METHODS: A total of 167 participants were recruited (male/female = 46/121; aged 22.0 ± 5.2). Chronotype was assessed via reduced Morningness-Eveningness Questionnaire (rMEQ). Participants tracked their sleep behaviors using an activity wristband (Xiaomi® Mi Smart Band 5), and recorded their smartphone screen time usage. Psychometric measures - WHO-5 Well-being Index, Cognitive Distortion Questionnaire (CDQUEST), Three-Factor Eating Questionnaire-R18, Brief Self-Control Scale (BSCS), and Power of Food Scale. Blood pressures (BP), anthropometrics, and body composition like high waist circumference (WC), waist-hip ratio (WHR), waist-to-height ratio (WHtR), body mass index (BMI) and visceral fat level (VFL) were also measured.
RESULTS: Men and women did not differ significantly in terms of chronotype and sleep behaviors, except Rapid Eye Movement (REM) sleep. Longer weekday total and deep sleeps significantly correlated with better WHO-5 well-being scores, while longer weekend time awake during sleep significantly correlated with greater cognitive distortion (higher CDQUEST scores). Longer average deep sleep significantly correlated with lower Cognitive Restraint (CR) but higher Food Available scores. Higher rMEQ scores (indicating morningness) significantly correlated with better WHO-5 well-being, BSCS Total and Restraint scores; and significantly correlated with decreased systolic and diastolic BP specifically among men. Evening-type participants had up to six-fold higher risk of becoming obese, and having high WC, WHR, and VFL; however, the significance was abolished after adjustment for socio-demographics. Indeed, WC, weight, WHtR, BMI, VFL, and resting metabolism were significantly higher among evening-types by analysis of covariance. BSCS Total and Impulsivity scores were significantly higher among neither-types. Lifestyle factors and smartphone screen time were not associated with chronotype or sleep behaviors.
CONCLUSIONS: Although chronotype and sleep behaviors did not differ between sexes, those with a morning chronotype had lower overall, central and visceral adiposity, better well-being and self-control. Those with good sleep behaviors also had better well-being, eating and appetitive behaviors. In conclusion, this study supports the continuous advocacy for a morning-chronotype and good sleep behaviors for better physical and mental health.
METHODS: Diurnal variation of intraocular pressure was measured in 202 eyes of suspected open-angle glaucoma patients and 100 control eyes, at 4-hourly intervals for 24 hours (phasing). Based on the phasing results, optic disc changes and visual field defects, the patients were diagnosed as primary open angle glaucoma (POAG), normal tension glaucoma (NTG), ocular hypertension (OHT), or physiologic cup (PC), or still remained as glaucoma suspects due to inconclusive diagnosis. The last group (glaucoma suspects) was then followed up 6-monthly for their eventual outcome.
RESULTS: The highest percentage of suspected glaucoma patients had peak (maximum) readings in the mid-morning (10-11 A.M.) and trough (minimum) readings after midnight (2-3 A.M.); the highest percentage of control group had peak readings in the late evening (6-7 P.M.) and trough readings after midnight (2-3 A.M.). The mean amplitude of variance was 6 mm Hg in suspected glaucoma group and 4 mm Hg in the control group. After 'phasing', 18.8% of the suspected glaucoma patients were diagnosed as POAG, 16.8% as NTG, 5% as OHT, and 28.7% as physiologic cup; 30.9% remained as glaucoma suspects. After 4 years follow-up, 70% of the glaucoma suspects still remained as glaucoma suspects, 6.7% developed NTG and another 6.7% POAG; 16.6% were normal.
CONCLUSIONS: Serial measurement of IOP ( phasing) in a 24-hour period is still needed, in order not to miss the peak and the trough IOP readings in suspected open-angle glaucoma patients, which helps in better management of glaucoma. Among 30.9% of patients who remained as glaucoma suspects after the initial phasing, 13.4% developed NTG/POAG over a period of 4 years.
METHODS: Ten government maternal and child health clinics in Kuala Lumpur, Malaysia will be randomly selected. Sample size of 438 first-trimester pregnant women will be followed-up until the birth of their infant. Salivary melatonin and cortisol concentration among subsample will be determined using enzyme-linked immunosorbent assay. Data on sleep quality, psychological distress and morningness/eveningness chronotype of pregnant women will be collected using validated questionnaires. Pedometer will be used to measure 5-day physical activity data. Total gestational weight gain will be determined at the end of pregnancy. Utilization of 3-day food record is to capture meal timing and nutrient intake. All measurements will be done in 2nd and 3rd trimester. Birth outcomes will be collected through clinic records and Centers for Disease Control and Prevention (CDC) Neonatal questionnaire. Infants will be followed-up at 6 and 12 months old to obtain anthropometric measurements.
DISCUSSION: There is a growing recognition of the role of maternal circadian rhythm, which entrains fetal circadian rhythms that may subsequently have long-term health consequences. The present study will identify the effect of circadian rhythm on pregnancy outcomes and infant growth in the first year of life.