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Circadian rhythm sleep quality -

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Rhythms 18, 80— Schermelleh-Engel, K. Evaluating the fit of structural equation models: tests of significance and descriptive goodness-of-fit measures. Methods Psychol. Online 8, 23— Schmidt, R. Cognitive and affective control in insomnia. The item Chinese Perceived Stress Scale CPSS was developed by Cohen , and the Chinese version is proven to be reliable Ng, It assesses the perceived stress level of individuals in the last month.

The cut-off for CPSS is 26 Cohen, Second, spearman correlation analysis was performed to assess the associations among perceived stress, circadian rhythm, and sleep quality.

In addition, Generalized Additive Model GAM was employed to estimate the non-linear associations Hastie and Tibshirani, Third, LPA was performed to identify potential subgroups with different circadian rhythm types. It began with a one-class model, continuing until fit indices could not be significantly improved.

Fourth, LPA-based differences in PSQI scores were estimated by Bayesian Factor. The Cauchy prior width was set at 0. The Bayes factor value greater than 10 indicates strong relative evidence for a hypothesis Quintana and Williams, Sixth, stratified analysis was performed to evaluate the difference in sleep quality among subgroups with different circadian rhythm types after controlling for potential covariates.

At last, the moderating role of LPA-based circadian rhythm types category variable was estimated between perceived stress continuous variable and sleep quality continuous variable. The data were run by Statistical Product and Service Solutions SPSS, version Significance was set at 0.

The BMI of male and female interns were The median of night shifts per month was three and Other demographic details are presented in Table 1. The mean and standard deviations of variables were perceived stress Spearman correlations are described in Figure 2A.

Figure 2. Spearman correlation Heatmap among perceived stress, circadian rhythms, and sleep quality A , and curve line regression of the above three variables B—D. One to five latent subgroups were checked based on fitting indicators and the three-class model was optimal in consideration of 1 relatively small AIC, BIC, and aBIC, 2 the sample size of each class was more than 50, and 3 a significant P -value of Lo-Mendell-Rubin LMR.

Other information is detailed in Figures 3A,B. Figure 3. Fitting index and group size of latent profile analysis models and logistic regression results for predicting external features on the 3-class pattern.

A Fitting index and group size of latent profile analysis models. Bold figures highlight the selected class solution. LL, Log-likelihood; AIC, Akaibe information criterion; BIC, Bayesian information criterion; aBIC, adjusted BIC; LMR, Lo, Mendell, and Rubin likelihood ratio test; C1, vigorous; C2, inadaptability; C3, flexibility.

B Parameters for the final three-class patterns. C Univariate and multivariate logistic regression results for predicting external features on the 3-class pattern. BMI, body mass index; OR, Odds ratio; CI, confidence interval.

Bold figures highlight statistically significant in the multivariate logistic regression. We named the latent profiles based on the overall distribution of the observed variables to distinguish heterogeneity in the circadian rhythms of interns.

Three circadian rhythm types were identified: Vigorousness These findings were confirmed by Bayesian Factor Robustness analysis Figure 4.

Figure 4. ANOVA comparison of PQSI scores across LPA-based groups and post hoc comparison by Bayesian factor analysis. A LPA-based differences on PSQI scores were estimated by Bayesian Factor.

V, Vigorous group; F, flexibility group; I, inadaptability group; SD, standard deviation; MD, mean difference; BF, Bayes Factor; η 2 , eta squared represents the explained unique variance of a dependent variable by three homogenous subgroups.

B ANOVA model averaged psterior distribution. C Inferential plots for Bayesian factor analysis. Figure 5. The effect of circadian rhythm subtypes on sleep quality by stratified analysis. Stratified associations between circadian rhythm types and sleep quality by physiological and environmental factors.

Analyses were adjusted for covariates gander, the habit of drinking coffee, regularity of diet, night shifts, BMI, PSS when they were not the strata variables.

OR, odds ratio; CI, confidence interval. Bold figures highlight statistically significant in the strata variables. The moderation analyses Figure 6A showed that the interactions of perceived stress and circadian rhythm types Vigorousness vs.

Inadaptability, Flexibility vs. Other information is listed in Figures 6A,B. Figure 6. The moderating effect of circadian rhythm types between perceived stress and sleep quality.

A Moderating role of circadian rhythm types in the association between perceived stress and sleep quantity. Regularity of diet was adjusted for each model. Independent variables were centered before analysis. B Simple slope plot of the interaction between circadian rhythm types and perceived stress on sleep quality.

This study illustrated the significant impact of night-shift on the sleep quality of nursing interns. We found that According to Bjorvatn and Waage , nurses who work in shifts are more likely to experience confusional arousal and nightmares than nurses who work only during the day.

This study was the first to examine latent profiles of circadian rhythm by LPA in a sample of nursing interns.

Using the LPA, individuals could be categorized into groups share similarity but differ from individuals in other groups Kongsted and Nielsen, According to the scoring patterns of the Circadian Type Inventory, they were named as Vigorousness resilient to decreased sleep time , Inadaptability vulnerable to sleep problems , and Flexibility can well regulate unusual working hours.

These results confirm the heterogeneity of circadian rhythms. Since the sleep—wake cycle of nursing interns with inadaptability In addition, the symptoms of sleepiness may be exacerbated by work fatigue, a reduction in alertness, and inability to recover from sleep Boivin and Boudreau, Consistent with previous studies, we found that females were more prone to Flexibility and more resilient to disruptions in circadian rhythms compared with males Fischer et al.

The rhythms of estrogen and androgen receptors that act on the suprachiasmatic nucleus SCN are ascribed to sexual dimorphism, with females showing higher oscillation amplitudes and peaks for gene expression than males Anderson and FitzGerald, ; Joye and Evans, The amplitude of the rhythm i.

In rodent experiments, female mice were more resilient to the destruction of genes and environment on circadian rhythm Bixler et al. We observed a significant difference in PSQI among three LPA-based circadian subgroups.

These findings are in line with previous research Muehlbach and Walsh, ; St-Onge et al. A cross-sectional study involving 4, emergency nurses found that nurses who worked more than four night shifts per month suffered from poorer sleep compared with those who never worked in night shifts Dong et al.

This discrepancy in findings may be attributed to the age, as the mean age of the participants in this study was A study reported that sleep—wake circadian rhythms become disrupted with aging, resulting in more awakenings and night terrors, and less slow-wave sleep Reilly et al.

Nursing staff with higher age and length of service have lower sleep phase stability and rhythmic amplitudes, indicating a greater tolerance for night shifts than interns Li et al. It should be noted that Vigorousness and Flexibility groups were not able to recover well from night shifts and had no better sleep quality than the Inadaptability group when the night shifts exceeded 2.

This phenomenon could also be recognized in interns with severe stress levels. This study confirmed that circadian rhythm types play significant moderating roles between perceived stress and sleep quality.

When exposed to increasing stress, the Flexibility and Vigorousness groups exhibited stable sleep quality, while the Inadaptability group was prone to poor sleep quality. An observational and longitudinal study revealed that medical internship like stress and night shifts plays an important role in the worsening of sleep quality and mental health Tafoya et al.

A random sample of 1, participants from Australia showed that both vigorous and flexible rhythms low amplitude and non-rigid were significantly more resilient, coped better, and required less daily sleep Di Milia and Folkard, The importance of these findings lies in showing that Inadaptability group exhibits low levels of resilience and circadian adaptation, which is reflected in poor sleep quality.

Additionally, individuals with high resilience tend to well regulate their emotions in response to stress and exhibit regular circadian cortisol rhythms Chi et al.

However, these confounders need further validation. Some preventive interventions should be developed for the Inadaptability group.

Second, a 60—90 min nap before a night shift is recommended, which is helpful for the body to complete a sleep cycle Mednick et al. Third, moderate and timely intake of caffeinated beverages, such as coffee, tea, and functional drinks, can effectively enhance work alertness and efficiency.

Lastly, Cognitive Behavioral Therapy for Insomnia CBT-I could also be recommended if necessary Newsom, Inevitably, the study has certain limitations. Thus, the findings of this study require further validation in a new sample with different backgrounds. An ongoing 2-year follow-up assessment of this cohort BRNC will provide additional insights in the future.

Hence, objective sleep data are required to validate these findings in future studies. Biological indicators, such as menstrual cycle, body temperature, melatonin, and cortisol, could be incorporated as objective calibrations of circadian rhythms, which will provide more insights into future research.

There is a high prevalence of poor sleep quality among nursing interns. The circadian rhythms of nursing interns are heterogeneous and attention should be paid to those with the Inadaptability type.

Additionally, the circadian rhythm subtypes moderate the association between perceived stress and sleep quality. Reasonable shift schedules and decreasing occupational stress should be considered when exploring preventive measures for poor sleep among nursing interns.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

The studies involving human participants were reviewed and approved by the Ethics Committee of The First Affiliated Hospital of Guangzhou University of Chinese Medicine [No: ZYYEC-ERK ]. XW: conceptualization, data curation, methodology, software, and writing—original draft. YL: investigation, resources, and validation.

XX, RC, NZ, and CZ: investigation and resources. ZY: supervision and writing—review and editing. All authors contributed to the article and approved the submitted version.

This work was supported by the National Natural Science Foundation of China No. We would like to thank nurse directors from participating universities for supporting data collection and all the participants for completing surveys.

We thank Bullet Edits Limited for the linguistic editing and proofreading of the manuscript. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Anderson, S. Sexual dimorphism in body clocks. Science , — doi: PubMed Abstract CrossRef Full Text Google Scholar. Axelsson, J. Tolerance to shift work-how does it relate to sleep and wakefulness? Circadian Rhythms.

Fold1 Content. What Scientists Know About How Circadian Rhythms Are Controlled NIGMS-Funded Research Advancing Our Understanding of Circadian Rhythms Research Organisms Used to Study Circadian Rhythms. What Are Circadian Rhythms? Health Effects of Disrupted Circadian Rhythms Circadian rhythms can fall out of sync with the outside world due to factors in the human body or environment.

For example: Variants of certain genes can affect the proteins that control biological clocks. Travel between time zones jet lag and shift work alters the normal sleep-wake cycle. Light from electronic devices at night can confuse biological clocks.

Circadian rhythm cycle of a typical teenager. Credit: NIGMS. NIGMS-Funded Research Advancing Our Understanding of Circadian Rhythms Researchers are studying circadian rhythms to gain better insight into how they work and how they affect human health.

Some of the most pressing questions that scientists seek to answer are: What molecular mechanisms underlie circadian rhythms?

Feedback loops that regulate biological clock proteins are an important part of maintaining circadian rhythms. Basic science research aims to identify more of the proteins and pathways involved in keeping time over hour cycles, responding to external cues such as light and food intake, and synchronizing circadian rhythms throughout the body.

Can scientists develop therapies that target circadian rhythm pathways to treat circadian dysfunction? Scientists are looking for therapies that may affect circadian rhythm pathways and help relieve the symptoms of circadian dysfunction.

What genetic variants lead to circadian rhythm dysfunction? Some patients have extreme circadian behaviors, including sleep-wake cycles that shift daily. These screens may also identify genes previously unknown to be associated with the biological clock. Research Organisms Used to Study Circadian Rhythms Microorganisms, fruit flies, zebrafish, and mice are often the research organisms that scientists study because they have similar biological clock genes as humans.

Traveling across time zones disrupts circadian rhythms. Credit: iStock. Picture selected ×. Home Contact Us Your Privacy Accessibility Disclaimers FOIA HHS Vulnerability Disclosure. Department of Health and Human Services National Institutes of Health: NIH Turning Discovery Into Health® USA.

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Sleep quality, circadian Circzdian, and mood Curcadian highly rhyth, processes. Remarkably, there is currently no Circadian rhythm sleep quality questionnaire that Cjrcadian all uqality of these clinically significant Mental toughness training The aim of this project rhythn to address this deficit. Circadian rhythm sleep quality Study 1, participants Circadian rhythm sleep quality a set sleeep potential items was generated from existing questionnaires in each of the three domains and refined to follow a single presentation format. Exploratory factor analysis was used to identify a parsimonious, three-factor latent structure. Following item reduction, the optimal representation of sleep quality, circadian phase, and mood was captured by a questionnaire with three 5-item scales: Depressed Mood, Morningness, and Good Sleep. Confirmatory factor analysis found the three-scale structure provided adequate fit. In both samples, Morningness and Good Sleep were positively associated, and each was negatively associated with the Depressed Mood scale. Thank you for visiting nature. You are using Circadiwn browser version rbythm limited Circadian rhythm sleep quality for CSS. To obtain the best experience, we recommend you use a qualuty Circadian rhythm sleep quality to date browser or turn off compatibility mode in Internet Explorer. In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. To study the alterations of sleep quality and circadian rhythm genes expressions upon elderly thyroid nodule patients, the risk factors associated with thyroid malignancies, and the potential relationship involved.