Journal List > J Korean Neuropsychiatr Assoc > v.51(4) > 1017583

Jang, Kim, Lee, and Lee: Sleep Wake Patterns and Nocturnal Sleep Parameters in the Morning and Evening Types



The aim of our study was to compare sleep wake patterns and nocturnal sleep parameters between the morning type (MT) and evening type (ET).


The Morningness-Eveningness Questionnaire, Pittsburgh Sleep Quality Index (PSQI), and Korean version of the Epworth Sleepiness Scale (KESS) were administered to subjects recruited among visitors to the Chuncheon National Museum from 2010 to 2011. Actigraphy data (Actiwatch-2, Philips-Respironics Co.) were collected from eight MT (Age 38.0±3.8, M : F=2 : 6), 12 neither type (NT) (Age 34.2±5.1, M : F=2 : 10), and nine ET (Age 30.3±6.8, M : F=2 : 7) subjects.


Scores for PSQI and KESS did not differ significantly among the MT, NT, and ET groups. No differences in time in bed, total sleep time, sleep efficiency, wake after sleep onset, sleep latency, and fragmentation index were observed among the three groups. In the ET group, the mean wake time on free days was significantly later, and the mean sleep duration on free days was significantly longer, compared with those of the MT group (p<0.01).


No differences in sleep quality, daytime sleepiness, and nocturnal sleep parameters were observed among the MT, NT, and ET groups. Compared to MT subjects, ET subjects showed later wake time and longer sleep duration on free days.

Figures and Tables

Fig. 1
Pearson's correlation analysis of PSQI scores with WASO (p<0.05), PSQI : Pittsburgh Sleep Quality Index, WASO : Wake time after sleep onset.
Table 1
Demographic features in the subjects with MT, NT and ET

* : Statistically significant ( : χ2-test or Kruskal-Wallis test). MT : Morning type, NT : Neither type, ET : Evening type, SD : Standard deviation

Table 2
Scores of MEQ, KESS and PSQI in the subjects with MT, NT and ET

* : Statistically significant (ANCOVA controlling for age), : 2 subjects with missing data were excluded. MT : Morning type, NT : Neither type, ET : Evening type, MEQ : Morningness-Eveningness Questionnaire, KESS : Korean version Epworth Sleepiness Scale, PSQI : Pittsburgh Sleep Quality Index, SD : Standard deviation

Table 3
Sleep parameters measured by actigraphy in the subjects with MT, NT and ET

ANCOVA controlling for age. MT : Morning type, NT : Neither type, ET : Evening type, SD : Standard deviation

Table 4
Sleep-wake pattern and caffeine use in the subjects with MT, NT and ET

* : Statistically significant (ANCOVA controlling for age), : 2 subjects with missing data were excluded, : 3 subjects with missing data were excluded. MT : Morning type, NT : Neither type, ET : Evening type, h : Hours, m : Minutes, SD : Standard deviation

Table 5
Sleep-wake pattern from sleep log and actigraphy in the subjects with MT, NT and ET

* : Statistically significant (ANCOVA controlling for age), : From sleep log, : From actigraphy. MT : Morning type, NT : Neither type, ET : Evening type, h : Hours, m : Minutes, SD : Standard deviation


1. Roenneberg T, Kuehnle T, Juda M, Kantermann T, Allebrandt K, Gordijn M, et al. Epidemiology of the human circadian clock. Sleep Med Rev. 2007. 11:429–438.
2. Duffy JF, Dijk DJ, Hall EF, Czeisler CA. Relationship of endogenous circadian melatonin and temperature rhythms to self-reported preference for morning or evening activity in young and older people. J Investig Med. 1999. 47:141–150.
3. Bailey SL, Heitkemper MM. Circadian rhythmicity of cortisol and body temperature: morningness-eveningness effects. Chronobiol Int. 2001. 18:249–261.
4. Klein DC, Moore RY, Reppert SM. Suprachiasmatic nucleus: The mind's clock. 1991. New York: Oxford University Press.
5. Mongrain V, Carrier J, Dumont M. Circadian and homeostatic sleep regulation in morningness-eveningness. J Sleep Res. 2006. 15:162–166.
6. Taillard J, Philip P, Coste O, Sagaspe P, Bioulac B. The circadian and homeostatic modulation of sleep pressure during wakefulness differs between morning and evening chronotypes. J Sleep Res. 2003. 12:275–282.
7. Horne JA, Ostberg O. A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. Int J Chronobiol. 1976. 4:97–110.
8. Smith CS, Reilly C, Midkiff K. Evaluation of three circadian rhythm questionnaires with suggestions for an improved measure of morningness. J Appl Psychol. 1989. 74:728–738.
9. Swaab DF, Fliers E, Partiman TS. The suprachiasmatic nucleus of the human brain in relation to sex, age and senile dementia. Brain Res. 1985. 342:37–44.
10. Ohayon MM, Zulley J, Guilleminault C, Smirne S, Priest RG. How age and daytime activities are related to insomnia in the general population: consequences for older people. J Am Geriatr Soc. 2001. 49:360–366.
11. Park YM, Matsumoto K, Seo YJ, Shinkoda H, Park KP. Sleep in relation to age, sex, and chronotype in Japanese workers. Percept Mot Skills. 1998. 87:199–215.
12. Roepke SE, Duffy JF. Differential impact of chronotype on weekday and weekend sleep timing and duration. Nat Sci Sleep. 2010. 2010:213–220.
13. Barclay NL, Eley TC, Buysse DJ, Archer SN, Gregory AM. Diurnal preference and sleep quality: same genes? A study of young adult twins. Chronobiol Int. 2010. 27:278–296.
14. Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999. 354:1435–1439.
15. Meier-Ewert HK, Ridker PM, Rifai N, Regan MM, Price NJ, Dinges DF, et al. Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol. 2004. 43:678–683.
16. Van Dongen HP, Maislin G, Mullington JM, Dinges DF. The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep. 2003. 26:117–126.
17. Kushida CA, Chang A, Gadkary C, Guilleminault C, Carrillo O, Dement WC. Comparison of actigraphic, polysomnographic, and subjective assessment of sleep parameters in sleep-disordered patients. Sleep Med. 2001. 2:389–396.
18. Ancoli-Israel S, Cole R, Alessi C, Chambers M, Moorcroft W, Pollak CP. The role of actigraphy in the study of sleep and circadian rhythms. Sleep. 2003. 26:342–392.
19. Weiss AR, Johnson NL, Berger NA, Redline S. Validity of activity-based devices to estimate sleep. J Clin Sleep Med. 2010. 6:336–342.
20. Carrier J, Monk TH, Buysse DJ, Kupfer DJ. Sleep and morningness-eveningness in the 'middle' years of life (20-59 y). J Sleep Res. 1997. 6:230–237.
21. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989. 28:193–213.
22. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991. 14:540–545.
23. Cho YW, Lee JH, Son HK, Lee SH, Shin C, Johns MW. The reliability and validity of the Korean version of the Epworth sleepiness scale. Sleep Breath. 2011. 15:377–384.
24. Paine SJ, Gander PH, Travier N. The epidemiology of morningness/eveningness: influence of age, gender, ethnicity, and socioeconomic factors in adults (30-49 years). J Biol Rhythms. 2006. 21:68–76.
25. Roenneberg T, Kuehnle T, Pramstaller PP, Ricken J, Havel M, Guth A, et al. A marker for the end of adolescence. Curr Biol. 2004. 14:R1038–R1039.
26. Chelminski I, Ferraro FR, Petros TV, Plaud JJ. An analysis of the "eveningness-morningness" dimension in "depressive" college students. J Affect Disord. 1999. 52:19–29.
27. Gau SF, Soong WT. The transition of sleep-wake patterns in early adolescence. Sleep. 2003. 26:449–454.
28. Lee JH, Kim IS, Kim SJ, Wang W, Duffy JF. Change in individual chronotype over a lifetime: a retrospective study. Sleep Med Res. 2011. 2:48–53.
29. Yang OK, Hyun KJ, No CL. Women and Welfare. 2002. Seoul: Ewha Womans University Press;304–305.
30. Carskadon MA, Dement WC. Cumulative effects of sleep restriction on daytime sleepiness. Psychophysiology. 1981. 18:107–113.
31. Schneider AM, Randler C. Daytime sleepiness during transition into daylight saving time in adolescents: Are owls higher at risk? Sleep Med. 2009. 10:1047–1050.
32. Hublin C, Kaprio J, Partinen M, Koskenvuo M. Insufficient sleep--a population-based study in adults. Sleep. 2001. 24:392–400.
33. Taillard J, Philip P, Bioulac B. Morningness/eveningness and the need for sleep. J Sleep Res. 1999. 8:291–295.
34. Ishihara K, Miyake S, Miyasita A, Miyata Y. Comparisons of sleep-wake habits of morning and evening types in Japanese worker sample. J Hum Ergol (Tokyo). 1988. 17:111–118.
35. Volk S, Dyroff J, Georgi K, Pflug B. Subjective sleepiness and physiological sleep tendency in healthy young morning and evening subjects. J Sleep Res. 1994. 3:138–143.
36. Roehrs T, Roth T. Caffeine: sleep and daytime sleepiness. Sleep Med Rev. 2008. 12:153–162.
37. Lee JH, Kim SJ, Kim IS, Jang KH, Lee HK, Duffy JF. Sex difference in self-reported sleep duration, daytime sleepiness, and caffeine use in morning and evening types. Sleep. 2011. 34:A59.
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