Social jetlag and depression status: Results obtained from the Netherlands Study of Depression and Anxiety

Abstract

Social jetlag, the misalignment between the internal clock and the socially required timing of activities, is highly prevalent, especially in people with an evening chronotype and is hypothesized to be related to the link between the evening chronotype and major depressive disorder. Although social jetlag has been linked to depressive symptoms in non-clinical samples, it has never been studied in patients with major depressive disorder (MDD). This study is aimed to study social jetlag in patients with major depressive disorder and healthy controls, and to further examine the link between social jetlag and depressive symptomatology. Patients with a diagnosis of MDD (n = 1084) and healthy controls (n = 385), assessed in a clinical interview, were selected from the Netherlands Study of Depression and Anxiety. Social jetlag was derived from the Munich Chronotype Questionnaire, by calculating the absolute difference between the midsleep on free days and midsleep on work days. Depression severity was measured with the Inventory of Depressive Symptomatology. It was found that patients with MDD did not show more social jetlag compared to healthy controls, neither in a model without medication use (β = 0.06, 95% CI: -0.03-0.15, p = 0.17) nor in a model where medication use is accounted for. There was no direct association between the amount of social jetlag and depressive symptoms, neither in the full sample, nor in the patient group or the healthy control group. This first study on social jetlag in a clinical sample showed no differences in social jetlag between patients with MDD and healthy controls.

Pulling the covers in electronic health records for an association study with self-reported sleep behaviors

“…The average weekend sleep duration of 8.59 hours closely matches sleep durations from other studies based on self-reported data (Fischer et al 2017; Koopman et al 2017; Liu et al 2012; Rutters et al 2014), which commonly overestimates sleep duration compared with objective measures such as actigraphy (Arora et al 2013; Dietch et al 2017; Lauderdale et al 2006; Silva et al 2007). Well-established trends in both objective and subjective sleep analyses demonstrate whites sleep upwards of 45 minutes longer than blacks (Dietch et al 2017; Lauderdale et al 2006), and women sleep upwards of 30 minutes longer than men (Dietch et al 2017; Lauderdale et al 2006; Liu et al 2012; Urbanek et al 2017), which are all consistent with our findings.…”

“…These patterns are consistent with expected constraints of working-age adults and altered sleep requirements in the elderly and have been observed previously (Hashizaki et al 2015; Ohayon et al 2004; Silva et al 2007). Both sleep midpoint and sleep lag also vary as a function of age, which has been observed in adolescents and young adults (Hashizaki et al 2015; Fischer et al 2017; Koopman et al 2017; Rutters et al 2014; Urbanek et al 2017). Gender and race did not explain social sleep lag, which may reflect broader cultural norms and chronotype shifts in younger individuals regardless of background.…”

“…In fact, associations of sleep with age, gender, race and metabolic parameters such as body mass index (BMI) are largely consistent, regardless of how the sleep metrics are acquired (Dietch et al 2017; Fischer et al 2017; Hashizaki et al 2015; Lauderdale et al 2006; Liu et al 2012; Ohayon et al 2004; Rutters et al 2014; Silva et al 2007; Urbanek et al 2017). Questionnaires such as the Morningness–Eveningness Questionnaire (Horne and Ostberg 1976) and Munich Chronotype Questionnaire (Roenneberg et al 2003) are common approaches to gauge an individual’s preferred schedule of activity and rest (i.e.…”

Stability of chronotype over a 7‐year follow‐up period and its association with severity of depressive and anxiety symptoms

“…Categorization was based on a participant's personal change in MSFsc between T1 and T2. Although a golden standard is lacking, differences in MSFsc have been reported between healthy controls and patients with a depressive disorder of less than 30 min (Knapen et al, 2018), or around 30 min (Morelatto De Souza, Paz, & Hidalgo, 2014). We considered MSFsc to be stable over time if the difference in MSFsc was less than 30 min (i.e., ΔMSFsc < 0.5, N = 665 [46.9%]), and instable if there was an advance (MSFsc T1 >T2, N = 473 [33.4%]) or a delay (MSFsc T1 <T2, N = 279 [19.7%]) of more than 30 min.…”

Clocks in the clinic: circadian rhythms in health and disease

“…The impact of chronotype on symptoms of depression may be mediated through SJL, as adolescents and younger adults with later chronotypes experience greater levels of SJL, which in turn is associated with depressive symptoms 46. However, analysis of a patient sample with MDD and healthy controls found no association between SJL and depressive symptoms in either sample when the analysis was stratified 47. As SJL is a function of both intrinsic chronobiology and social factors such as employment status, and such factors are culturally-determined and also heavily influenced by age, further study in diverse populations is required.…”