Teenage night owls or early birds? Chronotype and the mental health of adolescents

Abstract

Evidence suggests that the timing of sleep (chronotype) impacts mental health in young people, but previous studies have not accounted for sleep duration or school start time in this association, or examined a broad range of mental outcomes. In this study, we investigated the association between chronotype and mental health in a representative sample of adolescents from the 2014 Canadian Health Behaviour in School-Aged Children survey (29,635 students, 362 schools). We examined positive and negative aspects of mental health, using scores for emotional problems (range 0-33), emotional well-being (0-22), behavioural problems (0-28) and prosocial behaviours (0-25). We estimated chronotype using the time of mid-sleep on weekends and examined the associations using multilevel regressions, adjusted for sleep duration, school start time, individual, family and geographic characteristics. The average time of mid-sleep (chronotype) was 04:11 hr. An hour delay in mid-sleep time was associated with more emotional problems (0.34 [95% confidence interval 0.23, 0.45] point higher score), more behavioural problems (2.0% [95% confidence interval 1.4%, 2.6%] higher score), less emotional well-being (0.19 [95% confidence interval 0.09, 0.20] point lower score), and fewer prosocial behaviours (0.18 [95% confidence interval 0.08, 0.29] point lower score). A later chronotype was associated with poorer mental health, independent of sleep duration and school start time, and across internalizing and externalizing mental health domains. Further research is needed to clarify the mechanisms underlying this association. The timing of sleep, and not just its duration, may be an additional consideration for youth mental health.

A bio-ecological framing of evidence on the determinants of adolescent mental health - A scoping review of the international Health Behaviour in School-Aged Children (HBSC) study 1983–2020

“…Among Canadian adolescents, a later chronotype, i.e. going to bed late getting up late, was associated with poorer mental health, independent of sleep duration and school start time ( Gariepy et al, 2019 ). A study which used data from three consecutive HBSC surveys in Sweden found that sleeping less than recommended and sleep initiation difficulties were associated with increased odds of specific complaints and with having the greatest complaint load ( Norell-Clarke & Hagquist, 2018 ).…”

Biological Rhythm and Chronotype: New Perspectives in Health

“…A lack of synchronization with cultural standards related to activity timing can lead to worse academic achievement, higher anxiety, cardiometabolic risk, and complicated relationships with family members and school friends [26,169,179,[185][186][187][188]. In this regard, the misalignment associated with eveningness can be partly considered a biological vulnerability factor concerning physical and cognitive performance as well as the development of psychological problems [20].…”

Highlights of the ERS Lung Science Conference and Sleep and Breathing Conference 2021 and the new ECMC members

“…Several circadian-related characteristics and behaviours may account for different susceptibilities to mental disorders. Accordingly, the individual timing preference (chronotype) is associated with a higher rate of various mental disorders including seasonal and bipolar depression [70][71][72]. In addition, inappropriate exposure to light due to social schedules, such as shift work and jetlag, demonstrably affects the circadian rhythms and consequently increases the susceptibility to mental disorders [73][74][75].…”