Associations between chronotype, morbidity and mortality in the UK Biobank cohort

“We used data from the UK Biobank, a large, prospective, population-based cohort study that was designed to investigate risk factors for major disease of middle and older age (Sudlow et al. 2015).”

“Finally, the UK Biobank cohort is generally healthier than the general UK population (Fry et al. 2017), and the degree to which these findings are generalisable to the entire population, or to other countries, is not known.”

“Circadian biologists mainly use two validated instruments used to assess either circadian preference, the MEQ (Horne and Östberg 1976), or circadian timing of behaviour, the Munich Chronotype Questionnaire (Roenneberg et al. 2003).”

“Evening types also commonly experience greater “social jetlag” (Wittmann et al. 2006), which is caused by going to bed and waking up later on non-work days compared to work days.”

“Experimentally induced circadian misalignment has resulted in impairments in glucose metabolism (Scheer et al. 2009; Buxton et al. 2012; Leproult et al. 2014), profound disruption of rhythmic gene expression programmes (Archer et al. 2014) and impairments in mood (Boivin et al. 1997).”

“Shorter sleep durations are more common in evening types (Roenneberg et al. 2007) and shorter sleep is associated with increased morbidity and mortality (Knutson 2010; Yin et al. 2017).”

“Greater social jetlag has been associated with being overweight (BMI ≥25 kg/m²) (Roenneberg et al. 2012) and adverse cardiometabolic profiles (Rutters et al. 2014; Parsons et al. 2015).”

“Strategies could include therapies that target the circadian system and tailoring schedules to suit individual chronotype whenever possible (Roenneberg and Merrow 2016).”

“Experimentally induced circadian misalignment has resulted in impairments in glucose metabolism (Scheer et al. 2009; Buxton et al. 2012; Leproult et al. 2014), profound disruption of rhythmic gene expression programmes (Archer et al. 2014) and impairments in mood (Boivin et al. 1997).”

“However, this question is practically identical to the final question of the MEQ, which has been found to have the highest correlation (p = 0.89) to the total MEQ score (Adan and Almirall 1991), which suggests that misclassification may have been minimal.”

“Shorter sleep durations are more common in evening types (Roenneberg et al. 2007) and shorter sleep is associated with increased morbidity and mortality (Knutson 2010; Yin et al. 2017).”

“Experimentally induced circadian misalignment has resulted in impairments in glucose metabolism (Scheer et al. 2009; Buxton et al. 2012; Leproult et al. 2014), profound disruption of rhythmic gene expression programmes (Archer et al. 2014) and impairments in mood (Boivin et al. 1997).”

“The recruitment strategy aimed to be as inclusive as possible, with every individual within the inclusion age range who were registered with the National Health Service and living up to about 25 miles from one of the assessment centres invited to participate (Allen et al. 2012).”

“Shorter sleep durations are more common in evening types (Roenneberg et al. 2007) and shorter sleep is associated with increased morbidity and mortality (Knutson 2010; Yin et al. 2017).”

“2012) and adverse cardiometabolic profiles (Rutters et al. 2014; Parsons et al. 2015).”

“Three age bins were defined based on previous analyses of UK Biobank data (Ganna and Ingelsson 2015): 37–52, 53–62 and 63–73 years.”

“Other investigators reporting UK Biobank data (Jones et al. 2016) have chosen to classify this group as a fifth, intermediate response.”

“2014), profound disruption of rhythmic gene expression programmes (Archer et al. 2014) and impairments in mood (Boivin et al.”

“Experimentally induced circadian misalignment has resulted in impairments in glucose metabolism (Scheer et al. 2009; Buxton et al. 2012; Leproult et al. 2014), profound disruption of rhythmic gene expression programmes (Archer et al. 2014) and impairments in mood (Boivin et al. 1997).”

“Lower levels of melatonin have been associated with greater insulin resistance (Reutrakul et al. 2018), increased risk of diabetes (Mcmullan et al. 2013) and breast and prostate cancer (Kloog et al. 2009; Kloog et al. 2010).”

“Our findings both agree with and crucially add to previously reported associations between evening types and increased morbidity and associated risk factors (Merikanto et al. 2013; Yu et al. 2015; Koopman et al. 2017).”

“Our findings both agree with and crucially add to previously reported associations between evening types and increased morbidity and associated risk factors (Merikanto et al. 2013; Yu et al. 2015; Koopman et al. 2017).”

“It is also worth noting that daylight savings time (DST)/summer time places a further burden on individuals who are already struggling with the dictates of social norms on when to start the working day, and the switch to DST, which is perceived as more uncomfortable by evening types than by morning types (Nascimento D…”

“…later chronotype) have been associated with morbidity, including higher rates of metabolic dysfunction and cardiovascular disease (CVD) (Reutrakul and Knutson 2015; Merikanto et al. 2013; Yu et al. 2015; Koopman et al. 2017) and psychiatric symptoms (Jankowski 2016; Melo et al. 2017; Putilov 2017).”

“2012) and adverse cardiometabolic profiles (Rutters et al. 2014; Parsons et al. 2015).”

“Our findings both agree with and crucially add to previously reported associations between evening types and increased morbidity and associated risk factors (Merikanto et al. 2013; Yu et al. 2015; Koopman et al. 2017).”

“Evening types have also reported greater consumption of legal psychoactive substances (nicotine, alcohol and caffeine) (Adan 1994) as well as illegal drugs (Prat and Adan 2011), which could reflect either biological differences or sheer opportunity offered by being awake and active late at night.”

“Lower levels of melatonin have been associated with greater insulin resistance (Reutrakul et al. 2018), increased risk of diabetes (Mcmullan et al. 2013) and breast and prostate cancer (Kloog et al. 2009; Kloog et al. 2010).”

“Eveningness has been associated with less healthy diets, including greater proportion of fat intake (Kanerva et al. 2012; Sato-Mito et al. 2011), which could increase risk of cardiometabolic diseases.”

“Behaviourally, evening types have a greater tendency towards impulsivity and novelty seeking and lower harm avoidance (Adan et al. 2010; Caci et al. 2004).”

“Lower levels of melatonin have been associated with greater insulin resistance (Reutrakul et al. 2018), increased risk of diabetes (Mcmullan et al. 2013) and breast and prostate cancer (Kloog et al. 2009; Kloog et al. 2010).”

“Evening types have also reported greater consumption of legal psychoactive substances (nicotine, alcohol and caffeine) (Adan 1994) as well as illegal drugs (Prat and Adan 2011), which could reflect either biological differences or sheer opportunity offered by being awake and active late at night.”

“Behaviourally, evening types have a greater tendency towards impulsivity and novelty seeking and lower harm avoidance (Adan et al. 2010; Caci et al. 2004).”

“Eveningness has been associated with less healthy diets, including greater proportion of fat intake (Kanerva et al. 2012; Sato-Mito et al. 2011), which could increase risk of cardiometabolic diseases.”

“…later chronotype) have been associated with morbidity, including higher rates of metabolic dysfunction and cardiovascular disease (CVD) (Reutrakul and Knutson 2015; Merikanto et al. 2013; Yu et al. 2015; Koopman et al. 2017) and psychiatric symptoms (Jankowski 2016; Melo et al. 2017; Putilov 2017).”

“A prospective study of approximately 11 000 Finnish twins examined chronotype, shift work in the incidence as well as mortality due to prostate cancer (Dickerman et al. 2016).”

“The heritable component of chronotype has been calculated to be between 21% and 52% (von Schantz et al. 2015).”

“Greater eveningness has also been associated with depression and mood disorders, particularly in those 50 years or older (Kim et al. 2010).”

“In the UK Biobank Study, a large prospective cohort study, a preference for evening was also associated with more cardiovascular risk factors, such as higher rates of smoking and overweight/obesity (Patterson et al. 2017).”

“…of social norms on when to start the working day, and the switch to DST, which is perceived as more uncomfortable by evening types than by morning types (Nascimento De Alencar et al. 2017; Kantermann et al. 2007), also coincided with greater incidence of cardiovascular events (Jiddou et al. 2013).”

“One population-based 1050 K. L. KNUTSON AND M. VON SCHANTZ study in Finland reported that evening chronotypes were more likely to have respiratory disorders, such as asthma (Merikanto et al. 2014), and we made similar observations in the UK cohort.”

“Lower levels of melatonin have been associated with greater insulin resistance (Reutrakul et al. 2018), increased risk of diabetes (Mcmullan et al. 2013) and breast and prostate cancer (Kloog et al. 2009; Kloog et al. 2010).”

“…later chronotype) have been associated with morbidity, including higher rates of metabolic dysfunction and cardiovascular disease (CVD) (Reutrakul and Knutson 2015; Merikanto et al. 2013; Yu et al. 2015; Koopman et al. 2017) and psychiatric symptoms (Jankowski 2016; Melo et al. 2017; Putilov 2017).”

“…of social norms on when to start the working day, and the switch to DST, which is perceived as more uncomfortable by evening types than by morning types (Nascimento De Alencar et al. 2017; Kantermann et al. 2007), also coincided with greater incidence of cardiovascular events (Jiddou et al. 2013).”

““Chronotype” refers to one’s preferred timing of sleep and activity, and evening chronotypes (“night owls”) are more likely to experience circadian disruption because of a mismatch between their internal clock and their social or professional responsibilities, and have increased risk of all-cause mortality compared wi…”

“Chronotype (a measure of preferred timing of sleep and activity) may be linked to cardiovascular disease mortality, with evening types at higher risk [14].”

“However, sleep is multidimensional (10), such that studies of both the independent and joint effects of sleep duration with other sleep traits such as sleep quality (11), sleep timing (12) , insomnia (13), and daytime napping (14) on cardiovascular outcomes are warranted.”