Cited by 177Sleep and related disordersCircadian rhythm and melatoninSleep and Work-Related Fatigue

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Influence of Chronotype, Season, and Sex of Subject on Sleep Behavior of Young Adults

Lehnkering, Hanna, Siegmund, Renate·2007·Chronobiology International

DOI 10.1080/07420520701648259

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Abstract

The aim of this study was to investigate whether sex, season, and/or chronotype influence the sleep behavior of university students. Detailed data were collected on activity/rest patterns by wrist actigraphy combined with diaries. Thirty-four medical students (19 female and 15 male) were monitored by Actiwatch actometers for 15 consecutive days in May and again in November. The data of a modified Horne and Ostberg chronotype questionnaire, which were collected from 1573 female and 1124 male medical school students surveyed in the spring and autumn over an eight-year period, were evaluated. Actiwatch sleep analysis software was used to process the activity data with statistical analyses performed with ANOVA. We found no significant sex-specific differences in sleep efficiency, sleep onset latency, or actual sleep-time duration. However, we did find a difference in sleep efficiency between morning and evening types, with morning types having a higher sleep efficiency (87.9%, SD=1.3) than evening types (84.3%, SD=0.87%; p=0.007). Seasonal differences were also detected: the actual sleep-time duration in autumn was significantly longer (mean 6.9 h, SD=0.13 h) than in spring (6.6 h, SD=0.1 h; p=0.013). Evaluation of the chronotype questionnaire data showed that individuals with no special preference for morningness or eveningness (i.e., so-called intermediates) were most common. The distribution of chronotypes was related to the sex of subject. Men displayed eveningness significantly more often than women (28.9% males vs. 20.8% females; p<0.001), while females exhibited greater morningness (20.3% females vs.15.6% males; p<0.001). Sex influences chronotype distribution, but not actual sleep time-duration, sleep onset latency, or sleep efficiency. The latter, however, differed among chronotypes, while actual sleep-time duration was affected by season.

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BackgroundResult
SLEEP PATTERNS IN HIGH SCHOOL AND UNIVERSITY STUDENTS: A LONGITUDINAL STUDY
Urner, M., Tornic, J., & Bloch, K. E. (2009) · Chronobiology International · doi:10.3109/07420520903244600 · Cited by 64
“Sleep patterns are shaped by various factors, including environmental conditions (Lehnkering & Siegmund, 2007; Randler, 2008; Roenneberg et al., 2003), socio-economic factors (Teixeira et al., 2007), genetic determinants (Archer et al., 2003), and age (Roenneberg et al., 2004).”
Background
Sleep duration and subjective psychological well-being in adolescence: a longitudinal study in Switzerland and Norway
Brand, S., Lemola, S., Holsboer‐Trachsler, E., Grob, A., & Kalak, N. (2014) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s62533 · Cited by 74
“Sleep duration is associated with seasonal changes in day length; 54–59 however, we did not find stronger seasonality of sleep duration in Norway than in Switzerland as one might have expected due to the more dramatic seasonal differences in day length in northern countries.”
The Relationship between Chronotype and Sleep Quality in Korean Firefighters
Yun, J.-A., Ahn, Y., Jeong, K.-S., Joo, E.-J., & Choi, K. (2015) · Clinical Psychopharmacology and Neuroscience · doi:10.9758/cpn.2015.13.2.201 · Cited by 61
Chronotype and depressive symptoms: A moderated mediation model of sleep quality and resilience in the 1st‐year college students
Zhou, J., Hsiao, F., Shi, X., Yang, J., Huang, Y., Jiang, Y., Zhang, B., & Ma, N. (2020) · Journal of Clinical Psychology · doi:10.1002/jclp.23037 · Cited by 58
Comparison of dream anxiety and subjective sleep quality between chronotypes
Selvı, Y., Aydın, A., Güleç, M., Boysan, M., Beşiroğlu, L., Özdemir, P. G., & KILIC, S. (2011) · Sleep and Biological Rhythms · doi:10.1111/j.1479-8425.2011.00511.x · Cited by 56
Influence of Sleeping Patterns in Health and Academic Performance Among University Students
Toscano-Hermoso, M. D., Arbinaga, F., Ozcorta, E. J. F., Gómez-Salgado, J. C., & Ruíz-Frutos, C. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17082760 · Cited by 58
“Thus, whilst it has been possible to observe a higher prevalence of eveningness chronotype in males, both in samples of university students [41,42] and in the adult population [43], data has also been found to indicate a greater incidence of this chronotype in females with samples from the general population [66].”
BackgroundResult
Longitudinal Study of Sleep Patterns of United States Military Academy Cadets
Shattuck, N. L., Shattuck, L. G., & Mateangas, P. (2010) · SLEEP · doi:10.1093/sleep/33.12.1623 · Cited by 59
Bridging the Reciprocal Gap between Sleep and Fruit and Vegetable Consumption: A Review of the Evidence, Potential Mechanisms, Implications, and Directions for Future Work
Noorwali, E. A., Hardie, L. J., & Cade, J. E. (2019) · Nutrients · doi:10.3390/nu11061382 · Cited by 58
“Other non-modifiable determinants include race [136], sex [137], and age [138].”
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Sleep hygiene awareness: its relation to sleep quality and diurnal preference
Voinescu, B., & Szentagotai-Tatar, A. (2015) · Journal of Molecular Psychiatry · doi:10.1186/s40303-015-0008-2 · Cited by 57
“Despite theoretically better sleep quality owing to natural plasticity and automaticity of sleep and lesser likelihood of disease that interferes sleep [24], young people report poor sleep quality [12,18,45,50-53], possibly because they do not implement known techniques, due to the pressure of increased work, study or…”
Background
Predicting the actigraphy-based acrophase using the Morningness–Eveningness Questionnaire (MEQ) in college students of North Italy
Roveda, E., Vitale, J. A., Montaruli, A., Galasso, L., Carandente, F., & Caumo, A. (2017) · Chronobiology International · doi:10.1080/07420528.2016.1276928 · Cited by 55
Desynchronization of Daily Rest–Activity Rhythm in the Days Following Light Propofol Anesthesia for Colonoscopy
Dispersyn, G., Touitou, Y., Coste, O., Jouffroy, L., Lleu, J. C., Challet, É., & Pain, L. (2008) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.2008.179 · Cited by 54
“Duration of colonoscopy (min (SD in min)) 12 (12)”
Background
Chronotype and Body Composition in Bipolar Disorder
Soreca, I., Fagiolini, A., Frank, E., Goodpaster, B. H., & Kupfer, D. J. (2009) · Chronobiology International · doi:10.1080/07420520902929060 · Cited by 53
“…sleep quality, and body mass index has been reported in adolescents from the general population (Megdal & Schernhammer, 2007); eveningness is also associated with reduced sleep efficiency in the general population (Lehnkering & Siegmung, 2007), indicating this may not be specific to mood disorders.”
Background
Distribution of Chronotypes in a Large Sample of Young Adult Saudis
BaHammam, A. S., Almestehi, W., Albatli, A., & AlShaya, S. (2011) · Annals of Saudi Medicine · doi:10.4103/0256-4947.78207 · Cited by 52
AASM standards of practice compliant validation of actigraphic sleep analysis from SOMNOwatch™ versus polysomnographic sleep diagnostics shows high conformity also among subjects with sleep disordered breathing
Dick, R., Penzel, T., Fietze, I., Partinen, M., Hein, H., & Schulz, J. (2010) · Physiological Measurement · doi:10.1088/0967-3334/31/12/005 · Cited by 53
“It is also useful in detecting sleep wake patterns in normal populations (Lehnkering et al 2006, Lehnkering and Siegmund 2007, Fietze at al 2009).”
Background
Sleep patterns and their age-related changes in elementary-school children
Seo, W. S., Sung, H.-M., Lee, J. H., Koo, B., Kim, M. J., Kim, S. Y., Choi, S.-J., & Shin, I. H. (2010) · Sleep Medicine · doi:10.1016/j.sleep.2010.03.011 · Cited by 52
“Previous studies reported that women tend to be shifted toward morning [23,24].”
Background
Morningness or Morning Affect? A Short Composite Scale of Morningness
Milia, L. V. D., & Bohle, P. L. (2009) · Chronobiology International · doi:10.1080/07420520902820954 · Cited by 52
“Evening types are also found to have irregular sleep habits (Taillard et al., 1999) and significantly lower sleep efficiency (Lehnkering & Diegmund, 2007).”
Background
Exploring the Interdependence of Couples' Rest‐Wake Cycles: An Actigraphic Study
Meadows, R. P., Arber, S., Venn, S., Hislop, J., & Stanley, N. (2009) · Chronobiology International · doi:10.1080/07420520802678452 · Cited by 52
“…recorded measurement data can, with high reliability, be translated into information about a person’s sleep (Benedetti et al., 2007; Blood et al., 1997; Cole et al., 1992; Lehnkering & Siegmund, 2007; Pati et al., 2007; Sadeh et al., 1994, 1995; Tonetti et al., 2008; Webster et al., 1982).”
Background
Annual, seasonal, cultural and vacation patterns in sleep, sedentary behaviour and physical activity: a systematic review and meta-analysis
Ferguson, T., Curtis, R., Fraysse, F., Lagiseti, R., Northcott, C., Virgara, R., Watson, A., & Maher, C. A. (2021) · BMC Public Health · doi:10.1186/s12889-021-11298-3 · Cited by 53
“Lehnkering 2007 [35] Season (Sp, Au) Medical students, Germany (n = 34) Mean NR, 19–31, 56% Sleep Accelerometer: Actiwatch, Sleep diary 15 days × 2, 6month followup”
BackgroundMethodInfluential
Association between morningness and resilience in Korean college students
Lee, S.-J., Park, C., Kim, B., Lee, C.-S., Cha, B., Lee, Y. J., Soh, M., Park, J. A., Young, P. S., & Song, E. H. (2016) · Chronobiology International · doi:10.1080/07420528.2016.1220387 · Cited by 52
“In university students, eveningness is associated with poor sleep efficiency as well as poor sleep quality and quantity during weekdays (Lehnkering & Siegmund 2007; Vitale et al., 2015).”
Background
Possible Association of Prokineticin 2 Receptor Gene (PROKR2) with Mood Disorders in the Japanese Population
Kishi, T., Kitajima, T., Tsunoka, T., Okumura, T., Ikeda, M., Okochi, T., Kinoshita, Y., Kawashima, K., Yamanouchi, Y., Ozaki, N., et al. (2009) · NeuroMolecular Medicine · doi:10.1007/s12017-009-8067-0 · Cited by 49
“It is known that there are sex differences in not only the pathophysiology of mood disorders (Currier et al. 2006; Faraone et al. 1987) but also in circadian rhythms ( Lehnkering and Siegmund 2007 ).”
Background
CHRONOTYPE, SLEEP LOSS, AND DIURNAL PATTERN OF SALIVARY CORTISOL IN A SIMULATED DAYLONG DRIVING
Ogińska, H., Fąfrowicz, M., Golonka, K., Marek, T., Mojsa‐Kaja, J., & Tucholska, K. (2010) · Chronobiology International · doi:10.3109/07420528.2010.489412 · Cited by 49
DO RESTLESS LEGS SYNDROME (RLS) AND PERIODIC LIMB MOVEMENTS OF SLEEP (PLMS) PLAY A ROLE IN NOCTURNAL HYPERTENSION AND INCREASED CARDIOVASCULAR RISK OF RENALLY IMPAIRED PATIENTS?
Portaluppi, F., Cortelli, P., Buonaura, G. C., Smolensky, M. H., & Fabbian, F. (2009) · Chronobiology International · doi:10.3109/07420520903245276 · Cited by 49
“…preference, may influence physical and mental performance as well as health status (Digdon & Howell, 2008; Hirata et al., 2007; Jankowski & Ciarkowska, 2008; Jones et al., 2008; Lehnkering & Siegmund, 2007; Pedrazzoli et al., 2007; Randler 2008a, 2008b; Reilly et al., 2007; Tonetti et al., 2008).”
Background
Association Between Homeschooling and Adolescent Sleep Duration and Health During COVID-19 Pandemic High School Closures
Albrecht, J. N., Werner, H., Rieger, N., Widmer, N., Janisch, D., Huber, R., & Jenni, O. G. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.42100 · Cited by 54
Morningness/eveningness and menstrual symptoms in adolescent females
Negriff, S. L., & Dorn, L. D. (2009) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2009.01.011 · Cited by 46
“Studies report that Morning types have higher sleep efficiency than Evening types [8], and Evening types report higher scores on the Sleep/Wake Behavior Scale indicating more sleep problems [3].”
Background
Association between Specific Diurnal Preference Questionnaire Items andPER3VNTR Genotype
Ellis, J. G., von Schantz, M., Jones, K., & Archer, S. N. (2009) · Chronobiology International · doi:10.1080/07420520902820970 · Cited by 46
Self-Reported Perceptions of Sleep Quality and Resilience Among Dance Students
Arbinaga, F. (2018) · Perceptual and Motor Skills · doi:10.1177/0031512518757352 · Cited by 45
“However, sleep duration and sleep efficiency may be disturbed for athletes after long days of training and intense and structured exercise periods (Fischer et al., 2008; Knauth, 2007; Lehnkering & Siegmund, 2007).”
Background
Sleep and the endogenous melatonin rhythm of high arctic residents during the summer and winter
Paul, M. A., Love, R. J., Hawton, A., & Arendt, J. (2015) · Physiology & Behavior · doi:10.1016/j.physbeh.2015.01.021 · Cited by 43
The stress of losing sleep: Sex-specific neurobiological outcomes
Wright, C. J., Milosavljevic, S., & Pocivavsek, A. (2023) · Neurobiology of Stress · doi:10.1016/j.ynstr.2023.100543 · Cited by 47
Genetic variants in RBFOX3 are associated with sleep latency
Amin, N., Allebrandt, K. V., van der Spek, A., Müller‐Myhsok, B., Hek, K., Teder‐Laving, M., Hayward, C., Esko, T., van Mill, J. G., Mbarek, H., et al. (2016) · European Journal of Human Genetics · doi:10.1038/ejhg.2016.31 · Cited by 39
Effects of school start times and technology use on teenagers' sleep: 1999-2008: Teen sleep: School timimg and technology
Borlase, B. J., Gander, P. H., & Gibson, R. H. (2013) · Sleep and Biological Rhythms · doi:10.1111/sbr.12003 · Cited by 36
Hypoxia‐induced changes in recovery sleep, core body temperature, urinary 6‐sulphatoxymelatonin and free cortisol after a simulated long‐duration flight
Coste, O., Beers, P. V., & Touitou, Y. (2009) · Journal of Sleep Research · doi:10.1111/j.1365-2869.2009.00744.x · Cited by 38
“Indeed, seasonal differences in sleep patterns have been demonstrated recently in young adults (Lehnkering and Siegmund, 2007).”
Background
The midpoint of sleep on working days: A measure for chronodisruption and its association to individuals’ well-being
de Souza, C. M., & Hidalgo, M. P. L. (2014) · Chronobiology International · doi:10.3109/07420528.2014.979941 · Cited by 41
“Men and women behave differently and have different physiological needs (Adan Sánchez-Turet, 2001; Adan & Natale, 2002; Lehnkering & Siegmund, 2007; Roenneberg et al., 2007; Waterhouse et al., 2012).”
Background
Association between chronotype and cardio-vascular disease risk factors: A systematic review and meta-analysis
Bhar, D., Bagepally, B. S., & Balachandar, R. (2022) · Clinical Epidemiology and Global Health · doi:10.1016/j.cegh.2022.101108 · Cited by 37
“20,21 25 – 28 Further independent studies reported an association be-tween evening chronotype and clinical parameters of diabetes such as elevated insulin resistance and glucose tolerance.”
Background
A Prospective Study of Seasonal Variation in Shift‐Work Tolerance
McLaughlin, C., Bowman, M. L., Bradley, C. L., & Mistlberger, R. E. (2008) · Chronobiology International · doi:10.1080/07420520802118269 · Cited by 36
“Another factor that has not been comprehensively examined, and yet also has the potential to affect shift-work tolerance, is seasonal variation in daylight hours (Lehnkering & Siegmund, 2007).”
Background
The relationship between chronotype and mood fluctuation in the general population
Jeong, H. J., Moon, E., Park, J., Lee, B. D., Lee, Y. M., Choi, Y., & Chung, Y. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.07.067 · Cited by 35
“Previous research has shown that women have a greater preference for morning activity than do men (Takeuchi et al., 2001; Lehnkering and Siegmund, 2007).”
Background
Morning larks travel more than night owls? Chronotypical effect on travel frequency through novelty seeking
Chark, R., Lam, L. W., & Fong, L. H. N. (2019) · Tourism Management · doi:10.1016/j.tourman.2019.104035 · Cited by 37
The role of chronotype in the interaction between the alerting and the executive control networks
Martínez‐Pérez, V., Palmero, L. B., Campoy, G., & Fuentes, L. J. (2020) · Scientific Reports · doi:10.1038/s41598-020-68755-z · Cited by 34
Chronotype and seasonality: Morningness is associated with lower seasonal mood and behavior changes in the Old Order Amish
Zhang, L., Evans, D. S., Raheja, U. K., Stephens, S. H., Stiller, J. W., Reeves, G. M., Johnson, M. A., Ryan, K. A., Weizel, N., Vaswani, D., et al. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.11.039 · Cited by 32
“…with 21% of intermediate type and 1% evening type, which is very different from the circadian typology reported in non-Amish with intermediate type encompassing more than 50% of the study populations (Adan and Natale, 2002; BaHammam et al., 2011; Fabbri et al., 2007; Lehnkering and Siegmund, 2007).”
Result
Associations of pineal volume, chronotype and symptom severity in adults with attention deficit hyperactivity disorder and healthy controls
Bumb, J. M., Mier, D., Noelte, I., Schredl, M., Kirsch, P., Hennig, O., Liebrich, L., Fenske, S., Alm, B., Sauer, C., et al. (2016) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2016.03.016 · Cited by 30
“Further, studies showed significant interactions between the chronotype and sleep efficiency (quality and quantity), which was poorer in evening types (Lehnkering and Siegmund, 2007; Vitale et al., 2015).”
Background
Influence of Day Length and Physical Activity on Sleep Patterns in Older Icelandic Men and Women
Brychta, R. J., Arnardóttir, N. Ý., Jóhannsson, E., Wright, E. C., Eiríksdóttir, G., Gudnason, V. G., Marinac, C. R., Davis, M., Koster, A., Caserotti, P., et al. (2016) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.5486 · Cited by 30
“14,15 It is also plausible that changes in physical activity (PA) patterns may contribute to reduced quality and duration of sleep in older adults.”
The Association Between Dry Eye and Sleep Disorders: The Evidence and Possible Mechanisms
Li, A., Zhang, X., Guo, Y., Wang, J., Hao, Y., Gu, Y., & Jie, Y. (2022) · Nature and Science of Sleep · doi:10.2147/nss.s378751 · Cited by 31
Emotional trait and memory associates of sleep timing and quality
Pace-Schott, E. F., Rubin, Z. S., Tracy, L. E., Spencer, R. M. C., Orr, S. P., & Verga, P. W. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.05.069 · Cited by 29
“For example, young adult male college students are especially vulnerable to socially mediated delayed sleep potentially leading to delayed sleep phase syndrome in vulnerable individuals (Adan et al., 2012; Kudielka et al., 2006; Lehnkering and Siegmund, 2007).”
Neurochemical and Neuropharmacological Aspects of Circadian Disruptions: An Introduction to Asynchronization
Kohyama, J. (2011) · Current Neuropharmacology · doi:10.2174/157015911795596522 · Cited by 29
“In addition, regardless of sleep duration, problematic behaviors are known to be associated with the aforementioned disturbances in daily habits [45-57].”
Background
Changes in Season Affect Body Weight, Physical Activity, Food Intake, and Sleep in Female College Students: A Preliminary Study
Yoshimura, E., Tajiri, E., Hatamoto, Y., & Tanaka, S. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17238713 · Cited by 26
“reported that the sleep-time duration monitored by the Actiwatch accelerometer was longer in autumn (November) than spring (May) among college students [20].”
Background
Impact of lifestyle on circadian orientation and sleep behaviour
NAG, C., & PRADHAN, R. K. (2012) · Sleep and Biological Rhythms · doi:10.1111/j.1479-8425.2011.00529.x · Cited by 24
Screen time and sleep among medical students in Germany
Liebig, L., Bergmann, A., Voigt, K., Balogh, E., Birkás, B., Faubl, N., Kraft, T. A., Schöniger, K., & Riemenschneider, H. (2023) · Scientific Reports · doi:10.1038/s41598-023-42039-8 · Cited by 23
MORNINGNESS PROPENSITY IN YOUNG ADULTS BORN PREMATURELY: THE HELSINKI STUDY OF VERY LOW BIRTH WEIGHT ADULTS
Strang‐Karlsson, S., Kajantie, E., Pesonen, A., Räikkönen, K., Hovi, P., Lahti, J. M. T., Heinonen, K., Järvenpää, A., Eriksson, J. G., ANDERSSON, S. M., et al. (2010) · Chronobiology International · doi:10.3109/07420528.2010.512689 · Cited by 24
Influence of Nocturnal Asthma on Chronotype
Ferraz, É., Borges, M. D. C., & Vianna, É. O. (2008) · Journal of Asthma · doi:10.1080/02770900802395470 · Cited by 23
“In the present study, we confirmed the predominance of morning types among non-asthmatic women, in agreement with other studies showing that morningness is more common in women than in men (45, 46).”
Result
The influence of chronotype in the daily lives of young children
Zimmermann, L. K. (2016) · Chronobiology International · doi:10.3109/07420528.2016.1138120 · Cited by 24
“Given that the longer days of spring and summer months have been linked with a seasonal shift to shorter sleep duration (Lehnkering & Siegmund, 2007) and later sleep onset (Figueiro & Rea, 2010), a different pattern of results may be found at different times of year.”
Background
Seasonality of self-destructive behaviour: Seasonal variations in demographic and suicidal characteristics in Van, Turkey
Aydın, A., Güleç, M., Boysan, M., Selvı, Y., Selvi, F., Kadak, M. T., & Beşiroğlu, L. (2012) · International Journal of Psychiatry in Clinical Practice · doi:10.3109/13651501.2012.697565 · Cited by 22
“Seasonal variation in the actual sleep-time duration is generally accepted and actual sleep-time duration is longer in autumn than in spring [17].”
Background

Authors: Lehnkering, H., & Siegmund, R.
Affiliations: Charité – Universitätsmedizin Berlin (DE)
Corresponding author: Lehnkering, Hanna
Venue: Chronobiology International
Publisher: Informa UK Limited
Published: 2007-01
Volume: 24
Issue: 5
Pages: 875-888
ISSN: 0742-0528 (ISSN-L)
1525-6073
DOI: 10.1080/07420520701648259
OpenAlex: W1998610182
Cited by: 177
References: 38
Citations by year: 2026: 2 · 2025: 1 · 2024: 9 · 2023: 9 · 2022: 6 · 2021: 15 · 2020: 11 · 2019: 6 · 2018: 6 · 2017: 6 · 2016: 11 · 2015: 10 · 2014: 11 · 2013: 7 · 2012: 10
FWCI: 18.34
Type: journal article
Language: en
Open access: closed
Locations: Chronobiology International (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Keywords: chronotype, sleep behavior, sex differences, seasonal variation, sleep efficiency, sleep latency, sleep duration, medical students, university students, intermediates
MeSH terms: Activity Cycles, Adult, Circadian Rhythm, Female, Humans, Male, Surveys and Questionnaires, Seasons, Sex Characteristics, Sleep

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Influence of Chronotype, Season, and Sex of Subject on Sleep Behavior of Young Adults

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