Eveningness Chronotype, Daytime Sleepiness, Caffeine Consumption and Use of Other Stimulants Among Peruvian University Students A Whittiera, SE Sanchezb,c, B Castañedab, E Sanchezc, B Gelayea, D Yanezd, MA Williamsa aMultidisciplinary Health International Research Training Program, Harvard School of Public Health, Boston, MA, USA; bUniversidad de San Martin de Porres, Lima, Peru; cAsociacion Civil Proyectos en Salud (PROESA), Peru; dUniversity of Washington School of Public Health, Seattle, WA Results Table 1. Morningness /Eveningness in Relation To Consumption Of Energy Drinks, Caffeinated Introduction & Objective Beverages and Stimulants Morning Evening Unadjusted OR Adjusted OR° type type •Problems associated with insufficient N=384 N= 256 (95% CI) (95% CI) sleep and daytime sleepiness Exposure % % • Approximately 10% (95% CI 8.8-11.1%) of students Any Stimulant Beverages negatively affect many areas of life were found to be evening chronotypes while 35% No 46.6 33.6 1.00 (Reference) 1.00 (Reference) Yes 53.4 66.4 1.73 (1.24-2.40) 1.30 (0.86-1.96) including cognition, emotions, work, (95% CI: 32.7-36.4%) of them exhibited daytime Type of Beverage hobbies, and both physical and mental Red Bull 9.9 21.1 2.43 (1.55-3.82) 1.62 (0.91-2.88) sleepiness. Evolution Drink 4.2 3.1 0.74 (0.31-1.76) 0.42 (0.12-1.51) 1.13 (0.47-2.72) 0.45 (0.12-1.67) health. Several studies have examined Turbo 3.1 3.5 Maretazo 3.1 3.5 1.13 (0.47-2.72) 0.58 (0.18-1.90) the relationship between caffeine and • Age, sex, cigarette smoking, and alcohol consumption Shark 3.4 4.3 1.28 (0.57-2.91) 0.86 (0.31-2.41) sleep disorders, but few have examined Burn 6.) 7.0 1.09 (0.58-2.03) 0.72 (0.31-1.68) were significantly associated with evening chronotype. Other Energy Drinks* 0.8 2.0 2.53 (0.60-10.68) 0.00 (0.00-?) this in Latin America. Coffee No 74.5 71.9 1.00 (Reference) 1.00 (Reference) • Those who reported consuming stimulant beverages Yes 25.5 28.1 1.14 (0.80-1.63) 0.99 (0.63-1.57) •We sought to evaluate patterns of had a 73% increased odds of being evening Coke/Pepsi No 79.4 67.6 1.00 (Reference) 1.00 (Reference) circadian preferences and daytime chronotype (OR=1.73; 95% CI 1.24-2.40), and 37% Yes 20.6 32.4 1.85 (1.29-2.66) 1.45 (0.91-2.30) *P-value from Chi-Square test; **Numbers may not add up due to missing; ***Other energy sleepiness, and to examine the extent increased odds of excessive daytime sleepiness drinks includes the following (Liftoff, Vortes); °Adjusted for age, gender, smoking, body mass index, and to which the consumption of stimulant (OR=1.37; 95% CI 1.16-1.63). physical activity beverages is associated with daytime sleepiness and evening chronotype • Students who reported consuming any type of Figure 1. Prevalence of daytime sleepiness according to age and sex among Peruvian college students. stimulant beverage had 1.37-fold higher odds of 40 •students. daytime sleepiness (95% CI 1.16-1.63). In 35 multivariable adjusted models, the odds ratio was Methods 30 slightly attenuated toward the null but remained 25 statistically significant (OR=1.25; 95% CI 1.03-1.53). •The study was a cross-sectional 20 Male survey of 2,581 undergraduate Female • Students who frequently consumed Red Bull 15 students attending 2 universities in (OR=2.43, 95% CI 1.55-3.82) and cola beverages Prevalancedaytime of sleepiness Lima, Peru. 10 (e.g., Coca-Cola, Pepsi) (OR=1.85, 95% CI 1.29-2.66) 5 had higher odds of being classified as evening •Data was collected through 0 chronotype. 18 19 20 21 ≥22 anonymous, self-administered Age (years) questionnaires. •The Morningness-Eveningness Questionnaire (MEQ) and Epworth Table 2. Daytime Sleepiness in Relation to Consumption of Energy Drinks, Caffeinated Sleepiness Scale (ESS) were used to Beverages and Stimulants Conclusion assess chronotype and daytime Daytime sleepiness Unadjusted OR Adjusted OR° Yes No sleepiness. (N=866) (N=1,639) (95% CI) (95% CI) •Stimulant beverage consumption is associated with both Exposure % % evening chronotype and daytime sleepiness. However, after Any stimulant beverages •Multivariable logistic regression No 34.4 41.9 1.00 (Reference) 1.00 (Reference) controlling for other factors, the association with evening Yes 65.6 58.1 1.37 (1.16-1.63) 1.25 (1.03-1.53) procedures were usedto estimate the Type of beverage odds of eveningess chornotype, chronotype was no longer significant. Chronotype is also Red Bull 14.2 13.1 1.10 (0.87-1.40) 0.85 (0.62-1.15) significantly associated with age, sex, cigarette smoking status, Evolution Drink 3.2 2.9 1.11 (0.69-1.78) 1.14 (0.64-2.02) daytime sleepiness and poor quality Turbo 3.0 3.2 0.95 (0.59-1.52) 0.93 (0.51-1.68) and alcohol consumption, but not BMI or physical activity. Maretazo 3.0 2.7 1.12 (0.69-1.84) 1.28 (0.69-2.38) sleep in relation to stimulant use. Shark 2.8 2.8 0.99 (0.60-1.63) 1.07 (0.56-2.04) Covariate adjusted odds ratios (OR) Burn 6.7 7.8 0.85 (0.61-1.17) 0.65 (0.42-0.98) Other Energy Drinks* 1.4 0.7 1.91 (0.85-4.26) 7.18 (1.99-25.93) and 95% confidence intervals (95% Coffee CI) were calculated. All data analyses No 70.2 75.0 1.00 (Reference) 1.00 (Reference) Acknowledgement Yes 29.8 25.0 1.27 (1.06-1.53) 1.20 (0.96-1.50) were performed using SPSS Coke/Pepsi No 5.6 76.4 1.00 (Reference) 1.00 (Reference) Statistical Software. • This work was supported by an award from the National Yes 24.4 23.6 1.05 (0.86-1.27) 0.91 (0.72-1.15) *Other energy drinks includes the following: Carabao Daeng, Lipovitan-D or Lipo, Wrangyer, and Shark; °Adjusted Institutes of Health, National Center on Minority Health and for age, gender, smoking, body mass index, and physical activity Health Disparities (T37-MD001449000).Conclusion Morningness/Eveningness Chronotype, Poor Sleep Quality, and Daytime Sleepiness in Relation to Common Mental Disorders among Peruvian College Students Deborah Rosea, Bizu Gelayea, Sixto Sanchezb,c, Benjamín Castañedab, Elena Sanchezc, David Yanezd, Michelle A. Williamsa aMultidisciplinary International Research Training Program, Harvard School of Public Health, Boston, MA; bUniversidad de San Martin de Porres, Lima, Peru; cAsociacion Civil Proyectos en Salud (PROESA), Lima, Peru; dUniversity of Washington School of Public Health, Seattle, WA Introduction & Objectives Results The item “ability to face up to problems” Studies suggest that disturbances in circadian Table 1— Correlations of Pittsburgh Sleep Quality Index (PSQI) Total Score had highest correlation with PSQI and Epworth Sleepiness Scale (ESS) Score with GHQ-12 items rhythm, sleep quality, and daytime functioning (r=0.36) while “feeling unreasonably can lead to the development of common PSQI score ESS score happy” had the smallest correlations Spearman’s Spearman’s mental disorders. An accumulating body of GHQ-12 Items (r=0.17). Correlation* Correlation* evidence also shows that sleep disorders have Able to concentrate 0.31 0.17 shared pathophysiologic mechanisms with Participants classified as evening types Lost much sleep 0.25 0.09 mood disorder. were 1.43 times as likely to have CMDs Playing useful part 0.24 0.16 (OR = 1.43; 95% CI 1.00–2.05) than Capable of making decisions 0.27 0.17 This research seeks to examine the extent to participants classified as morning types Under stress 0.20 0.08 which the characteristics of morningness and Could not overcome difficulties 0.25 0.18 (Table 2). Enjoy normal activities 0.32 0.10 eveningness chronotype, daytime sleepiness and poor sleep quality are associated with Students with poor sleep quality had a Face up to problems 0.36 0.12 common mental disorders among a large Feeling unhappy and depressed 0.28 0.17 4.5-fold higher relative odds of CMDs (OR Losing confidence 0.26 0.13 sample of Peruvian college students, a = 4.50; 95% CI 3.69-5.49) compared to Thinking of self as worthless 0.27 0.14 population that has not been sufficiently those without poor sleep quality. Feeling reasonably happy 0.17 0.06 evaluated in this area of study. *All p<0.001 Students who reported excessive daytime sleepiness had a 1.68 higher Materials and Methods relative odds of CMDs (OR = 1.75, 95% CI The study was conducted among 2,538 1.46-2.08) compared to students without Table 2—Eveningness Chronotype, Daytime Sleepiness and Poor Sleep undergraduate Peruvian students. daytime sleepiness. Quality in Relation to Common Mental Disorders Unadjusted OR Age and gender Multivariate Students completed a self-administered Sleep Disorder Figure 1—Prevalence of CMDs According to Sex and Age (95% CI) adjusted OR (95% CI) adjusted OR (95% CI) questionnaire that gathered information about sleep 45 Chronotype 40.7 41.2 39.7 Morning type 1.00 (Reference) 1.00 (Reference) 1.00 (Reference) characteristics, socio-demographic and lifestyle data. 40 36.2 36.6 Evening type 1.51 (1.08–2.13) 1.53 (1.07-2.17) 1.43 (1.00-2.05) Evening chronotype, sleep quality, and daytime 35 Daytime sleepiness No 1.00 (Reference) 1.00 (Reference) 1.00 (Reference) 30 28.3 sleepiness and evening chronotype were assessed Yes 1.76 (1.48-2.09) 1.75 (1.46-2.08) 1.68 (1.41-2.01) 23.5 using the Horne and Ostberg Morningess- 25 22.5 23.2 Sleep quality Female 20 17.5 Good 1.00 (Reference) 1.00 (Reference) 1.00 (Reference) Eveningeness Questionnaire (MEQ), Pittsburgh Sleep Male Prevalence CMDof Poor 4.53 (3.73-5.49) 4.40 (1.01-1.08) 4.50 (3.69-5.49) Quality Index (PSQI), and Epworth Sleepiness Scale 15 *Adjusted for age, gender, alcohol consumption, activity, and energy drinks 10 (ESS) .