sleep quality and anxiety levels, according to the chronotype of university students. This study was conducted in colleges in São Paulo, Brazil, and involved application of a questionnaire to 162 university students. The questionnaire collected sociodemographic information meal and study times, and included scales assessing eveningness and morningness, sleep quality, and anxiety. Students demonstrating a phase delay in both chronotype and dinner timing exhibited higher levels of anxiety compared to morning-type students. Although no associations were observed between meal timing and sleep quality, sleeping later was associated with poorer sleep quality. The study suggests that evening students and those who eat late at night are more prone to presenting mental health symptoms. More studies are needed to further investigate this association.
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Affiliation(s)
- Cristina Souza da Silva Luz
- Department of Health, Life Cycles, and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | | | - Jefferson Souza Santos
- Department of Health, Life Cycles, and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
- Department of Theory and Foundations of Education, Education Sector, Federal University of Paraná, Curitiba 80230-130, Brazil
| | - John Fontenele Araujo
- Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal 59078-900, Brazil
| | - Leandro Lourenção Duarte
- Department for Health Sciences, Federal University of Recôncavo da Bahia, Cruz das Almas 44380-000, Brazil
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Regmi P, Young M, Minigo G, Milic N, Gyawali P. Photoperiod and metabolic health: evidence, mechanism, and implications. Metabolism 2024; 152:155770. [PMID: 38160935 DOI: 10.1016/j.metabol.2023.155770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/23/2023] [Accepted: 12/25/2023] [Indexed: 01/03/2024]
Abstract
Circadian rhythms are evolutionarily programmed biological rhythms that are primarily entrained by the light cycle. Disruption of circadian rhythms is an important risk factor for several metabolic disorders. Photoperiod is defined as total duration of light exposure in a day. With the extended use of indoor/outdoor light, smartphones, television, computers, and social jetlag people are exposed to excessive artificial light at night increasing their photoperiod. Importantly long photoperiod is not limited to any geographical region, season, age, or socioeconomic group, it is pervasive. Long photoperiod is an established disrupter of the circadian rhythm and can induce a range of chronic health conditions including adiposity, altered hormonal signaling and metabolism, premature ageing, and poor psychological health. This review discusses the impact of exposure to long photoperiod on circadian rhythms, metabolic and mental health, hormonal signaling, and ageing and provides a perspective on possible preventive and therapeutic approaches for this pervasive challenge.
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Affiliation(s)
- Prashant Regmi
- Faculty of Health, Charles Darwin University, Australia.
| | - Morag Young
- Cardiovascular Endocrinology Laboratory, Baker IDI Heart and Diabetes Institute, Australia
| | | | - Natalie Milic
- Faculty of Health, Charles Darwin University, Australia
| | - Prajwal Gyawali
- Centre of Health Research and School of Health and Medical Sciences, University of Southern Queensland, Australia
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Ventresca C, Mohamed W, Russel WA, Ay A, Ingram KK. Machine learning analyses reveal circadian clock features predictive of anxiety among UK biobank participants. Sci Rep 2023; 13:22304. [PMID: 38102312 PMCID: PMC10724169 DOI: 10.1038/s41598-023-49644-7] [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: 07/16/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023] Open
Abstract
Mood disorders, including depression and anxiety, affect almost one-fifth of the world's adult population and are becoming increasingly prevalent. Mutations in circadian clock genes have previously been associated with mood disorders both directly and indirectly through alterations in circadian phase, suggesting that the circadian clock influences multiple molecular pathways involved in mood. By targeting previously identified single nucleotide polymorphisms (SNPs) that have been implicated in anxiety and depressive disorders, we use a combination of statistical and machine learning techniques to investigate associations with the generalized anxiety disorder assessment (GAD-7) scores in a UK Biobank sample of 90,882 individuals. As in previous studies, we observed that females exhibited higher GAD-7 scores than males regardless of genotype. Interestingly, we found no significant effects on anxiety from individual circadian gene variants; only circadian genotypes with multiple SNP variants showed significant associations with anxiety. For both sexes, severe anxiety is associated with a 120-fold increase in odds for individuals with CRY2_AG(rs1083852)/ZBTB20_TT(rs1394593) genotypes and is associated with a near 40-fold reduction in odds for individuals with PER3-A_CG(rs228697)/ZBTB20_TT(rs1394593) genotypes. We also report several sex-specific associations with anxiety. In females, the CRY2/ZBTB20 genotype combination showed a > 200-fold increase in odds of anxiety and PER3/ZBTB20 and CRY1 /PER3-A genotype combinations also appeared as female risk factors. In males, CRY1/PER3-A and PER3-B/ZBTB20 genotype combinations were associated with anxiety risk. Mediation analysis revealed direct associations of CRY2/ZBTB20 variant genotypes with moderate anxiety in females and CRY1/PER3-A variant genotypes with severe anxiety in males. The association of CRY1/PER3-A variant genotypes with severe anxiety in females was partially mediated by extreme evening chronotype. Our results reinforce existing findings that females exhibit stronger anxiety outcomes than males, and provide evidence for circadian gene associations with anxiety, particularly in females. Our analyses only identified significant associations using two-gene combinations, underscoring the importance of combined gene effects on anxiety risk. We describe novel, robust associations between gene combinations involving the ZBTB20 SNP (rs1394593) and risk of anxiety symptoms in a large population sample. Our findings also support previous findings that the ZBTB20 SNP is an important factor in mood disorders, including seasonal affective disorder. Our results suggest that reduced expression of this gene significantly modulates the risk of anxiety symptoms through direct influences on mood-related pathways. Together, these observations provide novel links between the circadian clockwork and anxiety symptoms and identify potential molecular pathways through which clock genes may influence anxiety risk.
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Affiliation(s)
- Cole Ventresca
- Department of Mathematics, Colgate University, Hamilton, NY, USA
- Department of Computer Science, Colgate University, Hamilton, NY, USA
| | - Wael Mohamed
- Department of Computer Science, Colgate University, Hamilton, NY, USA
- Department of Psychological and Brain Sciences, Colgate University, Hamilton, NY, USA
| | | | - Ahmet Ay
- Department of Mathematics, Colgate University, Hamilton, NY, USA
- Department of Biology, Colgate University, Hamilton, NY, USA
| | - Krista K Ingram
- Department of Biology, Colgate University, Hamilton, NY, USA.
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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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Kabasakal Cetin A. Chronotype is associated with addiction-like eating behavior, mindful eating and ultra-processed food intake among undergraduate students. Chronobiol Int 2023; 40:1435-1443. [PMID: 37818640 DOI: 10.1080/07420528.2023.2267677] [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: 05/03/2023] [Accepted: 10/01/2023] [Indexed: 10/12/2023]
Abstract
This study aimed to investigate the relationships between chronotype and addiction-like eating behavior, mindful eating and ultra-processed food consumption among undergraduate students. Specific and validated scales were used in order to evaluate chronotype, addiction-like eating behavior and mindful eating (N = 605). Dietary intake was determined by food frequency questionnaire and percentage energy from ultra-processed food was calculated. Self-reported weights and heights were obtained from the participants. Mean scores of scales, social jetlag, energy intake, ultra-processed food intake and BMI were compared by chronotypes. Associations between chronotype, addiction-like eating behavior, mindful eating, ultra-processed food consumption and BMI were determined by Pearson's test. The relationships between chronotype and addiction-like eating behavior, mindful eating and ultra-processed food intake were assessed by linear regression models and adjusted for sex, BMI, energy intake, season, smoking and alcohol consumption. Evening-type participants had higher scores of social jetlag (2.01 ± 0.09), appetitive drive (26.02 ± 0.63), low dietary control (20.50 ± 0.41), addiction-like eating behavior (46.52 ± 0.85), lower scores of recognition (21.91 ± 0.43) and higher percentage energy from ultra-processed food (32.24 ± 1.26%). Chronotype score showed negative associations with addiction like eating behavior (β=-0.247, p < 0.001) and ultra-processed food consumption (β=-0.247, p < 0.001), and a positive association with recognition (β = 0.124, p < 0.001). Results suggest that chronotype is inversely associated with addiction-like eating behavior and ultra-processed food consumption, and positively associated with mindful eating among undergraduate students.
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Affiliation(s)
- Arzu Kabasakal Cetin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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Bouloukaki I, Tsiligianni I, Stathakis G, Fanaridis M, Koloi A, Bakiri E, Moudatsaki M, Pouladaki E, Schiza S. Sleep Quality and Fatigue during Exam Periods in University Students: Prevalence and Associated Factors. Healthcare (Basel) 2023; 11:2389. [PMID: 37685423 PMCID: PMC10487416 DOI: 10.3390/healthcare11172389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/23/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
The aim of our study was to assess university students' sleep quality and fatigue before and during the academic exam period and identify potential associated factors. A Web-based survey was completed by 940 students of 20 different Tertiary Institutions including demographics, sleep habits, exercise, caffeine, tobacco, alcohol use, subjective sleep quality (Pittsburgh Sleep Quality Index-PSQI), and fatigue (Fatigue severity scale-FSS) at the beginning of the semester and during the examination period. During the exam period, PSQI (8.9 vs. 6.1, p < 0.001) and FSS scores (36.9 vs. 32.7, p < 0.001) were significantly elevated compared to the pre-exam period. An increase in the PSQI score was associated with age (β = 0.111, p = 0.011), presence of chronic disease (β = 0.914, p = 0.006), and depressive symptoms (β = 0.459, p = 0.001). An increase in the FSS score was associated with female gender (β = 1.658, p < 0.001), age, (β = 0.198, p = 0.010), increase in smoking (β = 1.7, p = 0.029), coffee/energy drinks consumption (β = 1.988, p < 0.001), decreased levels of physical exercise (β = 1.660, p < 0.001), and depressive symptoms (β = 2.526, p < 0.001). In conclusion, our findings indicate that exam periods have a negative impact on the sleep quality and fatigue levels of university students. Potential factors were identified that could contribute to the formulation of strategies for improved sleep quality and wellness.
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Affiliation(s)
- Izolde Bouloukaki
- Department of Social Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece;
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Ioanna Tsiligianni
- Department of Social Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece;
| | - Giorgos Stathakis
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Michail Fanaridis
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Athina Koloi
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Ekaterini Bakiri
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Maria Moudatsaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Eleptheria Pouladaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Sophia Schiza
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
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Castelli L, Galasso L, Mulè A, Ciorciari A, Esposito F, Roveda E, Montaruli A. Physical activity and morningness: A helpful combination in improving the sleep quality of active Italian university students. Chronobiol Int 2023; 40:1028-1038. [PMID: 37525628 DOI: 10.1080/07420528.2023.2241906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 07/20/2023] [Accepted: 07/20/2023] [Indexed: 08/02/2023]
Abstract
University students are commonly described as having worsened sleep quality, especially when inactive and Evening-type (E-type) subjects. This study aimed to examine the interactions between physical activity and chronotype on sleep quality among a sample of active Sports Science university students. In November 2019, 433 participants (mean age: 19.7 ± 1.56 years; 70% males) completed the Pittsburgh Sleep Quality Index, the Godin-Shepard Leisure-Time Physical Activity Questionnaire (tertiles categorisation), and the Morningness-Eveningness Questionnaire. Females and E-type slept significantly worse than males and Neither-(N-types) and Morning-types (M-types), respectively. However, there were no significant differences in sleep quality based on physical activity levels. The three-way ANOVA revealed that sleep quality in N- and E-types appeared to be independent of physical activity, whereas M-types showed an improvement in sleep classification with increased physical activity. Moderation analysis indicated that physical activity significantly moderated the relationship between chronotypes and sleep quality. Specifically, M-types demonstrated a more pronounced improvement in sleep quality with increasing physical activity compared to the other chronotypes. In conclusion, M-type university students derived the greatest benefits from physical activity in improving sleep quality. Conversely, physical activity seemed to have a limited impact on sleep quality among active E-type university students.
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Affiliation(s)
- Lucia Castelli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Letizia Galasso
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Antonino Mulè
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Andrea Ciorciari
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- I.R.C.C.S. Ospedale Galeazzi-Sant'ambrogio, Milan, Italy
| | - Eliana Roveda
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- I.R.C.C.S. Ospedale Galeazzi-Sant'ambrogio, Milan, Italy
| | - Angela Montaruli
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- I.R.C.C.S. Ospedale Galeazzi-Sant'ambrogio, Milan, Italy
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Li H, Zhang Y. Effects of Physical Activity and Circadian Rhythm on SCL-90 Scores by Factors among College Students. Behav Sci (Basel) 2023; 13:606. [PMID: 37504053 PMCID: PMC10376651 DOI: 10.3390/bs13070606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/08/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE A study was conducted to investigate the effects of different levels of physical activity and circadian rhythm differences on the nine factors of obsessive-compulsive disorder, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoia, and psychoticism on the SCL-90 scale. METHODS A questionnaire and mathematical and statistical methods were used to conduct the study. Data were collected through a web-based cross-sectional survey of college students from three universities in Anhui. A statistical analysis of the collected data was conducted using mathematical and statistical methods. RESULTS A total of 1248 students were included in the statistics of this study. Binary logistic regression analysis revealed that low physical activity levels were associated with somatization (OR = 1.36, 95% CI = 0.95-1.94), obsessive-compulsive disorder (OR = 1.85, 95% CI = 1.25-2.75), interpersonal sensitivity (OR = 1.94, 95% CI = 1.30-2.88), depression (OR = 2.03, 95% CI = 1.31-3.16), anxiety (OR = 1.67, 95% CI = 1.03-2.69), hostility (OR = 1.80, 95% CI = 1.12-2.89), phobia (OR = 1.88, 95% CI = 1.20-2.94), and paranoia (OR = 2.23, 95% CI = 1.43-3.46). Circadian rhythm differences were associated with somatization (OR = 0.91, 95% CI = 0.87-0.96), obsessive-compulsive disorder (OR = 0.93, p < 0.01, 95% CI = 0.89-0.98), interpersonal sensitivity (OR = 0.90, 95% CI = 0.85-0.94), depression (OR = 0.92, 95% CI = 0.87-0.97), anxiety (OR = 0.89, 95% CI = 0.83-0.95), hostility (OR = 0.91, 95% CI = 0.86-0.97), phobia (OR = 0.87, 95% CI = 0.82-0.93), and paranoia (OR = 0.90, 95% CI = 0.85-0.95) were all negatively associated. In addition, gender was associated with somatization and obsessive-compulsive disorder (OR = 0.75, 95% CI = 0.57-0.98), depression (OR = 0.92, 95% CI = 0.87-0.97), and paranoia (OR = 0.55, 95% CI = 0.40-0.76). CONCLUSIONS Low-intensity physical activity was more likely to be associated with somatization, obsessive-compulsive disorder, relationship sensitivity, depression, anxiety, hostility, terror, and paranoia than high-intensity and moderate-intensity physical activity, and circadian rhythm differences showed that people who slept later (known as nocturnal) were more likely to have these problems.
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Affiliation(s)
- Huimin Li
- Department of Physical Education, College of Physical Education, Anhui Polytechnic University, Wuhu 241000, China
| | - Yong Zhang
- Department of Physical Education, College of Physical Education, Anhui Polytechnic University, Wuhu 241000, China
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Khazaie H, Najafi F, Chehri A, Rahimi-Movaghar A, Amin-Esmaeili M, Moradinazar M, Zakiei A, Pasdar Y, Brühl AB, Brand S, Sadeghi-Bahmani D. Physical Activity Patterns, Circadian Rhythms, and Aggressive and Suicidal Behavior among a Larger Sample of the General Population Aged 15 to 34 Years. J Clin Med 2023; 12:jcm12082821. [PMID: 37109158 PMCID: PMC10141705 DOI: 10.3390/jcm12082821] [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: 03/14/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND From a psychological perspective, aggressive behavior, non-suicidal self-injury and suicidal behavior could be considered dysfunctional coping strategies. Poor sleep patterns may further increase such dysfunctional coping. In contrast, regular physical activity may have the power to counteract such dysfunctional coping. Given this background, the aim of the present study was to combine categories of circadian rhythms as a proxy of normative sleep patterns and categories of physical activity patterns, and to associate these categories with aggressive behavior, non-suicidal self-injury and suicidal behavior among a larger sample of adolescents and young adults, aged 15 to 34 years. METHOD A total of 2991 (55.6% females) individuals aged 15 to 34 years of the so-called Ravansar non-communicable disease cohort study (RaNCD) took part in this study. Participants completed self-rating questionnaires covering circadian-related sleep patterns, regular physical activity, socio-demographic information and dimensions of aggression, non-suicidal self-injury and suicidal behavior. RESULTS In a first step, both sleep patterns (circadian rhythm disorder: yes vs. no) and physical activity patterns (high vs. low) were dichotomized. Next, participants were assigned to one of four prototypical clusters: No circadian sleep disorders and high physical activity ("Hi-Sleep-Hi-PA"); no circadian sleep disorders and low physical activity ("Hi-Sleep-Lo-PA"); circadian sleep disorders and high physical activity ("Lo-Sleep-Hi-PA"); circadian sleep disorders and low physical activity ("Lo-Sleep-Lo-PA"). Projecting these four clusters on dimensions of aggressive behavior, non-suicidal self-injury and suicidal behavior, the following findings were observed: Participants of the "Hi-Sleep-Hi-PA" reported the lowest scores for aggressive behavior, self-injury and suicidal behavior, compared to participants of the "Lo-Sleep-Lo-PA" cluster. No differences for aggressive behavior, self-injury and suicidal behavior were observed among participants of the "Hi-Sleep-Lo-PA" and the "Lo-Sleep-Hi-PA" clusters. CONCLUSIONS It appeared that the combination of favorable circadian sleep patterns and high physical activity patterns was associated with lower aggressive behavior, lower self-injury and suicidal behavior as proxies of favorable psychological functioning. In contrast, persons reporting high circadian sleep disorders and low physical activity patterns appeared to demand particular attention and counseling for both their lifestyle issues (sleep and physical activity) and their dysfunctional coping strategies.
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Affiliation(s)
- Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Farid Najafi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Azita Chehri
- Department of Psychology, Kermanshah Branch, Islamic Azad University, Kermanshah 6714673159, Iran
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran 1419733141, Iran
| | - Masoumeh Amin-Esmaeili
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran 1419733141, Iran
| | - Mahdi Moradinazar
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Ali Zakiei
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
| | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, University of Basel, 4002 Basel, Switzerland
| | - Serge Brand
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
- Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics of the University of Basel, University of Basel, 4002 Basel, Switzerland
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, 4002 Basel, Switzerland
- Addiction Research Prevention Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran 1419733141, Iran
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric Clinics of the University of Basel, University of Basel, 4002 Basel, Switzerland
| | - Dena Sadeghi-Bahmani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran
- Department of Psychology and Department of Epidemiology, Stanford University, Stanford, CA 94305, USA
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11
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Maciel FV, Wendt AT, Demenech LM, Dumith SC. Factors associated with sleep quality in university students. CIENCIA & SAUDE COLETIVA 2023; 28:1187-1198. [PMID: 37042899 DOI: 10.1590/1413-81232023284.14132022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 09/30/2022] [Indexed: 04/13/2023] Open
Abstract
To investigate factors associated with poor sleep quality. A cross-sectional study was conducted in 2019 with random sampling. Information on sleep was obtained using the Mini Sleep Questionnaire (MSQ). Independent variables included sociodemographic, behavioural, academic and psychological health characteristics. Adjusted analyzes were performed using Poisson regression. A total of 996 undergraduate students participated in the study. The poor sleep quality affected 23.1% of the sample (95%CI 20.5-25.9), ranging from 13.4% for those with little concern about violence in the neighbourhood to 36.5% for those with less social support. In the adjusted analysis, female sex [PR] 1.81; (95%CI 1.33-2.45), concern about violence in the neighbourhood [PR] 2.21; (95%CI 1.48-3.28), discrimination at university [PR] 1.42; (95%CI 1.08-1.86) and food insecurity [PR] 1.45; (95%CI 1.11-1.89) were associated with the presence of poor sleep quality, as well as having less social support and income and suffering psychological distress. The results highlight socioeconomic and mental health factors that affect sleep quality and demonstrate the need for reflection and interventions capable of minimizing this problem.
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Affiliation(s)
- Francine Villela Maciel
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande. R. Visconde de Paranaguá 102, Centro. 96200-190 Rio Grande RS Brasil.
| | - Andrea Tuchtenhagen Wendt
- Programa de Pós-Graduação em Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná. Curitiba PR Brasil
| | - Lauro Miranda Demenech
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande. R. Visconde de Paranaguá 102, Centro. 96200-190 Rio Grande RS Brasil.
| | - Samuel Carvalho Dumith
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal do Rio Grande. R. Visconde de Paranaguá 102, Centro. 96200-190 Rio Grande RS Brasil.
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12
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Al-Hazmi MH, Noorwali EA. Morning individuals in Saudi Arabia have higher self-regulation of eating behavior compared to evening types. Chronobiol Int 2022; 40:223-233. [PMID: 36545690 DOI: 10.1080/07420528.2022.2158846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Chronotype is a manifestation of an individual's circadian system, which can be presented as a preference for morningness or eveningness. Evening chronotype has been linked to unhealthy dietary habits. These habits are partially from poor self-regulation of eating behavior (SREB). SREB is a goal-directed process that helps resist food temptation and achieve desired dietary outcomes. It is unclear whether chronotype is associated with SREB. This study aims to investigate the association between chronotypes and SREB. A total of 599 adults (18-50 years) enrolled in this cross-sectional study. Participants received an online questionnaire that collected sociodemographic, anthropometrics, chronotype through the validated reduced Morningness-Eveningness Questionnaire (rMEQ) and SREB using the SREB Questionnaire. ANOVA, Chi-square and multivariate logistic regression were used. In adjusted models, morning types had 85% higher SREB compared to evening types (p = 0.003, OR = 1.85). Evening types found fried foods (p = 0.003), chips (p = 0.005) and French fries (p = 0.018) more tempting than morning types. These findings show a link between chronotype and SREB. Strategies focusing on SREB may help evening types improve dietary habits. Further studies are required to clarify the underlying mechanisms for these associations. This may have important implications for lifestyle and behavioral change policy.
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Affiliation(s)
- Marwa Hamed Al-Hazmi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Essra Abdulsalam Noorwali
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
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13
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Nouri A, Panjeh S, Cogo-Moreira H, Pompeia S. Factors that influence morningness-eveningness and daytime sleepiness: A cross-cultural comparison of Iranian and Brazilian adolescents. Chronobiol Int 2022; 40:162-173. [PMID: 36530145 DOI: 10.1080/07420528.2022.2157735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
As adolescents get older, they become more evening oriented and, because they are usually expected to wake early to attend school, they often present daytime sleepiness, which is associated with negative outcomes. It is still unclear if this is similar cross-culturally. Here, we studied morningness-eveningness and daytime sleepiness in early adolescence from two different developing nations (Brazil and Iran). A total sample of 697 Iranian and Brazilian early adolescents (9- to 15-year-old; 358 boys) from Tehran, Iran, and São Paulo, Brazil, varying in age and parental schooling (a proxy of socioeconomic status: SES) completed the Morningness-Eveningness Scale for Children (MESC) and the Pediatric Daytime Sleepiness Scale (PDSS) and reported their total sleep time on school nights. They also filled in the Pubertal Developmental Scale to determine their pubertal status. A negligible cross-cultural difference in morningness-eveningness was found, indicating that Brazilians showed a slight circadian-phase delay compared with Iranians throughout all tested ages. There was also seen a very slight increase in phase delay as early adolescents aged, indicative of more eveningness. However, there were no country differences in daytime sleepiness once total sleep time during school nights was controlled for, which was the only factor that affects PDSS scores.
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Affiliation(s)
- Ali Nouri
- Division of Curriculum and Pedagogy, Department of Education Studies, Faculty of Humanities, Malayer University, Malayer, Iran
| | - Sareh Panjeh
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Hugo Cogo-Moreira
- Department of Education, ICT and Learning, Østfold University College, Østfold, Norway
| | - Sabine Pompeia
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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14
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Kjørstad K, Vedaa Ø, Pallesen S, Saxvig IW, Hysing M, Sivertsen B. Circadian preference in young adults: Associations with sleep and mental health outcomes from a national survey of Norwegian university students. Chronobiol Int 2022; 39:1465-1474. [PMID: 36259436 DOI: 10.1080/07420528.2022.2121657] [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
Individual preferred timing of sleep and activity patterns, known as circadian preference, ranges from definitely morning types to definitely evening types. Being an evening type has been linked to adverse sleep and mental health outcomes. This study aimed to explore the associations between circadian preference and self-reported sleep, depression, anxiety, quality of life, loneliness, and self-harm/suicidal thoughts. Data stem from a national survey of students in higher education in Norway (the SHoT-study). All 169,572 students in Norway were invited to participate, and 59,554 students (66.5% women) accepted (response rate = 35.1%). Circadian preference was associated with sleep and mental health outcomes in a dose-response manner. For both genders, being an evening type (either definitely evening or more evening than morning) was associated with an increase in age-adjusted relative risk (RR-adjusted; range = 1.44 to 2.52 vs. 1.15 to 1.90, respectively) across all outcomes compared with definitely morning types. Overall, the present study provides further evidence that evening circadian preference is associated with adverse sleep and mental health outcomes in young adults. As such, future efforts to improve sleep and mental health in young adults should consider their circadian preferences.
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Affiliation(s)
- Kaia Kjørstad
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Øystein Vedaa
- Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway.,Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Optentia, The Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
| | - Ingvild West Saxvig
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Centre for Sleep Medicine, Haukeland University Hospital, Bergen, Norway
| | - Mari Hysing
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Børge Sivertsen
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse-Fonna HF, Haugesund, Norway
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15
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Lucifora C, Grasso GM, Nitsche MA, D'Italia G, Sortino M, Salehinejad MA, Falzone A, Avenanti A, Vicario CM. Enhanced fear acquisition in individuals with evening chronotype. A virtual reality fear conditioning/extinction study. J Affect Disord 2022; 311:344-352. [PMID: 35561887 DOI: 10.1016/j.jad.2022.05.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/09/2022] [Accepted: 05/05/2022] [Indexed: 11/18/2022]
Abstract
Circadian rhythms have received increasing attention within the context of mental disorders. Evening chronotype has been associated with enhanced risk to develop anxiety and post-traumatic stress disorder (PTSD). The classical fear conditioning paradigm is a powerful tool to reveal key mechanisms of anxiety and PTSD. We used this paradigm to study the neurocognitive basis of the association between chronotype and fear responses in healthy humans. 20 participants with evening chronotype and 20 controls (i.e., intermediate chronotype) completed a 2-day Pavlovian fear learning and extinction virtual reality task. Participants received fear conditioning, and extinction learning on day 1. Extinction memory recall was tested on day 2. To address interactions between chronotype and time of day of the fear conditioning, and extinction performance, half of the participants were tested in the morning, and the other half in the evening. Skin conductance response (SCR) and subjective fear ratings were measured as primary outcomes. Chronotype was established via the morningness-eveningness questionnaire (MEQ). We found an overall higher SCR for fear acquisition in participants with the evening chronotype profile, compared to controls. Moreover, the higher the MEQ scores -indicative of less eveningness - the lower the SCR was. No effects of chronotype were found for extinction and extinction recall. The higher vulnerability of the evening chronotype for anxiety and related disorders may thus be explained by enhanced fear acquisition of this group.
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Affiliation(s)
- Chiara Lucifora
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98121 Messina, Italy
| | - Giorgio M Grasso
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98121 Messina, Italy
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Ardeystr. 67, 44139 Dortmund, Germany
| | - Giovanni D'Italia
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98121 Messina, Italy
| | - Mauro Sortino
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98121 Messina, Italy
| | - Mohammad A Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Ardeystr. 67, 44139 Dortmund, Germany
| | - Alessandra Falzone
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98121 Messina, Italy
| | - Alessio Avenanti
- Centro Studi e Ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Alma Mater Studiorum - Università di Bologna, Campus di Cesena, 47521 Cesena, Italy; Centro de Investigación en Neuropsicología y Neurociencias Cognitivas, Universidad Católica Del Maule, 346000 Talca, Chile
| | - Carmelo M Vicario
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università Degli Studi di Messina, 98121 Messina, Italy.
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16
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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: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [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
- *Correspondence: Zhijian Yao,
| | - 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
- Qing Lu,
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17
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Boiko DI, Skrypnikov AM, Shkodina AD, Hasan MM, Ashraf GM, Rahman MH. Circadian rhythm disorder and anxiety as mental health complications in post-COVID-19. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:28062-28069. [PMID: 34988815 PMCID: PMC8730477 DOI: 10.1007/s11356-021-18384-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/24/2021] [Indexed: 04/12/2023]
Abstract
In 2020, the world gained dramatic experience of the development of the 2019 coronavirus disease pandemic (COVID-19) caused by severe acute respiratory syndrome 2 (SARS-CoV-2). Recent researches notice an increasing prevalence of anxiety and circadian rhythm disorders during COVID-19 pandemic. The aim of the study was describing clinical features of circadian rhythm disorders and the level of anxiety in persons who have had COVID-19. We have conducted a cohort retrospective study that included 278 patients who were divided into 2 study groups according to medical history: group 1 includes patients with a history of COVID-19; group 2 consists of patients who did not have clinically confirmed COVID-19 and are therefore considered not to have had this disease. To objectify circadian rhythm disorders, they were verified in accordance with the criteria of the International Classification of Sleep Disorders-3. The level of anxiety was assessed by the State-Trait Anxiety Inventory. The most common circadian rhythm disorders were sleep phase shifts. We found that COVID-19 in the anamnesis caused a greater predisposition of patients to the development of circadian rhythm disorders, in particular delayed sleep phase disorder. In addition, it was found that after COVID-19 patients have increased levels of both trait and state anxiety. In our study, it was the first time that relationships between post-COVID-19 anxiety and circadian rhythm disorders had been indicated. Circadian rhythm disorders are associated with increased trait and state anxiety, which may indicate additional ways to correct post-COVID mental disorders and their comorbidity with sleep disorders.
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Affiliation(s)
- Dmytro I. Boiko
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Andrii M. Skrypnikov
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Anastasiia D. Shkodina
- Department of Neurological Diseases With Neurosurgery and Medical Genetics, Poltava State Medical University, Poltava, Ukraine
- Neurological Department, Municipal Enterprise, “City Clinical Hospital of Poltava City Council”, Poltava, Ukraine
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, MawlanaBhashani Science and Technology University, Tangail, Bangladesh
| | - Ghulam Md. Ashraf
- Pre-Clinical Research Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Md. Habibur Rahman
- Department of Pharmacy, Southeast University, Banani, Dhaka, 1213 Bangladesh
- Department of Global Medical Science, Wonju College of Medicine, Yonsei University, Wonju, 26426 Gangwon-do Korea
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18
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School anxiety profiles in Spanish adolescents and their differences in psychopathological symptoms. PLoS One 2022; 17:e0262280. [PMID: 35061775 PMCID: PMC8782359 DOI: 10.1371/journal.pone.0262280] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 12/21/2021] [Indexed: 12/01/2022] Open
Abstract
School anxiety and psychopathological symptoms tend to co-occur across development and persist in adulthood. The present study aimed to determine school anxiety profiles based on Lang’s model of the triple response system (cognitive anxiety, psychophysiological anxiety, and behavioral anxiety) and to identify possible differences between these profiles in psychopathological symptoms (depression, hostility, interpersonal sensitivity, somatization, anxiety, psychoticism, obsessive-compulsive, phobic anxiety, and paranoid ideation). The School Anxiety Inventory (SAI) and the Symptom Assessment-45 Questionnaire (SA-45) were administered to 1525 Spanish students (49% girls) between 15 and 18 years old (M = 16.36, SD = 1.04). Latent Profile Analysis identified four school anxiety profiles: Low School Anxiety, Average School Anxiety, High School Anxiety, and Excessive School Anxiety. A multivariate analysis of variance revealed statistically significant differences among the school anxiety profiles in all the psychopathological symptoms examined. Specifically, adolescents with Excessive School Anxiety showed significantly higher levels of the nine psychopathological symptoms than their peers with Average School Anxiety and Low School Anxiety. In addition, the Excessive School Anxiety profile scored significantly higher in phobic anxiety than the High School Anxiety group. These findings allow to conclude that it is necessary enhance well-being and reduce psychopathology of those adolescents who manifest high and very high reactivity in cognitive, psychophysiological, and behavioral anxiety.
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19
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Naja F, Hasan H, Khadem SH, Buanq MA, Al-Mulla HK, Aljassmi AK, Faris ME. Adherence to the Mediterranean Diet and Its Association With Sleep Quality and Chronotype Among Youth: A Cross-Sectional Study. Front Nutr 2022; 8:805955. [PMID: 35127790 PMCID: PMC8808718 DOI: 10.3389/fnut.2021.805955] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/10/2021] [Indexed: 12/17/2022] Open
Abstract
Background Evidence indicates that many university students have poor adherence to a healthy diet accompanied by unhealthy lifestyle behaviors. Chrono-nutrition is an emerging field of research that examines the pattern of optimum daily activity in relation to the human's dietary patterns, and their reflections of variable health indicators such as sleep quality. However, there is a scarcity of research that examines the relationship between adherence to the healthy eating pattern, like the Mediterranean diet (MD), with sleep quality and chronotype among university students. Methods A cross-sectional study was conducted, and convenience sampling was used. Participants were assessed for adherence to the MD using the Mediterranean Diet Quality Index (KIDMED), for sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and for chronotype using the Morningness-Eveningness questionnaire (MEQ). Results The study included 503 university students, most of them (81.5%) were females. Only 15.1 and 16.9% reported morningness chronotype and good sleep quality, respectively. About half of the students showed medium and high adherence to the KIMED. In-depth analysis revealed that students with good adherence to the MD were more likely to have a good sleep quality (OR = 0.35; 95%CI: 0.21–0.59; P < 0.001) even after adjustment for age and sex (OR = 0.36; 95%CI: 0.21–0.62; P < 0.001). The regression analysis also showed that those with good adherence to the MD had a significant association with better subjective sleep quality, less sleep latency, sleep disturbance, and daytime dysfunction even after adjustment for age and sex. Those with morningness chronotype had about a six-fold higher chance to have good adherence to the MD (OR = 5.67; 95%CI: 2.86–11.26; P < 0.001, respectively). Conclusions Good adherence to the healthy diet presented in the MD among university students is associated with morningness chronotype and with improved overall sleep quality and sleep components. Long-term, controlled intervention research works are warranted for more elaboration on the impact of chronotype and dietary habits on sleep quality and other important aspects such as mental health and academic achievement.
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20
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Chen CH, Huang MC, Chiu YH, Chen IM, Chen CH, Lu ML, Wang TY, Chen HC, Kuo PH. Stress Susceptibility Moderates the Relationship Between Eveningness Preference and Poor Sleep Quality in Non-Acute Mood Disorder Patients and Healthy Controls. Nat Sci Sleep 2022; 14:711-723. [PMID: 35450221 PMCID: PMC9018012 DOI: 10.2147/nss.s339898] [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: 09/17/2021] [Accepted: 04/08/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the relationship between eveningness preference and poor sleep quality and eventually examine the moderation effect of stress susceptibility. METHODS Individuals with non-acute major depressive disorder or bipolar affective disorder and healthy participants were recruited. The Composite Scale of Morningness (CSM) and the Pittsburgh Sleep Quality Index (PSQI) were used to evaluate chronotype and sleep quality, respectively. Eysenck Personality Questionnaire, Tridimensional Personality Questionnaire, Perceived Stress Scale, and Beck Anxiety Inventory were used to formulate stress susceptibility and as indicator variables for empirical clustering by latent class analysis (LCA). Linear regression models were used to examine the relationship between chronotype preference and sleep quality. The interaction terms of CSM and stress susceptibility were examined for the moderation effect. RESULTS A total of 887 individuals were enrolled in this study, with 68.2% female and 44.1% healthy participants. Three subgroups were derived from LCA and designated as low stresssusceptibility (40.2%), moderate stress susceptibility (40.9%), and high stress susceptibility (18.8%) groups. After controlling for covariates, the CSM scores inversely correlated with PSQI scores [b (se)=-0.02 (0.01), p=0.01], suggesting that individuals with eveningness preferences tend to have poor sleep quality. Moreover, stress susceptibility moderated the relationship between CSM and PSQI scores (p for interaction term = 0.04). Specifically, the inverse association between CSM and PSQI was more robust in the high stress susceptibility group than that in the low stress susceptibility group. CONCLUSION Eveningness preference was associated with poor sleep quality, and this relationship was moderated by stress susceptibility.
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Affiliation(s)
- Chun-Hao Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Chyi Huang
- Department of Psychiatry, Taipei City Hospital, Songde Branch, Taipei, Taiwan
| | - Yi-Hang Chiu
- Department of Psychiatry, Wan-Fang Hospital, Taipei, Taiwan
| | - I-Ming Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan
| | - Chun-Hsin Chen
- Department of Psychiatry, Wan-Fang Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan-Fang Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tsung-Yang Wang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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21
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THE INFLUENCE OF ANXIETY LEVEL AND PAST COVID-19 ON SLEEP QUALITY AND INSOMNIA SEVERITY. WORLD OF MEDICINE AND BIOLOGY 2022. [DOI: 10.26724/2079-8334-2022-4-82-31-35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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22
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Li A, Zhang X, Guo Y, Wang J, Hao Y, Gu Y, Jie Y. The Association Between Dry Eye and Sleep Disorders: The Evidence and Possible Mechanisms. Nat Sci Sleep 2022; 14:2203-2212. [PMID: 36545475 PMCID: PMC9762265 DOI: 10.2147/nss.s378751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/01/2022] [Indexed: 12/16/2022] Open
Abstract
Dry eye is a disease that severely affects patients' quality of life, increasing the global burden on public health and finance. There is growing evidence that a poor lifestyle is a significant risk factor for dry eye. Along with the development of society, sleep, as a way of life, is also constantly changing. The main manifestations of sleep disorders are reduced sleep time, circadian rhythm disturbances, and sleep breathing disturbances. Sleep disorders and their secondary systemic diseases have attracted wide attention in recent years. This review mainly explored the correlation between sleep disorders and dry eye, and found that sleep-related problems and other factors potentially leading from sleep disorders could be critical factors for dry eye. These results suggest that ophthalmologists should pay attention to the sleep health problems in patients with dry eye, and we hope that this paper can provide help for future research in this field.
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Affiliation(s)
- Ao Li
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xiaozhao Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yihan Guo
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jingyi Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yiran Hao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yixuan Gu
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Ying Jie
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China
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23
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Ramos JN, Muraro AP, Nogueira PS, Ferreira MG, Rodrigues PRM. Poor sleep quality, excessive daytime sleepiness and association with mental health in college students. Ann Hum Biol 2021; 48:382-388. [PMID: 34544307 DOI: 10.1080/03014460.2021.1983019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM To estimate the prevalence of poor sleep quality and excessive daytime sleepiness (EDS) among college students and to analyse their association with aspects of mental health. SUBJECTS AND METHODS A cross-sectional study carried out with 1113 college students, enrolled in full-time courses at a public university in the Mid-West region of Brazil. Data were collected through a self-administered questionnaire with questions about demographics, socioeconomics, mental health, sleep quality, and EDS. Measurements of weight and height were taken to assess weight status using the body mass index. Multivariate logistic regression models were used to estimate the associations between perceived stress (classified as light, moderate, and high) and presence of depressive symptoms with poor sleep quality and presence of EDS. RESULTS High prevalence of poor sleep quality (65.5%) and EDS (55%) was observed. In the adjusted models, poor sleep quality was significantly associated with moderate and high perceived stress and presence of depressive symptoms. For EDS, there was also a significant association with moderate and high perceived stress and presence of depressive symptoms. CONCLUSIONS High prevalence of poor sleep quality and EDS was found among college students. Perceived stress and presence of depressive symptoms were significantly associated with both evaluated outcomes.
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Affiliation(s)
- Juliana Nunes Ramos
- Faculdade de Nutrição, Universidade Federal de Mato Grosso, Mato Grosso, Brasil
| | - Ana Paula Muraro
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Mato Grosso, Brasil
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24
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Wills C, Ghani S, Tubbs A, Fernandez FX, Athey A, Turner R, Robbins R, Patterson F, Warlick C, Alfonso-Miller P, Killgore WDS, Grandner MA. Chronotype and social support among student athletes: impact on depressive symptoms. Chronobiol Int 2021; 38:1319-1329. [PMID: 34039131 DOI: 10.1080/07420528.2021.1927072] [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
Previous studies have shown individuals with evening chronotype to have a greater likelihood for depression (self-reported and clinical ratings), especially in young adults. However, the mechanisms for this relationship remain unknown. Low levels of social support may be a plausible mechanism: young adults with evening chronotypes are awake when others are sleeping, which may lead to feelings of isolation or low support. This study examined links between chronotype, depression, and social support in relationship subtypes within a group of university student athletes. Data were obtained from 189 NCAA Division-I student athletes across all sports. Chronotype was assessed with the Circadian Energy Scale and ranged from -2 (definitely morning type) to +2 (definitely evening type). Depressive symptoms were assessed with Center for Epidemiological Studies Depression scale. Social support was assessed with the Multidimensional Scale of Perceived Social Support, which included subscales for Family, Friends, and Significant Other. A subscale for Team was created using the items from the Friends subscale (changing the word "friends" to "teammates"). Regression analyses adjusted for age, sex, and minority status. More evening chronotype was associated with higher reported depressive symptoms (p = .018), lower overall perceived social support (p = .001), and lower perceived social support specifically provided by family (p < .0001), friends (p < .0001), and teammates (p = .014). However, more evening chronotype was associated with higher depressive symptoms for higher, but not lower perceived social support from significant other. Moreover, chronotype-by-support interactions on depressive symptoms were observed; the statistical relationship between chronotype and depression was evident only in those with low (but not high) social support from friends and teammates. These data suggest that having a more evening chronotype may be associated with social isolation, and decreased opportunities for interactions with friends and teammates. This may contribute to the long-standing circadian association seen with depression in college student-athletes. Interventions aimed at increasing university support networks may reduce the impact of depression in students self-identifying with later chronotypes and sleep schedules.
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Affiliation(s)
- Chloe Wills
- Sleep and Health Research Program, University of Arizona, Tucson, Arizona, USA
| | - Sadia Ghani
- Sleep and Health Research Program, University of Arizona, Tucson, Arizona, USA
| | - Andrew Tubbs
- Sleep and Health Research Program, University of Arizona, Tucson, Arizona, USA
| | - Fabian-Xosé Fernandez
- Light Algorithms Laboratory, Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Amy Athey
- Department of Athletics, University of Arizona, Tucson, Arizona, USA
| | - Robert Turner
- Department of Clinical Research and Leadership, George Washington University, Washington, DC, USA
| | - Rebecca Robbins
- Division of Sleep and Circadian Disorders, Harvard Medical School, Boston, Massachusetts, USA
| | - Freda Patterson
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - Chloe Warlick
- Sleep and Health Research Program, University of Arizona, Tucson, Arizona, USA.,Department of Psychiatry and Behavioral Sciences, Northwestern University, Evanston, Illinois, USA
| | - Pamela Alfonso-Miller
- Sleep and Health Research Program, University of Arizona, Tucson, Arizona, USA.,Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
| | | | - Michael A Grandner
- Sleep and Health Research Program, University of Arizona, Tucson, Arizona, USA
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25
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Aguiar SO, Auad SM, Silveira KSR, Hermont AP, Prado IM, Vitória Diniz Reis T, Serra-Negra JM. The impact of social distancing caused by the COVID-19 pandemic in dietary and sleep features of graduate and postgraduate university students with different chronotype profiles. BIOL RHYTHM RES 2021. [DOI: 10.1080/09291016.2021.1920733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Sara O. Aguiar
- Department of Pediatric Dentistry, Dental School, Universidade Federal De Minas Gerais, Belo Horizonte, Brazil
| | - Sheyla M. Auad
- Department of Pediatric Dentistry, Dental School, Universidade Federal De Minas Gerais, Belo Horizonte, Brazil
| | - Karen S. R. Silveira
- Department of Pediatric Dentistry, Dental School, Universidade Federal De Minas Gerais, Belo Horizonte, Brazil
| | - Ana Paula Hermont
- Department of Pediatric Dentistry, Dental School, Universidade Federal De Minas Gerais, Belo Horizonte, Brazil
| | - Ivana M. Prado
- Department of Pediatric Dentistry, Dental School, Universidade Federal De Minas Gerais, Belo Horizonte, Brazil
| | - Thaliny Vitória Diniz Reis
- Department of Pediatric Dentistry, Dental School, Universidade Federal De Minas Gerais, Belo Horizonte, Brazil
| | - Júnia M. Serra-Negra
- Department of Pediatric Dentistry, Dental School, Universidade Federal De Minas Gerais, Belo Horizonte, Brazil
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26
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Montaruli A, Castelli L, Mulè A, Scurati R, Esposito F, Galasso L, Roveda E. Biological Rhythm and Chronotype: New Perspectives in Health. Biomolecules 2021; 11:biom11040487. [PMID: 33804974 PMCID: PMC8063933 DOI: 10.3390/biom11040487] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/03/2021] [Accepted: 03/16/2021] [Indexed: 12/11/2022] Open
Abstract
The circadian rhythm plays a fundamental role in regulating biological functions, including sleep–wake preference, body temperature, hormonal secretion, food intake, and cognitive and physical performance. Alterations in circadian rhythm can lead to chronic disease and impaired sleep. The circadian rhythmicity in human beings is represented by a complex phenotype. Indeed, over a 24-h period, a person’s preferred time to be more active or to sleep can be expressed in the concept of morningness–eveningness. Three chronotypes are distinguished: Morning, Neither, and Evening-types. Interindividual differences in chronotypes need to be considered to reduce the negative effects of circadian disruptions on health. In the present review, we examine the bi-directional influences of the rest–activity circadian rhythm and sleep–wake cycle in chronic pathologies and disorders. We analyze the concept and the main characteristics of the three chronotypes.
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Affiliation(s)
- Angela Montaruli
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
| | - Lucia Castelli
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
| | - Antonino Mulè
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
| | - Raffaele Scurati
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
| | - Letizia Galasso
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- Correspondence: ; Tel.: +2-5031-4656
| | - Eliana Roveda
- Department of Biomedical Sciences for Health, University of Milan, Via G. Colombo 71, 20133 Milan, Italy; (A.M.); (L.C.); (A.M.); (R.S.); (F.E.); (E.R.)
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161 Milan, Italy
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27
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Duarte LL, Menna-Barreto L. Chronotypes and circadian rhythms in university students. BIOL RHYTHM RES 2021. [DOI: 10.1080/09291016.2021.1903791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Leandro L. Duarte
- Laboratório De Estudos Em Neurociências, Cronobiologia & Sono. Centro De Ciências Da Saúde, Universidade Federal Do Recôncavo Da Bahia, Santo Antônio De Jesus, BA, Brasil
| | - Luiz Menna-Barreto
- Escola De Artes Ciências E Humanidades, Universidade De São Paulo, São Paulo, SP, Brasil
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