Morningness-Eveningness Questionnaire Research Articles

Evening Chronotypes With Depression Report Poorer Outcomes of Selective Serotonin Reuptake Inhibitors: A Survey-Based Study of Self-Ratings

BackgroundPreliminary evidence suggests that evening chronotype is related to poorer efficacy of selective serotonin reuptake inhibitors. It is unknown whether this is specific to particular medications, self-rated chronotype, or efficacy. MethodsIn the Australian Genetics of Depression Study (n = 15,108; 75% women; 18–90 years; 68% with ≥1 other lifetime diagnosis), a survey recorded experiences with 10 antidepressants, and the reduced Morningness-Eveningness Questionnaire was used to estimate chronotype. A chronotype polygenic score was calculated. Age- and sex-adjusted regression models (Bonferroni-corrected) estimated associations among antidepressant variables (how well the antidepressant worked [efficacy], duration of symptom improvement, side effects, discontinuation due to side effects) and self-rated and genetic chronotypes. ResultsThe chronotype polygenic score explained 4% of the variance in self-rated chronotype (r = 0.21). Higher self-rated eveningness was associated with poorer efficacy of escitalopram (odds ratio [OR] = 1.04; 95% CI, 1.02 to 1.06; p = .000035), citalopram (OR = 1.03; 95% CI, 1.01 to 1.05; p = .004), fluoxetine (OR = 1.03; 95% CI, 1.01 to 1.05; p = .001), sertraline (OR = 1.02; 95% CI, 1.01 to 1.04; p = .0008), and desvenlafaxine (OR = 1.03; 95% CI, 1.01 to 1.05; p = .004), and a profile of increased side effects (80% of those recorded; ORs = 0.93–0.98), with difficulty getting to sleep the most common. Self-rated chronotype was unrelated to duration of improvement or discontinuation. The chronotype polygenic score was only associated with suicidal thoughts and attempted suicide (self-reported). While our measures are imperfect, and not of circadian phase under controlled conditions, the model coefficients suggest that dysregulation of the phenotypic chronotype relative to its genetic proxy drove relationships with antidepressant outcomes. ConclusionsThe idea that variation in circadian factors influences response to antidepressants was supported and encourages exploration of circadian mechanisms of depressive disorders and antidepressant treatments.

Development and validation of a French version of the morningness-eveningness questionnaire

ABSTRACT The aim of this study was to validate a French version (FMEQ) of the morningness–eveningness questionnaire (MEQ). Study 1 consisted of a translation by experts and an evaluation. The FMEQ and MEQ were proposed to 19 bilingual participants (age = 38.7 ± 13.7 years). Strong correlations between MEQ and FMEQ were obtained for most items. Study 2 tested the factorial structure and reliability of the FMEQ on a sample of 187 participants (20.46 ± 1.31 years). The confirmatory factor analysis indicated that the model had a good fit (χ2/df = 1.8; SRMR = 0.057) and a good reliability (Cronbach’s alphas = 0.8). Concerning the temporal stability (20 participants: 20.48 ± 1.04 years), the Pearson r correlation coefficient for test–retest reliability was 0.87 (p < 0.001). Study 3 examined the predictive validity with 42 participants (19.52 ± 2.08 years). The global score of the FMEQ was significantly correlated with the time of peak temperature, wake-up time and bedtime. We did not observe superiority of a three-factors solution of the FMEQ. From now on, French subjects chronotype could be rigorously scored, and results from MEQ and FMEQ could be compared.

Validity and Reliability of the Korean Version of Reduced Morningness-Eveningness Questionnaire: Results From a General Population-Based Sample.

Chronotype refers to individual variations in diurnal preferences that manifest as everyday behaviors, including sleep patterns. Traditionally, the Horne &amp; Östberg Morningness-Eveningness Questionnaire (MEQ), which comprises of 19 items, has been the standard for determining chronotype. However, its length makes it cumbersome for widespread application. To address this issue, the reduced MEQ (rMEQ), a concise version containing only five items from the MEQ, was developed for a more practical approach to chronotype assessment. This study aimed to evaluate the validity and reliability of Korean version of rMEQ in a sample from the general Korean population. The Korean version of the rMEQ comprises of items 1, 7, 10, 18, and 19 of the original MEQ. The validity of the rMEQ was assessed by correlating its scores with those of the MEQ and Munich Chronotype Questionnaire (MCTQ). Its reliability was determined by calculating internal consistency. A total of 3,030 individuals participated in the study, yielding an average rMEQ score of 14.0 ± 3.4. There was a substantial positive correlation between the rMEQ and MEQ scores (r = 0.859, P < 0.001). Furthermore, the rMEQ scores were significantly negatively correlated with the midpoint of sleep on free days corrected for sleep debt as measured by the MCTQ (r = -0.388, P < 0.001), indicating a robust association with chronotype. The internal consistency of rMEQ, measured using Cronbach's alpha, was 0.609. This study finds the Korean version of the rMEQ to be a valid and reliable instrument for assessing chronotype in the general population.

Patient-reported outcomes on sleep quality and circadian rhythm during treatment with intravenous ketamine for treatment-resistant depression.

Intravenous (IV) ketamine is a rapid acting antidepressant used primarily for treatment-resistant depression (TRD). It has been suggested that IV ketamine's rapid antidepressant effects may be partially mediated via improved sleep and changes to the circadian rhythm. This study explores IV ketamine's association with changes in patient-reported sleep quality and circadian rhythm in an adult population with TRD. Adult patients (18-64 years) with TRD scheduled for IV ketamine treatment were recruited to complete patient rated outcomes measures on sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and circadian rhythm using the Morningness-Eveningness Questionnaire (MEQ). Over a 4-week course of eight ketamine infusions, reports were obtained at baseline (T0), prior to second treatment (T1), prior to fifth treatment (T2), and 1 week after eighth treatment (T3). Forty participants with TRD (mean age = 42.8, 45% male) were enrolled. Twenty-nine (72.5%) had complete follow-up data. Paired t tests revealed statistically significant improvements at the end of treatment in sleep quality (PSQI) (p = 0.003) and depressive symptoms (Clinically Useful Depression Outcome Scale-Depression, p < 0.001) while circadian rhythm (MEQ) shifted earlier (p = 0.007). The PSQI subscale components of sleep duration (p = 0.008) and daytime dysfunction (p = 0.001) also improved. In an exploratory post hoc analysis, ketamine's impact on sleep quality was more prominent in patients with mixed features, while its chronobiotic effect was prominent in those without mixed features. IV ketamine may improve sleep quality and advance circadian rhythm in individuals with TRD. Effects may differ in individuals with mixed features of depression as compared to those without. Since this was a small uncontrolled study, future research is warranted.

Dependence of Cerebral Oxygenation and Task Performance on Coloured Light Exposure and Chronotype: Blue and Red Do Not Have the Same Effects on the Prefrontal Cortex.

In our previous studies, we investigated the right-left asymmetry (RLA) of cerebral tissue oxygenation (StO2) at rest in humans and the influence of the individual chronotype (i.e. individual chronobiological disposition) on StO2. The aim of the current study was to investigate (i) whether the RLA exists during a cognitive task and coloured light exposure (CLE), and (ii) how changes in StO2 induced by CLE and cognitive performance during a 2-back task are related to the subject's chronotype. 36 healthy subjects (22 female, 14 male, age 26.3 ± 5.7 years) were studied twice on two different days. They were exposed to a sequence of blue followed by red light or vice versa in a randomised crossover study design. During CLE, subjects were asked to perform a 2-back task. We measured StO2 of the right and left prefrontal cortex (PFC) as well as the right and left visual cortex with functional near-infrared spectroscopy (fNIRS). At the behavioural level, we recorded the number of correct and incorrect answers given by the subjects. The chronotype was determined with the Horne and Östberg morningness-eveningness questionnaire. (i) We found that the blue and red light caused a RLA in the PFC. For red light exposure, the 2-back performance was negatively correlated with StO2 in the right PFC (r=-0.283, p=0.016), and for blue light, exposure in the left PFC (r=-0.326, p=0.005). (ii) 83% of subjects who performed the 2-back task at their optimal time of day according to their chronotype showed increased and higher changes in StO2 (ΔStO2>1%) compared to subjects who did not exercise at their optimal time of day. (iii) No correlation was found between chronotype and 2-back task performance (red: p=0.38; blue: p=0.42). We found for the first time that blue and red lightexposure target different regions of the PFC during performance of a 2-back task, which can be explained by the approach and withdrawal model. These results illustrate that studying the subregions (i.e. right, left, and even centre) of the cortex provides a better understanding of the CLE effects in the human brain. Our study also shows that individual chronotype plays an important role in the individual changes in StO2 induced by CLE.

Effect of Sleep Quality on Mitochondrial DNA Copy Number in Eveningness Chronotypes.

To determine the effect of sleep quality on mitochondrial DNA copy number in eveningness chronotype. Cross-sectional study. Place and Duration of the Study: Department of Physiology, Islamic International Medical College, in collaboration with Genetic Resource Centre, from August 2022 to May 2023. A total of 80 participants with eveningness chronotype based on the Morningness-Eveningness Questionnaire were recruited. The participants' sleep quality was assessed using Pittsburg Sleep Quality Index (PSQI). Accordingly, they were categorised into Group A (good sleep quality) and Group B (poor sleep quality) with 40 participants in each group. After extracting DNA using the Chelex method, mitochondrial DNA copy number of all participants was measured using the quantitative polymerase chain reaction. The mean values in both groups were analysed by Independent-samples t-test. Analysis of mitochondrial DNA copy number in both groups showed normal distribution after being transformed into logarithmic values. The mean value of Group A (2.65 ± 0.26) exhibited a significant increase in mitochondrial DNA copy number (95% CI: 0.18, 0.44; p <0.001) as compared to that in Group B (2.34 ± 0.29). People with good sleep quality have a higher mtDNA-CN than those with poor sleep quality. Good sleep quality may counteract negative effects of increased oxidative stress brought on by eveningness behaviour, thus leading to better mitochondrial function and increased mitochondrial biogenesis that was indicated by higher mtDNA-CN in individuals who experience good sleep quality. Mitochondria, Mitochondrial DNA copy number, Sleep quality, Chronotype.

Patients With Hemangioblastoma: Mood Disorders and Sleep Quality.

Sleep has confirmed physical, psychological, and behavioral benefits, and disruptions can result in disturbances in these states. Moreover, it can be linked bidirectionally with susceptibility to and the subsequent status of brain tumors. The current study examined mood disorders and sleep quality before and after surgery for hemangioblastoma brain tumors. Thirty-two patients diagnosed with hemangioblastoma brain tumors between 2017 and 2023 underwent surgical treatment. The Karnofsky Performance Status and ECOG performance status scales, the Brunel Mood Scale, the Morningness-Eveningness Questionnaire, and the Mini-Sleep Questionnaire were employed to assess the patients. The findings indicate that after surgery, sleep quality and mood disorders, including tension, vigor, and depression, did not exhibit significant differences in these patients (p>0.05). However, tension, vigor, depression, and sleep quality did have a significant impact on their functional status post-surgery (p<0.05). Depression is the significant mood factor in patients with brain tumors that impact their functional status. In this context, it is recommended that psychological therapies be considered for them, alongside conducting more comprehensive and in-depth studies on psychological disorders in patients with brain tumors.

Significant contribution of chronotype to emotional well-being in chronic psychiatric outpatients in Greece

Circadian rhythms are pivotal for human functioning, and their disruption holds significant implications for well-being. One common source for circadian disruptions is circadian misalignment that can be related to chronotypes. Chronotypes refer to an individual's preferred timing for sleep and wakefulness. Individuals with late chronotypes are at a disadvantage in the morning-oriented modern world and are demonstrated to have negative consequences in many aspects of life. In the context of psychiatric disorders, chronotypes are related to prevalence of disorders and to treatment effects but less attention is given to the relationship between chronotype and well-being in chronic psychiatric patients. The current study aims to elucidate the extent to which individual chronotypes contribute to emotional well-being within a cohort of individuals with chronic psychiatric disorder in outpatient clinic.Participants (n = 100) were recruited from the outpatient clinic of the 3rd Department of Psychiatry, AHEPA University Hospital, Thessaloniki, Greece, and the AX Mental Health Outpatient Clinic in Heraklion, Crete, Greece. Most participants were diagnosed within the F2 cluster, Psychotic disorders (n = 38), or F3 cluster, Mood (affective) disorders (n = 48). The Morningness-Eveningness Questionnaire (MEQ) was employed to assess chronotype. The STAI-Y1, CES-D, QoL Uniscale and RASS Questionnaires were used to assess aspects of emotional well-being. A single measure of emotional well-being was generated using Z-score transformation. Student's t-test, ANOVAs and Pearson's correlations were used to identify parameters contributing to emotional well-being, followed by a comprehensive regression model.Results show a significant contribution to emotional well-being by “psychiatric diagnosis” with schizophrenia/schizoaffective patients showing better emotional well-being compared with the “other” group, “receiving treatment” with patients receiving treatment showing higher score than ones who do not receive treatment, and “morningness/eveningness preference” where morningness was associated with higher score of emotional well-being. No other demographic or health-related parameters were significantly associated with emotional well-being score.These findings clearly indicate the critical importance of chronotypes to the emotional well-being of chronic psychiatric patients. Additional thought and research should explore possible chronotherapy interventions that will address this issue in patients.

Pressure Pain Sensitivity and Chronotype: A Population-based Study of Middle-aged Finns

Evening chronotype individuals experience pain more often than morning chronotypes, but relationships with pain sensitivity have rarely been studied. We examined whether chronotype is associated with pressure pain sensitivity, with special reference to mental health disorders, insomnia, and chronic musculoskeletal (MSK) pain as potential moderating factors. The study sample consisted of members of the Northern Finland Birth Cohort 1966 aged 46. Pressure pain threshold and tolerance were measured via the standardized protocol, categorized as lowest quartile versus others. Chronotype (morning [M; the reference], intermediate [I], and evening [E]) was defined using the Short Morningness-Eveningness questionnaire. Sex-stratified binary logistic regression models were separately adjusted for education, body mass index, long-term diseases (fully adjusted model), and for mental health disorders, insomnia, and chronic MSK pain (a residual confounding analysis). Interaction terms (Chronotype × Mental health/insomnia/chronic MSK pain) were tested. The study had 2,132 males and 2,830 females. The E-type males had 1.5-fold odds of having a low pain threshold (fully adjusted odds ratio [OR] 1.45, 95% confidence interval 1.05–2.00) and pressure pain tolerance (fully adjusted OR 1.47, 1.07–2.02), in comparison to M-types. Having a mental health disorder intensified the association with low pain threshold fourfold (4.06, 1.56–10.6). Being an E-type female was also associated with a low pain threshold, but the association was statistically nonsignificant (fully adjusted OR 1.18, .90–1.53). No statistically significant interactions were found among females. These results emphasize the role of chronotype in pain sensitivity and add an understanding of pain experience in light of innate circadian types. PerspectiveMale evening chronotypes are more sensitive to pain than morning chronotypes. Diagnosed mental health disorders in particular indicate a low pain threshold for evening chronotype males.

Chronotype, Eating Habits, and Body Mass Index in First-Year Undergraduate Medical Program Students

This cross-sectional study aimed to identify the correlation between chronotype and body mass index (BMI) in medical students, mediated by energy intake, and to explore eating habits. There were 46 participants who completed Morningness-Eveningness Questionnaire and Chrononutrition-Profile Questionnaire in the Indonesia version and a 3 days of 24-hour food record. Participants’ weight and height were measured by microtoise and digital body weight scale. Additionally, univariate and correlation analyses were conducted to identify the correlation of the variables. The study found no significant difference in the correlation between chronotype preference and BMI, chronotype preference and energy intake, and BMI and energy intake. Medical students had a habit of eating breakfast, even skipping breakfast, having dinner later, consuming the highest energy at lunchtime, and consuming high-calorie, high-fat, and high-sugar foods at night. The study revealed no significant correlation between chronotype, eating habits, and BMI. However, the eveningness medical students have bad eating habits.

HUBUNGAN KRONOTIPE DENGAN DERAJAT NYERI DISMENORE PADA REMAJA PUTRI

Dysmenorrhea is one of the most common menstrual disorders in young women. The prevalence of dysmenorrhea in adolescent girls in Indonesia ranges from 16.8-81%. Girls with dysmenorrhea symptoms have a higher risk of decreased activity, experiencing hip strain, back pain, headaches, and fatigue. In school children, it can interfere with learning activities and concentration, causing academic decline. Dysmenorrhea is influenced by several factors from daily activities and habits. Activity can affect a person's sleep and wake schedule. The difference in sleep and activity schedules of each person is known as kronotipe. The study aimed to determine the relationship between kronotipe and the degree of dysmenorrhea pain in adolescent girls at SMKN 1 Doko Blitar. The research was conducted in August-September 2021. The population of the study was 60 students of SMK 1 Doko in Blitar district aged 15-18 years old, non-smoking, and who want to join this study. The research plan is a cross-sectional study using MEQ-SA (Morningness-Eveningness Questionnaire Self-Assessment Version), and the dysmenorrhea questionnaire. Data analysis uses the chi-square test. The result of chi-square test showed a significant correlation between the kronotipe with the degree of dysmenorrhea pain (p-value= 0,000). There is a significant relationship between chronotype and the degree of dysmenorrhea pain. Adolescent girls need to set a regular sleep schedule to have an appropriate chronotype to reduce dysmenorrhea pain during menstruation.

The effect of time of day on Special Judo Fitness Test in active judokas: Evaluation in terms of chronotype

ABSTRACT The present cross-sectional study aims to examine the effect of time of day on the judo-specific performance in judokas, considering their chronotypes. Twenty-four male judokas participated in the study where the Morningness-Eveningness Questionnaire was administered, and on it, they were divided into morning-type (MT:12-judokas) and evening-type groups (ET:12-judokas). Afterwards, the Special Judo Fitness Test (SJFT) was applied to both groups at three different times (morning: 09:00 h, afternoon: 13:00 h and evening: 17:00 h) with body temperature measured before and after every SJFT performance. As a result, the Group*Test Time interaction significantly affected overall throwing performance during SJFT [F(2,44) = 29.437, p = 0.001, η2p: .572]. Furthermore, a significant time effect was found for the SJFT index [F(2,44) = 5.118, p = 0.010, η2p: .189] and for the Group*Test Time interaction with the mean value of the index [F(2,44) = 24.424, p < 0.001, η2p: .526]. Furthermore, body temperature had a significant time effect [F(2,44) = 301.454, p < 0.001, η2p: .932] and the Group*Test Time interaction [F(2,44) = 5.802, p = 0.006, η2p: .209]. In conclusion, coaches and exercise experts should consider judo athletes’ chronotype when planning special training programs to improve judo-specific anaerobic capacity. Furthermore, to minimize the impact of time of day and chronotype on athletes’ performance in competitions, it is recommended that MT athletes develop their judo-specific anaerobic capacity in the evening hours, when their performance is lower, while ET athletes should do so in the morning hours when their performance is lower via randori training.

CHRONOBIOLOGICAL ASPECTS OF SLEEP DISORDERS UNDER ANXIETY DISORDERS

Modern research highlights the connection between the deterioration of sleep quality, sleep efficiency and daytime sleepiness with the disruption of the sleep-wake pattern due to circadian dysfunction. The aim of the study is to investigate the features of sleep disorders in patients with anxiety disorders of neurotic genesis, taking into account individual chronotype.&#x0D; 91 patients, 48 women (52,7%) and 43 men (47,3%) with anxiety disorders of neurotic origin were examined at Regional Center of Psychiatric Care. The Horn-Ostberg Morningness-Eveningness Questionnaire was used to determine the chronotype of participants. The study was also conducted using the Hamilton anxiety scale, Pittsburgh sleep quality questionnaire, Insomnia severity index, Epworth sleepiness scale, and Fatigue severity scale. All patients, depending on the individual chronotype, were divided into 3 groups, representative by age and gender. The morning type group comprised 32 patients (35.2%), the intermediate type group consisted of 31 patients (34.1%), and the evening type group included 28 patients (30.7%).&#x0D; A significant difference has been established between groups of morning and evening type in terms of the total score of anxiety and its somatic component (p&lt;0.05). There is no difference in the indicator of the mental component of anxiety. However, this indicator is higher in people with extreme evening type compared to extreme morning type (p=0.001). Differences in indicators of sleep disturbances have been found to depend on the individual chronotype. Representatives of the evening type compared to the intermediate and morning types have significantly higher indicators of sleep latency and daytime dysfunction according to PSQI, as well as daytime sleepiness and fatigue severity (p&lt;0.001). People with an intermediate chronotype have better sleep duration (p&lt;0.05) and lower insomnia severity index than people with a morning (p&lt;0.05) and evening type (p&lt;0.01).

Behavioural Parameters of Circadian Rhythm Are Not Correlated with Dim Light Melatonin Onset: An Observational Study on Healthy Volunteers.

Dim light melatonin onset (DLMO) is considered the most reliable marker of the circadian rhythm phase in humans. DLMO may moderately correlate with sleep onset and sleep offset time. There are no sufficient data about the correlations between DLMO and clinical scales assessing sleep quality and daytime symptoms of poor night sleep. The aim of the study was to determine the association between DLMO and basic sleep parameters from actigraphy and sleep diaries, as well as the association between DLMO and the following insomnia clinical scales: the Athens Insomnia Scale (AIS), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and chronotype questionnaires: Morningness-Eveningness Questionnaire (MEQ) and Composite Scale of Morningness (CSM). Participants of the study were healthy volunteers. Sleep parameters were measured by sleep diaries and actigraphy, and the following clinical scales: the AIS, ISI, and ESS, and chronotype questionnaires: MEQ and CSM. DLMO was calculated based on plasma melatonin concentration. The blood samples were collected hourly at five time points between 20:00 and 00:00 during the session in dim red light (<50 lux). Melatonin concertation was determined by LC-MS/MS. Twenty-one volunteers participated in the study. DLMO was calculated in 12 participants. There was a significant correlation between DLMO and ISI (r = 0.60, p = 0.038) and ESS (r = 0.61, p = 0.034). The correlation coefficient between the DLMO and the AIS was also high, however insignificant (r = 0.57, p = 0.054). There were no significant correlations between DLMO and chronotype scales MEQ and CSM. DLMO did not correlate with sleep onset and sleep offset; however, DLMO correlated with the Sleep Fragmentation Index (SFI) (r = 0.67, p = 0.017). DLMO is associated with poorer sleep maintenance, a stronger feeling of insomnia, and sleepiness during the day. Simultaneously, chronotype pattern and circadian rhythm parameters do not correlate with DLMO. Biological circadian rhythm does not reflect the real-life sleep-wake rhythm, indicating that the lifestyle is more often disconnected from the biological clock.

Chronotype influences on posttraumatic stress disorder induced by the twin earthquakes in Turkey: A cross-sectional study among medical students

ABSTRACT This study aimed to investigate the correlation between chronotypes and posttraumatic stress disorder (PTSD) symptoms in medical students affected by earthquakes in Kahramanmaraş, Turkey, while elucidating if the PTSD manifestation varies among different chronotypes four months post-disaster. The study encompassed 193 medical students, subjected to the sociodemographic data form, the Morningness-Eveningness Questionnaire (MEQ) and the PTSD Checklist for DSM-5 (PCL-5). The results indicated that students identified as “evening types” reported significantly elevated PCL-5 scores (p < 0.001) relative to “morning” and “intermediate” types. According to PCL-5 scores, 43.5% of the participants exhibited PTSD, with a higher occurrence among the evening types. Multivariable linear regression analysis revealed that lower MEQ scores independently correlated with elevated PTSD symptoms (β = -0.1389 [95% CI = -0.273 ˗ −0.0048], p = 0.042), suggesting the potential of eveningness as a risk factor for PTSD post-disaster. These findings could enhance our understanding of PTSD, aid the development of preventive strategies, and underscore the importance of considering chronotypes. Further expansive, population-based studies with a longitudinal design are necessary to better understand the relationship between PTSD and the circadian system.

Sleep, activity, and diet in harmony: unveiling the relationships of chronotype, sleep quality, physical activity, and dietary intake.

This cross-sectional study aims to explore the intricate relationships among chronotype, sleep quality, physical activity, and dietary intake in a diverse cohort of 3,072 (50.2% female) participants residing in İstanbul, Türkiye. This study utilized established measurement tools, including the Morningness-Eveningness Questionnaire (MEQ) to assess chronotype, the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality, the International Physical Activity Questionnaire Short Form (IPAQ-SF) to measure physical activity, and a 24-h dietary recall method to assess dietary intake. The findings of this study revealed compelling associations. Firstly, a robust association was observed between sleep quality and chronotype (OR: 2.265; 95% CI: 1.954-2.626; p < 0.001) as well as physical activity (OR: 0.836; 95% CI: 0.750-0.932; p = 0.002). Specifically, evening chronotypes are more likely to have poor sleep quality, while highly active individuals tend to report lower sleep quality. Transitioning from inactivity to high activity was associated with a 16.4% increase in the odds of transitioning from normal to poor sleep, while a shift from an evening to a morning chronotype was linked to a substantial 126.5-fold increase in the odds of moving from poor to normal sleep. Additionally, morning chronotypes also display distinctive dietary patterns, characterized by higher energy, protein, and fat intake, and reduced carbohydrate intake. Poor sleep quality is associated with increased energy and macronutrient consumption. These findings underscore the intricate relationships of chrononutrition within the context of sleep quality, physical activity, and dietary choices. The study underscores the significance of personalized interventions to effectively address specific health behaviors, highlighting the complexity of chrononutrition's role in promoting overall health and wellbeing.

Differences in nutritional profile by chronotype among 12-h day shift and night shift nurses

ABSTRACT Acute care nurses may suffer substantial fatigue if working night shift or if assigned a shift contrasting their preferred sleep-wake patterns, called chronotype. Nurses are at higher risk for diet-related, metabolic diseases compared to other healthcare professionals. Yet, the impact of preferred chronotype and mismatch to assigned shift on nutritional intake and risk for metabolic disease among acute care nurses is unclear. This observational study analyzed dietary data from 52 acute care nurses. Participants completed the revised morningness-eveningness questionnaire which gives a total score between 4 and 26. Lower scores (<12) were flagged as evening type (E-type), higher scores (>17) defined as morning type (M-type), and scores between 12 and 17 were categorized as neither types (N-type). N-type participants were considered chronotype matched when assigned to either shift, whereas E-types were only considered matched if assigned to night shift, and M-types matched only if assigned to day shift. Participants also recorded all dietary intake for 7 d (reflecting a typical workweek) in the MyFitnessPal phone application. Findings indicated that eveningness nurses had markers of MetS, including a significantly larger body mass index and waist circumference than N-types (p < 0.05). E-types also consumed, on average, more calories than other chronotypes (m = 1833.7 kcal), although this was not a statistically significant finding. Mismatched day (n = 7, 13.4%) and night (n = 5, 9.6%) nurses in our sample consumed, on average, more calories (m = 1935.1 kcal, m = 1981.2 kcal, respectively) than matched day (n = 24, 46.2%, m = 1642.6 kcal) or night (n = 16, 30.8%, m = 1599.1 kcal) nurses, although this finding was not statistically significant. Mismatched day nurses consumed significantly less fiber than day matched nurses (median = 10.9 g versus median = 18.5 g, p = 0.04), while night mismatched consumed significantly more fiber compared to night matched (median = 21 g versus median = 12.2 g, p = 0.05) nurses. Participant diets overall did not follow recommendations by the United States Department of Agriculture (USDA), who consumed a higher percentage of calories from saturated fats and a smaller percentage of calories from fiber, habits which increase risk for metabolic syndrome. Further research surrounding nutritional pathways utilizing larger samples is needed to uncover relationships with metabolic syndrome especially for eveningness-type nurses or if working a shift mismatched with preferred chronotype.

Impact of Sleep Duration, Quality, and Chronotype on Learning and Academic Performance: A Cross-Sectional Study Among First Year Medical Students of a Tertiary Care Institute.

Introduction The link between sleep and cognitive processes, such as memory and learning, continues to be one of the most intriguing and perplexing theories. Undergraduate medical students in their first year are particularly vulnerable to sleep disturbances. Academic achievement and learning have been linked to sleep patterns, which include not only the quantity and quality of sleep but also the timing of sleep in relation to the natural sleep onsets, or chronotypes. There have been conflicting reports on the outcomes of sleep and relatively fewer researches focused on the impact of chronotypes on learning and academic achievement among medical students. The current study thus sought to determine the chronotypes of medical students, evaluate the quantity and quality of sleep, and determine the impact of these factors on learning and academic performance. Methods The study was conducted in the Department of Physiology, All India Institute of Medical Sciences (AIIMS) Gorakhpur, India. Sleep health was assessed in 167 first-year medical students using the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), morningness-eveningness questionnaire (MEQ), and sleep log books. Learning and memory assessment was performed using Raven's progressive matrices test. Grade point average (GPA) was used to assess their academic performance. The relationship of sleep scores with GPA and RPM scores were obtained by linear regression analysis. One-way analysis of variance (ANOVA) and unpaired t-test were used to investigate other comparisons among categories of chronotypes and those of mean GPA. A p-value of <0.05 was considered as significant. Results The mean GPA and RPM scores obtained in the groups with PSQI ≥ 5 (2.67± 1.1, 49.51 ±6.24, respectively) and PSQI < 5 (3.15± 0.59, 54.73± 4.01, respectively) and those in the group with ESS ≥ 10 (2.72± 1.17, 50.97± 5.92, respectively) and ESS < 10 (3.15 ± 0.6, 54.18± 3.91, respectively)varied with statistically significant differences (p < 0.05). Statistically significant R-squared values for the relationship of PSQI and ESS scores with RPM and GPA scores were obtained. No correlation between academic grades and chronotype was found. Poor GPA scores were found to be associated with reduced mean sleep duration for one week before the exams. Conclusion Learning and academic performance are negatively impacted by poor sleep quality and daytime sleep dysfunction. No definite evidence for the association of sleep chronotypes with the learning and memory could be attained. Higher test performance is more closely linked to the average sleep length over a duration of time preceding the exams.

The Relationship Among Seasonality, Night Eating, and Chronotype in Bipolar Disorder: Exploring the Mediating Role of Sleep Quality.

The purpose of the study was to explore the association among chronotype, seasonality, sleep quality, and night eating syndrome (NES) among patients with bipolar disorder (BD) and the mediating role of sleep quality in this relationship. Ninety-two individuals with BD type 1 who had been euthymic for at least 8 weeks and 87 healthy controls were included. In addition to sociodemographic/clinical data, chronotype, seasonality, sleep quality, and NES were evaluated using the Morningness-Eveningness Questionnaire (MEQ), Seasonal Pattern Assessment Questionnaire, Pittsburgh Sleep Quality Index, and Night Eating Questionnaire. The prevalence of NES (17.4%) was higher among BD than the controls. BD patients with NES had poorer sleep quality, greater seasonality, and lower MEQ scores. Chronotype had an indirect effect that was partially mediated by sleep quality on night eating symptoms in BD patients, in addition to a direct effect. Seasonality was found to have a direct effect on night eating symptoms. Therapeutic interventions that target both sleep and circadian disruption should be implemented when addressing NES in patients with BD.

Multimodal assessment of circadian sleep health in predicting mental health outcomes in adolescents

IntroductionAspects of circadian sleep health including circadian alignment, circadian phase, or chronotype may be related to mental health outcomes in adolescents. Using novel and robust data collection methods, this study explored the relationship between adolescents' circadian sleep health and traits related to depression, anxiety, stress, and emotional regulation.MethodsFifty-two healthy 14–18-year-olds (58% female; 94% European American) participated in this study. Across a 10-day period, participants completed wrist-worn actigraphy. Next, participants completed a dim-light melatonin onset (DLMO) protocol where 12 saliva samples were collected over a 6-h period to measure circadian phase. Circadian phase was calculated as the duration of time between DMLO to average sleep onset time across the monitoring period. Social jetlag was measured as the discrepancy between sleep times from weekday to weekend. Participants completed the Depression Anxiety Stress Scales (DASS-21), Emotion Regulation Questionnaire (ERQ), and the Morningness-Eveningness Questionnaire for Adolescents (MEQ). Following dichotomizing sleep outcomes into clinically relevant groups (late vs. early circadian phase, aligned vs. misaligned circadian rhythms, minimal social jetlag vs. presence of social jetlag, intermediate to morningness vs. eveningness chronotype), we conducted general linear models to determine circadian group differences in mental health outcomes (depression, anxiety, stress, expressive suppression, and cognitive reappraisal) while controlling for gender and pubertal development.ResultsCircadian phase had a large effect on depression symptoms in adolescents, with adolescents with later DLMO having significantly higher depression scores than those with earlier DLMO (p = 0.031). Chronotype had a medium but non-significant effect on anxiety and stress symptoms in adolescents, with adolescents with eveningness-tendencies having higher anxiety and stress symptoms than those with intermediate to morningness-tendencies (p's = 0.140 and 0.111, respectively).ConclusionsIn the first ever study using gold-standard methodologies to examine the relationship between mental health and circadian sleep health in healthy adolescents, we observed that adolescents with later circadian phase had increased depressive symptoms compared to earlier circadian phase. Furthermore, adolescents who endorsed behaviors that suggest eveningness tendencies may have heightened stress/anxiety. These conclusions encourage future experimental research regarding this topic and may help inform interventions aimed to decrease depression, anxiety, and stress in adolescents.