Self-reported sleep quality is more closely associated with mental and physical health than chronotype and sleep duration in young adults: A multi-instrument analysis

Abstract

Sleep and circadian rhythms are considered to be important determinants of mental and physical health. Epidemiological studies have established the contribution of self-reported sleep duration, sleep quality and chronotype to health outcomes. Mental health and sleep problems are more common in women and men are more likely to be evening types. Few studies have compared the relative strength of these contributions and few studies have assessed these contributions separately in men and women. Furthermore, sleep and circadian characteristics are typically assessed with a limited number of instruments and a narrow range of variables is considered, leaving the understanding of the relative contribution of different predictors somewhat fractionary. We compared sleep quality, sleep duration and chronotype as predictors for self-reported mental and physical health and psychological characteristics in 410 men and 261 women aged 18 to 30. To ascertain that results were not dependent on the use of specific instruments we used a multitude of validated instruments including the Morningness-Eveningness-Questionnaire, Munich-ChronoType-Questionnaire, Pittsburgh-Sleep-Quality-Index, British-Sleep-Survey, Karolinska-Sleep-Diary, Insomnia-Severity-Index, SF-36-Health Survey, General-Health-Questionnaire, Dutch-Eating-Behaviour-Questionnaire, Big-Five-Inventory, Behaviour-Inhibition-System-Behaviour-Activation-System, and the Positive-Affect-Negative-Affect-Schedule. Relative contributions of predictors were quantified as local effect sizes derived from multiple regression models. Across all questionnaires, sleep quality was the strongest independent predictor of health and in particular mental health and more so in women than in men. The effect of sleep duration and social jetlag was inconspicuous. A greater insight into the independent contributions of sleep quality and chronotype may aid the understanding of sleep-health interactions in women and men.