Reduced Morningness-Eveningness Questionnaire Research Articles

Comparison of chronotype and learning motivation in medical university students

BackgroundPeople differ in their preferred time for intellectual activities. Morningness-eveningness preferences describe the preferred time for performing daily activities and are determined by chronotype. Chronotype reflects circadian preference in humans and is divided into morning, intermediate, and evening types. Learning motivation is a key predictor of student success and may influence learning and study, academic performance, intention to continue medical research, and well-being. Helping students develop learning motivation may improve their educational achievement and health. There are opposing studies regarding chronotype and academic achievement. We hypothesized that chronotype affects the learning motivation of medical school students.MethodsWe used the reduced Morningness-Eveningness Questionnaire (rMEQ), and the Motivated Strategies for Learning Questionnaire (MSLQ) for Russian, Polish, Japanese, and Australian students in the first and second years of medical university. A total of 540 medical students answered the questionnaires. The MSLQ contains six subscales: intrinsic goal orientation, extrinsic goal orientation, self-efficacy for learning and performance, control of learning beliefs, task value, and test anxiety.ResultsThe rMEQ was used to classify the students into three types, which were morning (26.7%), intermediate (60.5%), or evening chronotypes (12.7%) based on their scores. The learning motivation scores for the intrinsic and extrinsic goal orientations, task value, and self-efficacy were lower in evening chronotypes.ConclusionsOur findings suggest that the evening chronotype had a lower learning motivation than the morning chronotype. Evening-oriented students may need a more flexible schedule, and a shift of the most important courses in the university to the afternoon may help them to attain higher motivation for learning medicine.

Validation of the English-language version of the Morningness-Eveningness-Stability-Scale-improved (MESSi), and comparison with a measure of sleep inertia

ABSTRACT The Morningness-Eveningness-Stability-Scale-improved (MESSi) assesses three components of circadian functioning: Morning Affect (time to fully awaken), Eveningness (orientation/preference for evening activity), and Distinctness (amplitude of diurnal variations in functioning). Following the original German version, translations of the MESSi (including Spanish, Turkish, and Chinese) have been validated, but validity evidence for the English-language version has been lacking. The current study tested the factor structure, internal consistency, and predicted correlations of the English-language MESSi. A sample of 600 adults from an online recruitment platform (aged 18–78, mean = 41.31, SD = 13.149) completed an online survey including the MESSi, reduced Morningness-Eveningness Questionnaire (rMEQ), Sleep Inertia Questionnaire (SIQ), and measures of personality and depressive symptoms. Exploratory factor analysis exactly reproduced the three-component structure of Morning Affect (MA), Eveningness, and Distinctness, with all items loading strongly on their respective component. Confirmatory factor analysis of this structure showed acceptable fit. The three subscales showed good internal consistency and replicated previously reported correlations with depressive symptoms, sleep inertia, sleep quality, and personality. Further factor analysis combining the items of the MESSi, rMEQ, and SIQ replicated a previously found seven-factor structure: Cognitive, Emotional, and Physiological sleep inertia (SI), Responses to SI (including one MA item); Duration of SI (one SIQ item, 3/5 MA items); Morningness-Eveningness (MESSi Eveningness items, plus 3/5 rMEQ items); Distinctness (5/5 MESSi items). In conclusion, the English-language MESSi shows sound psychometric properties, but Morning Affect may be more suitably characterised as a measure of sleep inertia duration, rather than morningness preference.

Moderating effects of PER3 gene DNA methylation on the association between problematic mobile phone use and chronotype among Chinese young adults: Focus on gender differences.

To investigate the rates of problematic mobile phone use (PMPU) and chronotypes in young adults, and examine the associations of PMPU with chronotypes, as well as its gender differences. Furthermore, we explored the moderating role of PER3 gene DNA methylation on the associations. From April to May 2019, a total of 1,179 young adults were selected from 2 universities in Anhui and Jiangxi provinces. The Self-rating Questionnaire for Adolescent Problematic Mobile PhoneUse (SQAPMPU) and reduced Morningness-Eveningness Questionnaire (rMEQ) were adopted to investigate PMPU and chronotypes in young adults, respectively. Moreover, 744 blood samples werecollected to measure PER3 gene DNA methylation. Multivariate logistic regression models were established to analyze the associations between PMPU and chronotypes. Moderating analysis was usedto determine whether PER3 gene DNA methylation moderated the relationships between PMPUand chronotypes. The prevalence of PMPU, morning chronotypes (M-types), neutral chronotypes (N-types), and evening chronotypes (E-types) of young adults were 24.6%, 18.4%, 71.1%, and 10.5%, respectively. Multivariate logistic regression results indicated that PMPU was positively correlated with E-types (OR = 3.53, 95%CI: 2.08-6.00), and the association was observed only in females after stratified by gender (OR = 5.36, 95%CI: 2.70-10.67). Furthermore, PER3 gene DNA methylation has a negative moderating role between PMPU and chronotypes and has a sex-based difference. This study can provide valuable information for the prevention and control ofcircadian rhythm disturbance among young adults from the perspective of epidemiology and biological etiology.

Psychometric properties of the Turkish reduced morningness and eveningness questionnaire

ABSTRACT The aim of this study was to examine the psychometric properties of the 5-item Turkish Reduced Morningness-Eveningness Questionnaire (rMEQ) for the first time. The study involved 875 university students in an adaptation and validation study. Participants completed the rMEQ, MEQ, Depression Anxiety Stress Scale-21 (DASS-21), Insomnia Severity Index (ISI), Barratt Impulsiveness Scale Short Form (BIS-SF), and Oxford Happiness Questionnaire Short Form (OHQ-SF). The factor structure, convergent validity, internal consistency, sensitivity, and specificity of the rMEQ were examined. The confirmatory factor analysis showed that the rMEQ had a one-dimensional structure with good fit indices (χ2/df = 2.94, CFI = 0.990, TLI = 0.979, RMSEA = 0.047, and SRMR = 0.019). There was a significantly strong correlation between rMEQ and MEQ. In addition, we found a significantly weak correlation between rMEQ and DASS-21, ISI, BIS-SF, and OHQ-SF. The internal consistency coefficients of rMEQ were Cronbach’s α = 0.706 and McDonald’s ω = 0.740. The sensitivity and specificity of rMEQ were 83.3%–92.7% for morning types and 86.3%–87.3% for evening types. The Turkish rMEQ has adequate psychometric properties and can be used to assess an individual’s chronotype.

The Japanese version of the reduced morningness-eveningness questionnaire

ABSTRACT Circadian typology, or “morningness” and “eveningness,” is generally assessed using the Morningness-Eveningness Questionnaire (MEQ), a 19-item scale that could be burdensome in large-scale surveys. To overcome this, a 5-item version known as the reduced morningness-eveningness questionnaire (rMEQ), which is sensitive to the assessment of circadian typology, was developed; however, a validated Japanese version of the rMEQ is yet to be established. This study aimed to develop and validate the Japanese version of the rMEQ. Five essential items for the rMEQ were selected from existing Japanese MEQ data (N = 2,213), and the rMEQ was compiled. We conducted a confirmatory factor analysis for the psychometric properties of the rMEQ and confirmed its robust one-factor structure for evaluating morningness-eveningness (GFI = 0.984, AGFI = 0.951, CFI = 0.935, and RMSEA = 0.091). Reliability was evaluated via internal consistency of rMEQ items using Cronbach’s α and McDonald’s ω, and the values were 0.618 and 0.654, respectively. The rMEQ scores strongly correlated with MEQ (ρ = 0.883, p < 0.001), and classification agreement (Morning, Neither, and Evening types) between rMEQ and MEQ was 77.6% (Cramer’s V = 0.643, Weighted Cohen’s κ = 0.72), confirming the validity. The Japanese rMEQ may be a valuable tool for the efficient assessment of circadian typologies.

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.

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.

Sex Differences in the Relationship between Chronotype and Eating Behaviour: A Focus on Binge Eating and Food Addiction.

Men are more likely than women to have subthreshold overeating disorders. Lifestyle plays a role as a determinant, while chronotype is an emerging factor. Chronotype explains the natural preferences of wakefulness and activity throughout the day: evening chronotypes (E-Types), those most productive in the evening, have been linked with unhealthy dietary patterns and a higher propensity to substance addiction than morning types (M-Types). We carried out a cross-sectional study on 750 overweight or obese adults (70% females, 48 ± 10 years, BMI 31.7 ± 5.8 kg/m2). The Binge-Eating Scale, the Yale Food Addiction Scale 2.0 (YFAS 2.0), the reduced Morningness-Eveningness Questionnaire (rMEQ), and the MEDAS questionnaire were used to assess binge eating, food addiction, chronotype, and adherence to the Mediterranean diet, respectively. No differences in BES binge-eating and FA food-addiction scores occurred between chronotypes, but we found significant interactions between sex × rMEQ score. While women showed the same prevalence for binge eating and food addiction across all chronotypes, binge eating and food addiction risk increased with reducing rMEQ score in men, indicating that being male and E-Type increases the risk association of binge eating and/or food addiction prevalence. chronotype is associated with binge eating and food addiction in men, emphasizing the link between chronobiology and sex differences as determinants in appetite and eating behaviour dysregulation and in overweight and obesity.

P051 Associations between Chronotype and Symptoms of Depression in Patients attending an Outpatient Sleep Clinic

Abstract Introduction Chronotype (or morningness-eveningness), individuals’ time-of-the-day preference for activity, has been associated with depressive symptoms. This cross-sectional study examined the association between chronotype and symptoms of depression in outpatients attending a sleep disorders clinic. Method The sample included individuals attending an outpatient sleep disorders clinic and provided opt-out consent for their data to be used for research purposes. Individuals included in the analyses provided demographic data, their typical weekly total sleep time (TST), and complete responses prior to treatment on the reduced Morningness-Eveningness Questionnaire (rMEQ; for chronotype), and the PROMIS depression scale. Results A total of 1641 (44.5% female, Mage = 45.20 years, SDage = 16.06 years) participants were included. On average, the sample scored intermediate chronotype (M = 14.73, SD = 4.35) and higher depressive symptom scores that were half a standard deviation higher compared to community norms (M = 55.80, SD = 10.01). Multiple linear regression controlling for age, sex, and TST showed that greater eveningness preferences predicted higher symptoms of depression, p&amp;lt;0.01, explaining 2.76% additional variance in depression scores above that of the covariates. Discussion Overall, sleep clinic outpatients had an intermediate chronotype and above average depressive symptoms. The findings are consistent with existing literature in other populations indicating that eveningness may be a risk factor for greater symptoms of depression. Future studies need to explore whether interventions to alter chronotype may benefit symptoms of depression in individuals with sleep complaints.

Bipolar disorder and delayed sleep-wake phase disorder: Findings on sustained attention, sleep, and circadian rhythm parameters

BackgroundSleep and circadian rhythm disruptions can contribute to cognitive disturbances in bipolar disorder (BD); however, the profile of specific sleep/circadian phenotypes remains to be elucidated. The aim of our work is to compare sleep/circadian parameters and sustained attention between patients with BD and comorbid delayed sleep-wake phase disorder (BD-DSWPD), patients with BD without DSWPD comorbidity (BD-Control), and healthy controls (HC). MethodsBD patients (N = 70, BD-DWSPD N = 25, BD-Control N = 45) and HC (N = 86) were evaluated through actigraphy for sleep and circadian rhythm parameters, the Pittsburgh Sleep Quality Index for sleep quality, the reduced Morningness-Eveningness Questionnaire for chronotype and the Psychomotor Vigilance Task for sustained attention. ResultsThe BD-DSWPD diagnosis was associated with poorer self-reported sleep quality, lower sleep efficiency, higher wake after sleep onset, and later acrophase compared to both HC and BD-Control groups. BD-DSWPD was also associated with lower relative amplitude compared to HC. Regarding sustained attention variables, the diagnosis of BD-DSWPD was associated with increased response times compared to HC, while both BD-DSWPD and BD-Control were associated with major lapses than HC. LimitationsSample size and multivariate statistics not adjusted for pharmacological treatment. ConclusionsPatients with BD-DSWPD showed greater disturbances in sleep and circadian rhythm parameters compared to both HC and BD-Controls; moreover, BD-DSWPD showed increased response times compared to HC. Further studies are required to evaluate whether treatments focused on advancing the sleep phase may contribute to improving cognition, sleep, and circadian rhythmicity in patients with BD and comorbid DSWPD.

Effects of exogenous melatonin on sleep and circadian rhythm parameters in bipolar disorder with comorbid delayed sleep-wake phase disorder: An actigraphic study

The present study evaluates the effect of exogenous melatonin (exo-MEL) on sleep and circadian parameters in patients with bipolar disorder (BD) and delayed sleep-wake phase disorder (DSWPD). BD euthymic patients (n = 83, mean age = 45.13 ± 13.68, males 56%) were evaluated for chronotype (reduced Morningness-Eveningness Questionnaire [rMEQ]), sleep quality (Pittsburgh Sleep Quality Index), sleep and circadian parameters (actigraphic monitoring). Patients that fulfilled criteria for DSWPD (n = 25) were treated for three months with exo-MEL 2 mg administered approximately 4 h before the sleep onset time (SOT) actigraphically-determined at baseline. Sleep and circadian parameters at baseline (T0) and after the exo-MEL treatment (T1) were compared using paired Wilcoxon test. In patients that completed the treatment (n = 19), the rMEQ score increased between T0 (median = 8.0 [IQR = 7.0, 11.0]) and T1 (median = 13.5 [IQR = 9.3, 15.0], p-value = 0.006), the SOT was advanced between T0 (median = 00:55 [IQR = 00:25, 01:39] and T1 (median = 00:09 [IQR = 23:41, 01:04], p-value = 0.039), the sleep efficiency and total sleep time increased (T0: median = 84.4 [IQR = 81.3, 89.4]; T1 (median = 90.3 [IQR = 85.5, 92.9] %, p-value = 0.01, and T0: median = 7.20 [IQR = 6.15, 8.15]; T1: median = 7.7 [IQR = 7.0, 9.3] hours, p-value = 0.04, respectively). These results indicate that in BD with comorbid DSWPD, the self-reported chronotype, the sleep onset time, and sleep efficiency and duration were modified after a personalized treatment with exo-MEL, suggesting its potential efficacy in improving sleep patterns in BD. The absence of proper control groups and of treatment randomization constitute limitations of our study and further randomized controlled trials are required to confirm our results.

616-P: Glucose Metabolism—Does Chronotype Matter?

Glucose and insulin follow circadian-mediated metabolic profiles. Accumulating evidence has demonstrated significant associations between circadian disruption-related lifestyles and an increased risk of type 2 diabetes typical of Evening-types (E-types), more active in the last part of the day, compared to Morning-types (M-types). However, few studies have examined the contribution of chronotype to abnormalities of glucose profile considering both lifestyle factors and body composition. We conducted a cross-sectional study on 575 adults (71% females, 48.5±12.8 years, BMI 29.3±6.0 kg/m2) with no endocrine diseases and no consumption of medications affecting endocrine function. Chronotype was assessed through the reduced Morningness-Eveningness Questionnaire (rMEQ), glycemia, insulinemia and HbA1c plasma levels HOMA-IR were estimated. Anthropometric parameters were collected and abdominal fat distribution was measured by ultrasonography. Smoking and physical activity habits were collected by a medical history and adherence to Mediterranean diet was assessed by MEDAS questionnaire. Logistic regression models were used to investigate the association between glycemia, insulinemia and chronotype. Sex, age, BMI, total body fat, visceral and subcutaneous fat, physical activity, smoking habits and MEDAS were included in all models. Insulin levels were significantly higher in the E-Types compared to M-Types. We did not find a significant interaction between chronotype, glycemia and HbA1c, however insulin and HOMA-IR decreased with increasing rMEQ score and morningness, indicating that E-Types have +5,6 and +1,4 points of insulinemia and HOMA-IR, respectively, compared to M-Types (β=−0.28 [−0.5; −0.1], p=0.003; β=−0.07 [−0,12; −0,02], p=0.005). Chronotype is independently associated with abnormalities in insulin profile, pointing to the importance of understanding the mechanisms underlying the impact of circadian disruption on glucose metabolism, which may contribute to improved glycemic control. Disclosure R.De amicis: None. A.Battezzati: None. A.Foppiani: None. A.Leone: None. L.Galasso: None. A.Montaruli: None. E.Roveda: None. L.Castelli: None. F.Esposito: None. S.Bertoli: None. Funding Italian National Recovery and Resilience Plan Mission 4 Component 2 Investment 1.3 - Call for Proposals (341) of 15 March 2022 of Italian Ministry of University and Research funded by the European Union - NextGenerationEU (PE00000003) Concession Decree (1550) of 11 October 2022 adopted by the Italian Ministry of University and Research (CUP D93C22000890001)

0647 Rest-activity pattern in Major depressive disorder - a case control study

Abstract Introduction Disruption of rest-activity pattern are important behavioral manifestations in patients with major depressive disorder (MDD). Actigraphy provides accessible and objective measurement on physical activity, sleep, and circadian rhythm, but it was not widely used in studying patients with MDD, especially among Asian population. Methods Rest-activity pattern was recorded by Actiwatch Spectrum Plus/PRO for 7 continuous days. Physical activity and sleep estimation was processed by Philips Actiware software 6. Circadian rhythm characteristics were generated by using the “cosinor” and “nparACT” packages in R to perform the cosinor and nonparametric analysis respectively. Results A total of 70 MDD subjects, and 59 age- and sex-comparable controls were included in the actigraphy data analysis. The mean age of MDD subjects was 51.24 ± 10.39 years, and 71.4% of MDD subjects were female. Of these MDD subjects, 54.3% were unremitted for their depressive illness. For sleep and circadian features, MDD subjects had higher Insomnia Severity Index (ISI score, MDD: 10.29 ± 5.70; controls: 6.05 ± 5.20, P &amp;lt; 0.001) and lower reduced Morningness-Eveningness questionnaire (rMEQ score, MDD: 13.19 ± 4.62; controls: 16.07 ± 3.28, P &amp;lt; 0.001) than controls. The percentage of mobility measured by actigraphy was significantly lower in MDD patients than controls (MDD: 58.58%; controls: 62.27%, P &amp;lt; 0.001), albeit the difference only occurred during rest period. MDD subjects had later acrophase (P = 0.024), M10 midpoint (P = 0.040) and a trend of delayed sleep midpoint (P = 0.076) and longer sleep duration (P = 0.067) than controls. When the comparison was performed among three groups, unremitted MDD subjects showed a higher intra-individual variability of sleep midpoint than remitted MDD group (P = 0.021) and higher intra-individual variability for sleep duration than controls (P = 0.016). Conclusion MDD subjects had increased insomnia and eveningness than controls, which was supported by the acitgraphy data at which MDD had a tendency of longer major rest interval and delayed circadian phase. Unremitted MDD subjects showed a higher intra-individual variability of sleep midpoint and sleep duration. These actigraphy parameters may be useful markers for phenotyping and monitoring of MDD. Support (if any)

External validity of the reduced Morningness-Eveningness Questionnaire for Children and Adolescents: an actigraphic study.

The aim of this study was to examine the external validity of the reduced Morningness-Eveningness Questionnaires for Children and Adolescents, using circadian motor activity, assessed through actigraphy, as an external criterion. Overall, 458 participants (269 females), with a mean (standard deviation) age of 15.75 (1.16) years, took part in this study. Each adolescent was requested to wear the actigraph Micro Motionlogger Watch actigraph (Ambulatory Monitoring, Inc., Ardlsey, NY, USA) around the non-dominant wrist for 1 week. At the end of the actigraphic recording, participants completed the reduced Morningness-Eveningness Questionnaires for Children and Adolescents. We extracted the motor activity counts, minute-by-minute over the 24 h, to depict the 24-h motor activity pattern, and we adopted the statistical framework of functional linear modelling to examine its changes according to chronotype. According to the reduced Morningness-Eveningness Questionnaires for Children and Adolescents cut-off scores, 13.97% of participants (n = 64) belonged to the evening-types category, 9.39% (n = 43) to morning-types, while the remaining (76.64%, n = 351) to the intermediate-types category. Evening types moved significantly more than the intermediate and morning types from around 10:00 p.m. to 2:00 a.m., while the opposite pattern of results was observed around 4:00 a.m. The results highlighted a significant difference in the 24-h motor activity pattern between chronotypes, in line with the expectations based on their well-known behaviour. Therefore, this study shows that the external validity of the reduced Morningness-Eveningness Questionnaire for Children and Adolescents, established by considering motor activity (recorded through actigraphy) as an external criterion, is satisfactory.

Validation of the Munich Chronotype Questionnaire (MCTQ) in Chinese college freshmen based on questionnaires and actigraphy

ABSTRACT The Munich Chronotype Questionnaire (MCTQ) was developed to determine an individual’s chronotype, and it provides information about sleep and wake times separately for work and free days. However, the MCTQ has not been effectively verified using a large sample based on multiple questionnaires and actigraphy measures. Three sequential studies were conducted. Study 1 used a large sample (n = 1066) to investigate the chronotype of Chinese college freshmen and assess the validity of the MCTQ compared with the reduced Morningness-Eveningness Questionnaire (rMEQ), actigraphy, and other related questionnaires. Study 2 verified the MCTQ compared with a sleep diary. Study 3 examined the test-retest reliability of the MCTQ at the 2-year follow-up. The results showed that MCTQ parameters were significantly associated with rMEQ scores, the actigraphy-based mid-point of sleep, sleep quality, depression, and trait anxiety. In addition, all MCTQ variables were significantly related to the diary-based sleep mid-point. The test-retest reliability of the mid-point of sleep adjusted for sleep debt (MSFsc) and mid-point of sleep on free days (MSF) was acceptable. These results indicate that the MCTQ is a practical and efficient tool with good reliability. Its further development is important for the accurate assessment of chronotypes and clinical diagnoses of sleep.

Morning affect or sleep inertia? Comparing the constructs and their measurement

ABSTRACT The construct of Morning Affect (MA; alertness upon awakening/time required to feel fully awake) emerged from exploratory factor analysis of morningness-eveningness questionnaires, and while it has been equated with morningness-eveningness preference it has much conceptual overlap with sleep inertia (SI; the transitional state between sleep and being fully awake). The current study compared questionnaire measures of these constructs to help clarify their inter-relationships. A volunteer sample of 453 students at an English-medium university in China completed an online survey including the Sleep Inertia Questionnaire (SIQ), the Morningness-Eveningness-Stability-Scale-improved (MESSi), with subscales for MA, Eveningness, and Distinctness (amplitude of diurnal variation), and the reduced Morningness-Eveningness Questionnaire (rMEQ). Measures of depression, sleep quality, mindfulness, and personality were also included. Exploratory factor analysis of the SIQ, MESSi, and rMEQ items revealed seven factors: Cognitive, Emotional, and Physiological SI, Responses to SI (including one MA item), and Duration of SI (one SIQ item, 3/5 MA items, and one rMEQ item); Morningness-Eveningness (MESSi Eveningness items, plus 3/5 rMEQ items); Distinctness (3/5 MESSi items). These results suggest that Morning Affect may be better characterised as a general measure of sleep inertia, and may contribute to ongoing development/refinement of questionnaire measures of circadian functioning.

Chronotype is differentially associated with lifetime mood and panic-agoraphobic spectrum symptoms in patients with bipolar disorder and healthy controls.

Although the association between chronotype and mood disorders has been consistently reported, conversely, attempts to measure the association between chronotype and anxiety symptoms have generated inconsistent results. We aimed at evaluating whether chronotype (assessed through subjective and objective measures) is associated with lifetime mood and panic-agoraphobic spectrum symptoms in healthy controls (HCs) and in patients with bipolar disorder (BD). Overall, 173 subjects, patients with BD in euthymic phase (n =76) and HC (n =97), were evaluated through the reduced Morningness-Eveningness Questionnaire (rMEQ), actigraphy monitoring and mood and panic-agoraphobic spectrum self-report (MOODS-SR and PAS-SR). The discrepancy between objective (actigraphic-based) versus subjective (rMEQ-based) circadian typology was estimated through the Circadian Classification Discrepancy Index (CCDI). rMEQ-based evening chronotype (ET) was associated with higher scores in MOODS-SR depressive and rhythmicity and vegetative functions domains in HC and BD.Both ET and morning chronotypes (MT) were associated with higher PAS-SR scores in BD only. Actigraphic-based MT was associated with higher MOODS-SR depressive scores in HC. Likewise, the discrepancy between actigraphic-based and rMEQ-based circadian typology was associated with depressive symptoms in HC only. Self-reported ET was consistently associated with mood symptoms, while associations with panic-agoraphobic symptoms only emerged in BD and involved both extreme chronotypes. The discrepancy between the preferred circadian typology (rMEQ-based) and the actual one (actigraphic-based) could contribute to depressive symptoms in HC. These results pave the way for interventional studies targeting circadian typology in an attempt to prevent or treat mental health disorders.

Validity of the Persian version of the Munich ChronoType Questionnaire (MCTQIR).

Currently, the most useful questionnaire for determining the chronotype is the Munich ChronoType Questionnaire (MCTQ). It determines chronotype based on sleep-wake behavior on workdays and work-free days and uses the mid-sleep time on free days (MSF), corrected for accumulated sleep debt over the work week to classify chronotype (MSFsc). Our study aimed at validating Persian version of the MCTQ. Participants completed the Persian version of the MCTQ, reduced Morningness-Eveningness Questionnaire (rMEQ), Epworth sleepiness scale (ESS), and demographic characteristics. Thestudy sample was comprised of 250 Iranian men and women (mean age 34 years, age range 30 to 58 years, 113 men). Results showed that there is a significant negative relationship between the components of MCTQ and rMEQ, and the strongest relationship related to the MSF index. The results alsoshowed that MCTQ parameters were not significantly related to the ESS scale. Cut-off values of MSFsc for chronotype categories were determined by inter-quartile range (Q25% = 3.44, Q50% = 4.68, and Q75% = 5.75). Like the MCTQ in other languages, the Persian version of the MCTQ is a reliable tool for assessing chronotype.

Exploratory Study on the Associations between Lifetime Post-Traumatic Stress Spectrum, Sleep, and Circadian Rhythm Parameters in Patients with Bipolar Disorder.

The present study aimed at exploring whether lifetime post-traumatic stress spectrum symptoms are associated with chronotype in patients with bipolar disorder (BD). Moreover, we explored whether the chronotype can moderate the potential associations between lifetime post-traumatic stress spectrum symptoms and rest-activity circadian and sleep-related parameters. A total of 74 BD patients were administered the Trauma and Loss Spectrum Self-Report (TALS-SR) lifetime version for lifetime post-traumatic stress spectrum symptoms, the Pittsburgh Sleep Quality Index (PSQI) for self-reported sleep quality, and the Reduced Morningness-Eveningness Questionnaire (rMEQ) to discriminate evening chronotypes (ETs), neither chronotype (NT), and morning chronotype (MT). Actigraphic monitoring was used to objectively evaluate sleep and circadian parameters. Patients classified as ET reported significantly higher scores in the re-experiencing domain, as well as poorer sleep quality, lower sleep efficiency, increased wake after sleep onset, and delayed mid-sleep point compared with both NT and MT (p-value ≤ 0.05). Moreover, ET presented significantly higher scores in the TALS-SR maladaptive coping domain than NT and lower relative amplitude than MT (p-value ≤ 0.05). Moreover, higher TALS-SR total symptomatic domains scores were significantly correlated with poor self-reported sleep quality. Regression analyses showed that the PSQI score maintained the association with the TALS total symptomatic domains scores after adjusting for potentially confounding factors (age and sex) and that no interaction effect was observed between the chronotype and the PSQI. Conclusions: This exploratory study suggests that patients with BD classified as ET showed significantly higher lifetime post-traumatic stress spectrum symptoms and more disrupted sleep and circadian rhythmicity with respect to other chronotypes. Moreover, poorer self-reported sleep quality was significantly associated with lifetime post-traumatic stress spectrum symptoms. Further studies are required to confirm our results and to evaluate whether targeting sleep disturbances and eveningness can mitigate post-traumatic stress symptoms in BD.

Habitual Videogame Playing Does Not Compromise Subjective Sleep Quality and Is Associated with Improved Daytime Functioning.

Research on the effects of videogames (VGs) on health has produced mixed results. Here, we assess the relationships of VG playing with sleep; chronotype; sleepiness; and levels of depression, anxiety, and stress; and how they are modulated by the level of exposure to VGs. Four hundred-and two adult participants (age = 26.2 ± 7.84; 227 F) completed an online survey including questions on VG use and a set of standardized questionnaires. The sample was divided into three groups: habitual gamers (HGs, 42.2%), nonhabitual gamers (NHGs, 36.5%), and non-gamers (NGs, 21.3%). No between-group differences emerged in sleepiness (Epworth Sleepiness Scale) or Pittsburgh Sleep Quality Index measures except the sleep disturbances subscore, which was higher in NHGs. HGs showed delayed bed- and risetimes and higher eveningness (reduced Morningness-Eveningness Questionnaire). HGs and NHGs showed higher depression subscores (Depression Anxiety Stress Scale) but remained in the subclinical range. Moreover, hours/week of VG playing predicted delayed sleep timing, lower daytime dysfunction, and lower sleepiness. Our data suggest that VG playing does not necessarily compromise sleep quality and may even benefit daytime functioning, underlining the need to reconsider the relationships between VG use and health by taking into account possible modulating factors such as habitual VG exposure.