Evening chronotype, insufficient weekday sleep, and weekday-weekend gap in sleep times: What is really to blame for a reduction in self-perceived health among university students?

The association of insufficient sleep with reduced self-perceived health was previously well established. Moreover, it was sometimes shown that the indicators of poorer health were significantly related to chronotype and weekday-weekend gaps in sleep timing and duration. It remains to be elucidated, however, whether chronotype and these gaps can contribute to the reduced health self-ratings independently from shortened sleep duration or, alternatively, their relationship with health can be simply explained by their association with insufficient sleep on weekdays. In an online survey, we tested whether the self-rated health of university students can be predicted by several individual characteristics of the sleep-wake cycles, such as chronotype, weekday and weekend sleep times, weekday-weekend gap in sleep times, sleepability and wakeability at different times of the day, etc. Responses to a question about general health and to items of several questionnaires for chronobiological assessment were collected from smartphones of 1582 university students (mean age ± standard deviation was 19.5 ± 1.7 y). The results of regression analyses suggested that lower odds of having good self-rated health were significantly associated with an earlier weekday risetime, a later weekday bedtime, and, consequently, a shorter weekday time in bed. After accounting for weekday sleep, self-rated health showed significant association with neither chronotype nor weekday-weekend differences in sleep duration and timing. Besides, the adverse health effects of reduced weekday sleep were independent from the significant adverse effects of several other individual sleep-wake characteristics including poorer nighttime sleepability and lower daytime wakeability. We concluded that university students perceive the negative health impacts of losing sleep by waking up early on weekdays irrespective of their night sleep quality and daytime level of alertness. Their chronotype and weekday-weekend difference in sleep times might not be among significant contributors to this perception. It is of practical importance to consider the reduction of weekday sleep losses among the interventions aimed at preventing sleep and health problems.

When early and late risers were left to their own devices: six distinct chronotypes under "lockdown" remained dissimilar on their sleep and health problems.

Under national "lockdown," the habitual late risers need not wake up early, and, similarly to the early risers, they don't lose much sleep on weekdays. We tested whether, despite a decrease in weekday sleep loss, the difference between distinct chronotypes in health and sleep problems persisted during "lockdown." Two online surveys were conducted from 10th to 20th of May, 2020 and 2021, one of them after 6 non-working weeks and another after 14 working weeks (during and after "lockdown," respectively). Participants were students of the same grade at the same university department (572 and 773, respectively). The self-assessments included the Single-Item Chronotyping (SIC) designed for self-choosing chronotype among several their short descriptions and several questions about general health, mood state, outdoors and physical activity, and sleep concerns. The results suggested that the responses to each of the questions were not randomly distributed over 6 distinct chronotypes. Such a nonrandomness was identified within each of three pairs of these chronotypes, evening vs. morning types (with a rising throughout the day vs. a falling level of alertness, respectively), afternoon vs. napping types (with a peak vs. a dip of alertness in the afternoon, respectively), and vigilant vs. lethargic types (with the levels of alertness being permanently high vs. low, respectively). Morning, afternoon, and vigilant types reported healthier sleep/mood/behavior/habits than three other types. The most and the least healthy sleep/mood/behavior/habits were reported by morning and evening types, respectively. These relationships with health and sleep problems and the frequencies of 6 chronotypes remained unchanged after "lockdown." Such results, in particular, suggested that the association of evening types with poorer health and sleep might not be attributed to a big amount of weekday sleep loss. The accounting for this association might help in designing interventions purposed on reduction of sleep and health problems.

Differences between male and female university students in sleepiness, weekday sleep loss, and weekend sleep duration.

INTRODUCTION: Women and men experience sleep differently and the difference in intrinsic desire for sleep might underlie some of the observed male-female differences. The objective of this cross-sectional questionnaire study of university students was to determine male-female differences in self-reported sleepiness and sleep-wake patterns. METHODS: Five questionnaires were completed by 1650 students at four Russian universities. RESULTS: Compared to male students, female students reported a lower subjective sleep quality score, had a higher morning sleepability score and lower nighttime and daytime wakeability scores. They more often reported excessive daytime sleepiness and expected to be sleepier at any time of the day with the largest male-female difference around the times of sleep onset and offset. On free days, they reported a longer sleep duration and an earlier sleep onset. Free-weekday difference was larger for sleep duration and smaller for sleep onset. Such male-female differences showed similarity to the differences observed in university and high school students from different countries around the globe. There was no significant male-female difference in weekly averaged sleep duration, weekday sleep duration, hours slept, midpoint of sleep on free days, free-weekday difference in sleep offset, social jetlag, and morningness-eveningness score. Therefore, when studies rely on these self-reports, the most salient male-female differences might not be immediately evident. CONCLUSIONS: It seems that the intrinsic desire for longer sleep duration might contribute to a higher susceptibility of female students to weekday sleep loss. Among these students, negative effects of reduced sleep duration might be more common and more detrimental.

Differential relationship of two measures of sleepiness with the drives for sleep and wake.

PURPOSE: Since disagreement has been found between an objective sleep propensity measured by sleep onset latency (SOL) and subjective sleepiness assessment measured by the Epworth sleepiness scale (ESS) score, distinct underlying causes and consequences were suggested for these two sleepiness measures. We addressed the issue of validation of the ESS against objective sleepiness and sleep indexes by examining the hypothesis that these two sleepiness measures are disconnected due to their differential relationship with the antagonistic drives for sleep and wake. METHODS: The polysomnographic records of 50-min napping attempts were collected from 27 university students on three occasions. Scores on the first and second principal components of the electroencephalographic (EEG) spectrum were calculated to measure the sleep and wake drives, respectively. Self-assessments of subjective sleepiness and sleep were additionally collected in online survey of 633 students at the same university. RESULTS: An ESS score was disconnected with the polysomnographic and self-assessed SOL in the nap study and online survey, respectively. An ESS score but not SOL was significantly linked to the spectral EEG measure of the sleep drive, while SOL but not ESS showed a significant association with the spectral EEG measure of the opposing wake drive. CONCLUSIONS: Each of two sleepiness measures was validated against objective indicators of the opposing sleep-wake regulating processes, but different underlying causes were identified for two distinct aspects of sleepiness. A stronger sleep drive and a weaker opposing drive for wake seem to contribute to a higher ESS score and to a shorter SOL, respectively.