Korean Journal of Biological Psychiatry (생물정신의학)

The Korean Society of Biological Psychiatry (대한생물정신의학회)
권호 표지
DOI QR코드

DOI QR Code

Association Between Sleep Pattern, Chronotype and Depressive Symptoms in Korean Adults

한국 성인에서 수면양상, 일주기 유형과 우울증상 간의 상관관계

  • Kim, Dong Hee (Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital) ;
  • Kang, Tae Uk (Department of Psychiatry, Uijeongbu Eulji Medical Center, Eulji University School of Medicine) ;
  • Koh, Sang Hyun (Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital)
  • 김동희 (서울특별시 은평병원 정신건강의학과) ;
  • 강태욱 (의정부 을지대학교병원 정신건강의학과) ;
  • 고상현 (서울특별시 은평병원 정신건강의학과)
  • Received : 2021.08.20
  • Accepted : 2021.09.14
  • Published : 2021.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives The aim of this study was to examine the association between the sleep pattern, chronotype (midpoint of sleep on free days) and the depressive symptoms in adults aged 19 years and over in Korea. This study also investigated the mediating effect of perceived usual stress (PUS) and self-rated health (SRH) on the association between chronotype and depressive symptoms. Methods Among the subjects of the 7th Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2018, 16142 adults aged 19 or over responded to the survey and finally 8604 were analyzed according to the exclusion conditions. Logistic regression analysis was conducted to see the risk of depressive symptoms, suicidal ideation over sleep pattern, chronotype. Finally, mediation analysis was performed in order to clarify how PUS and SRH are associated to chronoytpe and depression. Results After controlling for potential covariates, weekly sleep duration < 5 hours, ≥ 10 hours was associated with depressive symptoms. And late bed time sleeping after am 1:00 and later midpoints of sleep was associated with a higher level of depressive symptoms. Additionally, the PUS and SRH between chronotype and depressive symptoms showed a serial multiple mediation effect. Conclusions Short or long sleep duration, late bed time and later midpoints of sleep on free days are associated with depressive symptoms. Furthermore, the mechanism between chronotype and depressive symptoms needs to be further clarified by identifying the serial multiple mediation effects of PUS and SRH.

Keywords

References

  1. Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry 1994;51:8-19. https://doi.org/10.1001/archpsyc.1994.03950010008002
  2. Sinyor M, Rezmovitz J, Zaretsky A. Screen all for depression. BMJ 2016;352:i1617.
  3. Hammer-Helmich L, Haro JM, Jonsson B, Tanguy Melac A, Di Nicola S, Chollet J, et al. Functional impairment in patients with major depressive disorder: the 2-year PERFORM study. Neuropsychiatr Dis Treat 2018;14:239-249. https://doi.org/10.2147/NDT.S146098
  4. Liu Q, He H, Yang J, Feng X, Zhao F, Lyu J. Changes in the global burden of depression from 1990 to 2017: findings from the Global Burden of Disease study. J Psychiatr Res 2020;126:134-140. https://doi.org/10.1016/j.jpsychires.2019.08.002
  5. Kim GE, Jo MW, Shin YW. Increased prevalence of depression in South Korea from 2002 to 2013. Sci Rep 2020;10:16979. https://doi.org/10.1038/s41598-020-74119-4
  6. Al-Harbi KS. Treatment-resistant depression: therapeutic trends, challenges, and future directions. Patient Prefer Adherence 2012;6:369-388. https://doi.org/10.2147/PPA.S29716
  7. Siegel JM. Clues to the functions of mammalian sleep. Nature 2005;437:1264-1271. https://doi.org/10.1038/nature04285
  8. Akerstedt T, Knutsson A, Westerholm P, Theorell T, Alfredsson L, Kecklund G. Mental fatigue, work and sleep. J Psychosom Res 2004;57:427-433. https://doi.org/10.1016/j.jpsychores.2003.12.001
  9. Franzen PL, Buysse DJ. Sleep disturbances and depression: risk relationships for subsequent depression and therapeutic implications. Dialogues Clin Neurosci 2008;10:473-481. https://doi.org/10.31887/DCNS.2008.10.4/plfranzen
  10. Becker NB, Jesus SN, Joao KADR, Viseu JN, Martins RIS. Depression and sleep quality in older adults: a meta-analysis. Psychol Health Med 2017;22:889-895. https://doi.org/10.1080/13548506.2016.1274042
  11. van den Berg JF, Luijendijk HJ, Tulen JH, Hofman A, Neven AK, Tiemeier H. Sleep in depression and anxiety disorders: a population-based study of elderly persons. J Clin Psychiatry 2009;70:1105-1113. https://doi.org/10.4088/JCP.08m04448
  12. Watson NF, Harden KP, Buchwald D, Vitiello MV, Pack AI, Strachan E, et al. Sleep duration and depressive symptoms: a gene-environment interaction. Sleep 2014;37:351-358. https://doi.org/10.5665/sleep.3412
  13. Jiang J, Li Y, Mao Z, Wang F, Huo W, Liu R, et al. Abnormal night sleep duration and poor sleep quality are independently and combinedly associated with elevated depressive symptoms in Chinese rural adults: Henan Rural Cohort. Sleep Med 2020;70:71-78. https://doi.org/10.1016/j.sleep.2019.10.022
  14. Augner C. Associations of subjective sleep quality with depression score, anxiety, physical symptoms and sleep onset latency in students. Cent Eur J Public Health 2011;19:115-117. https://doi.org/10.21101/cejph.a3647
  15. Glozier N, O'Dea B, McGorry PD, Pantelis C, Amminger GP, Hermens DF, et al. Delayed sleep onset in depressed young people. BMC Psychiatry 2014;14:33. https://doi.org/10.1186/1471-244X-14-33
  16. Pandi-Perumal SR, Moscovitch A, Srinivasan V, Spence DW, Cardinali DP, Brown GM. Bidirectional communication between sleep and circadian rhythms and its implications for depression: lessons from agomelatine. Prog Neurobiol 2009;88:264-271. https://doi.org/10.1016/j.pneurobio.2009.04.007
  17. Hidalgo MP, Caumo W, Posser M, Coccaro SB, Camozzato AL, Chaves MLF. Relationship between depressive mood and chronotype in healthy subjects. Psychiatry Clin Neurosci 2009;63:283-290. https://doi.org/10.1111/j.1440-1819.2009.01965.x
  18. Haraden DA, Mullin BC, Hankin BL. The relationship between depression and chronotype: a longitudinal assessment during childhood and adolescence. Depress Anxiety 2017;34:967-976. https://doi.org/10.1002/da.22682
  19. Van den Berg JF, Kivela L, Antypa N. Chronotype and depressive symptoms in students: an investigation of possible mechanisms. Chronobiol Int 2018;35:1248-1261. https://doi.org/10.1080/07420528.2018.1470531
  20. Tokur-Kesgin M, Kocoglu-Tanyer D. Pathways to adolescents' health: chronotype, bedtime, sleep quality and mental health. Chronobiol Int 2021;38:1441-1448 https://doi.org/10.1080/07420528.2021.1931277
  21. Koskenvuo M, Hublin C, Partinen M, Heikkila K, Kaprio J. Heritability of diurnal type: a nationwide study of 8753 adult twin pairs. J Sleep Res 2007;16:156-162. https://doi.org/10.1111/j.1365-2869.2007.00580.x
  22. Kitamura S, Hida A, Watanabe M, Enomoto M, Aritake-Okada S, Moriguchi Y, et al. Evening preference is related to the incidence of depressive states independent of sleep-wake conditions. Chronobiol Int 2010;27:1797-1812. https://doi.org/10.3109/07420528.2010.516705
  23. Chan JWY, Lam SP, Li SX, Yu MWM, Chan NY, Zhang J, et al. Eveningness and insomnia: independent risk factors of nonremission in major depressive disorder. Sleep 2014;37:911-917. https://doi.org/10.5665/sleep.3658
  24. Kim SJ, Lee YJ, Kim H, Cho IH, Lee JY, Cho SJ. Age as a moderator of the association between depressive symptoms and morningness-eveningness. J Psychosom Res 2010;68:159-164. https://doi.org/10.1016/j.jpsychores.2009.06.010
  25. Schneider MLDM, Vasconcellos DC, Dantas G, Levandovski R, Caumo W, Allebrandt KV, et al. Morningness-eveningness, use of stimulants, and minor psychiatric disorders among undergraduate students. Int J Psychol 2011;46:18-23. https://doi.org/10.1080/00207594.2010.513414
  26. Wittmann M, Paulus M, Roenneberg T. Decreased psychological well-being in late 'chronotypes' is mediated by smoking and alcohol consumption. Subst Use Misuse 2010;45:15-30. https://doi.org/10.3109/10826080903498952
  27. Islam Z, Hu H, Akter S, Kuwahara K, Kochi T, Eguchi M, et al. Social jetlag is associated with an increased likelihood of having depressive symptoms among the Japanese working population: the Furukawa Nutrition and Health Study. Sleep 2020;43:zsz204. https://doi.org/10.1093/sleep/zsz204
  28. Hasler BP, Allen JJ, Sbarra DA, Bootzin RR, Bernert RA. Morningness-eveningness and depression: preliminary evidence for the role of the behavioral activation system and positive affect. Psychiatry Res 2010;176:166-173. https://doi.org/10.1016/j.psychres.2009.06.006
  29. Roeser K, Meule A, Schwerdtle B, Kubler A, Schlarb AA. Subjective sleep quality exclusively mediates the relationship between morningness-eveningness preference and self-perceived stress response. Chronobiol Int 2012;29:955-960. https://doi.org/10.3109/07420528.2012.699124
  30. Haraszti RA, Purebl G, Salavecz G, Poole L, Dockray S, Steptoe A. Morningness-eveningness interferes with perceived health, physical activity, diet and stress levels in working women: a cross-sectional study. Chronobiol Int 2014;31:829-837. https://doi.org/10.3109/07420528.2014.911188
  31. Takaesu Y, Shimura A, Komada Y, Futenma K, Ishii M, Sugiura K, et al. Association of sleep duration on workdays or free days and social jetlag with job stress. Psychiatry Clin Neurosci 2021;75:244-249. https://doi.org/10.1111/pcn.13274
  32. Kashani M, Eliasson A, Vernalis M. Perceived stress correlates with disturbed sleep: a link connecting stress and cardiovascular disease. Stress 2012;15:45-51. https://doi.org/10.3109/10253890.2011.578266
  33. Dua JK. The role of negative affect and positive affect in stress, depression, self-esteem, assertiveness, Type A behaviors, psychological health, and physical health. Genet Soc Gen Psychol Monogr 1993;119:515-552.
  34. Vingilis ER, Wade TJ, Seeley JS. Predictors of adolescent self-rated health. Can J Public Health 2002;93:193-197. https://doi.org/10.1007/bf03404999
  35. Wang MP, Ho SY, Lo WS, Lai MK, Lam TH. Smoking is associated with poor self-rated health among adolescents in Hong Kong. Nicotine Tob Res 2012;14:682-687. https://doi.org/10.1093/ntr/ntr266
  36. Frisher M, Mendonca M, Shelton N, Pikhart H, de Oliveira C, Holdsworth C. Is alcohol consumption in older adults associated with poor self-rated health? Cross-sectional and longitudinal analyses from the English Longitudinal Study of Ageing. BMC Public Health 2015;15:703. https://doi.org/10.1186/s12889-015-1993-x
  37. Maghout-Juratli S, Janisse J, Schwartz K, Arnetz BB. The causal role of fatigue in the stress-perceived health relationship: a MetroNet study. J Am Board Fam Med 2010;23:212-219. https://doi.org/10.3122/jabfm.2010.02.090132
  38. Cohen S, Kaplan GA, Salonen JT. The role of psychological characteristics in the relation between socioeconomic status and perceived health. J Appl Soc Psychol 1999;29:445-468. https://doi.org/10.1111/j.1559-1816.1999.tb01396.x
  39. Han B. Depressive symptoms and self-rated health in community-dwelling older adults: a longitudinal study. J Am Geriatr Soc 2002;50:1549-1556. https://doi.org/10.1046/j.1532-5415.2002.50411.x
  40. Roenneberg T, Kuehnle T, Juda M, Kantermann T, Allebrandt K, Gordijn M, et al. Epidemiology of the human circadian clock. Sleep Med Rev 2007;11:429-438. https://doi.org/10.1016/j.smrv.2007.07.005
  41. Antypa N, Vogelzangs N, Meesters Y, Schoevers R, Penninx BW. Chronotype associations with depression and anxiety disorders in a large cohort study. Depress Anxiety 2016;33:75-83. https://doi.org/10.1002/da.22422
  42. El-Den S, Chen TF, Gan YL, Wong E, O'Reilly CL. The psychometric properties of depression screening tools in primary healthcare settings: a systematic review. J Affect Disord 2018;225:503-522. https://doi.org/10.1016/j.jad.2017.08.060
  43. Shin C, Ko YH, An H, Yoon HK, Han C. Normative data and psychometric properties of the Patient Health Questionnaire-9 in a nationally representative Korean population. BMC Psychiatry 2020;20:194. https://doi.org/10.1186/s12888-020-02613-0
  44. Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. Psychiatr Ann 2002;32:509-521. https://doi.org/10.3928/0048-5713-20020901-06
  45. Simon GE, Rutter CM, Peterson D, Oliver M, Whiteside U, Operskalski B, et al. Does response on the PHQ-9 depression questionnaire predict subsequent suicide attempt or suicide death? Psychiatr Serv 2013;64:1195-1202. https://doi.org/10.1176/appi.ps.201200587
  46. Hayes AF, Preacher KJ. Statistical mediation analysis with a multi-categorical independent variable. Br J Math Stat Psychol 2014;67:451-470. https://doi.org/10.1111/bmsp.12028
  47. Kim HM, Lee SW. Beneficial effects of appropriate sleep duration on depressive symptoms and perceived stress severity in a healthy population in Korea. Korean J Fam Med 2018;39:57-61. https://doi.org/10.4082/kjfm.2018.39.1.57
  48. Hong YK, Lee MS. Impact of sleep time on psychic symptoms, suicidal ideation and suicide attempt in Korean adults: focus on gender difference. J Kor Acad-Ind Coop Soc 2020;21:372-383.
  49. Kim SH, Park HM, Lee JY, Linton JA. Associations between sleep duration and suicidal ideation: Korea National Health and Nutrition Examination Survey 4th, 5th survey. Korean J Fam Pract 2015;5(Suppl 3):S557-S562.
  50. Bea SS. Relationships between sleep duration and depression or suicidal thoughts in Korean adults. Korean J heal serv Manag 2018;12:219-228. https://doi.org/10.12811/kshsm.2018.12.4.219
  51. Minkel J, Moreta M, Muto J, Htaik O, Jones C, Basner M, et al. Sleep deprivation potentiates HPA axis stress reactivity in healthy adults. Health Psychol 2014;33:1430-1434. https://doi.org/10.1037/a0034219
  52. Shen J, Barbera J, Shapiro CM. Distinguishing sleepiness and fatigue: focus on definition and measurement. Sleep Med Rev 2006;10:63-76. https://doi.org/10.1016/j.smrv.2005.05.004
  53. van Noorden MS, van Fenema EM, van der Wee NJ, Zitman FG, Giltay EJ. Predicting outcome of depression using the depressive symptom profile: the Leiden Routine Outcome Monitoring Study. Depress Anxiety 2012;29:523-530. https://doi.org/10.1002/da.21958
  54. Morris BH, Bylsma LM, Rottenberg J. Does emotion predict the course of major depressive disorder? A review of prospective studies. Br J Clin Psychol 2009;48(Pt 3):255-273. https://doi.org/10.1348/014466508X396549
  55. Stranges S, Dorn JM, Shipley MJ, Kandala NB, Trevisan M, Miller MA, et al. Correlates of short and long sleep duration: a cross-cultural comparison between the United Kingdom and the United States: the Whitehall II Study and the Western New York Health Study. Am J Epidemiol 2008;168:1353-1364. https://doi.org/10.1093/aje/kwn337
  56. Kline CE, Zielinski MR, Devlin TM, Kripke DF, Bogan RK, Youngstedt SD. Self-reported long sleep in older adults is closely related to objective time in bed. Sleep Biol Rhythms 2010;8:42-51. https://doi.org/10.1111/j.1479-8425.2009.00422.x
  57. Stenholm S, Kronholm E, Bandinelli S, Guralnik JM, Ferrucci L. Self-reported sleep duration and time in bed as predictors of physical function decline: results from the InCHIANTI study. Sleep 2011;34:1583-1593. https://doi.org/10.5665/sleep.1402
  58. Gangwisch JE, Babiss LA, Malaspina D, Turner JB, Zammit GK, Posner K. Earlier parental set bedtimes as a protective factor against depression and suicidal ideation. Sleep 2010;33:97-106. https://doi.org/10.1093/sleep/33.1.97
  59. Matsushita M, Koyama A, Ushijima H, Mikami A, Katsumata Y, Kikuchi Y, et al. Sleep duration and its association with sleepiness and depression in "ronin-sei" preparatory school students. Asian J Psychiatr 2014;9:61-66. https://doi.org/10.1016/j.ajp.2014.01.006
  60. Daghlas I, Lane JM, Saxena R, Vetter C. Genetically proxied diurnal preference, sleep timing, and risk of major depressive disorder. JAMA Psychiatry 2021;78:903-910. https://doi.org/10.1001/jamapsychiatry.2021.0959
  61. Teh HC, Archer JA, Chang W, Chen SHA. Mental well-being mediates the relationship between perceived stress and perceived health. Stress Health 2015;31:71-77. https://doi.org/10.1002/smi.2510
  62. Lee J. Mediating effect of sleep satisfaction on the relationship between stress and self-rated health among Korean adolescents: a nationwide cross-sectional study. Child Youth Serv Rev 2020;109:104717. https://doi.org/10.1016/j.childyouth.2019.104717
  63. Biondi M, Picardi A. Psychological stress and neuroendocrine function in humans: the last two decades of research. Psychother Psychosom 1999;68:114-150. https://doi.org/10.1159/000012323
  64. Halford C, Anderzen I, Arnetz B. Endocrine measures of stress and self-rated health: a longitudinal study. J Psychosom Res 2003;55:317-320. https://doi.org/10.1016/S0022-3999(02)00634-7
  65. Kristenson M, Olsson AG, Kucinskiene Z. Good self-rated health is related to psychosocial resources and a strong cortisol response to acute stress: the LiVicordia study of middle-aged men. Int J Behav Med 2005;12:153-160. https://doi.org/10.1207/s15327558ijbm1203_4
  66. Simon GE, VonKorff M, Piccinelli M, Fullerton C, Ormel J. An international study of the relation between somatic symptoms and depression. N Engl J Med 1999;341:1329-1335. https://doi.org/10.1056/NEJM199910283411801