Sex differences in the association between chronotype and risk of depression

Abstract

Information on sex differences in the association between chronotype and depression is scarce. We aimed to investigate these differences using data from the Korea National Health and Nutrition Examination Survey in 2016. Chronotypes were categorised based on mid-sleep time on free days corrected by sleep debt accumulated on workdays (MSFsc): early type, < mean MSFsc − 1 standard deviation (SD); intermediate type, between mean MSFsc − 1 SD and MSFsc + 1 SD; and late type, > mean MSFsc + 1 SD. A Patient Health Questionnaire-9 score of ≥ 10 indicated depression. Among 5550 non-shift working adults aged 19–80 years, the prevalence rates of depression in the early, intermediate, and late chronotype groups were 7.4%, 4.5%, and 9.3%, respectively. Women with late chronotype (odds ratio [OR] = 2.9, 95% confidence interval [CI] = 1.8–4.7) showed a higher risk of depression than women with intermediate chronotype after adjusting for covariates. Women with early chronotype did not show a significant difference in depression risk (OR = 1.3, 95% CI = 0.9–2.0). In conclusion, late chronotype is associated with an increased risk of depression in women but not in men. Early chronotype is not associated with depression in women or men.

Biological Rhythm and Chronotype: New Perspectives in Health

“…The chronotype can also change with age and appears to be gender-related ( Figure 1 ). In adults, eveningness predominates among males and morningness among females, although the difference disappears in menopause and during old age when early chronotypes are associated with early wake-up timing [ 148 , 149 , 150 , 151 , 152 ].…”

Diurnal preference and depressive symptomatology: a meta-analysis

“…Of note, Kim et al recently reported no difference in prevalence rates for depression in late chronotypes vs. neither types in a population of Korean adults stratified by age (19–40, 41–59 and 60–80 years). However, although the total sample size was large ( N = 6382) the number of participants in the older 60–80 years group classified as evening-type was small ( N = 22) which may limit interoperability 101 . Counter to this, eveningness has been associated with increased odds for reporting depression in a large sample of older adults (age range 40–70 years) taken from the UK Biobank 102 .…”

Chronotype, circadian rhythm, and psychiatric disorders: Recent evidence and potential mechanisms

“…The evening chronotype among females has some unfavorable aspects concerning school and work in young and old females ( Fabbian et al, 2016 ). A potential explanation is the gender difference in melatonin, sex hormones, and behavioral and psychological factors (sleep quality, alcohol intake) ( Kim et al, 2020 ). In addition, the circadian gene PER3 variable number of tandem repeats was independently related to chronotype only in males ( Weiss et al, 2020 ).…”