Browse > Article
http://dx.doi.org/10.22857/kjbp.2021.28.2.004

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

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)
Publication Information
Korean Journal of Biological Psychiatry / v.28, no.2, 2021 , pp. 58-69 More about this Journal
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
Sleep pattern; Chronotype; Depressive symptoms; Perceived usual stress; Self-rated health; Korea National Health and Nutrition Examination Survey;
Citations & Related Records
연도 인용수 순위
  • Reference
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.   DOI
2 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.   DOI
3 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.   DOI
4 Siegel JM. Clues to the functions of mammalian sleep. Nature 2005;437:1264-1271.   DOI
5 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.   DOI
6 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.   DOI
7 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.   DOI
8 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.   DOI
9 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.   DOI
10 Al-Harbi KS. Treatment-resistant depression: therapeutic trends, challenges, and future directions. Patient Prefer Adherence 2012;6:369-388.   DOI
11 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.   DOI
12 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.   DOI
13 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.   DOI
14 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.   DOI
15 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.   DOI
16 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.   DOI
17 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.   DOI
18 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.   DOI
19 Halford C, Anderzen I, Arnetz B. Endocrine measures of stress and self-rated health: a longitudinal study. J Psychosom Res 2003;55:317-320.   DOI
20 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.   DOI
21 Biondi M, Picardi A. Psychological stress and neuroendocrine function in humans: the last two decades of research. Psychother Psychosom 1999;68:114-150.   DOI
22 Tokur-Kesgin M, Kocoglu-Tanyer D. Pathways to adolescents' health: chronotype, bedtime, sleep quality and mental health. Chronobiol Int 2021;38:1441-1448   DOI
23 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.   DOI
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.   DOI
25 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.   DOI
26 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.   DOI
27 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.   DOI
28 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.   DOI
29 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.   DOI
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.   DOI
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.   DOI
32 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.
33 Sinyor M, Rezmovitz J, Zaretsky A. Screen all for depression. BMJ 2016;352:i1617.
34 Kim GE, Jo MW, Shin YW. Increased prevalence of depression in South Korea from 2002 to 2013. Sci Rep 2020;10:16979.   DOI
35 Akerstedt T, Knutsson A, Westerholm P, Theorell T, Alfredsson L, Kecklund G. Mental fatigue, work and sleep. J Psychosom Res 2004;57:427-433.   DOI
36 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.   DOI
37 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.   DOI
38 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.   DOI
39 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.   DOI
40 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.   DOI
41 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.   DOI
42 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.   DOI
43 Kashani M, Eliasson A, Vernalis M. Perceived stress correlates with disturbed sleep: a link connecting stress and cardiovascular disease. Stress 2012;15:45-51.   DOI
44 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.   DOI
45 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.   DOI
46 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.   DOI
47 Han B. Depressive symptoms and self-rated health in community-dwelling older adults: a longitudinal study. J Am Geriatr Soc 2002;50:1549-1556.   DOI
48 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.   DOI
49 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.   DOI
50 Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. Psychiatr Ann 2002;32:509-521.   DOI
51 Bea SS. Relationships between sleep duration and depression or suicidal thoughts in Korean adults. Korean J heal serv Manag 2018;12:219-228.   DOI
52 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.   DOI
53 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.   DOI
54 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.   DOI
55 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.   DOI
56 Hayes AF, Preacher KJ. Statistical mediation analysis with a multi-categorical independent variable. Br J Math Stat Psychol 2014;67:451-470.   DOI
57 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.
58 Shen J, Barbera J, Shapiro CM. Distinguishing sleepiness and fatigue: focus on definition and measurement. Sleep Med Rev 2006;10:63-76.   DOI
59 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.   DOI
60 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.   DOI
61 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.   DOI
62 Franzen PL, Buysse DJ. Sleep disturbances and depression: risk relationships for subsequent depression and therapeutic implications. Dialogues Clin Neurosci 2008;10:473-481.   DOI
63 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.   DOI
64 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.   DOI
65 Vingilis ER, Wade TJ, Seeley JS. Predictors of adolescent self-rated health. Can J Public Health 2002;93:193-197.   DOI
66 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.