Sleep-Wake Pattern Assessment Questionnaire Research Articles

Chronobiological variables predict non-response to serotonin and noradrenaline reuptake inhibitors in fibromyalgia: a cross-sectional study

Available data shows associations between chronotype, circadian rhythms, sleep quality and fibromyalgia (FM) presentation. However, no studies have explored links between the chronobiological variables and effectiveness of pharmacotherapy. We aimed to assess the chronotypes, circadian rhythms, sleep-wake cycle and sleep quality in FM and their links to treatment response to serotonin and noradrenalin reuptake inhibitors (SNRI). 60 FM patients: 30 responsive to SNRI (FM T[+]), 30 non-responsive to SNRI (FM T[-]) and 30 healthy controls participated. Subjects were assessed by physician and with questionnaire tools: Composite Scale of Morningness, Biological Rhythms Interview of Assessment in Neuropsychiatry, Sleep-Wake Pattern Assessment Questionnaire, Pittsburgh Sleep Quality Index and Fibromyalgia Impact Questionnaire. ANOVA analysis and simple logistic regressions were used to examine the relationships between chronological variables and response to SNRI. FM T[-] vs. FM T[+] presented lower morning affect (11.50[95%CI 9.96-13.04] vs. 14.00[95%CI 12.42-15.57];p=0.04), anytime wakeability (2.27[95%CI 1.4-3.13] vs. 4.03[95%CI 2.99-5.08];p=0.013) worse overall (11.40[95%CI 9.92-12.88] vs. 7.97[95%CI 6.75-9.19];p=0.002) and subjective (1.70[95%CI 1.30-2.01] vs. 1.17[95%CI 0.94-1.39];p=0.008) sleep quality, higher circadian rhythm disruptions (55.47[95%CI 52.32-58.62] vs. 44.97[95%CI 41.31-48.62];p<0.001), sleep disturbances (1.63[95%CI 1.38-1.68] vs. 1.30[95%CI 1.1-1.5];p=0.04), sleeping-medication use (1.80[95%CI 1.27-2.32] vs. 0.70[95%CI 0.28-1.12];p=0.003). Levels of morningness (AIC=82.91,OR=0.93,p=0.05), morning affect (AIC=81.901,OR=0.86,p=0.03) diurnal dysrhythmia (AIC=69.566,OR=1.14,p<0.001), anytime wakeability (AIC=80.307,OR=0.76,p=0.015), overall sleep quality (AIC=74.665, OR=1.31,p=0.002) subjective sleep quality (AIC=79.353, OR=2.832,p=0.01) and disturbances (AIC=82.669,OR=2.54,p=0.043), sleep medication use (AIC=77.017, OR=1.9,p=0.003) and daytime disfunction (AIC=82.908, OR=1.971,p=0.049) were predictors of non-response to SNRI. Chronobiological variables vary between FM T[+] and FM T[-] and are predictors of non-response to SNRI.

A six-factor structure of individual variation in the tendencies to become sleepy and to sleep at different times of the day

A multidimensional approach has been previously applied for modeling and assessment of individual differences in the ability to sleep or to stay awake at certain clock hours. More recently the 19 time-point Visuo-verbal Judgment Task (VJT) has been proposed to predict changes in sleepiness level from the morning hours to the next day afternoon. The dimensionality of the VJT has not been explored so far. We applied a structural model of individual variation in sleep-wake behavior and habits for explaining the pattern of relationship between the VJT's dimensions yielded by rotation of principal components with eigenvalue>1. The responses to 19 items of the VJT, 72 items of 6-scale Sleep Wake Pattern Assessment Questionnaire (SWPAQ) and 60 items of 6-scale Sleep-Wake Adaptability Test (SWAT) were collected from 1037 survey participants. Factor analyses yielded 4 factorial dimensions of morning (08:00–11:00), daytime (12:00–20:00), nighttime (21:00–04:00), and after 24 h sleepiness (06:00–12:00 next day). The model was found to be capable to explain the correlations among 4 constructs of the VJT as well as the correlations among previously developed scales of the SWPAQ and SWAT. The results confirmed the predictive power of the model and its applicability for multidimensional assessments in chronobiological and chronopsychological studies.

Chronobiological traits predict the restrained, uncontrolled, and emotional eating behaviors of female university students

ABSTRACT Although significant associations between diurnal preference and restrained eating behaviors were previously reported, such reports are scarce and, in some respects, inconclusive. In this cross-sectional survey of 567 female university students aged between 17 and 23 years, we tried to clarify and extend the previous findings on chronobiological correlates of these behaviors. We administered the three-Factor-Eating-Questionnaire Revised and three questionnaires designed to assess trait-, ability-, and state-like differences in the domain of chronobiology, the Morningness-Eveningness Questionnaire (MEQ), the Sleep-Wake Pattern Assessment Questionnaire, and the Munich ChronoType Questionnaire, respectively. Statistical analyses included factor, correlation, and regression analyses. We found that any of three aspects of unhealthy eating behaviors (i.e., lack of cognitive eating restraint, uncontrolled eating, and emotional eating) was linked to one or more dimensions of individual chronobiological differences. We explained the previously reported inconclusive results by the differential relationship of two subconstructs of diurnal preferences to eating behaviors. For instance, such relationship was found for two (morning and evening) subscales of the MEQ. Cognitive eating restraint and uncontrolled eating were related to the morning subscale, while emotional eating was related to the evening subscale. These associations were supported by the associations revealed for morning vs. evening components of earliness-lateness assessed with two other questionnaires, (e.g., morning lateness and sleep offset vs. evening lateness and sleep onset, respectively). We conclude that unhealthy eating behaviors seem to be linked to unhealthy sleep-wake habits and behaviors and to inabilities to wake or sleep on demand at certain times of the day.

Overlap between individual variation in personality traits and sleep-wake behavior

The efforts to link the individual differences in personality to the individual differences in sleep-wake behavior have a long history. One of the topics of such research might be to determine the strength of association between these two domains of individual variation. This requires the implementation of several inventories designed for integrative multidimensional assessments of a set of broad personality traits and a set of sleep-wake behavioral traits. Four independent samples were collected (in total, 759 individuals) for estimating general overlap between the domains of individual variation in personality psychology and chronobiology. Canonical correlation analyses provided the estimates of general overlap of six broad personality traits assessed with the 172-word RCIP (Rugby Cake Inventory of Personality) with six distinct sleep-wake adaptabilities assessed with the 72-item SWPAQ (Sleep-Wake Pattern Assessment Questionnaire) and the SWAT (Sleep-Wake Adaptability Test) in two, the 60- and 168-item, versions. It was demonstrated that general overlap between individual variation in two domains was significant and replicable albeit rather weak (6%–8%). Moreover, regression analyses of specific overlaps of each of six scales for assessing sleep-wake adaptability with a set of six scales for personality assessment suggested that a score on any of adaptability scales seemed to be a significant predictor of, at least, one of six scores on personality trait scales. Studies in other tongues are desired for the replication of the results indicating the statistically significant general and specific overlaps between personality traits and sleep-wake adaptabilities.

Association of Chronotype, Road Traffic Accidents, and Polymorphisms in Genes Linked with the Biological Clock and the Dopaminergic System

Objective. To study the association between single-nucleotide polymorphisms (SNP) of the RORA (rs1159814), CLOCK (rs12649507), PER3 (rs2640909), NPSR1 (rs324981), NPAS2 (rs4851377), DRD3 (rs6280), SLC6A3 (rs6347), and DBH (rs1611125) genes, chronotype parameters, and road traffic accident (RTA) driver statistics. Materials and methods. The study included 303 drivers of Moscow inter-city buses working rolling shifts. The study addressed associations between genotyping results for SNP and the Munich Chronotype Questionnaire (MCTQ) and the Shortened Sleep-Wake Pattern Assessment Questionnaire (SWPAQ), and official RTA statistics. Results and conclusions. The cohort was dominated by the mixed chronotype, with a tendency to go to bed late and able to get up early; there was a marked shift between sleep patterns between working days and rest days. The SNP of the PER3 gene showed an association with parameters of morning activity. The SNP of the CLOCK gene was associated with a change in the pattern and the risk of causing RTA, while the minor alleles of the NPSR1 and SLC6A3 genes were associated with a later chronotype and an increase in RTA risk. It is suggested that these polymorphism may be among the genetic factors linking the chronotype to the ability to work.

An hour in the morning is worth two in the evening: association of morning component of morningness–eveningness with single nucleotide polymorphisms in circadian clock genes

Sub-constructs of morning–evening preference might be differentially related to polymorphisms in circadian clock genes. We previously reported significant association between a single nucleotide polymorphism in PER3 (rs2640909) and Morning but not Evening Lateness scale of the Sleep–Wake Pattern Assessment Questionnaire. To further explore such a scale-specific relationship, seven single nucleotide polymorphisms in five circadian clock genes were studied using exploratory and confirmatory samples (in total, n = 698). The association of rs2640909 with Morning Lateness scale was not replicated in the confirmatory sample but remained significant in the merged sample. Moreover, we found and confirmed an association of this scale with rs1159814 in RORα. The results provided further evidence for differential relationship of polymorphisms in circadian clock genes with morning and evening components of morning–evening preference. We also suggested possibility to take into account the pattern of geographic variation in allele frequency for prioritization of circadian clock polymorphisms in candidate gene studies.

The Study of Internet Addiction in Relation to Sleep Pattern – “Morning Lateness” Among Youth

The Internet is a massive, computer-linked network system used globally. In spite of the widely perceived merits of the tool, the excessive use of Internet is a primary attention of researchers all over the world.. Now, the term Internet addiction has become a worldwide and problematic phenomenon. The purpose of the present study was to find out the relationship of internet addiction with “Morning lateness” subscale of SWAPQ . The study was conducted on the sample of 170 (non- internet addict (45), moderate addict (85) and severe addict (40)) college students of Madhya Pradesh (M.P.), age range between 18 to 23 years. Young Internet Addiction (IAT), Sleep Wake Pattern Assessment Questionnaire (SWAPQ) were used for this study. Descriptive statistics, One-way ANOVA and Post-Hoc mean comparison test were applied to determine the significant difference on “Morning lateness” subscale of SWAPQ between internet addicts and non internet addicts. The significant differences were found between them.

A Study of Biological Rhythm Disturbances in Polish Remitted Bipolar Patients using the BRIAN, CSM, and SWPAQ Scales

Background/Aims: The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) is a novel tool allowing for a complex assessment of biological rhythms. We compared patients with bipolar disorder (BD) and healthy control subjects (HC) using the Polish version of the BRIAN scale. Method: Fifty-four remitted BD patients (17 males and 37 females aged 52 ± 13 years) and 54 healthy control subjects (25 males and 29 females aged 42 ± 14 years) were studied. In addition to the BRIAN scale, the Composite Scale of Morningness (CSM) and the Sleep-Wake Pattern Assessment Questionnaire (SWPAQ) were employed. Results: The Polish version of the BRIAN scale displayed high feasibility and consistency, showing that the patients had greater biological rhythm disturbances than the controls. After regression analysis, significant differences were obtained for the BRIAN subscales activity and predominant chronotype, and for the SWPAQ items quality of night-time sleep and ability to stay awake. We obtained positive correlations between higher BRIAN scores and morningness and eveningness, but the correlations with vigilance and the ability to stay awake (on the SWPAQ) were negative. Conclusions: Using the BRIAN scale, we confirmed the greater disturbances of biological rhythm in Polish remitted bipolar patients, compared with healthy controls. The differences between these 2 groups in sleep-awake patterns were also demonstrated by the SWPAQ scores. In contrast to other studies, we were unable to confirm an evening chronotype as a discriminating factor between remitted bipolar patients and healthy subjects. This can be explained by the older age and the use of lithium by a significant proportion of the patients.

Validation of Nighttime Sleepability Scale Against Objective and Subjective Measures of Sleep Quality

Quick self-assessment of night sleep quality with reliable and valid instruments is often required in various fundamental and applied studies in the field of sleep medicine and chronomedicine. Individual differences in sleep quality are usually assessed with a special scale, whereas such a scale is absent in most of questionnaires for evaluation of individual differences in the domain of chronobiology. One of two exceptions is the 6-scale Sleep-Wake Pattern Assessment Questionnaire. It contains the 12-item scale S designed to self-assess nighttime sleepability. The purpose of the present report was to examine external validity of this scale by searching for correlates and predictors of S score. One hundred and sixty participants of sleep deprivation experiments self-reported their sleep latency, total sleep duration, nap frequency, and times for going to bed and awakening for one week prior to the experiment. Their objective and subjective sleepiness after sleepless night was measures in the course of experiment. Moreover, sleep latency and total sleep duration were measured by means of polysomnography in studies with 35 female participants. Other objective measurements included percentages of sleep stages, awakenings after sleep onset, and sleep efficiency. Additionally, sleep latencies were detected during 9 day- and nighttime 20-min napping attempts of 15 from 35 participants. It was found that significant correlates and predictors of S score include subjective and objective measures of sleep latency, percentage of slow wave sleep, subjectively and objectively assessed sleepiness, and self-reported total sleep time. These results provided solid evidence for external validity of scale S.

Reliability and external validity of the six scales of 72-item Sleep-Wake Pattern Assessment Questionnaire (SWPAQ)

The 72-item Sleep-Wake Pattern Assessment Questionnaire (SWPAQ) provides possibility to self-assess individual variation along as many as 6 factorial dimensions. We examined reliability and external validity of each of its 12-item scales, E, M, W, V, F, and S (evening and morning lateness, anytime and daytime wakeability, anytime and night-time sleepability, respectively). Questionnaire data were collected from residents of Novosibirsk and two smaller Russian cities (N = 755 and 720, respectively). Analysis of these two data-sets suggested good and acceptable internal consistency of each of the scales, respectively. Evidence for external validity of each of the 6 scales was obtained by applying stepwise linear regression analysis to data collected from 160 participants of sleep deprivation experiments who were asked to self-report 6 characteristics of their sleep for a week prior to the experiment. As expected, predictors of scales? scores were a later self-reported time for going to bed (E, W), an earlier/later time for final awakening (W/M), a shorter/longer sleep latency (F, S/E), a shorter/longer total sleep time (W + V/F), a lower/higher sleep satisfaction score (M/W + V), a lower/higher nap frequency (V/F), and a lower self-scored sleepiness after deprivation from sleep for a night (W, V).

Sleep Wake Patterns and Academic Performance in University Students of Saudi Arabia

Purpose: University students have their day preferences (morningness or eveningness) and also different sleep patterns. The purpose of the current study was to assess the correlation between sleep, wake pattern and academic performance in Saudi university students. Materials and Methods: The survey included 268 university students aged 18–25 years. Sleep-wake pattern was assessed using Sleep-Wake Pattern Assessment questionnaire. The domains measured were morning lateness (M), evening lateness (E), nighttime sleep ability (S), anytime sleep ability (F), and anytime wake ability (W). Results: The majority of the students (82%) reported evening lateness. The strong negative correlation was observed between eveningness and academic performance (r=−0.7). Morningness and quality of nighttime sleep were positively correlated with academic grades (r=0.12; (r=0.18) and the other correlations between grades and ability to awake or fall asleep at unusual hours (scales W and F) did not gain significance (r=0.0). An independent t-test showed significant differences between male and female students in morningness scores while the other scales proved no significant deviation in relation to gender. Conclusion: Our findings suggest that eveningness is more common among Saudi University students leading to inadequate academic functioning.

Empirical evaluation of a model-driven approach to enlargement of multi-dimensional questionnaires for assessing adaptability of the sleep–wake cycle

The spherical cube model was earlier proposed for explaining interrelationships between scales of multidimensional questionnaires designed for assessing adaptability of the human sleep–wake cycle. The purpose of this report was to use the model’s predictions for identification of new items associated with yet unassessed sub-traits of the sleep–wake adaptability. The 72-item Sleep–Wake Pattern Assessment Questionnaire (SWPAQ) and an initial 320-item list created for a new inventory were administered to 139 respondents. Results of correlating the responses to these items with scores on six SWPAQ’ scales were used for classification of items in accord with the nomenclature proposed by the model and for selection of 120 items for the new inventory that allowed the assessment of the majority (more than 24) of the sleep–wake adaptability sub-traits predicted by the model. Some of these newly assessed sub-traits reflect individual variation in the success of biological adaptation to night and shift work.

Overall and specific interrelationships between inter-individual variations in personality and sleep-wake adaptability

General and specific overlaps between the self-perceived traits of sleep-wake adaptability and personality were evaluated. The traits were assessed using multi-dimensional emic inventories, the 72-item Sleep-Wake Pattern Assessment Questionnaire and the 148-word Spherical Cube Inventory of Personality Structure. Additionally, 130 of 265 respondents self-reported their sleep history and alertness/sleepiness in the course of total sleep deprivation. The results of canonical correlation analysis indicated that a set of trait scorings in one domain significantly accounted for trait variation in another domain, but an amount of explained variance did not exceed 10%. The results of correlation and linear regression analyses suggested that lateness traits (chronotype) weaker correlated with personality traits than either sleepability or wakeability traits (somnotype and trototype, respectively). We also proposed a theoretically-grounded approach to classification, generalization, and explanation of the findings of numerous studies on personality correlates of chronotype.

Overall and specific relationships between inter-individual variations in personality and sleep–wake adaptability

The aim of this study was to evaluate the general and specific overlaps between the self-perceived traits of sleep–wake adaptability and personality. The traits were assessed using multi-dimensional emic inventories, the 72-item Sleep–Wake Pattern Assessment Questionnaire and the 148-word Spherical Cube Inventory of Personality Structure. Additionally, 130 of 265 respondents self-reported their sleep history and alertness/sleepiness in the course of total sleep deprivation. The results of the canonical correlation analysis indicated that a set of trait scorings in one domain significantly accounted for trait variation in another domain, but an amount of explained variance did not exceed 10%. The results of correlation and linear regression analyses suggested that lateness traits (chronotype) correlated more weakly with personality traits than either sleepability or wakeability traits (somnotype and trototype, respectively). We also proposed a theoretically grounded approach to classification, generalisation and explanation of the findings of numerous studies on personality correlates of chronotype.

Association of morning and evening lateness with self-scored health: Late to bed and early to rise makes a man healthy in his own eyes

A widely quoted motto “Early to bed and early to rise makes a man healthy, wealthy, and wise” was rarely and inconclusively examined in chronobiological research. To test associations of morningness–eveningness with self-assessed health status, depression, anxiety and somatic complains, 1969 adults were chronotyped on Evening and Morning lateness scales (E and M) of the Sleep–Wake Pattern Assessment Questionnaire. Health was found to decline from the best in long active type (with positive E score) though moderate in morning and evening types (with none and both positive scores, correspondingly) to the worst in short active type (with positive M score). Despite linear association with long/short active types, self-reported sleep length exhibits a U-shaped rather than linear relationship with health problems. It is concluded that the difference between E and M scores, but not their sum, predicts self-assessed health: healthier respondents prefer earlier wake up times and later, but not earlier bedtimes.

Gender differences in morning and evening lateness

Studies of morning–evening preference consistently recognize age differences, but gender differences are rarely reported. To examine these differences, we applied the Sleep–Wake Pattern Assessment Questionnaire (Putilov 1990, 2000, 2007). Unlike unidimensional morningness–eveningness scales, it includes separate scales for the measurement of Evening and Morning lateness (E and M, respectively). Data on 7465 adolescents and adults suggest that both E and M scores significantly decline with age. Genders are identical on the sum of E and M scores, but female respondents of any age cohort have a lower E score and a higher M score. Differences between these scores remain constant across ages. Analysis of a subset of data on 2016 adults revealed significant correlation of this difference with self-reported sleep length which, however, is not significantly longer in women. We concluded that, compared to men, women prefer earlier bedtimes and later wake up times and can desire but not obtain more sleep.

A new SWPAQ's scale predicts the effects of sleep deprivation on the segmental structure of alpha waves

The three-dimensional cube-in-globe model predicts the possibility to delineate six main adaptive abilities of the sleep – wake cycle (Putilov & Putilov, 2005). Such prediction led to the inclusion of a new sixth scale named “daytime wakeability” (Putilov & Putilov, 2006; Putilov, 2007) in the Sleep-Wake Pattern Assessment Questionnaire (SWPAQ; Putilov, 1990, 2000). This new scale permits self-assessment of the ability to keep waking at daytime in sleep provoking conditions. In the study reported here we applied the procedure of adaptive segmentation of the EEG record (SECTION 0.1®, Human Brain Research Group, Moscow State University) to determine whether sleep deprivation changes the temporal pattern of alpha activity and, if yes, whether this change is associated with state and trait self-measures of alertness/sleepiness including a score on “daytime wakeability” scale. In the course of sustained wakefulness, EEG was recorded nine times with three-hour intervals in frontal and occipital derivations in 39 healthy subjects. The procedure of adaptive segmentation allowed cutting EEG records on quasi-stationary segments and determining such characteristics of each segment as within-segmental amplitude, coefficient of its variation and segment length. These characteristics obtained in the morning hours on the first and second experimental days were compared. They were found to increase in the second morning, when eyes are open, but do not change when eyes are closed. It was also documented that “daytime wakeability” score along with other trait and state self-measures of alertness/sleepiness can serve as predictors of the response of alpha waves to sleep deprivation.

Introduction of the tetra-circumplex criterion for comparison of the actual and theoretical structures of the sleep – wake adaptability

In a search for the natural structure of the sleep – wake adaptability, the questionnaire data (total n = 680) were analysed to examine whether the structure of the 72-item Sleep Wake Pattern Assessment Questionnaire (SWPAQ) fits to a theorized circular model. The tetra-circumplex criterion was introduced to measure the extent of deviation of the SWPAQ structure from the structure of the sleep – wake adaptability predicted by the three-dimensional (cube-in-globe) model (Putilov & Putilov 2005). The results of the analysis of correlations among the subdimensions of the SWPAQ indicate that these subdimensions might be configured into four two-dimensional circumplex-like shapes. This means that, at least in general, the questionnaire exhibits a clear three-dimensional circumplex structure in accord with the theoretical expectations, and that the deviations from this structure appear to be random. It was concluded that this finding provides empirical evidence of similarity between the actual and theorised structures of the sleep – wake adaptability. Moreover, this finding supports the claim of applicability of the tetra-circumplex criterion for a theoretically based evaluation of structures of chronotypological questionnaires.

Big six of the individual adaptive ability of the sleep-wake cycle: Explanation and measurement

Research is directed at understanding the nature of differences between individuals in the adaptive abilities of their sleep–wake cycles. We proposed a three-dimensional model that reduces the subjectively assessed variation of the sleep–wake patterns to three underlying physiological variables. This model explains the results of factor analysis of chronotypological questionnaires and predicts the hierarchical structure of the sleep–wake adaptability with three most general abilities at the top level, six basic abilities at the middle level, and 18 primary (most specific) abilities at the bottom level. Any such subjectively assessed trait of any of these three hierarchical levels might be located in the space of three physiological parameters (namely, these are amplitude of circadian modulation of sleep–wake states, rate of accumulation of sleep debt and intensity of circadian arousal). The present study is aimed at generation and testing a particular prediction of the model. It points to the features of one basic and five primary abilities that are not accounted by the 52-item Sleep–Wake Pattern Assessment Questionnaire. Twenty new questionnaire items relevant to these predicted abilities were produced and corrected through a series of three questionnaire surveys of the residents of Novosibirsk (n = 150, 180 and 200). The results of factor analysis of the intermediate and final versions of the questionnaire provided evidence of applicability of the model for identification of the abilities that have not yet been measured by means of the questionnaire and for improvement of measurement of already identified abilities.