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Academic burnout in nursing students is a serious problem worldwide that results in emotional exhaustion, cynicism and low professional efficacy. The aim of the current study was to examine the association between sleep quality and circadian rhythm indicators and academic burnout among Iranian nursing students. This cross-sectional study was conducted on 325 undergraduate nursing students studying at Qazvin University of Medical Sciences between November and February 2023. Data collection was carried out using self-report questionnaires including demographic characteristics, The Pittsburgh Sleep Quality Index (PSQI), reduced-Morningness-Eveningness Questionnaire (r-MEQ), and the Maslach Burnout Inventory-Student Survey (MBI-SS). Social jetlag (SJL) was defined as the absolute value of the difference between the midpoint of sleep on free days (MSF) and the midpoint of sleep on workdays (MSW). Data were analyzed using univariate and multivariate linear regression models. About 31.4% of participants had evening chronotype and almost half of them suffered from poor sleep quality. About 47.7% of the participants had SJL ≥ 2 h. In the multivariate linear regression model, students with evening chronotype compared to morning chronotype experienced more academic burnout in emotional exhaustion, cynicism and professional efficacy. PSQI score was only correlated with emotional exhaustion and cynicism subscales. Increased SJL was a predictor on all three subscales of academic burnout. The findings suggested that evening chronotype, poor sleep quality, and high SJL were associated with increased likelihood of academic burnout in nursing students. Assessment of circadian preference and sleep quality is beneficial for timely identification and prevention of academic burnout in nursing students. [ABSTRACT FROM AUTHOR]

In adults affected by Major Depressive Disorder (MDD), most findings point to higher electroencephalographic (EEG) theta power during wake compared to healthy controls (HC) as a potential biomarker aiding the diagnostic process or subgrouping for stratified treatment. Besides these group differences, theta power is modulated by time of day, sleep/wake history, and age. Thus, we aimed at assessing if the time of recording alters theta power in teenagers affected by MDD or HC. Standardized wake EEG power was assessed with high-density EEG in 15 children and adolescents with MDD and in 15 age- and sex-matched HC in the evening and morning. Using a two-way ANOVA, group, time, and their interaction were tested. In patients, the current severity of depression was rated using the Children's Depression Rating Scale. Broadband EEG power was lower in the morning after sleep, with a significant interaction (group x time) in central regions in the 4-6 Hz range. In MDD relative to HC, theta power was decreased over occipital areas in the evening and increased over frontal areas in the morning. A higher frontal theta power was correlated with more severe depressive mood in the morning but not in the evening. This was a cross-sectional study design, including patients on antidepressant medication. In conclusion, depending on time of recording, region-specific opposite differences of theta power were found between teenagers with MDD and HC. These findings stress the importance of the time of the recording when investigating theta power's relationship to psychopathology. [ABSTRACT FROM AUTHOR]

Background: This study was intended to investigate the correlation between depression and suicidal ideation among Chinese college students during the COVID-19 pandemic and the potential mediating roles of chronotype and sleep quality in this relationship. Methods: A sample of 4,768 college students was selected from four institutions in Anhui Province, China, and the study was conducted during the COVID-19 pandemic (November to December 2020) using a stratified, cluster, multi-stage sampling method. This study used the two-item Patient Health Questionnaire (PHQ-2) to assess depressive symptoms, the Morningness-Eveningness Questionnaire 19 (MEQ-19) to determine individual sleep chronotypes (i.e., morning or evening preference), and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Participants were asked about suicidal ideation. MPLUS 8.3 software was used to analyze the mediating effect of chronotype and sleep quality on the relationship between depression and suicidal ideation. Results: During the COVID-19 pandemic, the prevalence of suicidal ideation among Chinese college students was 5.4%. Depression was inversely correlated with chronotype (beta = − 0.346, P < 0.01) and positively correlated with sleep quality (beta = 0.846, P < 0.001), indicating that students experiencing depressive symptoms were more likely to have a later chronotype and poor sleep quality. A later chronotype (beta = − 0.019, P < 0.05) and poor sleep quality (beta = 0.066, P < 0.01) predicted suicidal ideation. Depression emerged as a direct and significant risk factor for suicidal ideation (effect value = 0.535, 95% confidence interval: 0.449 ~ 0.622). Chronotype and sleep quality were found to have potential mediating effects on the relationship between depression and suicidal ideation; however, the chain-mediating effect of chronotype and sleep quality was not statistically significant. Conclusions: Our findings suggest that during the COVID-19 pandemic, depression can precipitate suicidal ideation through its influence on sleep chronotype and quality. These compelling findings highlight the urgency of early intervention strategies intended to mitigate suicidal thoughts, particularly among students exhibiting depressive symptoms, who experience disrupted sleep patterns and poor sleep quality. [ABSTRACT FROM AUTHOR]

Objective: To explore the correlation between physical activity, circadian rhythms, and sleep in adolescents, and analyze the influencing factors of sleep quality in this population. Methods: A total of 381 high school students were selected through cluster sampling in a specific high school. The Pittsburgh Sleep Quality Index (PSQI) was employed to categorize the participants into a good sleep quality group (n=199) and a poor sleep quality group (n=182). Comprehensive assessments were conducted using the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), PSQI, Morningness-Eveningness Questionnaire-5 (MEQ-5), and International Physical Activity Questionnaire Short Form (IPAQ-SF). Results: The prevalence of poor sleep quality is 47.8%. The BMI in the poor sleep quality group is higher than that in the good sleep quality group, and the male ratio is lower than that in the good sleep quality group. The poor sleep quality group exhibits significantly higher levels of depression, anxiety, evening chronotype, and low physical activity compared to the good sleep quality group. Spearman rank correlation analysis revealed a positive correlation between the PSQI total score and HAMA and HAMD scores, and a negative correlation with physical activity and MEQ-5 scores. Binary logistic stepwise regression analysis identified lack of physical activity, eveningness chronotype, anxiety, and depression as risk factors for poor sleep quality. Conclusion: Adolescent sleep quality is correlated with gender, BMI, anxiety, depression, chronotype, and physical activity levels. The findings highlight the importance of considering these factors in interventions aimed at improving sleep health in adolescents. [ABSTRACT FROM AUTHOR]

Summary Chronotype may affect tolerance for circadian disruption induced by shift work. This study examines the association between chronotype, self‐reported sleep timing, shift type preference, and sleep problems among nurses, and studies chronotype stability over time. The study included 37,731 Dutch female nurses who completed a baseline (2011) and follow‐up questionnaire (2017), with information on shift work (e.g., job history, shift type preference [collected in 2017 only]), and sleep characteristics (e.g., chronotype, preferred sleep–wake time in a work‐free period [collected in 2017 only], and sleep problems between working days according to Medical Outcomes Study‐Sleep Problem Index II [MOS‐SPI‐II]). The association between chronotype and sleep timing was examined using (age‐adjusted) linear regression. Associations between chronotype and shift type preference and sleep problems (MOS‐SPI‐II >30) were examined using ordered logistic and Poisson regression, respectively. With later chronotype, midsleep time increased (definite evening vs. intermediate types [reference]: β = 55 min, 95% confidence interval [95% CI]: 54–55), the odds ratio (OR) for 1‐point increase in preference for night (2.68; 95% CI: 2.48–2.90) and evening shifts increased (OR 2.20; 95% CI: 2.03–2.38), while the odds for day (OR 0.17; 95% CI: 0.16–0.18) and morning shifts (OR 0.22; 95% CI: 0.21–0.24) decreased. Intermediate chronotype was associated with fewer sleep problems (median MOS‐SPI‐II = 27.2, p < 0.01), compared with definite morning (28.9) and evening types (31.7). This study shows that chronotype is associated with sleep–wake times in a work‐free period, shift type preference, and sleep problems in nurses. Future studies on the association of shift work‐induced circadian disruption and health outcomes should therefore consider chronotype as effect‐modifier. [ABSTRACT FROM AUTHOR]

Introduction: Chronotype refers to individual preference in circadian cycles and is associated with psychiatric problems. It is mainly classified into early (those who prefer to be active in the morning and sleep and wake up early) and late (those who prefer to be active in the evening and sleep and wake up late) chronotypes. Although previous research has demonstrated associations between chronotype and cognitive function and brain structure in adults, little is known regarding these associations in children. Here, we aimed to investigate the relationship between chronotype and cognitive function in children. Moreover, based on the significant association between chronotype and specific cognitive functions, we extracted regions-of-interest (ROI) and examined the association between chronotype and ROI volumes. Methods: Data from 4,493 children (mean age of 143.06 months) from the Adolescent Brain Cognitive Development Study were obtained, wherein chronotype (mid-sleep time on free days corrected for sleep debt on school days) was assessed by the Munich Chronotype Questionnaire. Subsequently, the associations between chronotype, cognitive function, and ROI volumes were evaluated using linear mixed-effects models. Results: Behaviorally, chronotype was negatively associated with vocabulary knowledge, reading skills, and episodic memory performance. Based on these associations, the ROI analysis focused on language-related and episodic memory- related areas revealed a negative association between chronotype and left precentral gyrus and right posterior cingulate cortex volumes. Furthermore, the precentral gyrus volume was positively associated with vocabulary knowledge and reading skills, while the posterior cingulate cortex volume was positively associated with episodic memory performance. Discussion: These results suggest that children with late chronotype have lower language comprehension and episodic memory and smaller brain volumes in the left precentral gyrus and right posterior cingulate cortex associated with these cognitive functions. [ABSTRACT FROM AUTHOR]

Introduction. This study aimed to investigate the relationship between obstructive sleep apnea (OSA), circadian rhythms, and individual sleep–wake preferences, as measured by chronotype, and to assess the association between circadian clock gene expression and subjective sleep-related variables. Methods: A total of 184 individuals were recruited, underwent polysomnography (PSG), and completed questionnaires including a chronotype questionnaire (CQ), insomnia severity index (ISI), and Epworth sleepiness scale (ESS). Blood samples were collected in the evening before and morning after PSG. Gene expression analysis included BMAL1, CLOCK, PER1, CRY1, NPAS2, and NR1D1. Results: In the OSA group, the subjective amplitude (AM score of CQ) positively correlated with all circadian clock genes in the morning (R ≥ 0.230 and p < 0.05 for each one), while the morningness–eveningness (ME score of CQ) was only associated with the evening BMAL1 level (R = 0.192; p = 0.044). In healthy controls, insomnia severity correlated with evening expression of BMAL1, PER1, and CRY1. Conclusions: The findings highlight the complex interplay between OSA, circadian rhythms, and sleep-related variables, suggesting potential determinants of morning chronotype in OSA and implicating disrupted circadian clock function in subjective feelings of energy throughout the day. Further research is warranted to elucidate underlying mechanisms and guide personalized management strategies. [ABSTRACT FROM AUTHOR]

Light-at-night is known to produce a wide variety of behavioral outcomes including promoting anxiety, depression, hyperactivity, abnormal sociability, and learning and memory deficits. Unfortunately, we all live in a 24-h society where people are exposed to light-at-night or light pollution through nightshift work - the need for all-hours emergency services - as well as building and street-lights, making light-at-night exposure practically unavoidable. Additionally, the increase in screentime (tvs and smart devices) during the night also contributes to poorer sleep and behavioral impairments. Compounding these factors is the fact that adolescents tend to be "night owls" and prefer an evening chronotype compared to younger children and adults, so these teenagers will have a higher likelihood of being exposed to light-at-night. Making matters worse is the prevalence of high-school start times of 8 am or earlier - a combination of too early school start times, light exposure during the night, and preference for evening chronotypes is a recipe for reduced and poorer sleep, which can contribute to increased susceptibility for behavioral issues for this population. As such, this mini-review will show, using both human and rodent model studies, how light-at-night affects behavioral outcomes and stress responses, connecting photic signaling and the circadian timing system to the hypothalamic-pituitary adrenal axis. Additionally, this review will also demonstrate that adolescents are more likely to exhibit abnormal behavior in response to light-at-night due to changes in development and hormone regulation during this time period, as well as discuss potential interventions that can help mitigate these negative effects. [ABSTRACT FROM AUTHOR]

Background: Exercise is known to provide multiple metabolic benefits such as improved insulin sensitivity and glucose control in individuals with type 2 diabetes mellitus (T2DM) and those at risk. Beyond the traditional exercise dose, exercise timing is perceived as a contemporary hot topic, especially in the field of T2DM; however, the number of intervention studies assessing exercise timing and glucose metabolism is scarce. Our aim is to test the effect of exercise timing (i.e., morning, afternoon, or evening) on the inter-individual response variability in glycemic control and related metabolic health parameters in individuals with T2DM and those at risk during a 12-week intervention. Methods: A randomized crossover exercise intervention will be conducted involving two groups: group 1, individuals with T2DM; group 2, age-matched older adults with overweight/obesity. The intervention will consist of three 2-week blocks of supervised post-prandial exercise using high-intensity interval training (HIIT). Between each training block, a 2-week washout period, where participants avoid structured exercise, will take place. Assessments will be conducted in both groups before and after each exercise block. The primary outcomes include the 24-h area under the curve continuous glucose monitoring-based glucose. The secondary outcomes include body composition, resting energy expenditure, insulin response to a meal tolerance test, maximal aerobic capacity, peak power output, physical activity, sleep quality, and insulin and glucose levels. All primary and secondary outcomes will be measured at each assessment point. Discussion: Outcomes from this trial will provide us additional insight into the role of exercise timing on the inter-individual response variability in glycemic control and other related metabolic parameters in two distinct populations, thus contributing to the development of more effective exercise prescription guidelines for individuals with T2DM and those at risk. Trial registration: ClinicalTrials.gov NCT06136013. Registered on November 18, 2023. [ABSTRACT FROM AUTHOR]

Chronotype is an established concept designed to capture the internal clock's phase in real-life conditions. It is vital in many aspects of daily life and can interfere considerably with numerous factors in a given population. Recognizing nonmodifiable and modifiable factors is crucial for identifying covariates of interest when studying the link between chronotype and health status. To date, chronotype and its related factors have not been extensively investigated. The present study aimed to explore the association of chronotypes with meal frequency, physical activity, and demographic factors among the Saudi population. This cross-sectional web-based questionnaire involved 1369 adults (aged 18 years and above) from the general public in Saudi Arabia and was conducted between March and May 2019. Chronotype was assessed using the reduced version of the original Horne and Ostberg morningness-eveningness questionnaire (MEQ). Meal frequencies and demographics data (age, gender, marital status, place of residence, educational level, employment status, income) were obtained. Physical activity level was also obtained using the international physical activity questionnaire. The MEQ scores group individuals into three categories: morning-type, neither-type, and evening-type. The neither-type individuals represented 41.6% (95% confidence interval [CI], 37.5% − 45.6%) of the study population, followed by the morning-type (34.1%; 95% [CI], 29.8% − 38.4%), then the evening-type (24.3%, 95% [CI], 19.6% − 28.9%). Chronotype was significantly associated with age, marital status, employment status and monthly income (All p < 0.05). Significant associations between chronotype with meal frequencies (number of meals per day, breakfast frequency, lunch frequency, and dinner frequency) and physical activity were also observed (All p < 0.05). This study highlights that meal frequencies and physical activity levels are associated with chronotype distribution. Furthermore, demographics, including age, marital status, employment status, and income, were associated with chronotype distribution. [ABSTRACT FROM AUTHOR]

While the association between sleep-related variables and academic achievement is widely acknowledged, limited attention has been directed towards exploring non-cognitive predictors of academic achievement such as conscientiousness and self-regulation. In this study, we investigated the relationships between various sleep-related factors (circadian preference, chronotype, sleep duration, quality, and irregularity) and non-cognitive predictors (conscientiousness, self-regulation, self-efficacy, and achievement motivation) in 637 university students. Bivariate analyses revealed moderate to strong correlations among several sleep-related measures. Notably, distinctness, representing the subjective perception of daily changes, and daytime sleepiness exhibited negative associations with self-regulation, while high sleep quality was positively linked to robust self-regulation. These findings emphasize the importance of exploring various measures, particularly distinctness within circadian typology. Furthermore, we discuss the potential integration of sleep intervention programs with strategies aimed at enhancing self-regulation. [ABSTRACT FROM AUTHOR]

Background: Research suggests that exposure therapy delivered in the morning is more successful than delivered in the evening, which is often explained by higher diurnal endogenous cortisol levels. However, this "morning exposure effect" might also be explained by other factors such as sleep or vigilance. Methods: The current study aimed to disentangle these effects by assessing the impact of video-based exposure therapy delivered in the morning or in the evening, whilst considering pre-exposure sleep quality, vigilance, and cortisol levels. To this end, 80 snake fearful individuals were randomly assigned to receive exposure treatment in the morning or evening. Results: Contrary to previous findings, groups did not differ in their pre-post and post-follow up decrease of snake anxiety. However, higher vigilance was found to be associated with a greater pre-post and post-follow-up decrease in snake anxiety. Moreover, pre-exposure sleep efficiency moderated the post-follow-up decrease in snake anxiety across groups: In individuals with high pre-exposure sleep efficiency, those receiving exposure in the morning were estimated to show a stronger decrease in snake anxiety than those receiving exposure in the evening. The opposite pattern was found in individuals with low pre-exposure sleep efficiency. Conclusions: The results of this study illustrate that diurnal effects on exposure therapy might be more complex than previously assumed. Trial Registration: The study was prospectively preregistered at the German Clinical Trial Register (https://drks.de/search/en/trial/DRKS00016183). [ABSTRACT FROM AUTHOR]

Summary: Transition to motherhood is a period full of challenges and demands. In this review, we focused on the associations of sleep and circadian activity patterns during and after pregnancy with postpartum mental health factors. A systematic review and meta‐analysis were conducted (PROSPERO reference 316,505). A search for articles was performed using PsycARTICLES, PsycINFO, PubMed, MEDLINE, Scopus, Cochrane, DARE, hand search, and citation tracking. The search was meant to identify peer‐reviewed, experimental and observational studies reporting on women over 18 years old that assessed sleep and circadian activity patterns during pregnancy or postpartum using actigraphy, and investigated postpartum mental health factors. Nineteen relevant publications were selected. Postpartum total sleep at night was the indicator that was most closely related to the psychological functioning of women after childbirth. The results of the systematic review indicated that postpartum total sleep at night was related to postpartum fatigue, and the results of the meta‐analysis suggested that total sleep at night was most strongly linked with postpartum depression. More studies are needed to estimate the associations of sleep–wake rhythm during pregnancy and in the postpartum period with postpartum mental health factors. [ABSTRACT FROM AUTHOR]

Summary: Light can influence many psychophysiological functions beyond vision, including alertness, circadian rhythm, and sleep, namely the non‐image forming (NIF) effects of light. Melanopic equivalent daylight illuminance (mel‐EDI) is currently recommended as the predictor of the NIF effects of light. Although light dose is also critical for entraining and regulating circadian cycle, it is still unknown whether relatively low mel‐EDI light exposure for prolonged duration in the evening would affect pre‐sleep arousal and subsequent sleep. In all, 18 healthy college students (10 females, mean [standard deviation] age 21.67 [2.03] years) underwent 2 experimental nights with a 1 week interval in a simulated bedroom environment. During experimental nights, participants were either exposed to high or low mel‐EDI light (73 versus 38 lx mel‐EDI, 90 versus 87 photopic lx at eye level, 150 photopic lx at table level) for 3.5 h before regular bedtime, and their sleep was monitored by polysomnography. Subjective sleepiness, mood, and resting‐state electroencephalography during light exposure were also investigated. Results showed no significant differences in sleep structure and sleep quality between the two light conditions, whereas 3.5 h of exposure to high versus low mel‐EDI light induced marginally higher physiological arousal in terms of a lower delta but higher beta power density before sleep, as well as a lower delta power density during sleep. Moreover, participants felt happier before sleep under exposure to high versus low mel‐EDI light. These findings together with the current literature suggest that evening prolonged relatively low mel‐EDI light exposure may mildly increase arousal before and during sleep but affected sleep structure less. [ABSTRACT FROM AUTHOR]

Summary: Recent research provides evidence for the negative social perceptions of evening chronotypes and their consequences on mental health. However, there is a lack of studies indicating whether these negative, socially shared beliefs may become internalized in negative self‐perceptions of evening‐types (E‐types). The present article provides a seminal empirical analysis of the role of self‐liking and self‐competence in the associations between chronotype and both depressiveness and well‐being. In the first part of the study, the participants completed the Composite Scale of Morningness. On the basis of the chronotype cut‐off criteria for Composite Scale of Morningness distribution, 100 individuals were classified as morning‐types (M‐types) and 66 individuals as E‐types. Therefore, 166 participants (80 women and 86 men) aged 18–36 years (M ± SD: 29.27 ± 4.81 years) took part in the second part of the study, and completed questionnaires measuring self‐liking, self‐competence, life satisfaction, positive and negative affect, and depressiveness. Results show that E‐types scored lower in self‐liking, self‐competence and subjective well‐being, and higher in depressive symptoms than M‐types. Controlling for age and gender, we obtained significant mediation effects, showing that the relationship between chronotype and subjective well‐being might stem from the lower levels of self‐liking and self‐competence among E‐types, and that the relationship between chronotype and depressive symptoms might stem from the lower level of self‐liking among E‐types. Our results suggest that self‐liking and self‐competence are important antecedents of lower well‐being and higher depressiveness reported by E‐types. Socially shared stereotypes of M‐types and E‐types can be internalized by the extreme chronotypes, which may significantly affect their psychological health. [ABSTRACT FROM AUTHOR]

Summary: Hippocampal atrophy is a prominent neurodegenerative feature of Alzheimer's disease and related dementias. Alterations in circadian rhythms can exacerbate cognitive aging and neurodegeneration. This study aimed to examine how dim light melatonin onset and melatonin levels are associated with hippocampal volume in cognitively healthy individuals. We studied data from 52 later‐life adults (mean age ± SD = 70.0 ± 6.3 years). T1‐weighted anatomical images from 3.0 T magnetic resonance imaging data were collected and processed using the BRAINSTools toolbox. Dim light melatonin onset was used to assess circadian timing. The area under the curve was calculated to quantify melatonin concentration levels 6 hr before bedtime, and 14‐day wrist actigraphy data were used to assess habitual bedtime. Multiple linear regression modelling with hippocampal volume as the dependent variable was used to analyse the data adjusting for age and sex. The average dim light melatonin onset was 19:45 hours (SD = 84 min), and area under the curve of melatonin levels 6 hr before habitual bedtime was 38.4 pg ml−1 × hr (SD = 29.3). We found that later dim light melatonin onset time (b = 0.16, p = 0.005) and greater area under the curve of melatonin levels 6 hr before habitual bedtime (b = 0.05, p = 0.046) were associated with greater adjusted hippocampal volume. The time between dim light melatonin onset and the midpoint of sleep timing was not associated with hippocampal volume. The findings suggest that earlier circadian timing (dim light melatonin onset) and reduced melatonin may be associated with reduced hippocampal volume in older adults. Future research will help researchers utilize circadian rhythm information to delay brain aging. [ABSTRACT FROM AUTHOR]

Summary: Digital cognitive behavioural therapy for chronic insomnia (D‐CBT‐I) has been shown to be as efficacious as traditional CBT‐I. However, not all patients achieve insomnia remission after treatment. We explored the factors influencing the effectiveness of D‐CBT‐I in a clinical practice. A total of 414 Asian chronic insomniacs were studied during a 6 week D‐CBT‐I intervention. All patients were assessed at baseline and posttreatment and were determined to be remitters or non‐remitters, responders or non‐responders by posttreatment criteria; Insomnia Severity Index (ISI <8) or ISI reduction ≥8, to examine whether remission and response status were associated with patient baseline characteristics. The average baseline ISI score in all subjects was 16.29 points. At posttreatment, 192 (46.4%) patients achieved ISI remission and 218 (52.7%) patients demonstrated an ISI response. An increased baseline early morning awakening time and ISI score were independently associated with a lower odds for remission (OR, 0.995 and 0.991, respectively). Increased baseline Patients Health Questionnaire‐9 score was independently associated with higher odds for response (OR, 1.114). Our results suggest that D‐CBT‐I can be recommended as the first‐line treatment for chronic insomnia, particularly in insomniacs with milder insomnia symptoms and more severe depressive symptoms. Meanwhile, the effectiveness of D‐CBT‐I was adversely affected by longer early morning awakening time and higher insomnia severity at pretreatment, which may be improved by more intense intervention and greater therapeutic support or by traditional CBT‐I. [ABSTRACT FROM AUTHOR]

Globally, breast cancer continues to be the leading cause of cancer-related incidence and mortality among females. Research has shown that sleep patterns significantly influence tumor onset and progression. In this research, the association was examined through the application of a two-sample Mendelian randomization (MR) approach. For the analysis of seven sleep patterns, genetic tools were sourced from both the UK Biobank and 23andMe, including morning/evening person (chronotype) n = 177,604, morning person (chronotype) n = 248,094, daytime dozing/sleepiness n = 193,472, getting up in the morning n = 193,717, and sleeplessness n = 193,987; sleep duration n = 192,810; and nap during the day n = 166,853. The Breast Cancer Association Consortium (BCAC) supplied genome-wide association studies (GWAS) data, including 133,384 breast cancer cases and 113,789 controls, alongside subtype-specific data with 106,278 cases and 91,477 controls. We discovered that chronotype encompasses both morning and evening types contributes to the risk of overall breast cancer. While daytime dozing and morning person (chronotype) are linked to a lower risk of breast cancer in general, In subtype-specific analyses, morning person (chronotype) was negatively associated with luminal B, HER2-negative-like, and daytime dozing was negatively correlated with luminal A-like, luminal B-like, and HER2-enriched-like. The study corroborates that chronotype is a danger element for breast cancer, aligning with previous observational findings. The association between being a morning person (chronotype) or having daytime dozing and a decreased risk of breast cancer underscores the significance of sleep patterns in formulating strategies for cancer prevention. [ABSTRACT FROM AUTHOR]

Background: Canine coxofemoral joint osteoarthritis is a common, painful and debilitating condition. The objective of this study was to evaluate if any measurable changes in pain or lameness occurred in this patient group immediately after a single treatment with pulsed electromagnetic field therapy. Eight dogs with coxofemoral joint osteoarthritis presenting with signs of pain and lameness were prospectively recruited to this randomised, controlled, double blinded, cross-over study. Subjects attended the research facility on two occasions for one active and one placebo treatment with pulsed electromagnetic field therapy. The immediate effect of one pulsed electromagnetic field therapy treatment on pain and lameness was measured subjectively with the Helsinki Chronic Pain Index and Visual Analogue Scale and objectively using a pressure sensitive walkway. Results: A statistically significant difference (P = 0.03) for change in stride length in the affected limb was recorded for subjects between the active and placebo treatments with pulsed electromagnetic field therapy. Within the active treatment results, there was a statistically significant change in the measurement for reach (P = 0.04) and stride length (P = 0.047) which got shorter in the affected limb post treatment. For the subjective outcome measures, there was no statistically significant difference between the active and placebo treatments for the evening of the treatment day or the next morning from pre-treatment values. Within the placebo treatment results a statistically significant change (improvement) was detected in Visual Analogue Score (P = 0.03) between pre-treatment and the next morning values. Conclusions: The findings of this study do not show demonstrable improvement in owner assessed pain levels or temporospatial performance in dogs with coxofemoral joint osteoarthritis immediately after a single application of pulsed electromagnetic field therapy. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the genetic correlation and causal links between sleep traits (including sleep duration, chronotype, and insomnia) and myopia. Methods: Summary data on three sleep traits (sleep duration, chronotype and insomnia) and myopia from FinnGen (n = 214,211) and UK Biobank (n = 460,536) were analyzed using linkage disequilibrium score regression (LD Score), univariable and multivariable mendelian randomization (MR) experiments and Causal Analysis Using Summary Effect (CAUSE) estimation. Results: LD Score regression detected candidate genetic correlation between sleep traits and myopia, such as sleep duration, chronotype (Genetic Correlation Z-score >10.00, h2_observed_p < 0.005, Lambda GC > 1.05, p > 0.05). Univariable MR analyses indicated that increased sleep duration has a promotional effect on the occurrence of myopia (p = 0.046 < 0.05, P_FDR = 0.138 < 0.2, OR = 2.872, 95% CI: 1.018-8.101). However, after accounting for potential confounding factors, multivariable MR and CAUSE analysis did not provide evidence for a causal effect of the three sleep traits on myopia. Conclusion: There may be a potential genetic correlation between sleep duration, chronotype and myopia. However, neither of sleep duration, chronotype or insomnia had causal effect on myopia. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the association between sleep duration and muscle quality index (MQI) in middle-aged and older age groups, as limited evidence exists on this topic. Methods: In order to assess the relationship between sleep duration and MQI, a cross-sectional study was undertaken, utilizing data from the National Health and Nutrition Examination Survey (NHANES) acquired during the period from 2011 to 2014. The study comprised a total of 4598 participants aged 20 years and above. To examine the association between sleep duration and MQI, sophisticated weighted multivariate linear regression models were employed. Additionally, smooth curve fitting techniques were applied to examine the possibility of any non-linear relationship between the two variables. Results: The average age of the adults who were enrolled in the study was 38.48±11.69 years, and 46.75% of them were female. The results of the multivariable linear regression models showed that sleep duration had a positive correlation with MQI. However, when subgroup analysis was conducted, it was found that this positive correlation only existed among women (β = 0.09, 95% CI: 0.014 to 0.167). To further confirm the differences between sexes in the relationship between sleep duration and MQI, a weighted generalized additive model (GAM) was used. Conclusions: This research study provides evidence that there is a positive correlation between the duration of sleep and MQI specifically in females, while no such association was observed in males. These findings shed light on the existence of gender disparities in the connection between sleep duration and MQI. [ABSTRACT FROM AUTHOR]

Background: Social jetlag is a chronic disruption of sleep timing that is characterized by different sleep timing during workdays and free days. Social jetlag has been associated with disturbed glucose metabolism, insulin resistance, and increased risk of metabolic syndrome and type 2 diabetes. In this study, we aim to investigate whether a combination of bright light therapy in the morning, bright light reduction in the evening and sleep advance instructions for 3 weeks reduces social jetlag and if this results in improvement of glycemic and metabolic control, sleep, mood and quality of life after 3 and 12 weeks in people with prediabetes and type 2 diabetes and to assess possible mediators, compared to regular sleep habits. Methods: In this randomized controlled trial, 60 people with prediabetes or type 2 diabetes with > 1 h social jetlag will be recruited. The intervention consists of bright light therapy (5000 lx) emitted by Vitamine-L (Lumie, UK) for 30 min each morning, combined with the advice to follow sleep advance instructions and to wear bright light-dimming goggles every evening for a period of 3 weeks. The control group adheres to their regular sleep habits and conditions. The primary outcome is glycated hemoglobin (HbA1c) after 12 weeks comparing the intervention and control in an intention-to-treat analysis. Secondary outcomes at 3 and 12 weeks are (1) social jetlag; (2) insulin sensitivity, fasting blood glucose, glucose-lowering medication use, and frequency of perceived hypoglycemia; (3) metabolic outcomes, including body mass index (BMI), waist circumference, body fat percentage, and blood pressure; (4) mood, including depression, fatigue and anxiety (measured with questionnaires); and (5) quality of life measured using EQ5D questionnaire. To assess other factors that might play a role as possible mediators, we will measure (para)sympathetic nervous system activity assessed with ECGs and electrochemical skin conductance tests, sleep quality and sleep phase distribution assessed with a sleep measuring headband (ZMax), the Dim Light Melatonin Onset in saliva samples (in a subgroup) at 3 and 12 weeks, the feeling of satiety and satiation with a 10-cm visual analog scale (VAS), diet using a food frequency questionnaire, and physical activity using an accelerometer (ActiGraph). Discussion: Social jetlag can contribute to poorer glycemic control and metabolic control in those with type 2 diabetes. With this intervention, we aim to reduce social jetlag and thereby improve glycemic and metabolic control. This could offer a way to improve overall population health and to reduce the disease burden of type 2 diabetes. Trial registration: ISRCTN registry ISRCTN11967109. Registered on 9 May 2024. [ABSTRACT FROM AUTHOR]

The rMEQ, a popular tool for assessing chronotype/circadian preference across languages, lacks availability in Hindi, a widely spoken language. Therefore, the study aims to validate Hindi version of rMEQ in Indian adults with additional objectives to explore the prevalence and impact of chronotype on energy levels and sleep-wake behavior. It involved 605 participants aged 18-50, using the Hindi-rMEQ, with Hindi Composite Scale of Morningness (CSM-Hindi), Circadian Energy Scale (CIRENS), also recording sleep/wake times on workdays and free days. Most participants belonged to morning chronotypes (56.7%), followed by 34.2% neither type, and 9.1% evening chronotypes. The rMEQ-H demonstrated satisfactory internal consistency (Cronbach’s α=0.602) and confirmed a one-dimensional morningness construct validated through principal component analysis with varimax rotation. Positive correlations between rMEQ-H and CSM-Hindi scores validated the chronotype classifications between the two inventories. While significant negative correlations with CIRENS scores and sleep-wake times supported the effectiveness of rMEQ-H in quantifying chronotype, indicating its convergent validity. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATI-ONPurpose: The study examined the benefits of transparent versus non-transparent surgical masks on the speech intelligibility in quiet of adult cochlear implant (CI) users, in conjunction with patient preferences and the acoustic effects of the different masks on the speech signal.Methods: Speech tracking test (STT) scores and acoustical characteristics were measured in quiet for live speech in three different conditions, without mask, with a non-transparent surgical mask and with a transparent surgical mask. Patients were asked about their experience with the face masks. The study sample consists of 30 patients using a cochlear implant.Results: We found a significant difference in speech perception among all conditions, with the speech tracking scores revealing a significant advantage when switching from the non-transparent surgical mask to the transparent one. The transparent surgical mask, although it does not transmit high frequencies effectively, seems to have minimal effect on speech comprehension in practice when lip movements are visible. This substantial benefit is further emphasized in the questionnaire, where 82% of the patients express a preference for the transparent surgical mask.Conclusion: The study highlights significant benefits for patients in speech intelligibility in quiet with the use of medically safe transparent facemasks. Transitioning from standard surgical masks to transparent masks demonstrates highly significant effectiveness and patient satisfaction for patients with hearing loss. This research strongly advocates for the implementation of transparent masks in broader hospital and perioperative settings.In scenarios mandating mask usage, it’s advisable for caregivers to opt for transparent surgical masks. Specifically within perioperative settings, where patients might not be able to utilise their hearing aids or cochlear implants, it becomes imperative for all caregivers to consistently wear transparent surgical masks to prevent communication impediments.When utilising a transparent surgical mask, caregivers must recognise that sound may be altered and maintaining a clear view of the face and lips is crucial for effective communication.In scenarios mandating mask usage, it’s advisable for caregivers to opt for transparent surgical masks. Specifically within perioperative settings, where patients might not be able to utilise their hearing aids or cochlear implants, it becomes imperative for all caregivers to consistently wear transparent surgical masks to prevent communication impediments.When utilising a transparent surgical mask, caregivers must recognise that sound may be altered and maintaining a clear view of the face and lips is crucial for effective communication. [ABSTRACT FROM AUTHOR]

Assessing chronotype is essential in clinical and research environments, but the Munich ChronoType Questionnaire (MCTQ), a widely utilised tool, is not available in French. Therefore, we carried out an observational monocentric study to validate the French MCTQ against the sleep diary for sleep schedules, the Morningness-Eveningness Questionnaire (MEQ) for chronotype, and polysomnography measures. We utilised the mid-sleep point on free days (MSF), adjusted for sleep debt (MSFsc), to gauge morningness/eveningness. The study included 80 participants (average age: 40.9 years, 50% female). The sleep schedules determined by the MCTQ and the sleep diary showed a high correlation. The MSFsc demonstrated a significant correlation with the MEQ, persisting even under sleep constraints such as an alarm on free days. The predictive accuracy was strong for a morning chronotype and moderate for an evening chronotype as assessed using the MEQ. In summary, the French MCTQ is a reliable tool for researchers and clinicians for assessing sleep schedules and chronotype in French-speaking populations. The MSFsc can effectively predict chronotype, even under sleep constraints. However, for the evening chronotype, self-assessment appears to be more accurate. The association with polysomnography measures enriches our understanding of the chronotype at the intersection of behaviour and physiology. [ABSTRACT FROM AUTHOR]

Ecological momentary assessment (EMA) allows measuring intra-individual processes moment by moment, identifying and modeling, in a naturalistic way, individual levels and changes in different psychological processes. However, active EMA requires a high degree of adherence, as it implies a significant burden for patients. Moreover, there is still no consensus on standardized procedures for implementation. There have been few results in detecting desirable characteristics for the design and implementation of an EMA device. Studies that address these issues from the perspectives of participants in psychotherapeutic processes are needed. To analyze the perspectives of patients, therapists and supervisors on the implementation of an EMA device in a psychotherapeutic treatment for depression. The sample will include eight patients, eleven therapists and five supervisors, taken from a research project that implemented an EMA system for monitoring the dynamics of affectivity at the beginning of psychotherapies for depression. Semi-structured interviews specific to each group are being conducted and analyzed from a qualitative approach based on consensual qualitative research (CQR). Participants reported having a positive evaluation of the study's informational resources and implementation. Difficulties were expressed in responding in the morning hours and the importance of having a customized EMA that is tailored to the needs of the patients was expressed. Furthermore, patients and therapists agreed that the impact of the use of the monitoring system on treatment was neutral or positive. In contrast, patients considered the EMA to be positive for their daily life. [ABSTRACT FROM AUTHOR]

Hunting triggers behavioral responses in wildlife that may have important consequences for conservation and wildlife management. We studied movement and habitat selection in 51 global positioning system‐collared red deer (Cervus elaphus) in response to 63 large‐scale (x̄ = 18.8 km2) drive hunts conducted in 2015‐2022 on a military training area in southern Germany. The drive hunts were characterized by a low density of beaters and dogs to avoid rapid and long‐distance displacement of red deer. We determined if red deer spatial responses to drive hunts differed in various forest covers, between sexes, and in relation to the individual position prior to the hunt. On the hunting days, red deer increased their hourly displacement rates and shifted their preference for forest versus open habitats from early morning to late morning hours. Individuals initially located within the boundaries of the hunted areas exhibited longer maximum net displacements, had a greater probability of leaving their home ranges, and spent longer times outside of their home ranges than individuals outside the hunted areas. All these parameters were greater in the more forested site than in the less forested site. Males displayed shorter net displacements than females. Red deer moved away (i.e., fled) from their initial positions for variable periods, either only during the hunt or until the next day. The probability of prolonged flight was greater in the more forested site and more likely if the individuals were deeper in the forest in the less forested site. The prolonged flight behavior was desired from the hunters' perspective because red deer displaying this type of response were less likely to leave the hunted area during the hunt. Prolonged flight was associated with greater costs for the red deer, such as greater movement distances after the hunt and longer times outside of home ranges. Wildlife managers should consider that drive hunts may cause prolonged behavioral responses in game that occur both inside and outside the hunted areas. These responses depend on habitat characteristics and may be stronger in more forested landscapes. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess age- and sex-related differences in multiple sleep latency test (MSLT) results and in the performance of the Epworth Sleepiness Scale (ESS) at classifying objective hypersomnia (mean sleep latency (MSL) ≤ 8 min). We studied 480 consecutive adults (39.3 ± 15.3 years old [18–93], 67.7% female) who underwent hypersomnia evaluation. We fit linear regression models to investigate associations between age and sex and sleep latencies (mean and for every nap), after adjusting for total sleep time and sleep efficiency (on polysomnography), and REM-suppressing antidepressant effect. A logistic regression was performed to assess whether age and sex were associated with sleep-onset REM period (SOREMP) occurrence. ROC analysis assessed the diagnostic performance of ESS scores to identify a MSL ≤ 8 min in different age/sex groups. For every 10 years of age, there was 0.41 (95% CI 0.11–0.72, p = 0.008) min reduction in MSL. Objectively (MSL ≤ 8 min) sleepy patients had shortening of latencies in naps 4 and 5 with aging. Female sex was associated with a higher MSL only in patients with MSL > 8 min. A 2.4% reduction in the odds of SOREMP occurrence was observed for every year of age in objectively sleepy patients (p = 0.045). ESS scores had a better diagnostic performance in older (≥ 50 years old) men than younger (< 50 years old) women (p < 0.05). Older patients with objectively confirmed hypersomnia may be sleepier in later naps, possibly due to less restorative naps and/or circadian rhythm factors. Self-reported sleepiness is more predictive of objective sleepiness in older men than younger women. [ABSTRACT FROM AUTHOR]

Evening chronotype is known to be associated with various chronic diseases and cardiovascular risk factors. Metabolic syndrome is a group of conditions that together raise the risk of coronary heart disease, diabetes, stroke, and other serious health problems. Only a few studies have been published on the association between chronotype and metabolic syndrome in unselected population data, with conflicting results. The aim of this study was to evaluate the association between chronotype and metabolic syndrome at population level by using unselected Northern Finland Birth cohort 1966 (NFBC1966) database. The study population consists of participants with NFBC66 (n = 5,113, 57% female) at the age of 46 yr old. Chronotype was determined with shortened Morningness–Eveningness Questionnaires and expressed as morning (44%), intermediate (44%), and evening types (12%). Metabolic syndrome was determined according to the definition of International Diabetes Federation. One-way ANOVA, Kruskal–Walli's test, and χ2 tests were used to compare the chronotype groups, followed by logistic regression analysis (adjusted with alcohol consumption, smoking, marital status, level of education, and leisure-time physical activity). In women, the prevalence of metabolic syndrome was statistically significantly higher in the evening type group: 23, 24, and 34% for morning, intermediate, and evening groups, respectively (P < 0.001). In logistic regression analysis, evening chronotype was associated with higher risk of having metabolic syndrome (OR 1.5; CI 95% 1.2 to 2.0). In this population-based birth cohort study, the evening chronotype was independently associated with higher prevalence of metabolic syndrome in women. NEW & NOTEWORTHY: Only a few studies have been conducted on the association between chronotype and metabolic syndrome in unselected population data, with conflicting results. In this population-based cohort study of 5,113 participants, the evening chronotype associated with metabolic syndrome in women when there was no such association in men. The result supports a previous South Korean population study of 1,620 participants, in which the association was also found in women, but not in men. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the prevalence, clinical correlates and the relationship between hypersomnolence and clinical outcomes in a cohort of MDD patients. This is a cross-sectional study of a MDD cohort in an university-affiliated adult psychiatric outpatient clinic. The diagnosis of MDD and severity of depression were ascertained by the clinician with structured clinical interviews. Each participant completed the Epworth Sleepiness Scale (ESS), 1-week sleep diary, and a battery of questionnaires that assessed usual sleep pattern, insomnia, anxiety, depression, fatigue and circadian preference. Hypersomnolence was defined as ESS score ≥14 among those reported ≥7 h of nighttime sleep. Univariate analysis and multiple logistic regression were used to analyze the relationships between the variables. Among 252 recruited subjects, 11 % met the criteria of hypersomnolence as defined by a ESS score ≥14 despite ≥7 h of nighttime sleep. Patients with hypersomnolence had greater depression ratings, higher rates of suicidal ideations over the past week, and more likely to meet a diagnosis of atypical depression (p < 0.05) than those without hypersomnolence. Step-wise logistic regression demonstrated that hypersomnolence was an independent risk factor associated with a 3-fold increase in the risk of depression non-remission (adjusted OR 3.13; 95 % CI 1.10–8.95; p = 0.034). Patients with hypersomnolence despite seemingly adequate sleep represent a subgroup of MDD patients who have a more severe illness profile with higher non-remission rate and suicidality. The findings highlight the importance of addressing both sleep and mood symptoms in the management of MDD. • EDS despite adequate sleep is a common problem in MDD (11 %). • Hypersomnolence is associated with a 3-fold increase in risk of non-remission. • Comprehensive assessment of hypersomnolence is needed to improve the depression outcomes. [ABSTRACT FROM AUTHOR]

Preliminary 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. In 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. The 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. The idea that variation in circadian factors influences response to antidepressants was supported and encourages exploration of circadian mechanisms of depressive disorders and antidepressant treatments. [ABSTRACT FROM AUTHOR]

We investigated the effects of daily ultraviolet A1 (UV-A1, 340–400 nm) exposures on mood states (#R19055, approval on 21 October 2020). Based on our earlier findings of the influence of diurnal preference on mood, we investigated further whether diurnal preference plays a role in the influence of UV-A1 on mood states. Forty-one healthy participants aged 19–55 years were randomized to receive either UV-A1 (n = 21) or control (n = 20) exposures (violet light, 390–440 nm). The irradiations were administered on three consecutive mornings on the skin of the buttocks and middle back. Diurnal preference was assessed with the modified 6-item Morningness-Eveningness Questionnaire (mMEQ). Changes in mood were assessed with Total Mood Disturbance (TMD) score of the 40-item Profile of Mood States (POMS) before the first irradiation, immediately after each irradiation and one week after the last irradiation. Mood improved among those subjected to UV-A1 exposures compared with the controls (p = 0.031). Individuals with more pronounced morningness had mood improvement (p = 0.011), whereas those with more pronounced eveningness did not (p = 0.41). At follow-up of one week after the last irradiation the mood improvement had disappeared. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Most airline pilots reported having suffered from sleep disorders and fatigue due to circadian disruption, a potential risk to flight safety. This study attempted to uncover the actual scenario of circadian disruption and working load status among airline pilots. METHODS: In study 1, 21 pilots were invited to participate in a 14-d sleep monitoring and a dual 2-back test to monitor their sleep patterns and cognitive function level. To provide an in-depth view, data from scheduled flights, including 567 airline pilots, was analyzed in Study 2. The present study used cluster analysis to reflect the distribution of the flight scheduling characteristics, including working time and actual working hours. A simulation model was then developed to predict the pilots' 1-mo sleep-wake pattern. RESULTS: The results indicated that sleep problems were prevalent in this population, especially the night before an earlier morning shift. Regarding the cognitive test, they scored the lowest on earlier morning shifts compared with daytime and evening shifts. It was found that over 70% of the flight schedules can lead to circadian disruption, and 47.44% of the pilots worked under high-load status. DISCUSSION: Airline pilots inevitably work irregular hours and the current policies for coping with circadian disruption seem inefficient. This study thus calls for urgency in improving scheduling and fatigue management systems from the circadian rhythm perspective. [ABSTRACT FROM AUTHOR]

Introduction: Depressive disorder is a common public health problem that significantly impairs quality of life and has a high risk of mortality and morbidity. The aim of this study was to investigate circadian rhythm differences, stressful life events an d coping styles in patients with depression. Materials and Methods: The study involved 100 participants, including 50 patients with depression and 50 healthy controls, recruited from the psychiatric clinic of one-university hospital. The participants completed a sociodemographic information form, Beck Depression Inventory (BDI), Life Events Checklist (LEC-5), Coping Inventory for Stressful Situations-Short Form (CISS-21) and MorningnessEveningness Questionnaire (MEQ). Results: The mean age of the patients with depression was 31.88±10.6 years, and the control group was 29.84±8.02 years. Emotional coping was significantly higher in patients with depression compared to the control group, whereas task -oriented coping was significantly lower than the control group. The majority of both depression and the control group consisted of intermediate type. Natural disasters, severe suffering, and other stressful events or experiences were more frequent stressful life events in the depression group. Task-oriented coping scores and emotional coping scores showed significant discrimination with sensitivity and specificity values. Conclusion: Recognizing stressful life events and the coping strategies used to deal with them is important for identifying major depression and developing treatment and follow-up plans. Longitudinal studies are needed to fully understand how coping methods interacts with depression in recovery from traumatic events. [ABSTRACT FROM AUTHOR]

Introduction: Sleep is associated with psychiatric disorders. However, their causality remains unknown. Methods: The study explored the causal relationship between seven sleep parameters (sleep duration, insomnia, sleep apnea, chronotype, daytime dozing, napping during the day, and snoring) and three psychiatric disorders including major depressive disorder (MDD), schizophrenia, and attention-deficit/ hyperactivity disorder (ADHD) using two-sample Mendelian randomization (MR). Genome-wide association study (GWAS) summary data for sleep parameters were obtained from the United Kingdom biobank, FinnGen biobank, and EBI databases. MR-Egger, weighted median, inverse-variance weighted (IVW), simple mode, weighted mode, maximum likelihood, penalized weighted median, and IVW(fixed effects) were used to perform the MR analysis. The heterogeneity was detected by Cochran’s Q statistic. The horizontal pleiotropy was detected by MR Egger. The sensitivity was investigated by the leave-one-out analysis. Results: Insomnia (OR = 2.02, 95%CI = 1.34–3.03, p = 0.001, False-discovery rate (FDR) corrected p-value = 0.011) and napping during the day (OR = 1.81, 95%CI = 1.34–2.44, FDR corrected p-value<0.001) were associated with an increased risk of MDD. Longer sleep duration (OR = 2.20, 95%CI = 1.24–3.90, FDR corrected p-value = 0.049) had an association with the increased risk of schizophrenia, while daytime dozing (OR = 4.44, 95%CI = 1.20–16.41, corrected p-value = 0.088)and napping during the day (OR = 2.11, 95%CI = 1.11–4.02, FDR corrected p-value = 0.088) had a suggestive association with an increased risk of schizophrenia. Longer sleep duration had a suggestive association with a decreased risk of ADHD (OR = 0.66, 95%CI = 0.42–0.93, FDR corrected p-value = 0.088). Conclusion: This study provides further evidence for a complex relationship between sleep and psychiatric disorders. Our findings highlight the potential benefits of addressing sleep problems in the prevention of psychiatric disorders. [ABSTRACT FROM AUTHOR]

Many insects depend on high-altitude, migratory movements during part of their life cycle. The daily timing of these migratory movements is not random, e.g. many insect species show peak migratory flight activity at dawn, noon or dusk. These insects provide essential ecosystem services such as pollination but also contribute to crop damage. Quantifying the diel timing of their migratory flight and its geographical and seasonal variation, are hence key towards effective conservation and pest management. Vertical-looking radars provide continuous and automated measurements of insect migration, but large-scale application has not been possible because of limited availability of suitable devices. Here, we quantify patterns in diel flight periodicity of migratory insects between 50 and 500 m above ground level during March-October 2021 using a network of 17 vertical-looking radars across Europe. Independent of the overall daily migratory movements and location, peak migratory movements occur around noon, during crepuscular evening and occasionally the morning. Relative daily proportions of insect migration intensity and traffic during the diel phases of crepuscular-morning, day, crepuscular-evening and night remain largely equal throughout May-September and across Europe. These findings highlight, extend, and generalize previous regional-scale findings on diel migratory insect movement patterns to the whole of temperate Europe. This article is part of the theme issue 'Towards a toolkit for global insect biodiversity monitoring'. [ABSTRACT FROM AUTHOR]

Summary Arousal is a central component of many emotional symptoms and can contribute to insomnia. Here we assessed how the timing and fluctuating nature of arousal‐related symptoms over the course of the day relate to insomnia symptom severity. In this study, 361 participants (M age = 31.9 years, 282 women, 77 men, 2 non‐binary individuals) completed the Insomnia Severity Index to assess severity of insomnia symptoms, followed by repeated ratings of anxiety or nervousness, stress, sleepiness, and feeling down via their mobile phone between ~08:00 hours and 00:00 hours across 1 day. Measures of dynamics included: mean levels across the day; variation (standard deviation); instability (mean squared successive differences); and resistance to change/inertia (first‐order autocorrelation). Time‐of‐day patterns were modelled using generalized additive mixed effects models. Insomnia symptom severity (mean Insomnia Severity Index = 9.1, SD = 5.2, range 0–25) was associated with higher mean levels of all arousal‐related symptoms, and increased instability and variation throughout the day in anxiety or nervousness, stress, and feeling down. Resistance to change (inertia) was not associated with insomnia symptom severity. Generalized additive mixed effects analyses showed that while individuals with more severe insomnia symptoms had elevated symptoms across the entire day, they were especially more anxious or nervous and sleepy in the early morning (~08:00 hours), anxious or nervous, stressed and sleepy in the late afternoon/early evening (~16:00 hours–21:00 hours), and anxious or nervous and stressed in the late evening (~22:00 hours). Remarkably, higher arousal occurred in the presence of high subjective sleepiness. Together these results indicate that insomnia symptom severity is associated with problems with daytime and evening arousal regulation. [ABSTRACT FROM AUTHOR]

Rapid eye movement sleep (REMS) is increasingly suggested as a discriminant sleep state for subtle signs of age-related neurodegeneration. While REMS expression is under strong circadian control and circadian dysregulation increases with age, the association between brain aging and circadian REMS regulation has not yet been assessed. Here, we measure the circadian amplitude of REMS through a 40-h in-lab multiple nap protocol in controlled laboratory conditions, and brain microstructural integrity with quantitative multi-parameter mapping (MPM) imaging in 86 older individuals. We show that reduced circadian REMS amplitude is related to lower magnetization transfer saturation (MTsat), longitudinal relaxation rate (R1) and effective transverse relaxation rate (R2*) values in several white matter regions mostly located around the lateral ventricles, and with lower R1 values in grey matter clusters encompassing the hippocampus, parahippocampus, thalamus and hypothalamus. Our results further highlight the importance of considering circadian regulation for understanding the association between sleep and brain structure in older individuals. This study highlights the circadian regulation of rapid eye movement sleep as a neurophysiological correlate of subtle brain microstructural changes in key brain regions sensitive to aging and involved in sleep-wake regulation. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Adolescents vary considerably in their circadian phase preference; those with greater “eveningness” (also known as “night owls”) have later bedtimes, wake times, and peak arousal compared to those with greater “morningness.” Prior research suggests that (a) greater eveningness is associated with worse academic, executive, and attentional functioning; and (b) adolescents with attention‐deficit/hyperactivity disorder (ADHD) tend to be high in eveningness and to have deficits in these school‐related constructs. However, few studies have examined circadian preference alongside two potential confounds—sleep duration and sleep quality—as predictors of daytime functioning, or whether the strength of associations differs across adolescents with and without ADHD.Participants were 302 adolescents (Mage = 13.17 years; 44.7% female; 81.8% White); approximately half (52%) had ADHD. A multi‐method, multi‐informant design was used. Specifically, adolescents reported on their circadian preference, school night sleep duration, and sleep quality. Adolescents provided ratings of their academic motivation (intrinsic, extrinsic, and amotivation) and were administered standardized achievement tests in reading and math. Adolescents and parents completed ratings of daily life executive functioning (behavioral, emotion, and cognitive regulation), and they and teachers also provided ratings of ADHD inattentive symptoms.Above and beyond sleep duration, sleep quality, and covariates (sex, family income, pubertal development, medication use), greater eveningness was uniquely associated with poorer academic, executive, and attentional functioning across most measures. Sleep quality was uniquely associated with a handful of outcomes, and sleep duration was not significantly uniquely associated with any outcome in the regression analyses. ADHD status did not moderate effects.This study provides compelling evidence that poorer academic, executive, and attentional functioning are more closely associated with greater eveningness than with sleep duration or quality in adolescents. Findings suggest that targeting circadian preference may be important to reduce these problems in adolescents, especially in clinical samples such as ADHD for whom academic, executive, and attentional difficulties are exceptionally common. [ABSTRACT FROM AUTHOR]

The negative effects of shift work on oxidant-antioxidant balance are known, but its impact on dietary total antioxidant capacity (dTAC) is less studied. This cross-sectional study investigated dTAC among nurses on rotating schedules N = 44). Dietary intake of antioxidants – total carotenoids, ascorbic acid, tocopherols, and total flavonoids – was assessed using seven consecutive 24-hour dietary recalls. The dTAC was estimated using four methods: oxygen radical absorption capacity (ORAC), Trolox equivalent antioxidant capacity (TEAC), total radical trapping antioxidant parameter (TRAP), and ferric reducing antioxidant potential (FRAP). Sleep quality and chronotype were assessed using the Pittsburgh Sleep Quality Index and the Morningness-Eveningness Questionnaire, respectively. Findings indicated a significant elevation in dTAC during night shifts (p < 0.05), driven by increased tea consumption, despite reduced fruit and legume intake. These findings highlight the importance low-calorie, antioxidant-rich food – such as vegetables, fruits, and legumes – to enhance flavonoid intake and dTAC levels in shift workers. [ABSTRACT FROM AUTHOR]

Protecting brain health is a goal of early intervention. We explored whether sleep quality or chronotype could predict white matter (WM) integrity in emerging mental disorders. Young people (N = 364) accessing early‐intervention clinics underwent assessments for chronotype, subjective sleep quality, and diffusion tensor imaging. Using machine learning, we examined whether chronotype or sleep quality (alongside diagnostic and demographic factors) could predict four measures of WM integrity: fractional anisotropy (FA), and radial, axial, and mean diffusivities (RD, AD and MD). We prioritised tracts that showed a univariate association with sleep quality or chronotype and considered predictors identified by ≥80% of machine learning (ML) models as 'important'. The most important predictors of WM integrity were demographics (age, sex and education) and diagnosis (depressive and bipolar disorders). Subjective sleep quality only predicted FA in the perihippocampal cingulum tract, whereas chronotype had limited predictive importance for WM integrity. To further examine links with mood disorders, we conducted a subgroup analysis. In youth with depressive and bipolar disorders, chronotype emerged as an important (often top‐ranking) feature, predicting FA in the cingulum (cingulate gyrus), AD in the anterior corona radiata and genu of the corpus callosum, and RD in the corona radiata, anterior corona radiata, and genu of corpus callosum. Subjective quality was not important in this subgroup analysis. In summary, chronotype predicted altered WM integrity in the corona radiata and corpus callosum, whereas subjective sleep quality had a less significant role, suggesting that circadian factors may play a more prominent role in WM integrity in emerging mood disorders. [ABSTRACT FROM AUTHOR]

In the current study, we examined the association between eveningness and testosterone levels in men. Specifically, we differentiated between free and total testosterone fractions, with free testosterone being recognized as the most bioavailable form of this hormone. We collected blood samples from 298 men aged 18–44 to assess total and free testosterone. Additionally, we measured sleep timing variables using the Munich Chronotype Questionnaire. The main result of the current study indicated that evening chronotype was associated with higher levels of free testosterone, but was unrelated to total testosterone. Sleep loss was unrelated to the both testosterone fractions. We expanded prior findings by utilizing a more comprehensive testosterone assay what indicated that evening chronotype is primarily associated with the most bioavailable form of testosterone (i.e. free testosterone) in adult men. [ABSTRACT FROM AUTHOR]

The bimodal preference is a fourth diurnal preference proposed by re-scoring the Morningness-Eveningness Questionnaire. The present work aimed to describe the prevalence of the bimodal preference in a sample of undergraduate students and to characterize the bimodal type in terms of their health and sleep-related outcomes. A web-based cross-sectional study conducted between September 2018 and March 2021 (convenience sampling method). The sample was composed of undergraduate students who completed an electronic form that included the Morningness and Eveningness Questionnaire, the Pittsburgh Sleep Quality Index, the Self-Compassion Scale, the Epworth Sleepiness Scale, the Hospital Anxiety and Depression Scale, and the World Health Organization Subjective Well-Being Index. The final sample consisted of 615 students (82% female, mean age: 23.4 ± 6.5 years), of whom 108 (18%) had positive bimodality indexes. Bimodal subjects comprised 48 students, 8% of the total sample. Bimodal subjects had poorer subjective sleep quality, more daytime sleepiness, lower subjective well-being, greater anxiety and depression symptoms, and lower self-compassion than morning and/or intermediate types; they did not differ from evening types. The description of bimodal diurnal preference in this population may be of interest for the design of academic policies more in line with the circadian reality of students. [ABSTRACT FROM AUTHOR]

Sleep timing is an important output of the circadian system. The COVID-19-mandated social restrictions significantly altered commuting time and sleep duration regionally in Japan. This study aimed to elucidate sleep patterns, especially chronotype and social jetlag (SJL), due to changes in social time pressure through the social restrictions between the Metropolitan and Regional areas in Japan. As part of the Global Chrono Corona Survey 2020 (GCCS), the data were collected during social restrictions (SR), but pre-COVID-19 behaviours were also queried retrospectively. We analyzed a cohort of 729 respondents representing both the Metropolitan and the Regional areas separately for workdays and work-free days. While the areas showed no difference in SJL before SR, the differential decrease was larger in the Metropolitan area during SR, resulting in a significant difference in SJL between the areas. The outdoor light exposure before SR was 30 min longer in the Metropolitan areas than in the Regional; during SR both areas showed similarly low (below 1 h) outdoor light exposures. The variables associated with decreased SJL were the Metropolitan areas, work-from-home, a no-usage alarm clock on workdays, and chronotypes (mid-sleep time on free days corrected for sleep deficit accumulated over the workweek, MSFsc) during SR. The results suggest that relaxed social schedules, as reflected in the increased frequency of work-from-home and reduced alarm clock use, and moving towards earlier MSFsc during SR were linked to decreased SJL and were more prominent in the Metropolitan areas. This study provides insights into sleep patterns and the social time pressure markers, by comparison between residential groups in Japan. [ABSTRACT FROM AUTHOR]

Fixed‐dose combination (FDC) therapies can enhance patient convenience and adherence to prescribed treatment regimens. Elagolix is a novel oral gonadotropin‐releasing hormone receptor antagonist approved for management of moderate to severe pain associated with endometriosis and heavy menstrual bleeding associated with uterine fibroids. Hormonal add‐back therapy can attenuate the reversible hypoestrogenic effects of elagolix. An FDC formulation containing elagolix/estradiol (E2)/norethindrone acetate (NETA) 300/1/0.5 mg as the morning dose and an elagolix 300 mg capsule as the evening dose, were evaluated in 2 bioequivalence studies including the effects of food. Study 1 in premenopausal women assessed the bioavailability of the elagolix 300‐mg capsule relative to the commercially available elagolix 300‐mg tablet. Study 2 in postmenopausal women, elagolix/E2/NETA (300 mg/1 mg/0.5 mg) FDC capsule was assessed relative to the elagolix 300‐mg tablet coadministered with E2/NETA 1‐mg/0.5‐mg tablet, the regimen that was studied in Phase 3 uterine fibroid studies. Under fasting conditions, the test elagolix 300‐mg capsule was bioequivalent to the reference elagolix 300‐mg tablet. Under fasting conditions, the elagolix/E2/NETA FDC capsule was bioequivalent to the coadministered elagolix 300‐mg tablet and E2/NETA 1/0.5‐mg tablet. Following administration of elagolix/E2/NETA FDC capsule after a high‐fat breakfast, elagolix mean maximum concentration (Cmax) and area under the plasma concentration‐time curve (AUC) were 38% and 28% lower, relative to fasting conditions. NETA mean Cmax was 51% lower and AUC from time 0 to infinity was 20% higher, while baseline‐adjusted total estrone mean Cmax and AUC were 46% and 14% lower, respectively. No safety concerns were identified. These results enabled bridging the elagolix/E2/NETA FDC capsule. [ABSTRACT FROM AUTHOR]

Molecular timing mechanisms known as circadian clocks drive endogenous 24-h rhythmicity in most physiological functions, including innate and adaptive immunity. Consequently, the response to immune challenge such as vaccination might depend on the time of day of exposure. This study assessed whether the time of day of vaccination (TODV) is associated with the subsequent immune and clinical response by conducting a systematic review of previous studies. The Cochrane Library, PubMed, Google, Medline, and Embase were searched for studies that reported TODV and immune and clinical outcomes, yielding 3114 studies, 23 of which met the inclusion criteria. The global severe acute respiratory syndrome coronavirus 2 vaccination program facilitated investigation of TODV and almost half of the studies included reported data collected during the COVID-19 pandemic. There was considerable heterogeneity in the demography of participants and type of vaccine, and most studies were biased by failure to account for immune status prior to vaccination, self-selection of vaccination time, or confounding factors such as sleep, chronotype, and shiftwork. The optimum TODV was concluded to be afternoon (5 studies), morning (5 studies), morning and afternoon (1 study), midday (1 study), and morning or late afternoon (1 study), with the remaining 10 studies reporting no effect. Further research is required to understand the relationship between TODV and subsequent immune outcome and whether any clinical benefit outweighs the potential effect of this intervention on vaccine uptake. [ABSTRACT FROM AUTHOR]

We aim to examine the association of sleep duration, sleep quality, late chronotype, and circadian misalignment with glycemic control and risk of complications in young adults with youth-onset type 2 diabetes followed in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study. Self-reported sleep duration, quality, timing, and circadian misalignment were assessed via a modified Pittsburgh Sleep Quality Index (PSQI) questionnaire, and chronotype was assessed via the Morningness-Eveningness Questionnaire (MEQ). We examined diabetes complications including loss of glycemic control (defined as hemoglobin A1c ≥8%), hypertension, dyslipidemia, albuminuria, and diabetic peripheral neuropathy. Multivariable logistic regression models were constructed to assess associations between sleep and circadian measures with outcomes of interest, such as loss of glycemic control and diabetes complications. A total of 421 participants (34.2% male), mean age 23.6 ± 2.5 yr, mean body mass index (BMI) of 36.1 ± 8.3 kg/m2, and mean diabetes duration of 10.0 ± 1.5 yr were evaluated. Self-reported short sleep duration, daytime sleepiness, and sleep quality were not associated with loss of glycemic control or diabetes complications. Late self-reported bedtime (after midnight) on work/school nights, rather than self-expressed chronotype or circadian misalignment, was independently associated with loss of glycemic control. An association was seen between late bedtimes and albuminuria but was attenuated after adjusting for depression. In conclusion, late bedtime on work/school days, rather than short sleep duration, daytime sleepiness, or poor sleep quality, was independently associated with loss of glycemic control in this longitudinal cohort of young adults with youth-onset type 2 diabetes. NEW & NOTEWORTHY: The prevalence of type 2 diabetes in youth is increasing at an alarming rate. Identifying potentially modifiable factors modulating glycemic control is critically important to reduce micro and macrovascular complications. In a large cohort of youth-onset type 2 diabetes, self-reported late bedtime on work/school days was independently associated with loss of glycemic control in this longitudinal cohort of young adults with youth-onset type 2 diabetes. [ABSTRACT FROM AUTHOR]

Evening-type and insomnia symptoms are significantly related to each other and independently associated with depressive symptoms, yet few studies have examined the potential interaction between these two conditions. Therefore, we aimed to examine the associations of evening-type and insomnia symptoms with depressive symptoms among Chinese youths, with a specific focus on the joint effects of the two conditions on depressive symptoms. Participants aged between 12 and 25 were invited to participate in an online survey from December 15, 2022, to May 26, 2023. Multivariate logistic regression models and additive interaction models were used to examine the independent and joint effects of chronotypes and insomnia symptoms on depressive symptoms, respectively. Of the 6145 eligible youths, the prevalence of evening-type and insomnia symptoms were 24.9 % and 29.6 %, respectively. Both evening-type (adjusted OR, [AdjOR]: 3.21, 95 % CI: 2.80–3.67) and insomnia symptoms (AdjOR: 10.53, 95 % CI: 9.14–12.12) were associated with an increased risk of depressive symptoms. In addition, the additive interaction models showed that there is an enhanced risk of depression related to interaction between evening-type and insomnia symptoms (relative excess risk due to interaction, [RERI]: 11.66, 95 % CI: 7.21–16.11). The present study provided additional evidence demonstrating the presence of interaction between evening-type and insomnia symptoms, which can lead to a higher risk of depressive symptoms. Our findings argue the need for addressing both sleep and circadian factors in the management of depressive symptoms in young people. • Insomnia symptoms and evening-type are prevalent in young people. • Both insomnia symptoms and evening-type are independent risk factors of depressive symptoms. • There is a greater combined impact of insomnia symptoms and evening-type on depression (synergistic effect) than the mere sum of their individual effect. • Addressing both insomnia and circadian problems may be beneficial for managing depressive symptoms in young people. [ABSTRACT FROM AUTHOR]

Background: An accessible self-assessment questionnaire is needed to evaluate quality of life in olfactory dysfunction. The need to address this gap led to the development of the brief version of the Questionnaire of Olfactory Disorders (brief QOD), which holds particular value in the context of telemedicine. Objectives: The aim of this study is to examine the reliability and validity of the Arabic brief QOD. Methods: This study included 307 patients suffering from olfactory dysfunction as well as a control group filled a questionnaire including demographic information, the olfaction Visual Analog Scale (VAS), the Sino-nasal Outcome Test 22 (SNOT-22) questionnaire, and the Arabic version of the brief QOD. The Arabic brief QOD's reliability was assessed using Cronbach's a to measure internal consistency. To evaluate test-retest reliability, the intraclass correlation coefficient (ICC) was employed. The discriminative ability: score differences between the two groups were analyzed. The validity Arabic brief QOD was evaluated by comparing it to the olfaction VAS. Results: The Cronbach's a coefficients were 0.757 for Questionnaire of Olfactory Disorders-Parosmia (QOD-P), 0.832 Questionnaire of Olfactory Disorders-quality of life (QOD-QoL), and 0.817 Questionnaire of Olfactory Disorders-visual analog scale (QOD-VAS). The reliability of the overall brief QOD was 0.93. The ICC exceeded the acceptable threshold of 0.7, indicating strong test-retest reliability. The highest correlation was observed between the SNOT-22 and QOD total scores (r = 0.552 and p < .001) as well as between SNOT-22 and QOD VAS (r = 0.512 and p < .001). Conclusion: Excellent validity and reliability have been shown for the Arabic brief QOD as a self-assessment tool assessing quality of life among olfactory dysfunction patients. [ABSTRACT FROM AUTHOR]

Chronotype represents individual preferences to work specific shifts. Few researchers have examined the impact of chronotype on critical care (CC) nurses' physical and psychological health as well as performance in the workplace. to investigate the impact of specific chronotypes on the physiological and psychological health of CC nurses as well as their performance in the workplace. A descriptive cross-sectional design was used to conduct the study. Data were collected using three instruments: the Morningness-Eveningness Questionnaire, the Standard Shiftwork Index (SSI), and the Six Dimension Scale of Nursing Performance (Six-D Scale). A convenient sample of 101 nurses working in critical care units at two hospitals in Jordan was recruited. Results showed that the trend of nurses to the chronotypes compatibility less than those who did not show their compatibility (45.5%). Results also indicated weak negative associations between chronotype and gastrointestinal health and cardiovascular health, respectively (r = −.108; r = −.020). There was a weak positive association between chronotype and psychological health (r =.000). Regarding work performance, negative significant correlations between chronotype and the two domains of work performance (i.e. frequency [P =.01] and quality of nursing activity [P =.05]) were discovered. Chronotype is typically induced by the shiftwork system, so it may be more appropriate to plan work requirements and daily activities based on chronotype to avoid the consequences of health disruptions. [ABSTRACT FROM AUTHOR]