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Fulltext Circadian Rhythm Disruption and Alzheimer's Disease: The Dynamics of a Vicious Cycle

Sharma A, Sethi G, Tambuwala MM, Aljabali AAA, Chellappan DK, Dua K, et al.

Curr Neuropharmacol, 2021;19(2):248-264.
PMID: 32348224 DOI: 10.2174/1570159X18666200429013041

All mammalian cells exhibit circadian rhythm in cellular metabolism and energetics. Autonomous cellular clocks are modulated by various pathways that are essential for robust time keeping. In addition to the canonical transcriptional translational feedback loop, several new pathways of circadian timekeeping - non-transcriptional oscillations, post-translational modifications, epigenetics and cellular signaling in the circadian clock - have been identified. The physiology of circadian rhythm is expansive, and its link to the neurodegeneration is multifactorial. Circadian rhythm disruption is prevelant in contamporary society where light-noise, shift-work, and transmeridian travel are commonplace, and is also reported from the early stages of Alzheimer's disease (AD). Circadian alignment by bright light therapy in conjunction with chronobiotics is beneficial for treating sundowning syndrome and other cognitive symptoms in advanced AD patients. We performed a comprehensive analysis of the clinical and translational reports to review the physiology of the circadian clock, delineate its dysfunction in AD, and unravel the dynamics of the vicious cycle between two pathologies. The review delineates the role of putative targets like clock proteins PER, CLOCK, BMAL1, ROR, and clock-controlled proteins like AVP, SIRT1, FOXO, and PK2 towards future approaches for management of AD. Furthermore, the role of circadian rhythm disruption in aging is delineated.

Matched MeSH terms: Circadian Rhythm*
Roles of clock genes in the pathogenesis of Parkinson's disease

Shkodina AD, Tan SC, Hasan MM, Abdelgawad M, Chopra H, Bilal M, et al.

Ageing Res Rev, 2022 02;74:101554.
PMID: 34973458 DOI: 10.1016/j.arr.2021.101554

Parkinson's disease (PD) is a common motor disorder that has become increasingly prevalent in the ageing population. Recent works have suggested that circadian rhythms disruption is a common event in PD patients. Clock genes regulate the circadian rhythm of biological processes in eukaryotic organisms, but their roles in PD remain unclear. Despite this, several lines of evidence point to the possibility that clock genes may have a significant impact on the development and progression of the disease. This review aims to consolidate recent understanding of the roles of clock genes in PD. We first summarized the findings of clock gene expression and epigenetic analyses in PD patients and animal models. We also discussed the potential contributory role of clock gene variants in the development of PD and/or its symptoms. We further reviewed the mechanisms by which clock genes affect mitochondrial dynamics as well as the rhythmic synthesis and secretion of endocrine hormones, the impairment of which may contribute to the development of PD. Finally, we discussed the limitations of the currently available studies, and suggested future potential studies to deepen our understanding of the roles of clock genes in PD pathogenesis.

Matched MeSH terms: Circadian Rhythm/genetics
Fulltext Light exposure behaviors predict mood, memory and sleep quality

Siraji MA, Spitschan M, Kalavally V, Haque S

Sci Rep, 2023 Aug 01;13(1):12425.
PMID: 37528146 DOI: 10.1038/s41598-023-39636-y

Ample research has shown that light influences our emotions, cognition, and sleep quality. However, little work has examined whether different light exposure-related behaviors, such as daytime exposure to electric light and nighttime usage of gadgets, especially before sleep, influence sleep quality and cognition. Three-hundred-and-one Malaysian adults (MeanAge±SD = 28 ± 9) completed the Light Exposure Behavior Assessment tool that measured five light exposure behaviors. They also completed the Morningness-Eveningness Questionnaire, Positive and Negative Affect Schedule, Pittsburgh Sleep Quality Index, and single items assessing trouble in memory and concentration. A partial least square structural equation model, showing 72.72% predictive power, revealed that less use of wearable blue filters outdoors during the day and more within one hour before sleep predicted early peak time (direct effect = -0.25). Increased time spent outdoors predicted a positive affect (direct effect = 0.33) and a circadian phase advancement (direct effect: rising time = 0.14, peak time = 0.20, retiring time = 0.17). Increased use of mobile phone before sleep predicted a circadian phase delay (direct effect: retiring time = -0.25; rising time = -0.23; peak time = -0.22; morning affect = -0.12), reduced sleep quality (direct effect = 0.13), and increased trouble in memory and concentration (total effect = 0.20 and 0.23, respectively). Increased use of tunable, LED, or dawn-simulating electric light in the morning and daytime predicted a circadian phase advancement (direct effect: peak time = 0.15, morning affect = 0.14, retiring time = 0.15) and good sleep quality (direct effect = -0.16). The results provide valuable insights into developing a healthy light diet to promote health and wellness.

Matched MeSH terms: Circadian Rhythm*
Potential role of melatonin in prevention and treatment of lung cancer

Ngai ZN, Chok KC, Ng KY, Koh RY, Chye SM

Horm Mol Biol Clin Investig, 2022 Dec 01;43(4):485-503.
PMID: 35728260 DOI: 10.1515/hmbci-2022-0018

Lung cancer is the second most common cancer and the most lethal cancer worldwide. Melatonin, an indoleamine produced in the pineal gland, shows anticancer effects on a variety of cancers, especially lung cancer. Herein, we clarify the pathophysiology of lung cancer, the association of circadian rhythm with lung, and the relationship between shift work and the incidence of lung cancer. Special focus is placed on the role of melatonin receptors in lung cancer, the relationship between inflammation and lung cancer, control of cell proliferation, apoptosis, autophagy, and immunomodulation in lung cancer by melatonin. A review of the drug synergy of melatonin with other anticancer drugs suggests its usefulness in combination therapy. In summary, the information compiled may serve as a comprehensive reference for the various mechanisms of action of melatonin against lung cancer, as a guide for the design of future experimental research and for advancing melatonin as a therapeutic agent for lung cancer.

Matched MeSH terms: Circadian Rhythm/physiology
Diurnally sub-periodic microfilarial pattern in Brugia malayi in West Malaysia

Dondero TJ, Sivanandam S

Trans R Soc Trop Med Hyg, 1971;65(5):691-3.
PMID: 5159155
Matched MeSH terms: Circadian Rhythm*
Weight status of working adults: The effects of eating misalignment, chronotype, and eating jetlag during mandatory confinement

Kaur S, Ng CM, Tang SY, Kok EY

Chronobiol Int, 2023 Apr;40(4):406-415.
PMID: 36883329 DOI: 10.1080/07420528.2023.2186120

This study aimed to examine the association between chronotype, eating jetlag, and eating misalignment with weight status among Malaysian adults during the COVID-19 restriction. This online cross-sectional study included 175 working adults recruited from March to July 2020. The chronotype was assessed using Morningness Eveningness Questionnaire (MEQ) while eating jetlag and mealtime variability were measured using Chrononutrition Profile Questionnaire (CPQ). Multiple linear regression demonstrated that lower breakfast frequency (β = -0.258, p = .002) and longer eating duration (β = 0.393, p

Matched MeSH terms: Circadian Rhythm*
Fulltext Not by the light of the moon: Investigating circadian rhythms and environmental predictors of calling in Bornean great argus

Clink DJ, Groves T, Ahmad AH, Klinck H

PLoS One, 2021;16(2):e0246564.
PMID: 33592004 DOI: 10.1371/journal.pone.0246564

Great argus pheasants are known for their elaborate visual mating displays, but relatively little is known about their general ecology. The use of passive acoustic monitoring-which relies on long-term autonomous recorders-can provide insight into the behavior of visually cryptic, yet vocal species such as the great argus. Here we report the results of an analysis of vocal behavior of the Bornean great argus (Argusianus argus grayi) in Sabah, Malaysia, using data collected with 11 autonomous recording units. Great argus regularly emitted two call types, the long call and the short call, and we found that although both call types were emitted throughout the day, the short calls were more likely to occur during the morning hours (06:00-12:00LT). Great argus were less likely to call if there was rain, irrespective of the time of day. A substantial portion of calls at our site (~20%) were emitted between the hours of 18:00-06:00LT. We found that for nighttime calls, calling activity increased during new moon periods and decreased during periods of rain. We attribute the negative influence of rain on calling to increased energetic costs of thermoregulation during wet periods, and propose that the influence of the lunar cycle may be related to increased predation risk during periods with high levels of moonlight. Little is known about the behavioral ecology of great argus on Borneo, so it is difficult to know if the results we report are typical, or if we would see differences in calling activity patterns depending on breeding season or changes in food availability. We advocate for future studies of great argus pheasant populations using paired camera and acoustic recorders, which can provide further insight into the behavior of this cryptic species.

Matched MeSH terms: Circadian Rhythm/physiology*
Evening dosing versus morning dosing of antihypertensive medications for nocturnal hypertension: a systematic review and meta-analysis of 107 randomized controlled trials

Lee EK, Wang S, Ng WL, Ramdzan SN, Tse E, Chan L, et al.

J Hypertens, 2024 Oct 01;42(10):1653-1664.
PMID: 39196688 DOI: 10.1097/HJH.0000000000003783

Since the effects of once-daily antihypertensive (HT) medications are more pronounced within the first few hours of ingestion, evening administration of anti-HT medications can be a feasible treatment for nocturnal HT. However, no relevant meta-analysis has been conducted in patients with nocturnal HT. This meta-analysis included randomized controlled trials involving patients with elevated mean nocturnal blood pressure (BP) and compared evening anti-HT administration with morning administration. Multiple databases, including grey literature (e.g. clincialtrial.gov), were searched. Study selection and data extraction were conducted by two independent authors. Risk of bias assessment and overall quality of evidence were conducted using Cochrane risk-of-bias tool and GRADE by two independent authors. A total of 107 studies were included, 76 of which were investigated in China and had not been identified in previous reviews. Only one trial was ranked low risk-of-bias. Evening administration of anti-HT medications was effective in reducing nocturnal systolic BP (4.12-9.10 mmHg; I2 = 80.5-95.2%) and diastolic BP (3.38-5.87 mmHg; I2 = 87.4-95.6%). Subgroup analyses found that the effectiveness of evening administration was contributed by data from the Hermida group and China. Evening administration did not provide additional nocturnal/daytime/24-h BP reduction in non-Hermida/non-China studies (I2 = 0) and in meta-analyses that included studies with unclear or low risk of bias. The effectiveness of nocturnal BP reduction was similar across different types, doses, and half-lives of medications. Evening administration of anti-HT medications may reduce proteinuria, left ventricular hypertrophy (LVH), nondipping and morning surge. The overall quality of evidence was ranked as very low to low. Our results highlight the scarcity of low risk-of-bias studies and emphasize the need for such trials to evaluate the efficacy of evening dosing of anti-HT medications as a standard treatment for patients with nocturnal HT across diverse populations.

Matched MeSH terms: Circadian Rhythm*
Worldwide melatonin research: a bibliometric analysis of the published literature between 2015 and 2019

Zakaria R, Ahmi A, Ahmad AH, Othman Z

Chronobiol Int, 2021 01;38(1):27-37.
PMID: 33164592 DOI: 10.1080/07420528.2020.1838534

This study presents a bibliometric analysis of the publications on melatonin research from the Scopus database during the period 2015-2019. Based on the keywords used, which are related to melatonin in the article title, the study retrieved 4411 documents for further analysis using various tools. We used Microsoft Excel to conduct the frequency analysis, VOSviewer for data visualization, and Harzing's Publish or Perish for citation metrics and analysis. This study reports the results using standard bibliometric indicators such as the growth of publications, authorship patterns, collaboration, and prolific authors, country contribution, most active institutions, preferred journals, and top-cited articles. Based on our findings, there is a continuous growth of publications on melatonin research for 5 years since 2015. China was the largest contributor to melatonin research, followed by the United States. The Journal of Pineal Research published the most number of publications related to melatonin research. Our findings suggest that the role of melatonin in plant and food sciences, as well as in cancer, may in later years take over the clusters that earlier dominated melatonin research.

Matched MeSH terms: Circadian Rhythm
Fulltext Circadian rhythm in systemic autoimmune conditions: Potential of chrono-immunology in clinical practice: A narrative review

Awuah WA, Huang H, Kalmanovich J, Mehta A, Mikhailova T, Ng JC, et al.

Medicine (Baltimore), 2023 Aug 11;102(32):e34614.
PMID: 37565922 DOI: 10.1097/MD.0000000000034614

The circadian rhythm (CR) is a fundamental biological process regulated by the Earth's rotation and solar cycles. It plays a critical role in various bodily functions, and its dysregulation can have systemic effects. These effects impact metabolism, redox homeostasis, cell cycle regulation, gut microbiota, cognition, and immune response. Immune mediators, cycle proteins, and hormones exhibit circadian oscillations, supporting optimal immune function and defence against pathogens. Sleep deprivation and disruptions challenge the regulatory mechanisms, making immune responses vulnerable. Altered CR pathways have been implicated in diseases such as diabetes, neurological conditions, and systemic autoimmune diseases (SADs). SADs involve abnormal immune responses to self-antigens, with genetic and environmental factors disrupting self-tolerance and contributing to conditions like Systemic Lupus Erythematosus, Rheumatoid Arthritis, and Inflammatory Myositis. Dysregulated CR may lead to increased production of pro-inflammatory cytokines, contributing to the systemic responses observed in SADs. Sleep disturbances significantly impact the quality of life of patients with SADs; however, they are often overlooked. The relationship between sleep and autoimmune conditions, whether causal or consequential to CR dysregulation, remains unclear. Chrono-immunology investigates the role of CR in immunity, offering potential for targeted therapies in autoimmune conditions. This paper provides an overview of the connections between sleep and autoimmune conditions, highlighting the importance of recognizing sleep disturbances in SADs and the need for further research into the complex relationship between the CR and autoimmune diseases.

Matched MeSH terms: Circadian Rhythm
Fulltext Association between polarity of first episode and solar insolation in bipolar I disorder

Bauer M, Glenn T, Achtyes ED, Alda M, Agaoglu E, Altınbaş K, et al.

J Psychosom Res, 2022 Sep;160:110982.
PMID: 35932492 DOI: 10.1016/j.jpsychores.2022.110982

OBJECTIVE: Circadian rhythm disruption is commonly observed in bipolar disorder (BD). Daylight is the most powerful signal to entrain the human circadian clock system. This exploratory study investigated if solar insolation at the onset location was associated with the polarity of the first episode of BD I. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area of the Earth.
METHODS: Data from 7488 patients with BD I were collected at 75 sites in 42 countries. The first episode occurred at 591 onset locations in 67 countries at a wide range of latitudes in both hemispheres. Solar insolation values were obtained for every onset location, and the ratio of the minimum mean monthly insolation to the maximum mean monthly insolation was calculated. This ratio is largest near the equator (with little change in solar insolation over the year), and smallest near the poles (where winter insolation is very small compared to summer insolation). This ratio also applies to tropical locations which may have a cloudy wet and clear dry season, rather than winter and summer.
RESULTS: The larger the change in solar insolation throughout the year (smaller the ratio between the minimum monthly and maximum monthly values), the greater the likelihood the first episode polarity was depression. Other associated variables were being female and increasing percentage of gross domestic product spent on country health expenditures. (All coefficients: P ≤ 0.001).
CONCLUSION: Increased awareness and research into circadian dysfunction throughout the course of BD is warranted.

Matched MeSH terms: Circadian Rhythm
Circadian and solar clocks interact in seasonal flowering

Yeang HY

Bioessays, 2009 Nov;31(11):1211-8.
PMID: 19795408 DOI: 10.1002/bies.200900078

The plant maintains a 24-h circadian cycle that controls the sequential activation of many physiological and developmental functions. There is empirical evidence suggesting that two types of circadian rhythms exist. Some plant rhythms appear to be set by the light transition at dawn, and are calibrated to circadian (zeitgeber) time, which is measured from sunrise. Other rhythms are set by both dawn and dusk, and are calibrated to solar time that is measured from mid-day. Rhythms on circadian timing shift seasonally in tandem with the timing of dawn that occurs earlier in summer and later in winter. On the other hand, rhythms set to solar time are maintained independently of the season, the timing of noon being constant year-round. Various rhythms that run in-phase and out-of-phase with one another seasonally may provide a means to time and induce seasonal events such as flowering.

Matched MeSH terms: Circadian Rhythm*
Nocturnal oviposition behavior of necrophagous dipterans in Kelantan, Malaysia*

Pritam HM, Jayaprakash PT

J Forensic Sci, 2009 Sep;54(5):1135-40.
PMID: 19570050 DOI: 10.1111/j.1556-4029.2009.01095.x

The likelihood of dipteran maggots colonizing a corpse due to nocturnal oviposition can be used to challenge the postmortem interval (PMI) estimated assuming diurnal oviposition. Earlier experiments tested nocturnal oviposition behavior by exposing fresh baits once during a single night. In this pilot study, oviposition behavior was studied using beef baits, which, simulating the decay of the body seen in case situations, decomposed inside cages designed to open and close at scheduled intervals during consecutive night or twilight periods. Freshly hatched maggots from diurnally oviposited eggs emerged in control baits on the third day, while a limited number of maggots attributable to nocturnal or twilight oviposition were observed in experimental baits only on the fifth or sixth day, indicating a categorical delay. These results suggest that such delayed and limited nocturnal oviposition is not forensically significant since the larger maggots deriving from diurnal oviposition would be the ones considered when estimating PMI.

Matched MeSH terms: Circadian Rhythm/physiology*
Diel changes in the CO2 exchange rates of reproductive organs of the tropical tree Durio zibethinus

Ogawa K, Abdullah AM, Awang M, Furukawa A

J Plant Res, 2005 Jun;118(3):187-92.
PMID: 15937725

The daily variations in the in situ CO(2) exchange of the reproductive organs of Durio zibethinus trees, growing in an experimental field at University Putra Malaysia (UPM), were examined at different growth stages. Reproductive organs emerged on the leafless portions of branches inside the crown. The photon flux densities (PFD) in the chambers used for the measurements were less than 100 mumol m(-2) s(-1) and were 40% of the PFD outside of the crown. The daytime net respiration rate and the nighttime dark respiration rate were higher at the time of flower initiation and during the mixed stages, when flower buds, flowers, and fruit coexist, than at the flower bud stage. The net respiration rate was lower than the daytime dark respiration rate at given temperatures, especially at the flower bud and fruit stages. Conversely, the net respiration rate was similar to the daytime dark respiration rate at the mixed stage. Photosynthetic CO(2) refixation reduced the daily respiratory loss by 17, 5, 0.3, and 24% at the flower bud, flower initiation, mixed, and fruit stages, respectively.

Matched MeSH terms: Circadian Rhythm*
Fulltext Dopa responsive dystonia with diurnal fluctuation (Segawa's syndrome)

Ong LC, Tang SF, Lal TR

Med J Malaysia, 1994 Jun;49(2):176-8.
PMID: 8090100

A 10-year-old girl presented with progressive dystonia with diurnal fluctuation. Response to low dose L-Dopa was dramatic and sustained with no complications. Recurrence of symptoms was observed on attempted withdrawal. Because of the dramatic response to therapy, dopa-responsive dystonia must be considered in the differential diagnosis of disorders presenting as gait disorders in childhood.

Matched MeSH terms: Circadian Rhythm*
Fulltext Myocardial infarction, circadian rhythm and delay in hospital admission

Quek DK, Ong SB, Lim LY

Med J Malaysia, 1989 Mar;44(1):14-22.
PMID: 2626108

Circadian variations have been observed in the onset of acute coronary syndromes including acute myocardial infarction. We studied 422 acute myocardial infarction patients who presented to the coronary care unit of General Hospital Kuala Lumpur. Of the 318 (75.4%) patients whose data was complete, a circadian rhythm with bimodal peak was demonstrated. The second quarter of the day i.e. 6.00 a.m. to 12 noon was shown to have a significantly increased frequency of onset of acute myocardial infarction (p less than 0.05). Time delay in presenting to the hospital was also determined. This showed that 56.8% of acute myocardial infarction patients presented early, within four hours of the onset of symptoms. By six hours, more than 71% had sought hospital care. This early presentation to the hospital may offer a realistic opportunity for optimal thrombolytic therapy should this treatment modality be offered as routine to infarct patients.

Matched MeSH terms: Circadian Rhythm*
Fulltext The Effects of Circadian Rhythm Disruption on Mental Health and Physiological Responses among Shift Workers and General Population

Ahmad M, Md Din NSB, Tharumalay RD, Che Din N, Ibrahim N, Amit N, et al.

Int J Environ Res Public Health, 2020 09 30;17(19).
PMID: 33007836 DOI: 10.3390/ijerph17197156

Background: The effect of circadian disruption on the bio-psychological clock system has been widely studied. However, the mechanism and the association of circadian rhythm disruption with mental health and physiological responses are still unclear. Therefore, this study was conducted to investigate the effects of circadian rhythm disruption on mental health and physiological responses among shift workers and the general population. Methods: A total of 42 subjects participated in this quasi-experimental study. Participants were divided into a group of shift workers (n = 20) and a general population group (n = 22). Polysomnography tests, blood tests (cortisol, triglycerides and glucose), and psychological tests (Abbreviated Profile of Mood States, General Health Questionnaire-28, Working Memory and Processing Speed Indexes of the Wechsler Adult Intelligent Scale (WAIS-IV) were used to examine the effects of circadian rhythm disruption. Results: The results showed a significant relationship between circadian rhythm disruption and mood (r = 0.305, p < 0.05). The findings of this study also indicated that there was a significant effect of circadian rhythm disruption on mood (F(2,40) = 8.89, p < 0.001, η2 =0.182), processing speed (F(2,40) = 9.17, p < 0.001, η2 = 0.186) and working memory (F(2,40) = 4.963, p < 0.01, η2 = 0.11) in shift workers and the general population. Conclusions: Our findings showed that circadian rhythm disruption affects mood and cognitive performance, but it does not significantly affect psychological wellbeing and physiological responses. Future studies are warranted to examine moderator and mediator variables that could influence the circadian rhythm disruption.

Matched MeSH terms: Circadian Rhythm*
Fulltext Evening home lighting adversely impacts the circadian system and sleep

Cain SW, McGlashan EM, Vidafar P, Mustafovska J, Curran SPN, Wang X, et al.

Sci Rep, 2020 11 05;10(1):19110.
PMID: 33154450 DOI: 10.1038/s41598-020-75622-4

The regular rise and fall of the sun resulted in the development of 24-h rhythms in virtually all organisms. In an evolutionary heartbeat, humans have taken control of their light environment with electric light. Humans are highly sensitive to light, yet most people now use light until bedtime. We evaluated the impact of modern home lighting environments in relation to sleep and individual-level light sensitivity using a new wearable spectrophotometer. We found that nearly half of homes had bright enough light to suppress melatonin by 50%, but with a wide range of individual responses (0-87% suppression for the average home). Greater evening light relative to an individual's average was associated with increased wakefulness after bedtime. Homes with energy-efficient lights had nearly double the melanopic illuminance of homes with incandescent lighting. These findings demonstrate that home lighting significantly affects sleep and the circadian system, but the impact of lighting for a specific individual in their home is highly unpredictable.

Matched MeSH terms: Circadian Rhythm/physiology*
Modified Munich chronotype questionnaire for application to short-interval split sleep of non-shift workers

Mazri FH, Manaf ZA, Shahar S, Mat Ludin AF, Karim NA, Ban AY, et al.

Chronobiol Int, 2021 05;38(5):659-665.
PMID: 33733959 DOI: 10.1080/07420528.2021.1887209

The Munich Chronotype Questionnaire (MCTQ) has been widely validated among various types of populations. However, determination of chronotype among individuals who have a split sleep pattern with short intervals between the first and second sleep bouts on free days has not yet been reported. This study aimed to validate the MCTQ modified for this purpose by assessing the actual sleep-wake timing against the Morningness-Eveningness Questionnaire (MEQ). The modified calculation for the midpoint of sleep on free days (MSF) of the split sleep pattern considers the second sleep bout as the total sleep duration on free days. We recruited 161 participants (mean age: 38.7 ± 7.8 years; 73% females, 29% with split sleep pattern) were recruited to administer the modified version of the MCTQ and MEQ. All of the MCTQ original parameters: midpoint of sleep on work days (MSW, r = -0.575), midpoint of sleep on free days (MSF, r = -0.568), and midpoint of sleep on free days corrected for sleep debt (MSFsc,r = -0.566) were significantly correlated with MEQ. The MEQ was further tested against MSF in four conditions of the split sleep pattern. The MSF modified for split sleep within 60 minutes after the first awakening showed highest correlation (r = -0.576) against MEQ score. The results demonstrate the modified version of MCTQ is valid to determine the chronotype in participants who practice consolidated and split sleep patterns.

Matched MeSH terms: Circadian Rhythm*
Psychological state during pregnancy is associated with sleep quality: preliminary findings from MY-CARE cohort study

Teoh AN, Kaur S, Mohd Shukri NH, Shafie SR, Ahmad Bustami N, Takahashi M, et al.

Chronobiol Int, 2021 07;38(7):959-970.
PMID: 33779445 DOI: 10.1080/07420528.2021.1902338

Psychological distress during pregnancy may increase the risk of adverse maternal and infant outcomes. Past studies have demonstrated the association between circadian disturbances with psychological health. However, the roles of chronotype and social jetlag on psychological state during pregnancy are yet to be identified. We aimed to examine the psychological state in pregnant women and its relations to chronotype, social jetlag (SJL), sleep quality and cortisol rhythm. The current study included a subsample of participants from an ongoing cohort study. A total of 179 primigravidas (mean age 28.4 ± 4.0 years) were recruited. Chronotype and sleep quality during the second trimester were assessed using the Morning-Eveningness Questionnaire (MEQ) and Pittsburgh Sleep Quality Index (PSQI), respectively. SJL was calculated based on the difference between mid-sleep on workdays and free days. Psychological state of participants was evaluated using the Depression, Anxiety, and Stress Scale-21 (DASS-21). Subsamples (n = 70) provided salivary samples at 5 time points over a 24 h period during the second trimester for cortisol assay. A higher proportion of pregnant women experienced moderate to severe anxiety symptoms (n = 77, 43.0%), followed by depressive (n = 17, 9.5%) and stress (n = 14, 7.8%) symptoms. No association was observed between chronotype and psychological distress during pregnancy. There was no significant difference in cortisol rhythms in relation to psychological distress. SJL and sleep quality were significantly associated with stress symptoms among pregnant women in the second trimester. Poor sleep quality, particularly daytime dysfunction (β = 0.37, p = .006) and sleep disturbances (β = 0.23, p = .047), were significantly associated with psychological distress (depressive, anxiety and stress symptoms) during the second trimester. The findings suggest that sleep is a potential modifiable lifestyle factor that can be targeted to improve psychological health among pregnant women.

Matched MeSH terms: Circadian Rhythm*

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