Exploring the Link between Evening Chronotypes and T2DM among South Indians: A Cross-Sectional Study.

To estimate the prevalence of daytime sleepiness and circadian preferences, and to examine the extent to which caffeine consumption and Khat (a herbal stimulant) use are associated with daytime sleepiness and evening chronotype among Ethiopian college students. A cross-sectional study was conducted among 2,410 college students. A self-administered questionnaire was used to collect information about sleep, behavioral risk factors such as caffeinated beverages, tobacco, alcohol, and Khat consumption. Daytime sleepiness and chronotype were assessed using the Epworth Sleepiness Scale (ESS) and the Horne & Ostberg Morningness /Eveningness Questionnaire (MEQ), respectively. Linear and logistic regression models were used to evaluate associations. Daytime sleepiness (ESS≥10) was present in 26% of the students (95% CI: 24.4-27.8%) with 25.9% in males and 25.5% in females. A total of 30 (0.8%) students were classified as evening chronotypes (0.7% in females and 0.9% in males). Overall, Overall, Khat consumption, excessive alcohol use and cigarette smoking status were associated with evening chronotype. Use of any caffeinated beverages (OR=2.18; 95%CI: 0.82-5.77) and Khat consumption (OR=7.43; 95%CI: 3.28-16.98) increased the odds of evening chronotype. The prevalence of daytime sleepiness among our study population was high while few were classified as evening chronotypes. We also found increased odds of evening chronotype with caffeine consumption and Khat use amongst Ethiopian college students. Prospective cohort studies that examine the effects of caffeinated beverages and Khat use on sleep disorders among young adults are needed.

BackgroundChronodisruption, marked by circadian rhythm misalignment, is linked to inflammatory diseases like obesity. Chronotypes, reflecting individual circadian behavior, include morning, intermediate, and evening types, with evening chronotypes showing worse body composition and higher metabolic risk. This study evaluated the inflammatory profile of visceral adipose tissue (VAT) across chronotypes in individuals with obesity and examined clock gene expression.MethodsTwenty-five participants with obesity (11/14 F/M, BMI 41.59 ± 7.69 kg/m², age 41.13 ± 11.08 years) candidates for bariatric surgery were classified using the Morningness-Eveningness Questionnaire (MEQ): morning (36%), intermediate (28%), or evening (36%) chronotypes. VAT biopsies were analyzed for cytokines, chemokines, and growth factors via multiplex ELISA, and clock genes (PER1, CLOCK, BMAL1) were assessed using qPCR.ResultsBody composition and biochemical parameters were similar across groups, but evening chronotypes had higher triglyceride levels (p = 0.012) and lower phase angle (p = 0.035). VAT inflammatory markers, including IL-1β (p = 0.04), IL-8 (p = 0.03), bFGF (p = 0.01), MCP-1 (p = 0.01), and MIP-1β (p = 0.05), were highest in evening and lowest in morning chronotypes. Evening chronotypes had significantly elevated bFGF levels compared to other groups (p = 0.04). PER1 mRNA expression was also higher in evening chronotypes (p = 0.02) and correlated with VAT-released bFGF (p = 0.03) and IL-1β (p = 0.03). MEQ scores negatively correlated with VAT bFGF (p = 0.02), MCP-1 (p = 0.02), and PER1 expressions.ConclusionDespite similar metabolic profiles, evening chronotypes exhibit heightened VAT inflammation and altered clock gene expression, potentially worsening their metabolic risk.

Objective The present study was aimed at investigating the clinical correlates of evening chronotype in a population of subjects suffering from bipolar disorders (BD). Methods We assessed chronotype using the Morningness-Eveningness Questionnaire. We administered the brief Temperament Evaluation of Memphis, Pisa, and San Diego, the Barratt Impulsiveness Scale, and the Alda Scale to evaluate affective temperaments, impulsiveness, and response to mood stabilisers. We performed bivariate analyses and ran a logistic regression model to analyse clinical variables associated with evening chronotype. Results In our sample (n = 178), subjects with an evening chronotype (n = 56, 31.5%) more often suffered from BD type I and reported higher prevalence of seasonality, antidepressant-induced mood switches, psychotic, aggressive, mixed, and anxiety features, and substance use disorders. The number of lifetime suicide attempts and mood episodes was higher in this subgroup. Depressive, cyclothymic, irritable, and anxious temperament scores were higher among evening-chronotype subjects, who also displayed greater levels of impulsiveness and worse treatment response. At the logistic regression, evening chronotype was associated with depressive and irritable temperaments. Conclusions Subjects with evening chronotype display higher clinical severity and worse BD course. Clinicians should evaluate the presence of evening chronotype in BD subjects, especially in those with irritable or depressive temperament. Key points Evening chronotype is a frequent clinical feature in subjects suffering from bipolar disorders (BD); Affective temperaments, particularly depressive and irritable, are associated with evening chronotype in BD; Evening chronotype underpins higher severity of the clinical picture in BD, as well as a worse response to mood stabiliser treatment; Circadian preferences should be systematically assessed in subjects suffering from BD, with particular attention to evening preference.

Quasi-causal associations between chronotype and post-traumatic stress disorder symptoms: A twin study

“Evening chronotype associates with increased triglyceride levels in young adults in two independent populations”

ABSTRACTAt the Center for Addiction and Mental Health (CAMH) Integrated Day Treatment (IDT) program, each patient attends either a morning stream or an afternoon stream, but not both. We examined whether subjective chronotype, or the time of day an individual prefers to be most active and alert, predicted treatment outcomes differentially in depressed patients attending the morning vs. afternoon IDT streams. The Horne-Östberg Morningness-Eveningness Questionnaire (MEQ) was administered before IDT treatment to 203 consecutive patients experiencing a major depressive episode. Multiple regression was used to predict change in depression and quality of life scores based on treatment stream (morning or afternoon), baseline MEQ scores and the treatment stream by MEQ interaction. The treatment stream by MEQ interaction was a highly significant predictor of both depression and quality of life change scores. Post-hoc analyses based on established MEQ categories revealed that definite evening chronotypes had significantly better responses in the morning stream than did morning chronotypes, and significantly worse responses in the afternoon stream relative to moderate evening or neutral chronotypes. There were insufficient morning chronotypes in the afternoon stream to assess clinical responses for this subgroup. In the morning stream only, there was a significant positive correlation between the change in MEQ scores after four weeks of IDT treatment (i.e. a shift to greater morningness) and the decrease in depression scores (r = .36, p = .003), consistent with a therapeutic phase advance in circadian rhythms. In sum, these preliminary data suggest that definite evening chronotypes may have the greatest relative benefit from attending the morning vs. afternoon IDT stream. As patients currently select which IDT stream they will attend, future work based on randomized treatment assignment and using passive actigraphy to assess circadian phase is currently planned to extend these preliminary findings.

Chronotype, which reflects an individual’s preference for activity and sleep timing, has been associated with various chronic conditions, particularly the evening chronotype. Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that collectively increase the risk of developing type 2 diabetes mellitus and cardiovascular diseases. Previous studies on chronotype and MetS have been inconsistent, and none has explored the longitudinal association between MetS and its components. Therefore, this study investigated these associations in middle-aged Japanese civil servants. We analyzed 2231 non-rotating, non-night shift workers (aged 29–69, 71.6% male) from the Aichi Workers’ Cohort Study who participated in surveys in 2018 (baseline) and 2022 and were free of MetS at baseline. Participants were classified into morning, evening, or intermediate chronotypes using the shortened Morningness – Eveningness Questionnaire. MetS was defined according to the harmonized criteria for Japanese, based on waist circumference (≥85 cm for men and ≥90 cm for women), triglycerides, HDL cholesterol, blood pressure, and blood sugar levels. Over 4 y, 232 participants (10.4%) developed MetS, with a cumulative incidence rate of 9.9% in morning, 17.6% in evening, and 9.5% in intermediate types. Logistic regression analysis adjusted for sex, age, educational background, occupation, leisure-time physical activity, alcohol intake, sleep duration, smoking status, snoring, night-time awakening, sleep medication use, working hours, breakfast eating habit, and medication use for diabetes, hypertension, and dislipdemia, revealed that the evening type individuals had a significantly higher risk of MetS (OR: 2.30, 95% CI: 1.48–3.57) compared to intermediate types. In conclusion, evening chronotype was independently associated with a higher risk of developing MetS in middle-aged Japanese civil servants.

BackgroundApproximately half of patients with multiple sclerosis (PWMS) experience sleep disorders or changes in the circadian rhythm, that may further promote the pathogenesis of multiple sclerosis. As the prevalence of chronotypes among PWMS remains unclear, we aimed to evaluate the prevalence of chronotypes among Lithuanian PWMS; to assess the relationship of chronotypes with depression, anxiety, and fatigue symptoms; and to compare these results with those of healthy controls.MethodsWe enrolled 101 PWMS and 100 healthy controls. We included 130 (64.7%) and 71 (35.3%) women and men, respectively. The median age of all respondents was 39 [interquartile range (IQR) 20.75] years. Participants were assessed using general questionnaire, Horne-Östberg Morningness-Eveningness Questionnaire (MEQ), Hospital Anxiety and Depression Scale (HADS), and Shortened Fatigue Questionnaire (SFQ). Chronotypes were identified based on the total MEQ score.ResultsThe average MEQ scores of the PWMS and control groups were 54 (IQR 15.0) and 53.5 (IQR 13), respectively, which indicated the intermediate chronotype. There was no significant between-group difference in the prevalence of chronotypes (p = 0.893). In both groups, individuals with moderate evening and intermediate chronotypes showed higher average HADS depression scores (p = 0.022). Further, in both groups, the individuals with the evening chronotype showed the highest average HADS anxiety scores (p = 0.001). The PWMS group had a higher average SFQ score than the control group (p < 0.001). High SFQ scores were more common among PWMS who had the intermediate (p < 0.001) and morning chronotypes (p = 0.011). The fatigue level was higher among healthy individuals with the evening chronotype (p < 0.001).ConclusionThe most common chronotype for PWMS and healthy controls was the intermediate chronotype. Further, in both groups, higher HADS depression and anxiety scores were associated with the evening chronotype. Fatigue was more commonly found in healthy controls with the evening, and in PWMS - with intermediate and morning chronotypes.

Chronotype has been increasingly linked to problematic digital technology use. However, its role among individuals diagnosed with bipolar disorder (BD) is not well studied. This study aimed to examine the association between chronotype and internet, social media, and smartphone addiction in BD patients. The study included 75 BD patients and 50 matched healthy controls (HC). Chronotype was measured using the Morningness – Eveningness Questionnaire (MEQ). Digital addiction was evaluated via the Internet Addiction Test (IAT), Bergen Social Media Addiction Scale (BSMAS), and Nomophobia Questionnaire (NMPQ).The BD group showed significantly higher nomophobia levels compared to the HC group (p = 0.036). Within the BD group, individuals with an evening chronotype had higher IAT and NMPQ scores than their non-evening counterparts (p = 0.008 and p = 0.020), although the difference in DIU was not significant (p = 0.302). In the MEQ scores were negatively correlated with IAT in the BD group (r = –0.255, p = 0.027), and with all addiction-related measures in the HC group. Covariance analysis indicated that the associations between eveningness and both IAT and NMPQ scores remained significant after controlling for DIU (p = 0.01 and p = 0.04) in BD group. Evening chronotype is associated with higher levels of internet addiction and nomophobia, particularly among individuals with BD. Chronotype should be considered a relevant factor in understanding digital addiction patterns in BD patients.

Background: Circadian preference refers to individual differences for mental and physical activity in the morning and evening. We hypothesized, that inadvertent use of electronic media can cause circadian misalignment that influences sleeping habits and sleep quality of young adults. Aims and Objectives: The aim of the study was to investigate the effect of circadian preferences on sleeping habits and the association of electronic media use with sleep quality and sleep disturbances. Materials and Methods: A total of 188 subjects were enrolled and divided into three groups: Evening, intermediate, and morning chronotype based on the Morningness-Eveningness score. Electronic media use at bedtime and duration of use were assessed subjectively. Sleep quality and subjective sleep disturbances, daytime sleepiness, and chronotype were assessed by the Pittsburgh Sleep Quality Index, Epworth Sleepiness Score, and Morningness-Eveningness Questionnaire Self-assessment version, respectively. Results: The majority of subjects with the evening chronotypes suffered from poor sleep quality compared to other chronotypes and the difference was statistically significant. In evening-type subjects, electronic media use at bedtime, long sleep latency, short sleep duration, and daytime sleepiness were significantly associated with poor sleep quality with odds ratios of 2.34 (1.08–5.08), 11.42 (4.98–26.19), 8.54 (1.01–68.24), and 1.68 (1.03–2.73), respectively. Conclusion: The majority of evening-type subjects had poor sleep quality, altered sleeping habits, and electronic media use at bedtime is significantly associated with poor sleep quality. Hence, history regarding sleep habits and lifestyle, especially electronic media use, should be taken from young adults, who are coming to the outpatient department for other than sleep disorders, to prevent the development of health-related problems.

SummaryChronotype is linked to adverse health measures and may have important associations with obstructive sleep apnea and blood pressure, but data are limited. This study aimed to determine the separate and combined associations of chronotype with obstructive sleep apnea and blood pressure in a middle‐aged community population. Adults (n = 811) from the Raine Study (female = 59.2%; age mean [range] = 56.6 [42.1–76.6] years) were assessed for chronotype (Morningness–Eveningness Questionnaire), blood pressure and hypertension (doctor diagnosed or systolic blood pressure ≥ 140 mmHg and/or diastolic ≥ 90 mmHg), and obstructive sleep apnea at different in‐laboratory apnea–hypopnea index thresholds (5, 10, 15 events per hr). Linear and logistic regression models examined relationships between chronotype and the presence and severity of obstructive sleep apnea, blood pressure, hypertension, and blood pressure stratified by obstructive sleep apnea severity at above‐mentioned apnea–hypopnea index thresholds. Covariates included age, sex, body mass index, alcohol consumption, smoking, physical activity, sleep duration, anti‐hypertensive medication, insomnia, and depressive symptoms. Most participants were categorised as morning (40%) or intermediate (43%), with 17% meeting criteria for evening chronotypes. Participants with apnea–hypopnea index ≥ 15 events per hr and morning chronotype had higher systolic (9.9 mmHg, p < 0.001) and a trend for higher diastolic blood pressure (3.4 mmHg, p = 0.07) compared with those with an evening chronotype, and higher systolic blood pressure compared with those with an intermediate chronotype (4.8 mmHg, p = 0.03). Across chronotype categories, no differences in systolic or diastolic blood pressure or odds of hypertension were found at apnea–hypopnea index thresholds of ≥ 5 or ≥ 10 events per hr. Among participants with apnea–hypopnea index ≥ 15 events per hr, systolic blood pressure is higher in those with a morning chronotype than evening and intermediate chronotypes. Assessment for morning chronotype may improve risk stratification for hypertension in patients with obstructive sleep apnea.

Diurnal Preference Contributes to Maximal UVB Sensitivity by the Hour of the Day in Human Skin In Vivo

ObjectiveThis study aimed to investigate the independent or synergistic effects of evening chronotype and poor sleep quality on cognitive impairment in patients with major depressive disorder (MDD).MethodsA cross-sectional study was conducted on 249 individuals diagnosed with MDD, recruited from the Mental Health Center of Renmin Hospital of Wuhan University. Chronotype preference was assessed using the reduced Horne and Ostberg Morningness - Eveningness Questionnaire (rMEQ), while sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Cognitive function was evaluated through the Digit Symbol Substitution Test (DSST), defining impairment as a DSST score ≤ 56 (the lowest quartile of the cohort). Univariate analysis and logistic regression models were employed to explore the factors associated with cognitive impairment, focusing on the potential interactive effects of evening chronotype and poor sleep quality.ResultsOf the 249 subjects recruited, about 41% were classified as evening chronotype. These individuals exhibited poorer sleep quality and more severe depressive symptoms compared to non-evening chronotype (p < 0.01). Univariate analysis revealed that first episode status, Hamilton Depression Rating Scale (HAMD-17) scores, evening chronotype, and poor sleep quality were significantly associated with cognitive impairment (p < 0.05). Multivariate logistic regression analysis further demonstrated that the co-existence of evening chronotype and poor sleep quality significantly increased the likelihood of cognitive impairment (adjusted odds ratio [AdjOR] = 2.65, 95% confidence interval [CI] = 1.09–6.45, p < 0.05).ConclusionOur findings suggest that evening chronotype, poor sleep quality, and their interaction are important contributors to cognitive impairment in patients with MDD, alongside the severity of depression and first episode status. These results emphasize the need for integrated approaches targeting circadian rhythm disruptions and sleep disturbances in the treatment of cognitive dysfunction in MDD.

ABSTRACTCircadian preferences may affect the severity and symptom structure of depression and could influence specific symptom clusters of depression. This study aims to examine the relationship between chronotypes and symptomatology in patients with major depression. One hundred and one drug-naïve outpatients with major depression were evaluated through the use of the Hamilton Rating Scale for Depression (HRSD). The Morningness–Eveningness Questionnaire (MEQ) was used to the define chronotypes and the quality of subjective sleep was measured with Pittsburgh Sleep Quality Index (PSQI). The medical records of patients were evaluated retrospectively to determine the presence of another medical illness. HRSD total score and cognitive and vegetative factor scores were significantly higher in the evening chronotype than in the morning and intermediate chronotypes (p < .001). In the regression analysis, MEQ total score was inversely related to HRSD-vegetative factor score (p < .001). The ratio of comorbid illness was found to be statistically significant among depressed patients with evening chronotype (p = .001). Additionally, binary logistic regression analysis was performed to ascertain the likelihood of participants having comorbid medical illness; only age (p = .010) and MEQ total score (p = .011) were associated with exhibiting comorbid illness. General and psychiatric clinical examinations need to be considered with the understanding of circadian preference.

Background: Chronotype is the behavioral manifestation of an individual’s innate circadian rhythm. Evening chronotype (i.e. being a “night owl”) is linked to elevated chronic disease and mortality risk in European and Asian populations. Evidence from US cohorts is limited, particularly among women, in whom evening chronotype prevalence becomes higher from midlife onward, coinciding with life stages and hormonal changes associated with higher cardiovascular disease (CVD) risk. Hypothesis: Being a definite evening chronotype would be associated with poor cardiovascular health (CVH) and elevated cardiometabolic risk factors. Methods: Participants were 506 diverse women (mean age=37±16y, 62% racial/ethnic minority) in the AHA Go Red for Women Strategically Focused Research Network at Columbia University. Chronotype was measured using the Morningness-Eveningness Questionnaire (MEQ), the most widely used validated tool by circadian biologists to ascertain chronotype. Higher scores reflected greater morningness. Participants were also categorized as “evening” vs. “intermediate/morning” chronotypes based on their MEQ scores. Health behaviors (diet, physical activity, sleep, and sedentary time) were assessed using validated questionnaires. Health factors (BMI, blood pressure, fasting glucose, and cholesterol) were assessed at the clinic visit. Overall CVH was evaluated using the AHA Life’s Simple 7 (LS7) score (0-8: poor, 9-14: moderate to high). Linear and logistic regression models adjusted for age, race/ethnicity, education, health insurance, and menopause were used to examine associations of chronotype with CVH, clinical risk factors, and health behaviors. Results: Overall, 13% of women identified as being evening chronotypes. Higher MEQ scores (i.e. greater morningness) were associated with higher AHA LS7 scores (β=0.02, p=0.01), indicative of more favorable CVH. Higher MEQ scores were also associated with having a lower Pittsburgh Sleep Quality Index, i.e. better sleep quality, (β=-0.07, p&lt;0.0001), a lower Insomnia Severity Index (β=-0.14, p&lt;0.0001), shorter time to fall asleep (β=-0.28, p=0.04), and less sedentary time (β=-0.11, p=0.001). In contrast, being an evening chronotype was associated with higher odds of poor CVH (OR (95%CI): 2.41 (1.20-4.85)), not meeting AHA diet (OR (95%CI): 2.89 (1.59-5.23)) and physical activity guidelines, (OR (95%CI): 1.78 (1.03-3.07)), and having short sleep (&lt;7h) (OR (95%CI): 2.15 (1.24-3.73)) or insomnia symptoms (OR (95%CI): 2.69 (1.53-4.75)). Conclusions: Women with evening chronotypes have greater odds of having poor CVH and adverse health behaviors after adjustment for sociodemographic factors and menopausal status. Chronotype may be important to consider and target in lifestyle interventions aimed at CVD prevention, particularly among middle-aged and older women who are prone to sleep changes.