The relationship between chronotype and obesity in children and adolescent with attention deficit hyperactivity disorder

ABSTRACT

Children and adolescents with Attention De?cit Hyperactivity Disorder (ADHD) have a high prevalence of obesity, but the relationship between these two problems is not clear. Chronotype preferences may be one of the possible mechanisms underlying the link between ADHD and obesity. This is the ?rst study to investigate whether chronotype preferences are a mechanism linking ADHD symptoms to obesity in children and adolescents. This cross-sectional study included 110 drug-naive children and adolescents aged 7–17 years with ADHD. The Kiddie Schedule for Affective Disorders and Schizophrenia‐Present and Lifetime Version (K‐SADS‐PL) was used to diagnose ADHD or to exclude psychiatric comorbidity. The Conners’ Parents Rating Scale-Revised Short Version (CPRS-RS) and Children’s Chronotype Questionnaire (CCQ) were used to assess the severity of ADHD symptoms and chronotype preferences. Body mass index (BMI) was calculated and classified according to national age- and gender-specific reference values. The participants were divided into three groups as normal weight (<85%, n = 38), overweight (85%-95%, n = 30) and obesity (>95%, n = 42) according to their BMI percentile. There were statistically significant differences between the three groups in terms of chronotype preference (p = .000). Morningness preference was 86.84% in the normal BMI group and 26.19% in the obese BMI group. Eveningness preference was 7.89% in the normal BMI group and 61.90% in the obese BMI group. There was a correlation between the BMI percentile scores and the morningness/eveningness scale (M/E) scores. Moreover, there was a correlation between the BMI percentile scores and the oppositional and ADHD index scores. According to logistic regression analysis, the odds ratio of having evening type for obesity was 5.66 and the odds ratio of having morning type for normal weight was 13.03. Independently from ADHD symptoms, eveningness was directly related to obesity and morningness was directly related to normal weight. Prospective studies should be performed to better understand the relationship between ADHD, overweight/obesity and chronotype.     

Effects of chronotype and environmental factors upon sleep and mental health in Japanese students aged 18–40 yrs

An integrated questionnaire was administered to a total of 4142 (2137 women, 2005 men; answer rate: 94.4%) university students and medical training schools students aged 18–40 years. The survey was carried out between May and October, 2004–2013. This questionnaire consisted of assessment of diurnal type, questions on sleep habits, mental health (upset emotionally, irritated, angered by small triggers, and suppressed), frequency of watching TV at night, use of mobile phone and playing TV games between 21:00 and 03:00 h, and questions on lighting conditions during the daytime and night. Sleep length in evening-type students (E-type; diurnal-type scores = 7–12) was shorter than in intermediate-types (I-type; diurnal-type scale (DTS) = 13–16) and morning-types (M-type; DTS = 17–28) on weekdays (p < 0.001), whereas sleep length in evening-types was shorter than intermediate- and morning-type students at weekends (p < 0.001). Mental health index scores of the E-type students were significantly lower than those of I-type and M-type students in both sexes (p < 0.001). Seventy-three percent of E-type women students watched TV after 23:00 h, significantly higher than 65.0 and 52.5% of I-type and M-type females, respectively (p < 0.001), and 70.4% of E-type male students watched the TV after 23:00 h, significantly higher than 66.1 and 59.7% of I-type and M-type males, respectively (p = 0.001). With regard to lighting conditions in the room in the afternoon, a slightly lower, but significantly so, percentage of the E-type students used the sunlight coming through the window than did the other types (p < 0.001). The frequency of having three nutritionally rich meals (especially breakfast) – including carbohydrates, proteins, vitamins, and minerals – was significantly higher in M-type than I-types and E-types (p < 0.001). Premenstrual syndrome (PMS) was significantly more severe in E-type than I-type and M-type females (p = 0.002). Lighting conditions throughout the 24 h and at breakfast can act as a strong zeitgeber for students and exert a great influence on their mental and physical health and can also affect PMS in women students.     

Interrelationships between distinct circadian manifestations of possible bruxism,perceived stress,chronotype and social jetlag in a population of undergraduate students

ABSTRACT

This study investigates the recently hypothesized association between distinct circadian manifestations of possible bruxism in subjects with different chronotype profiles, social jetlag and levels of perceived stress. A cross-sectional study was performed by surveying dental students’ of Lithuanian University of Health Sciences. A survey instrument was designed and pilot tested for reliability and validity prior to full-scale administration. The instrument consisted of four sections: socio-demographic questions, bruxism-related items, the Perceived Stress Scale and the Munich ChronoType Questionnaire. The study included 228 students (82.5% females; mean age 22.67 ± 2.27). Awake grinding was significantly associated with later chronotype values (p = 0,039). Despite the lack of significance, binary regression models demonstrated that students with later chronotypes report higher rates of possible bruxism, especially as far as awake grinding (p = .170; OR = 1.89) and sleep grinding (p = .140; OR = 1.60) are concerned. There were no significant associations between perceived stress, social jetlag and bruxism. The scores of perceived stress did not correlate with chronotype values, although a high positive correlation was found between chronotype and social jetlag (r = 0.516, p = .000). It can be concluded that later chronotypes increase the odds for self-reported bruxism, and are significantly associated with higher rates of awake grinding and social jetlag. No interrelationships were found between perceived stress, possible bruxism and social jetlag.     

Associations between chronotype,morbidity and mortality in the UK Biobank cohort

Later chronotype (i.e. evening preference) and later timing of sleep have been associated with greater morbidity, including higher rates of metabolic dysfunction and cardiovascular disease (CVD). However, no one has examined whether chronotype is associated with mortality risk to date. Our objective was to test the hypothesis that being an evening type is associated with increased mortality in a large cohort study, the UK Biobank. Our analysis included 433 268 adults aged 38–73 at the time of enrolment and an average 6.5-year follow-up. The primary exposure was chronotype, as assessed through a single self-reported question-defining participants as definite morning types, moderate morning types, moderate evening types or definite evening types. The primary outcomes were all-cause mortality and mortality due to CVD. Prevalent disease was also compared among the chronotype groups. Analyses were adjusted for age, sex, ethnicity, smoking, body mass index, sleep duration, socioeconomic status and comorbidities. Greater eveningness, particularly being a definite evening type, was significantly associated with a higher prevalence of all comorbidities. Comparing definite evening type to definite morning type, the associations were strongest for psychological disorders (OR 1.94, 95% CI 1.86–2.02, p = < 0.001), followed by diabetes (OR 1.30, 95% CI 1.24–1.36, p = < 0.001), neurological disorders (OR 1.25, 95% CI 1.20–1.30, p = < 0.001), gastrointestinal/abdominal disorders (OR 1.23, 95% CI 1.19–1.27, p = < 0.001) and respiratory disorders (OR 1.22, 95% CI 1.18–1.26, p = < 0.001). The total number of deaths was 10 534, out of which 2127 were due to CVD. Greater eveningness, based on chronotype as an ordinal variable, was associated with a small increased risk of all-cause mortality (HR 1.02, 95% CI 1.004–1.05, p = 0.017) and CVD mortality (HR 1.04, 95% CI 1.00–1.09, p = 0.06). Compared to definite morning types, definite evening types had significantly increased risk of all-cause mortality (HR 1.10, 95% CI 1.02–1.18, p = 0.012). This first report of increased mortality in evening types is consistent with previous reports of increased levels of cardiometabolic risk factors in this group. Mortality risk in evening types may be due to behavioural, psychological and physiological risk factors, many of which may be attributable to chronic misalignment between internal physiological timing and externally imposed timing of work and social activities. These findings suggest the need for researching possible interventions aimed at either modifying circadian rhythms in individuals or at allowing evening types greater working hour flexibility.     

Effects of shift work on attention deficit,hyperactivity, and impulsivity,and their relationship with chronotype

There is growing evidence that shift-work schedules cause severe disturbances to circadian rhythms and the sleep–wakefulness cycle, and that these changes in turn lead to cognitive and behavioral problems. The objective of this study is to explore the relationships between biological rhythm differences (chronotype) and impulsive behaviors and attention-deficit hyperactivity symptoms in shift workers. Seventy-nine nurses working in the daytime and 127 nurses working on night shifts were evaluated with the Barratt Impulsiveness Scale, Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS), and Morningness–Eveningness questionnaire for identifying circadian preference. It was found that shift workers had more attention deficit (p < .05) and impulsivity (p < .01) when compared with daytime workers. Morning-type workers reported lower hyperactivity and ASRS total scores than evening- and intermediate-type workers. The mean impulsivity score of evening-type workers was higher than both the other groups (p < .05). It has been shown that attention deficit, hyperactivity, and impulsivity levels that appear as a result of working shifts might change in accordance with the individual’s chronotype. It might, therefore, be desirable to evaluate an individual’s chronotype to establish suitability for working shifts.     

Associations of chronotype,Big Five,and emotional competences with perceived stress in university students

ABSTRACT

This study aimed to investigate the associations between individual difference factors (chronotype, Big Five, emotional competences) and perceived stress in French university students. In total, 362 students agreed to take part (M _age = 20.19 ± 1.75 years). Participants completed the Caen Chronotype Questionnaire, Big Five Inventory, the Profile of Emotional Competences, and the Perceived Stress Scale. Results showed that chronotype amplitude (+), eveningness chronotype (+), neuroticism (+), conscientiousness (-), and intrapersonal emotional competences (-) were important for perceived stress. These findings have theoretical and practical implications in terms of identifying students who might benefit most from stress management interventions.     

The relationship between chronotype,sleep disturbance,severity of fibromyalgia,and quality of life in patients with fibromyalgia

ABSTRACT

Patients with fibromyalgia (FM) report high levels of sleep disturbance and chronic diffuse musculoskeletal pain. These patients experience diminished quality of life (QoL) due to pain and other comorbidities. Chronotype preferences have been suggested as a potential factor connecting increased severity of FM, sleep disturbances, and poor overall QoL. The present study is the first study examining the possible association between chronotype preferences, sleep disturbance, severity of FM, and QoL in patients with FM.

One hundred drug-free patients diagnosed with FM participated in this cross-sectional study. Of them, 79 (79%) were females and 21 (21%) were males. The mean age was 41.65 ± 9.17 years (range: 21–62 years). The severity of FM symptoms, chronotype preferences, and QoL was evaluated using the Fibromyalgia Impact Questionnaire (FIQ), Morningness-Eveningness Questionnaire (MEQ), and World Health Organization Questionnaire on Quality of Life: Short Form (WHOQOL-BREF). The participants’ anxiety/depressive symptoms and sleep problems were assessed using the Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI).

The participants were classified according to their MEQ scores as evening type (score: 16–41), neither type (score: 42–58), and morning type (score: 59–86). It was found that there were significant differences in the FIQ score between the three groups (p < .001). It was determined that the total PSQI score was significantly higher in the evening type than the other two types (p < .05). It was found that there were significant differences in the general health, physical health, psychological, and environmental domain scores of the WHOQOL-BREF between the three groups (p < .05). It was detected that there were significant correlations between MEQ scores, WHOQOL-BREF subscale scores, FIQ scores, HADS-A and HADS-D scores, and PSQI scores. According to hierarchical regression analysis, eveningness preference explained an additional 21.9% of the variation in FM severity, thereby causing a statistically significant change in R-squared.

Our results indicated that eveningness preference was directly related to increased FM symptom severity and poorer QoL. Based on these findings, neglecting to take chronotype preference into account may not result in optimal response to standard treatment for some patients with FM.     

Evening chronotype is associated with poor cardiovascular health and adverse health behaviors in a diverse population of women

ABSTRACT

Chronotype reflects time of day preferences for performing daily activities. Previous research within Asian and European cohorts indicates evening chronotype is associated with elevated cardiometabolic risk. However, evidence is limited from population-based US cohorts, particularly among women in whom evening chronotype prevalence may become higher after middle-age, coinciding with life stages associated with higher cardiovascular disease (CVD) risk. This cross-sectional study evaluated associations of chronotype with overall cardiovascular health (CVH), health behaviors, and cardiometabolic risk factors among 506 women (mean age = 37 ± 16y, 62% racial/ethnic minority) in the American Heart Association (AHA)’s Go Red for Women Strategically-Focused Research Network cohort at Columbia University (New York City, NY, USA). Chronotype was assessed using the validated Morningness-Eveningness Questionnaire (MEQ) and categorized as “evening”, “intermediate”, and “morning” chronotypes. Health behaviors (diet, physical activity, and sleep) were assessed using validated questionnaires. Anthropometrics, clinical blood pressure, and blood biomarkers were assessed at the clinic visit. CVH was evaluated using the AHA Life’s Simple 7 (LS7) metrics; LS7 scores of 0–8 and 9–14 were considered indicative of poor and moderate-to-high CVH, respectively. Linear and logistic regression models adjusted for age, race/ethnicity, education, health insurance, and menopausal status were used to examine associations of MEQ scores and chronotype categories with overall CVH, clinical cardiometabolic risk factors, and health behaviors. Overall, 13% of women identified as evening chronotypes, while 55% and 32% reported being intermediate and morning types. In linear models, higher MEQ scores were associated with higher AHA LS7 scores (β(SE) = 0.02(0.01); p = .014), indicative of more favorable CVH, and with health behaviors not included in the LS7. Higher MEQ scores were also associated with lower Pittsburgh Sleep Quality Index, i.e. better sleep quality, (β(SE) = ?0.07(0.02), p < .0001), lower insomnia severity (β(SE) = ?0.14(0.01), p < .0001), shorter time to fall asleep (β(SE) = ?0.28(0.14), p = .044), and less sedentary time (β(SE) = ?0.11(0.03), p = .001). In logistic regression models, evening chronotype, compared to intermediate/morning type, was associated with higher odds of having poor CVH (OR(95%CI):2.41(1.20–4.85)), not meeting AHA diet (OR(95%CI):2.89(1.59–5.23)) and physical activity guidelines (OR(95%CI):1.78(1.03–3.07)), and having short sleep (OR(95%CI):2.15(1.24–3.73)) or insomnia (OR(95%CI):2.69(1.53–4.75)). The evening type compared to morning type was also associated with being a current smoker (OR(95%CI):2.14(1.02–4.52)) and having poor sleep quality (OR(95%CI:2.35(1.27–4.37)) and long sleep onset latency (OR(95%CI:1.89(1.00–3.56)). In our cohort of women, evening chronotype was related to poor CVH, likely driven by its influence on health behaviors. These findings, although warranting confirmation prospectively in other populations, suggest chronotype is an important factor to consider and possibly target when designing lifestyle interventions for CVD prevention.     

The association between chronotype and perceived academic stress to depression in medical students

Depression is a multifactorial illness that is highly prevalent among medical students (MS). Chronotypes, which reflect circadian preference in humans, as well as academic stress have been associated with depression in different populations. However, it is not known how chronotype and stress might alone or in combination, associate with depression in MS. Thus, we aimed to evaluate the association between stress, chronotype and depression in MS. In a cross-sectional study, we evaluated a total of 1068 medical students from a public Medical School in Mexico City. The Patient Health Questionnaire-9 (PHQ-9) was used to evaluate depressive symptom severity and the presence of a current depressive episode with a cutoff score of 10 or higher. The Morning-Evening Questionnaire (MEQ) was used to establish chronotype and the Academic Stress Inventory was used to measure perceived academic stress (PAS). We observed that depressive symptom severity was higher in non-morning chronotypes and moderate/severe PAS groups. A factorial ANOVA showed an association between PAS groups and depressive symptom severity. Linear regression showed an association between depressive symptom severity and variables such as PAS scores (p = 0.001), family history of depression (p = 0.001), gender (p = 0.001) and academic year (p = 0.029). Logistic regression analysis showed that evening chronotype (OR: 2.3, 95% CI: 1.2–4.3, p = 0.01) and severe PAS (OR: 4.4, 95% CI: 2.8–7.0, p = 0.0001) were associated with depression. Further, MS with the combination of severe PAS and morning (OR: 5.9, 95% CI: 1.6–22.2, p = 0.01), intermediate (OR: 7.5, 95% CI: 2.3–24.4, p = 0.001) or evening (OR: 10.6, 95% CI: 2.8–40.0, p = 0.001) chronotypes showed a greater association with depression than any PAS or chronotype group alone. Being female, perceiving restricted or limited economic resources, having severe scores of academic stress, and evening chronotype were associated with an increased probability to suffer a current depressive episode. Collectively, these results show that chronotype and PAS are factors associated with depression in MS, and when combined promote this association. Our results might aid in early identification of MS susceptible to depression. Future research could focus on the implementation of simple, low cost preventive strategies, such as chronotype-oriented academic schedules.     

Chronotype and depressive symptoms in students: An investigation of possible mechanisms

ABSTRACT

Individuals with an evening chronotype are at increased risk of experiencing emotional problems, including depressive symptoms. However, the mechanisms underlying these associations remain unclear. The present study aimed to determine whether poor sleep quality, substance use and cognitive emotion regulation difficulties – which have been implicated in the etiology of depression – mediate the relationship between chronotype and depressive symptoms in a student sample, which was assessed cross-sectionally and after 1 year. A total of 742 Dutch students (75% women, mean age 21.4 ± 2.9 years) completed the Quick Inventory of Depressive Symptomatology, the Morningness-Eveningness Questionnaire, the Pittsburgh Sleep Quality Index, a questionnaire assessing alcohol, caffeine, tobacco and cannabis use, the Cognitive Emotion Regulation Questionnaire and the Behavioral Inhibition/Activation Scale. A subsample (n = 115) was assessed 1 year later with the same questionnaires. Cross-sectional analyses showed that evening chronotype was associated with more depressive symptoms, adjusted for age and gender (β = ?0.082, p = 0.028). The relationship between eveningness and depressive symptoms was mediated by sleep quality, alcohol consumption and the cognitive emotion regulation strategies of self-blame and positive reappraisal. In longitudinal analyses, eveningness at baseline predicted more depressive symptoms at follow-up, adjusted for age and gender (β = ?0.29, p = 0.002); after additional adjustment for baseline depressive symptoms, chronotype remained a significant predictor of depressive symptoms at T2 (β = ?0.16, t = ?2.01, p = 0.047). Only poor sleep quality at follow-up was a significant mediator of this relationship. Even though the effect is small in terms of explained variance, eveningness is related to depressive symptoms and this relationship is mediated by poor sleep quality, also in a prospective design. Self-blame and reduced positive reappraisal are correlated with eveningness. Further research is needed to assess the efficacy of chronotherapeutic interventions for the prevention of depression, in addition to sleep education and cognitive approaches.     

Premature birth and circadian preference in young adulthood: evidence from two birth cohorts

A preference for eveningness (being a “night owl”) and preterm birth (<37 weeks of gestation) are associated with similar adversities, such as elevated blood pressure, impaired glucose regulation, poorer physical fitness, and lower mood. Yet, it remains unclear if and how preterm birth is associated with circadian preference. The aim of this study was to assess this association across the whole gestation range, using both objective and subjective measurements of circadian preference.

Circadian preference was measured among 594 young adults (mean age 24.3 years, SD 1.3) from two cohorts: the ESTER study and the Arvo Ylppö Longitudinal Study. We compared 83 participants born early preterm (<34 weeks) and 165 late preterm (34 to <37 weeks) with those born at term (≥37 weeks, n = 346). We also compared very low birth weight (VLBW, <1500 g) participants with term-born controls. We obtained objective sleep data with actigraphs that were worn for a mean period of 6.8 (SD 1.4) nights. Our primary outcome was sleep midpoint during weekdays and weekend. The sleep midpoint is the half-way time between falling asleep and waking up, and it represents sleep timing. We also investigated subjective chronotype with the Morningness–Eveningness Questionnaire (MEQ) in 688 (n = 138/221/329) ESTER participants. The MEQ consists of 19 questions, which estimates the respondent to be of a “morning”, “evening,” or “intermediate” chronotype, based on the Morningness–Eveningness Score (MES). We analyzed the data from the actigraphs and the MES with three linear regression models, and analyzed distribution of the chronotype class with Pearson χ2.

There were no consistent differences across the study groups in sleep midpoint. As compared with those born at term, the mean differences in minutes:seconds and 95% confidence intervals for the sleep midpoint were: early preterm weekdays 11:47 (?8:34 to 32:08), early preterm weekend 4:14 (?19:45 to 28:13), late preterm weekdays ?10:28 (?26:16 to 5:21), and late preterm weekend ?1:29 (?20:36 to 17:37). There was no difference in sleep timing between VLBW-participants and controls either. The distribution of chronotype in the MEQ among all participants was 12.4% morningness, 65.4% intermediate, and 22.2% eveningness. The distribution of the subjective chronotype class did not differ between the three gestational age groups (p = 0.98). The linear regression models did not show any influence of gestational age group or VLBW status on the MES (all p > 0.5).

We found no consistent differences between adults born early or late preterm and those born at term in circadian preference. The earlier circadian preference previously observed in those born smallest is unlikely to extend across the whole range of preterm birth.     

Narrow-band ultraviolet B (NB UV-B) exposures improve mood in healthy individuals differently depending on chronotype

ABSTRACT

The evening chronotype is associated with psychological symptoms such as depressed mood, while skin exposure to ultraviolet radiation (UVR) may affect mood and behavior through neural and humoral routes. This pilot study aimed to investigate the impact of whole-body narrow-band (NB) UV-B exposure on current mood state and circulating 25-hydroxyvitamin D3 (25(OH)D₃), interleukin-6 (IL-6), cortisol and β-endorphin (β-END) levels in healthy participants. Here, eleven healthy women received full-body NB UV-B exposures on four afternoons, and the chronotype was assessed with a shortened version of Horne and Östberg’s Morningness-Eveningness Questionnaire (MEQ). Perceived mood was evaluated using the Visual Analogue Scale (VAS), and serum 25(OH)D₃, IL-6, cortisol and β-END concentrations were monitored daily. Decreasing VAS values showed mood to improve significantly over the five days after the four suberythematous NB UV-B exposures (p = .038), and the more the circadian preference was inclined toward eveningness, the greater the improvement in the mood dimension of wellbeing (p = .021). Baseline mood state was correlated with baseline 25(OH)D₃ (r = ?0.54, 95% CI: ?0.86 to ?0.09) and with baseline cortisol (r = ?0.57, 95% CI: ?0.87 to ?0.04). During the NB UV-B exposures, 25(OH)D₃ increased significantly, as expected, and IL-6 declined significantly by ?0.35 (95% CI: ?0.69 to ?0.07) pg/mL from the initial values of 1.12 ± 0.66 pg/mL (p = .025). In conclusion, in our pilot study, NB UV-B exposure improved mood, especially among those with evening preference for their daily activities, as well as circulating 25(OH)D₃ levels, whereas circulating IL-6 levels decreased.

Abbreviations: UVR: Ultraviolet radiation; NB UV-B: narrow-band UV-B; VAS: Visual Analogue Scales; β-END: β-endorphin; IL-6: Interleukin-6     

Native language background and academic achievement: Is socioemotional well-being a mediator?

This study examined the extent to which socioemotional well-being mediated the relationship between language status and achievement, while exploring variability in this relationship based on informant (student versus teacher reports of socioemotional problems) and native language background (Spanish-speaking English language learners [ELLs] versus ELLs from Asian-language backgrounds). Participants included 9,046 fifth-grade students from the Early Childhood Longitudinal Study-Kindergarten Cohort of 1998. Results from structural equation modeling showed that Spanish-speaking ELLs reported more social-emotional problems as compared to English-monolingual (EM) and Asian-language ELL classmates in third grade, which partially explained their lower achievement levels in fifth grade. The model accounted for approximately 34% of the variance in students’ academic achievement in fifth grade (R² = .343, p < .001). When comparing ELL and EM students, results differed when using teachers’ versus students’ reports of socioemotional well-being. For both Spanish-speaking and Asian-language ELLs, teachers perceived fewer social and emotional difficulties than the students themselves reported in comparison to their EM classmates.     

Influence of Chronotype,Season, and Sex of Subject on Sleep Behavior of Young Adults

The aim of this study was to investigate whether sex, season, and/or chronotype influence the sleep behavior of university students. Detailed data were collected on activity/rest patterns by wrist actigraphy combined with diaries. Thirty‐four medical students (19 female and 15 male) were monitored by Actiwatch® actometers for 15 consecutive days in May and again in November. The data of a modified Horne and Östberg chronotype questionnaire, which were collected from 1573 female and 1124 male medical school students surveyed in the spring and autumn over an eight‐year period, were evaluated. Actiwatch® sleep analysis software was used to process the activity data with statistical analyses performed with ANOVA. We found no significant sex‐specific differences in sleep efficiency, sleep onset latency, or actual sleep‐time duration. However, we did find a difference in sleep efficiency between morning and evening types, with morning types having a higher sleep efficiency (87.9%, SD=1.3) than evening types (84.3%, SD=0.87%; p=0.007). Seasonal differences were also detected: the actual sleep‐time duration in autumn was significantly longer (mean 6.9 h, SD=0.13 h) than in spring (6.6 h, SD=0.1 h; p=0.013). Evaluation of the chronotype questionnaire data showed that individuals with no special preference for morningness or eveningness (i.e., so‐called intermediates) were most common. The distribution of chronotypes was related to the sex of subject. Men displayed eveningness significantly more often than women (28.9% males vs. 20.8% females; p<0.001), while females exhibited greater morningness (20.3% females vs.15.6% males; p<0.001). Sex influences chronotype distribution, but not actual sleep time‐duration, sleep onset latency, or sleep efficiency. The latter, however, differed among chronotypes, while actual sleep‐time duration was affected by season.     

Melatonin ingestion after exhaustive late-evening exercise improves sleep quality and quantity,and short-term performances in teenage athletes

ABSTRACT

The present study aimed to explore the effects of a single 10-mg dose of melatonin (MEL) administration after exhaustive late-evening exercise on sleep quality and quantity, and short-term physical and cognitive performances in healthy teenagers. Ten male adolescent athletes (mean ± SD, age = 15.4 ± 0.3 years, body-mass = 60.68 ± 5.7 kg, height = 167.9 ± 6.9 cm and BMI = 21.21 ± 2.5) performed two test sessions separated by at least one week. During each session, participants completed the Yo-Yo intermittent-recovery-test level-1 (YYIRT-1) at ~20:00 h. Then, sleep polysomnography was recorded from 22:15 min to 07:00 h, after a double blind randomized order administration of a single 10-mg tablet of MEL (MEL-10 mg) or Placebo (PLA). The following morning, Hooper wellness index was administered and the participants performed the Choice Reaction Time (CRT) test, the Zazzo test and some short-term physical exercises (YYIRT-1, vertical and horizontal Jumps (VJ; HJ), Hand grip strength (HG), and five-jump test (5-JT)). Evening total distance covered in the YYIRT-1 did not change during the two conditions (p > 0.05). Total sleep time (Δ = 24.55 mn; p < 0.001), sleep efficiency (Δ = 4.47%; p < 0.001), stage-3 sleep (N3 sleep) (Δ = 1.73%; p < 0.05) and rapid-eye-movement sleep (Δ = 2.15%; p < 0.001) were significantly higher with MEL in comparison with PLA. Moreover, sleep-onset-latency (Δ = –8.45mn; p < 0.001), total time of nocturnal awakenings after sleep-onset (NA) (Δ = –11 mn; p < 0.001), stage-1 sleep (N1 sleep) (Δ = –1.7%; p < 0.001) and stage-2 sleep (N2 sleep) (Δ = ?1.9%; p < 0.05) durations were lower with MEL. The Hooper index showed a better subjective sleep quality, a decrease of the subjective perception of fatigue and a reduced level of muscle soreness with MEL. Moreover, MEL improved speed and performance but not inaccuracy during the Zazzo test. CRT was faster with MEL. Morning YYIRT-1 (Δ = 82 m; p < 0.001) and 5-JT (Δ = 0.08 m; p < 0.05) performances were significantly higher with MEL in comparison with PLA. In contrast, HG, VJ and HJ performances did not change during the two conditions (p > 0.05). The administration of a single dose of MEL-10 mg after strenuous late-evening exercise improved sleep quality and quantity, selective attention, subjective assessment of the general wellness state, and some short-term physical performances the following morning in healthy teenagers.     

Chronotype and energy intake timing in relation to changes in anthropometrics: a 7-year follow-up study in adults

Individuals with a later preference for the daily activities (evening types) tend to have unhealthier behaviors, which could increase their risk for obesity when compared those with an earlier preference (morning types). Furthermore, later food intake timing, another behavior more characteristic of evening types, has been associated with obesity. However, chronotype differences in the long-term weight change and the role of chronotype in the association between energy intake timing and obesity risk are not clear. To study this we first examined the independent associations of chronotype and energy intake timing with anthropometric changes and then whether chronotype modified the association between energy intake timing and obesity risk. Our data included 1097 Finns from DILGOM (DIetary Lifestyle and Genetic Determinants of Obesity and Metabolic syndrome) 2007 (baseline) and 2014 (follow-up) and from Findiet 2007. Chronotype was assessed with a shortened version of Horne and Östberg’s morningness–eveningness questionnaire. Energy intake timing (as percentages of the total energy intake in the morning/evening) was assessed with 48-h dietary recalls. Weight, body mass index (BMI), and waist circumference were based on measured and self-reported values. Analysis of co-variance and multivariable logistic regression models were used for statistical analyses. Evening typed women had greater weight gain (+ 2.3 kg vs. + 0.3 kg, P = 0.016) and increase in BMI (0.7 kg/m² vs. ?0.1 kg/m², P = 0.024) than morning typed women. After excluding participants with depression, these associations attenuated to non-significant. Compared to participants whose energy intake was proportionally lowest during evening, those with proportionally highest energy intake during evening were more likely with obesity (BMI≥ 30 kg/m²) after follow-up (OR 1.97, 95% CI 1.21–3.21, Ptrend = 0.042). Participants’ chronotype did not modify this association (Pinteract = 0.95). In conclusion, our findings indicated that evening energy intake may play a role in obesity regardless of the chronotype. Furthermore, evening typed women were more prone to increases in their anthropometrics, which seem to be at least partly explained by depression. Further studies of this topic are warranted.     

Anxiety symptomatology,sex and chronotype: The mediational effect of diurnal sleepiness

ABSTRACT

Diurnal subjective sleepiness has been associated with a large number of negative outcomes, such as increased risk of accidents and development of mental disorders as depression and anxiety. However, the role of the diurnal subjective sleepiness as a mediator is poorly understood. The goal of the present study was to examine the role of diurnal subjective sleepiness as a mediator of the relationship between sex, chronotype and anxiety symptoms in healthy young adults. Four-hundred and sixty-seven healthy young adults (64.8% females, age range 18–32 years, mean 20.7, ±2.3) were evaluated with validated and widely used scales for the measurement of diurnal sleepiness, anxiety symptoms and morningness–eveningness preference. We have found that diurnal subjective sleepiness correlated with anxiety symptoms when evaluated both in the total sample and within chronotypes. This association was more important in females than in males (p < 0.0001). Regarding chronotype, only for morning-types, diurnal subjective sleepiness was a significant mediator of the relationship between sex and anxiety symptoms. This is the first study that examines the mediator role of diurnal subjective sleepiness in the known relationship between sex and anxiety symptoms, and adds new evidence about the effect of the chronotype on sleep problems and mental health. Although future work is required, our results have important implications for clinical settings and public health interventions.     

Association of possible sleep bruxism in children with different chronotype profiles and sleep characteristics

Sleep bruxism (SB) in children has been associated with several sleep characteristics, which may alter their sleep pattern. This change affects the internal biological clock and consequently the chronotype profile. The aim of this study was to evaluate the existence of an association between possible SB in children with specific chronotype profiles and sleep characteristics. The study included 207 parents/guardians of children aged between 3 and 12 years who were waiting for their children’s dental treatment at the Pediatric Dentistry Clinic of the Federal University of Rio de Janeiro, Brazil. A questionnaire on the socio-demographic characteristics of parents and children as well as on the features of the children’s sleep was applied. In addition, the CIRENS scale (Circadian Energy Scale) was completed by the parents to identify the children’s chronotype. A chi-squared test was used to determine the association between possible SB, the chronotype, and sleep characteristics. A multiple logistic regression model was implemented to observe the influence of chronotype, age, and other independent variables on the possible SB. The logistic regression model demonstrated that nocturnal agitation (p = 0.009; OR = 3.42) and nightmares (p = 0.045; OR = 3.24) were associated with possible SB in children. Although no significant association (p = 0 .089) between the chronotype profile and possible SB was observed in the 3 to 5 years age group, a proportional difference was observed between the chronotype categories in this age group—12.5% of children with SB had a morning type, while 26.4% had an intermediate type and 47.8% an evening type compared to those without possible SB. Nocturnal agitation and nightmares were associated with possible SB. In addition, young children with an evening chronotype had a tendency toward possible SB.     

Individual differences in chronotypes associated with academic performance among Chilean University students

A chronotype is an individual trait that determines circadian rhythm (dark/light cycle) characteristics, associated with bedtime, waking, and other daily activities. A chronotype is classified as morning, intermediate, and evening. The objective is to associate chronotypes with academic performance in university students. A cross-sectional study was performed to evaluate the chronotype of university students (n = 703) by Horne-Ostberg questionnaire and associated with academic performance. The group with higher GPAs had higher chronotype scores (p = 0.002). Morning and intermediate chronotypes exhibited better academic performance; however, more studies are necessary to determine the underlying causes, which could influence cognitive aspects.