Eveningness , Insomnia, and Delayed Sleep Phase Syndrome in University Students

1. Eveningness, Insomnia, and Delayed Sleep Phase Syndrome in University Students Kendra Clay College of Arts & Sciences, Honors College Faculty Mentor: Daniel Taylor, Ph.D. Psychology Department, College of Arts & Sciences

2. Morningness & Eveningness • The Morningess/EveningnessQuestionaire (MEQ) is intended to classify people along a scale of morningness/eveningness in circadian rhythms (Anderson et al., 1991). • Evidence suggests that eveningness is associated with moodiness, emotional problems, and decreased academic performance (Medeiros et al., 2001; Gau et al., 2007).

3. Insomnia • Insomnia is characterized by difficulty falling asleep, maintaining sleep, or a frequent feeling of nonrestorative sleep (Brown, 2006). • Severe/chronic insomnia affects around 10% of the general population • ~ 30% of the population complains of occasional insomnia symptoms (Brown, 2006).

4. Delayed Sleep Phase Syndrome • Delayed Sleep Phase Syndrome (DSPS) is a circadian rhythm disorder which shifts the sleep-wake cycle significantly later than what is socially acceptable (Dagan et al., 2006; Herman, 2006). • The prevalence of DSPS in the general population is unknown, but it is estimated to affect 7%-16% of young adults (Daganet al., 2006).

5. Potential of Misdiagnosis • Because DSPS and insomnia share the characteristic of difficulty falling asleep, it is possible that the two may sometimes be misdiagnosed. • What may appear to be insomnia could in fact be a combination of DSPS and environmental factors (i.e. early morning class times).

6. Hypotheses • Evening types will score worse than morning types on GPA and other measures of daytime functioning. • A significant percentage of those students with self-reported insomnia will actually have DSPS. • Daytime functioning will be the lowest in subjects with DSPS, then higher in subjects with insomnia, and highest in those subjects without a diagnosable sleep problem.

7. Method • Cross-sectional survey of UNT students (N = 824) aged 18-26, conducted in Fall 2006 and Spring 2007.

8. Method • Survey contained many inventories, including: • Measures of Independent Variables: • Morningness/EveningnessQuestionaire (MEQ) • Sleep Diaries • Health Survey • Measures of Dependent Variables: • Quick Inventory of Depressive Symptomatology – self report (QIDS) • State-Trait Anxiety Inventory (STAI) • Alcohol Use Disorders Identification Test (AUDIT) • Brief COPE • Perceived Stress Scale (PSS) • Marijuana Problem Scale (MPS)

9. Method – Operational Definitions • Insomnia - Participants self-reported insomnia in the Health Survey. • DSPS - Classification as a subject with DSPS required a self-reported bedtime between 2-6 am. • Bedtime data obtained from the Sleep Diary.

10. Analyses • Polynomial Regression Analyses between the MEQ and dependent variables. • Frequency analysis to determine the prevalence rate of DSPS in subjects with self-reported insomnia. • Chi-square goodness of fit (DSPS vs. DSPS + Insomnia), with equivalence assumed. • Multivariate Analysis of Variance to determine if levels of daytime functioning differ between groups • Normal vs. DSPS vs. Insomnia vs. DSPS + Insomnia

11. MEQ Linear relationship with MPS (p = .032) Cubic relationship with AUDIT (p <.001 ) Cumulative GPA (p <.001) All other variables NS MEQ Analyses Results

12. Insomnia vs. DSPS • Frequency Analysis • 28% (n = 229) report insomnia • 26% (n = 203) report DSPS bedtime • How many people with insomnia report DSPS? • Total insomnia n = 229 • 64% (n = 147) have insomnia only • 36% (n = 82) report DSPS as well • 2 = 6589.78, p < .001

14. Univariate Analyses p < .001 p= .012 p < .001 p < .001 p < .001 p = .006 p= .035 p = .009 p = .015 p < .001 p= .037 p < .001 p < .001 p = .008

15. Conclusions • Eveningness predicts poorer academic performance in college students. • 28% of subjects self-report insomnia. • Of those, 36% report DSPS bedtimes as well. • Subjects with DSPS, insomnia, or both perform differently on measures of daytime functioning and academic performance than those without a sleep problem. • Differences vary between measures • In general subjects with DSPS only performed worse, except on QOL. • More research is needed on QOL discrepancy.

16. References Anderson, M.J., Petros, T.V., Beckwith, B.E., Mitchell, W.W., & Fritz, S. (1991). Individual differences in the effect of time of day on long-term memory access. The American Journal of Psychology, 104(2), 241-255. Brown, W. D. (2006). Insomnia: Prevalence and daytime consequences. In T. Lee-Chiong (Ed.), Sleep: A comprehensive handbook (p. 93-98). Hoboken, NJ: John Wiley & Sons, Inc. Gau, S. S-F., Shang, C.-Y., Merikangas, K. R., Chiu, Y.-N., Soong, W.-T., & Chengm A. T.-A. (2007). Association between morningness-eveningness and behavioral/emotional problems among adolescents. Journal of Biological Rhythms, 22(3), 268-274. Medeiros, A. L. D., Mendes, D. B. F., Lima, P. F., Araujo, J. F. (2001). The relationships between sleep-wake cycle and academic performance in medical students. Biological Rhythm Research, 32 (2), 263-270. Dagan, Y., Borodkin, K., & Ayalon, L. (2006). Advanced, delayed, irregular, and free-running sleep-wake disorders. In T. Lee-Chiong (Ed.), Sleep: A comprehensive handbook (p. 383-388). Hoboken, NJ: John Wiley & Sons, Inc. Herman, J. H. (2006). Circadian rhythms disorders in infants, children, and adolescents. In T. Lee-Chiong (Ed.), Sleep: A comprehensive handbook (p. 589-595). Hoboken, NJ: John Wiley & Sons, Inc.

17. Acknowledgements • Dr. Daniel Taylor, Assistant Professor, Department of Psychology, College of Arts & Sciences • Dr. Warren Burggren, Dean, College of Arts & Sciences • Dr. Gloria Cox, Dean, Honors College • Dr. Susan Eve, Associate Dean, Honors College