The practice of Daylight Saving Time in Canada: Its suitability with respect to sleep and circadian rhythms.

Daylight Saving Time (DST) is the practice of setting the clocks one hour forward from Standard Time (ST) in the spring and back again to ST in the fall. This commentary discusses the impact of bi-annual time changes on sleep and circadian rhythms and suggests avenues to minimize negative outcomes on the well-being of Canadian citizens. Ideally, ST should be close to solar time, meaning that daylight is equally distributed before and after noon time, i.e., when the sun is at its highest point in the sky. In Canada, some provinces are proposing to opt out of DST to either return to constant ST throughout the year or to implement permanent DST. National and international associations of clinicians and researchers on sleep and biological rhythms and in health sciences have positioned themselves in favour of permanent ST. In Canada, the Canadian Sleep Society and the Canadian Society for Chronobiology have also issued such a position. This commentary focuses on the implications of previous research findings for sleep and health in Canada given its northern geographical location. It concludes with a research agenda focusing on the Canadian context.

RéSUMé: L'heure avancée (HA) consiste à avancer les horloges d'une heure par rapport à l'heure normale (HN) au printemps et à revenir à l'HN à l'automne. Le but de ce commentaire est de traiter de l'impact des changements d'heure semestriels sur le sommeil et les rythmes circadiens et de proposer des moyens d'en minimiser les conséquences négatives sur le bien-être des citoyens canadiens. Idéalement, l'HN devrait être proche de l'heure solaire, ce qui signifie que la lumière du jour est répartie de manière égale avant et après midi, c'est-à-dire lorsque le soleil est à son point culminant dans le ciel. Au Canada, certaines provinces proposent de renoncer à la pratique du changement d'heure pour revenir à une HN constante tout au long de l'année ou mettre en place l'HA de façon permanente. Des associations nationales et internationales de cliniciens et de chercheurs sur le sommeil, les rythmes biologiques et les sciences de la santé se sont prononcées en faveur de l'HN permanente. Au Canada, la Société canadienne du sommeil et la Société canadienne de chronobiologie ont adopté la même position. Le commentaire est centré sur les retombées des résultats de recherches antérieures pour le sommeil et la santé au Canada, compte tenu de sa situation géographique nordique. Il se termine par un programme de recherche axé sur le contexte canadien.

Creation of a shortened version of the Sleep Disorders Questionnaire (SDQ).

The 176-item Sleep Disorders Questionnaire (SDQ) was initially developed using canonical discriminant function analysis on 4 groups of sleep disorder patients, but it was never studied by factor analysis in its entirety. Several authors have criticized 2 of its subscales as being confounded with each other, and its narcolepsy scale as substantially over-diagnosing narcolepsy. This study describes its first exploratory factor analysis (EFA), the intent of which was to reassess item membership on the 4 existing subscales and to derive new scales to improve differential diagnosis between patient groups. It was also hoped that EFA could reduce the total number of questions, to increase speed of completion. The EFA was performed on the anonymized SDQ results from a retrospective review of the charts of 2131 persons from 7 sleep disorders clinics and research centers. Factors were assessed via scree plots and eigenvalues. The EFA identified four main factors: insomnia, daytime sleepiness, substance use, and sleep-disordered breathing. The insomnia factor had 3 subfactors: psychological symptoms of insomnia, subjective description of insomnia, and insomnia due to periodic limb movements. The sleepiness factor had two subfactors: daytime sleepiness and neurological symptoms of narcolepsy. The novel substance use factor was homogeneous, as was the sleep-disordered breathing factor. Importantly, the EFA reassigned items from the original SDQ's NAR, PSY, and PLM subscales to five of the new subscales. The Sleep Apnea (SA) subscale emerged mostly unchanged. The 7 resulting factors comprised only 66 items of the original 176-item SDQ. These results have allowed the creation of a new shorter questionnaire, to be called the SDQ-2. External validation of the SDQ-2 is currently underway. It will likely prove to be a superior differential diagnostic instrument for sleep disorders clinics, compared to the original SDQ.