Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/S2237-60892013000100002
Trends in Psychiatry and Psychotherapy
Trend

Chronotype: a review of the advances, limits and applicability of the main instruments used in the literature to assess human phenotype

Cronotipo: uma revisão dos avanços, limites e aplicabilidade dos principais instrumentos utilizados na literatura para avaliar o fenótipo humano

Rosa Levandovski; Etianne Sasso; Maria Paz Hidalgo

Downloads: 0
Views: 362

Abstract

The study of circadian typology differences has increased in the last few years. As a result, new instruments have been developed to estimate the individual circadian phase of temporal human behavior, also referred as chronotype. The current review was conducted to evaluate the differences among the questionnaires most frequently used to assess chronotype: the Morningness-Eveningness Questionnaire (MEQ), the Composite Scale of Morningness (CSM), and the Munich Chronotype Questionnaire (MCTQ). Each instrument evaluates a different aspect of chronotype. MEQ is considered to evaluate the phase preferences of individual behavior over a 24-hour day, while MCTQ measures the phase of sleep positions for both free and work days. CSM is similar to MEQ, but is more sensitive to measure shift work. The concept of chronotype has been used to refer to phase positions or phase preferences in the literature reviewed. Most of the time this is a consequence of different interpretations: it is not clear whether phase preferences are a direct manifestation of the individual’s internal clock or a result of external cues, e.g., social interaction (including the alarm clock). Also, phase preferences are not uniform throughout life. Therefore, a single assessment, not taking age into consideration, will not accurately describe the sample. We suggest that MCTQ is the best instrument for investigators dealing with desynchronization and as an instrument for sleep phase. Conversely, if the goal is to assess characteristics that change under specific situations - chronotype -, the MEQ should be used.

Keywords

Chronobiology phenomena, circadian rhythm, morningness, eveningness, review

Resumo

O estudo das diferenças de tipologia circadiana tem aumentado nos últimos anos. Como resultado, novos instrumentos têm sido desenvolvidos para estimar as preferências interindividuais de fase circadiana, denominada de cronotipo, responsável pela organização temporal do processo de regulação do organismo. O objetivo desta revisão foi avaliar as diferenças dos principais questionários utilizados para avaliar cronotipos: o Questionário de Matutinidade e Vespertinidade (Morningness-Eveningness Questionnaire, MEQ), o Composite Scale of Morningness (CSM) e o Questionário de Cronotipo de Munique (Munich Chronotype Questionnaire, MCTQ). Cada instrumento avalia um aspecto diferente dos cronotipos. Considera-se que o MEQ avalia as preferências de fase do comportamento individual ao longo de um dia de 24 horas, ao passo que o MCTQ mede a posição da fase de sono tanto em dias livres como em dias de trabalho. O CSM é semelhante ao MEQ, mas é mais sensível para ser utilizado em indivíduos que realizam trabalho em turnos. O conceito de cronotipo tem sido utilizado para se referir a posições de fase ou preferências de fase na literatura revisada. Na maioria das vezes, isso é consequência de diferentes interpretações: não está claro se as preferências de fase são uma manifestação direta do relógio interno do indivíduo ou um resultado de sinais externos, como por exemplo, interação social (incluindo o uso de despertador). Além disso, as preferências de fase não são uniformes ao longo da vida. Sendo assim, uma única avaliação, sem levar em consideração a idade do indivíduo nos escores utilizados nessas escalas, não descreverá a amostra com precisão. Sugerimos, através desta revisão, que o MCTQ deve ser considerado como instrumento para investigações que lidam com dessincronização e como instrumento de medida de fase de sono. Por outro lado, se o objetivo é avaliar características que mudam em determinadas situações - cronotipo -, o MEQ deve ser utilizado.

Palavras-chave

Fenômenos cronobiológicos, ritmo circadiano, matutino, vespertino, revisão

References

Horne JA, Ostberg O. A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. Int J Chronobiol. 1976;4:97-110.

Benedito-Silva A, Menna-Barreto L, Cipolla-Neto J, Marques N, Tenreiro S. Latitude and social habits as determinants of the distribution of morning and evening types in Brazil. Biol Rhythm Res. 1998;29:591-7.

Roenneberg T, Kuehnle T, Juda M, Kantermann T, Allebrandt K, Gordijn M, Merrow M. Epidemiology of the human circadian clock. Sleep Med Rev. 2007;11:429-38.

Kerkhof GA. Inter-individual differences in the human circadian system: a review. Biol Psychol. 1985;20:83-112.

Adan A, Natale V. Gender differences in morningness-eveningness preference. Chronobiol Int. 2002;19:709-20.

Kima S, Duekera GL, Lynn Hasherb L, Goldsteinb D. Children’s time of day preference: age, gender and ethnic differences. Pers Individ Dif. 2002;33:1083-90.

Baehr EK, Revelle W, Eastman CI. Individual differences in the phase and amplitude of the human circadian temperature rhythm: with an emphasis on morningness-eveningness. J Sleep Res. 2000;9:117-27.

Andrade MM, Benedito-Silva AA, Menna-Barreto L. Correlations between morningness-eveningness character, sleep habits and temperature rhythm in adolescents. Braz J Med Biol Res. 1992;25:835-9.

Duffy JF, Rimmer DW, Czeisler CA. Association of intrinsic circadian period with morningness-eveningness, usual wake time, and circadian phase. Behav Neurosci. 2001;115:895-9.

Bailey SL, Heitkemper MM. Circadian rhythmicity of cortisol and body temperature: morningness-eveningness effects. Chronobiol Int. 2001;18:249-61.

Archer SN, Robilliard DL, Skene DJ, Smits M, Williams A, Arendt J. A length polymorphism in the circadian clock gene Per3 is linked to delayed sleep phase syndrome and extreme diurnal preference. Sleep. 2003;26:413-5.

Katzenberg D, Young T, Finn L, Lin L, King DP, Takahashi JS. A CLOCK polymorphism associated with human diurnal preference. Sleep. 1998;21:569-76.

Pedrazzoli M, Ling L, Finn L, Kubin L, Young T, Katzenberg D. A polymorphism in the human timeless gene is not associated with diurnal preferences in normal adults. Sleep Res Online. 2000;3:73-6.

Pereira DS, Tufik S, Louzada FM, Benedito-Silva AA, Lopez AR, Lemos NA. Association of the length polymorphism in the human Per3 gene with the delayed sleep-phase syndrome: does latitude have an influence upon it?. Sleep. 2005;28:29-32.

Taillard J, Philip P, Chastang JF, Bioulac B. Validation of Horne and Ostberg Morningness-Eveningness Questionnaire in a middle-aged population of French workers. J Biol Rhythms. 2004;19:76-86.

Adan A, Almirall H. Horne & Ostberg Morningness-Eveningness Questionnaire: a reduced scale. Pers Individ Dif. 1991;12:241-53.

Caci H, Deschaux O, Adan A, Natale V. Comparing three morningness scales: age and gender effects, structure and cut-off criteria. Sleep Med. 2009;10:240-5.

Natale V, Esposito MJ, Martoni M, Fabbri M. Validity of the reduced version of the Morningness-Eveningness Questionnaire. J Biol Rhythms. 2006;4:72-4.

Smith CS, Reilly C, Midkiff K. Evaluation of three circadian rhythm questionnaires with suggestions for an improved measure of morningness. J Appl Psychol. 1989;74:728-38.

Torsvall L, Akerstedt T. A diurnal type scale: Construction, consistency and validation in shift work. Scand J Work Environ Health. 1980;6:283-90.

Caci H, Nadalet L, Staccini P, Myquel M, Boyer P. Psychometric properties of the French version of the composite scale of morningness in adults. Eur Psychiatry. 1999;14:284-90.

Greenwood KM. Long-term stability and psychometric properties of the Composite Scale of Morningness. Ergonomics. 1994;37:377-83.

Roenneberg T, Wirz-Justice A, Merrow M. Life between clocks: daily temporal patterns of human chronotypes. J Biol Rhythms. 2003;18:80-90.

Roenneberg T, Kuehnle T, Pramstaller PP, Ricken J, Havel M, Guth A. A marker for the end of adolescence. Curr Biol. 2004;14:R1038-9.

Allebrandt KV, Roenneberg T. The search for circadian clock components in humans: new perspectives for association studies. Braz J Med Biol Res. 2008;41:716-21.

Zavada A, Gordijn MC, Beersma DG, Daan S, Roenneberg T. Comparison of the Munich Chronotype Questionnaire with the Horne-Ostberg's Morningness-Eveningness Score. Chronobiol Int. 2005;22:267-78.

Sack RL, Auckley D, Auger RR, Carskadon MA, Wright Jr. KP, Vitiello MV. Circadian rhythm sleep disorders: Part I, basic principles, shift work and jet lag disorders. An American Academy of Sleep Medicine review. Sleep. 2007;30:1460-83.

Paine SJ, Gander PH, Travier N. The epidemiology of morningness-eveningness: influence of age, gender, ethnicity, and socioeconomic factors in adults (30-49 years). J Biol Rhythms. 2006;21:68-76.

Smith C, Folkard S, Schmieder RA, Parra LF, Spelten E, Almiral H. Investigation of morning-evening orientation in six countries using the preferences scale. Pers Individ Dif. 2002;32:949-68.

Martynhak BJ, Louzada FM, Pedrazzoli M, Araujo JF. Does the chronotype classification need to be updated?: Preliminary findings. Chronobiol Int. 2010;27:1329-34.

Korczak AL, Martynhak BJ, Pedrazzoli M, Brito AF, Louzada FM. Influence of chronotype and social zeitgebers on sleep/wake patterns. Braz J Med Biol Res. 2008;41:914-9.

Adan A, Almirall H. The influence of age, work schedule and personality on morningness dimension. Int J Psychophysiol. 1992;12:95-9.

Campos M, Martino M. Chronobiologic aspects of sleep-wake cycle and anxiety levels of nurses working on different shifts. Rev Esc Enferm USP. 2004;38:415-21.

Mitchell PJ, Hoese EK, Liu L, Fogg LF, Eastman CI. Conflicting bright light exposure during night shifts impedes circadian adaptation. J Biol Rhythms. 1997;12:5-15.

Petru R, Wittmann M, Nowak D, Birkholz B, Angerer P. Effects of working permanent night shifts and two shifts on cognitive and psychomotor performance. Int Arch Occup Environ Health. 2005;78:109-16.

Park YM, Matsumoto K, Seo YJ, Shinkoda H, Park KP. Effects of aging on morningness-eveningness and sleep habits in Korean and Japanese workers. Psychiatry Clin Neurosci. 1998;52:245-6.

Adan A, Caci H, Prat G. Reliability of the Spanish version of the Composite Scale of Morningness. Eur Psychiatry. 2005;20:503-9.

Costa G, Lievore F, Casaletti G, Gaffuri E, Folkard S. Circadian characteristics influencing interindividual differences in tolerance and adjustment to shiftwork. Ergonomics. 1989;32:373-85.

Nakade M, Takeuchi H, Taniwaki N, Noji T, Harada T. An integrated effect of protein intake at breakfast and morning exposure to sunlight on the circadian typology in Japanese infants aged 2-6 years. J Physiol Anthropol. 2009;28:239-45.

Fleig D, Randler C. Association between chronotype and diet in adolescents based on food logs. Eat Behav. 2009;10:115-8.

Carrier J, Monk TH, Buysse DJ, Kupfer DJ. Sleep and morningness-eveningness in the 'middle' years of life (20-59 y). J Sleep Res. 1997;6:230-7.

Duffy JF, Czeisler CA. Age-related change in the relationship between circadian period, circadian phase, and diurnal preference in humans. Neurosci Lett. 2002;318:117-20.

Monk TH, Kupfer DJ. Which aspects of morningness-eveningness change with age?. J Biol Rhythms. 2007;22:278-80.

Carskadon MA, Vieira C, Acebo C. Association between puberty and delayed phase preference. Sleep. 1993;16:258-62.

Russo PM, Bruni O, Lucidi F, Ferri R, Violani C. Sleep habits and circadian preference in Italian children and adolescents. J Sleep Res. 2007;16:163-9.

BaHammam AS, Almistehi W, Albatli A, AlShaya S. Distribution of chronotypes in a large sample of young adult Saudis. Ann Saudi Med. 2011;31:183-6.

Motohashi Y. Sex difference in the morningness-eveningness preference in student and hospital nurse samples. Ind Health. 1988;26:245-9.

Ishihara K, Miyasita A, Inugami M, Fukuda K, Miyata Y. Differences in sleep-wake habits and EEG sleep variables between active morning and evening subjects. Sleep. 1987;10:330-42.

Clodore M, Benoit O, Foret J, Touitou Y, Touron N, Bouard G. Early rising or delayed bedtime: which is better for a short night's sleep?. Eur J Appl Physiol Occup Physiol. 1987;56:403-11.

Matchock RL, Mordkoff JT. Chronotype and time-of-day influences on the alerting, orienting, and executive components of attention. Exp Brain Res. 2009;192:189-98.

Volk S, Dyroff J, Georgi K, Pflug B. Subjective sleepiness and physiological sleep tendency in healthy young morning and evening subjects. J Sleep Res. 1994;3:138-43.

Dijk DJ, Duffy JF. Circadian regulation of human sleep and age-related changes in its timing, consolidation and EEG characteristics. Ann Med. 1999;31:130-40.

Roenneberg T, Merrow M. Entrainment of the human circadian clock. Cold Spring Harb Symp Quant Biol. 2007;72:293-9.

Brown SA, Fleury-Olela F, Nagoshi E, Hauser C, Juge C, Meier CA. The period length of fibroblast circadian gene expression varies widely among human individuals. PLoS Biol. 2005;3.

Pagani L, Schmitt K, Meier F, Izakovic J, Roemer K, Viola A. Serum factors in older individuals change cellular clock properties. Proc Natl Acad Sci U S A. 2011;108:7218-23.

Satoh K, Mishima K, Inoue Y, Ebisawa T, Shimizu T. Two pedigrees of familial advanced sleep phase syndrome in Japan. Sleep. 2003;26:416-7.

Wyatt JK, Stepanski EJ, Kirkby J. Circadian phase in delayed sleep phase syndrome: predictors and temporal stability across multiple assessments. Sleep. 2006;29:1075-80.

Ahn YM, Chang J, Joo YH, Kim SC, Lee KY, Kim YS. Chronotype distribution in bipolar I disorder and schizophrenia in a Korean sample. Bipolar Disord. 2008;10:271-5.

Ferraz E, Borges MC, Vianna EO. Influence of nocturnal asthma on chronotype. J Asthma. 2008;45:911-5.

Wood J, Birmaher B, Axelson D, Ehmann M, Kalas C, Monk K. Replicable differences in preferred circadian phase between bipolar disorder patients and control individuals. Psychiatry Res. 2009;166:201-9.

Hofstra WA, Gordijn MC, van Hemert-van der Poel JC, van der Palen J, De Weerd AW. Chronotypes and subjective sleep parameters in epilepsy patients: a large questionnaire study. Chronobiol Int. 2010;27:1271-86.

Hidalgo MP, Caumo W, Posser M, Coccaro SB, Camozzato AL, Chaves ML. Relationship between depressive mood and chronotype in healthy subjects. Psychiatry Clin Neurosci. 2009;63:283-90.

Levandovski R, Dantas G, Fernandes L, Caumo W, Torres I, Roenneberg T. Depression scores associate with chronotype and social jetlag in a rural population. Chronobiol Int. 2011;28:771-8.

616b1af8a9539530bf777817 trends Articles
Links & Downloads

Trends Psychiatry Psychother

Share this page
Page Sections