Research Article
The Relationship Between Chronotype and Social Jetlag in Adolescents: Are Premenstrual Symptoms a Mediator?
Abstract
Objective: Chronotype and social jetlag are related in adolescents. Specifically, an evening chronotype can extend the duration of social jetlag, posing a threat to adolescent health. Identifying the factors mediating this relationship is important for managing negative outcomes. However, there is limited information in the literature on this topic, and the role of premenstrual symptoms in this relationship has not yet been fully explored. This study aims to examine the mediating role of premenstrual symptoms in the effect of chronotype on social jetlag in adolescents.
Method: The sample of this descriptive and correlational study included 309 adolescents (n=309). Data were collected using the Personal Information Form, Premenstrual Syndrome Scale, and Morningness-Eveningness Scale for Children.
Results: As chronotype scores increased, social jetlag duration (β: -0.457; p<0.001) and premenstrual syndrome score (β: -0.342; p<0.001) decreased, while an increase in premenstrual syndrome score had no effect on social jetlag (β: 0.096; p>0.05). When the mediation effect was analysed, premenstrual symptoms did not mediate the interaction between chronotype and social jetlag (95% CI [-0.073; 0.006]; p>0.05).
Conclusion: Chronotype affects social jetlag and premenstrual symptoms, while premenstrual symptoms have no effect on social jetlag. Also, premenstrual symptoms do not mediate the relationship between chronotype and social jetlag. To effectively answer the question, “Are premenstrual symptoms a mediator?”, it is recommended to plan similar studies in different regions, taking into account diverse cultural and sociodemographic characteristics and mental/cultural/governmental policies.
Ethical Statement
Ethics committee permission required for the research was obtained from the non-interventional research ethics committee of a university (18.01.2022-49)
Supporting Institution
nONE
Thanks
The authors thank the adolescents who participated in the study.
References
- Arslan M, Deniz FN (2024) Investigating the associations between chronotype, physical activity, premenstrual syndrome, hunger, and food choice among Turkish women. Psychol Health Med, doi: 10.1080/13548506.2024.2439136..
- Armini NKA, Zahriya AN, Hidayati L, Dewi KI (2022) Physical activity and anxiety with complaints of PMS in adolescents during the COVID-19 pandemic. Int J Public Health Sci, 11:601-606.
- Baron RM, Kenny DA (1986) The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol, 51:1173.
- Buddhabunyakan N, Kaewrudee S, Chongsomchai C, Soontrapa S, Somboonporn W, Sothornwit J (2017) Premenstrual syndrome (PMS) among high school students. Int J Womens Health, 9:501-505.
- Carskadon MA, Vieira C, Acebo C. (1993) Association between puberty and delayed phase preference. Sleep, 16:258-262.
- Chan NY, Li SX, Wing YK (2021) Are adolescents sleeping less and worse than before? Lancet Reg Health West Pac, 11:100167.
- Conzatti M, Perez AV, Maciel RF, De Castro DH, Sbaraini M, Wender MCO (2021) Sleep quality and excessive daytime sleepiness in women with premenstrual syndrome. Gynecol Endocrinol, 37:945-949.
- Crouse JJ, Carpenter JS, Song YJC, Hockey SJ, Naismith SL, Grunstein RR et al. (2021) Circadian rhythm sleep–wake disturbances and depression in young people: implications for prevention and early intervention. Lancet Psychiatry, 8:813-823.
- Dutta A, Sharma A (2021) Prevalence of premenstrual syndrome and premenstrual dysphoric disorder in India: a systematic review and meta-analysis. Health Promot Perspect, 11:161.
- Feliciano EMC, Rifas-Shiman SL, Quante M, Redline S, Oken E, Taveras EM (2019) Chronotype, social jet lag, and cardiometabolic risk factors in early adolescence. JAMA Pediatr, 173:1049-1057.
- Gençdoğan B (2006) Premenstrual sendrom için yeni bir ölçek. Turkiye’de Psikiyatri, 8:81-87.
- Hayes AF (2017) Introduction to Mediation, Moderation, and Conditional Process Analysis, 2nd Ed. New York, Guilford.
- Hennegan J, Winkler IT, Bobel C, Keiser D, Hampton J, Larsson G et al. (2021) Menstrual health: a definition for policy, practice, and research. Sex Reprod Health Matters, 29:31-38.
- Itriyeva K (2022) Premenstrual syndrome and premenstrual dysphoric disorder in adolescents. Curr Probl Pediatr Adolesc Health Care, 52:101187.
- Jehan S, Auguste E, Hussain M, Pandi-Perumal SR, Brzezinski A, Gupta R et al. (2016) Sleep and premenstrual syndrome. J Sleep Med Disord, 3:1061.
- Jeong D, Lee H, Kim J (2023) Effects of sleep pattern, duration, and quality on premenstrual syndrome and primary dysmenorrhea in korean high school girls. BMC Womens Health, 23:456.
- Jung HN, Suh D, Jeong WC, Ryu J, Kim YM, Yoon S, Kim H (2023) Associations of chronotype and insomnia with menstrual problems in newly employed nurses at university hospitals in the Republic of Korea. Ann Occup Environ Med, 35:e30.
- Kim T, Jang SJ (2022) Shift nurses’ social jetlag, anxiety, and premenstrual symptoms: a cross-sectional study. Collegian, 29:477-483.
- Komada Y, Ikeda Y, Sato M, Kami A, Masuda C, Shibata S (2019) Social jetlag and menstrual symptoms among female university students. Chronobiol Int, 36:258-264.
- Lee H, Kim S, Kang SH, Chung H, Choi J, So H et al. (2016) Association of premenstrual syndrome and premenstrual dysphoric disorder with depression, sleep quality and sleep pattern in the Korean female high-school students. Anxiety and Mood, 12:113-118.
- Magnusdottir S, Magnusdottir I, Gunnlaugsdottir AK, Hilmisson H, Hrolfsdottir L, Paed AEEM (2024) Sleep duration and social jetlag in healthy adolescents. association with anxiety, depression, and chronotype: a pilot study. Sleep Breath, 28:1541-1551.
- Malone SK, Zemel B, Compher C, Souders M, Chittams J, Thompson AL et al. (2016) Social jet lag, chronotype and body mass index in 14–17-year-old adolescents. Chronobiol Int, 33:1255-1266.
- Matsumoto T, Egawa M, Kimura T, Hayashi T (2019) A potential relation between premenstrual symptoms and subjective perception of health and stress among college students: a cross-sectional study. Biopsychosoc Med, 13:26.
- Meers JM, Nowakowski S (2020) Sleep, premenstrual mood disorder, and women’s health. Curr Opin Psychol, 34:43-49.
- Michels KA, Mendola P, Schliep KC, Yeung EH, Ye A, Dunietz GL et al. (2020) The influences of sleep duration, chronotype, and nightwork on the ovarian cycle. Chronobiol Int, 37:260-271.
- Nexha A, Caropreso L, de Azevedo Cardoso T, Suh JS, Tonon AC, Frey BN. (2024) Biological rhythms in premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. BMC Women's Health, 24:551.
- Otsuka Y, Kaneita Y, Spira AP, Mojtabai R, Itani O, Jike M et al (2021) Trends in sleep problems and patterns among Japanese adolescents: 2004 to 2017. Lancet Reg Health West Pac, 9:100107.
- Önder İ, Beşoluk Ş (2013) Adaptation of the morningness eveningness scale for children into Turkish. Biol Rhythm Res, 44:313-323.
- Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB et al. (2016) Our future: a lancet commission on adolescent health and wellbeing. Lancet, 387:2423-2478.
- Qu Y, Li T, Xie Y, Tao S, Yang Y, Zou L et al (2023) Association of chronotype, social jetlag, sleep duration and depressive symptoms in Chinese college students. J Affect Disord, 320:735-741.
- Roenneberg T, Pilz LK, Zerbini G, Winnebeck EC (2019) Chronotype and social jetlag: a (self-) critical review. Biology, 8:54.
- Ryu A, Kim TH (2015) Premenstrual syndrome: A mini review. Maturitas, 82:436-440.
- Sommer M, Torondel B, Hennegan J, Phillips-Howard PA, Mahon T, Motivans A et al. (2021) How addressing menstrual health and hygiene may enable progress across the sustainable development goals. Glob Health Action, 14:1920315.
- Tarokh L, Saletin JM, Carskadon MA (2016) Sleep in adolescence: Physiology, cognition and mental health. Neurosci Biobehav Rev, 70:182-188.
- Taillard J, Sagaspe P, Philip P, Bioulac S (2021) Sleep timing, chronotype and social jetlag: impact on cognitive abilities and psychiatric disorders. Biochem Pharmacol, 191:114438.
- Uekata S, Kato C, Nagaura Y, Eto H, Kondo H (2019) The impact of rotating work schedules, chronotype, and restless legs syndrome/Willis-Ekbom disease on sleep quality among female hospital nurses and midwives: a cross-sectional survey. Int J Nurs Stud, 95:103-112.
- Uslu E, Özsaban A (2022) Sirkadiyen saat ile sosyal saat uyuşmazlığı: sosyal jetlag. Journal of Turkish Sleep Medicine, 7:70-74.
- Uslu E, Özsaban A, Çağan Ö (2021) Social jetlag in adolescents: From a nursing perspective. J Child Adolesc Psychiatr Nurs, 34:276-282.
- Wang L, Yan Y, Qiu H, Xu D, Zhu J, Liu J, Li H (2022) Prevalence and risk factors of primary dysmenorrhea in students: a meta-analysis. Value Health, 25:1678-1684.
- Wittmann M, Dinich J, Merrow M, Roenneberg T. (2006) Social jetlag: misalignment of biological and social time. Chronobiol Int, 23:497-509.
- Wilbur J, Morrison C, Iakavai J, Shem J, Poilapa R, Bambery L et al. (2022) “The weather is not good”: exploring the menstrual health experiences of menstruators with and without disabilities in Vanuatu. Lancet Reg Health West Pac, 18:100325.
- Yue L, Cui N, Jiang L, Cui N (2023) Screen use before sleep and emotional problems among adolescents: preliminary evidence of mediating effect of chronotype and social jetlag. J Affect Disord, 328:175-182.
- Zhu MQ, Oliveros H, Marín C, Mora-Plazas M, Villamor E (2023) Is the association of chronotype with adolescent behavior problems mediated through social jetlag? Chronobiol Int, 40:864-873.
Year 2025,
Volume: 17 Issue: Supplement 1, 26 - 34
Abstract
Amaç: Adölesanlarda kronotip ve sosyal jetlag birbiri ile ilişkilidir. Özellikle akşamcıl kronotip sosyal jetlag süresini uzatarak adölesan sağlığı açısından tehdit oluşturabilmektedir. Bu ilişkiye aracılık eden faktörlerin belirlenmesi olumsuz sonuçların yönetilmesi açısından önemlidir. Ancak literatürde bu konuda sınırlı bilgi bulunmakta olup, premenstrual semptomların bu ilişki üzerindeki rolü henüz tam olarak incelenmemiştir. Bu çalışmanın amacı kronotipin sosyal jetlag üzerindeki etkisinde premenstrual semptomların aracılık rolünü incelemektir.
Yöntem: Tanımlayıcı ve ilişki arayacı desendeki bu çalışmanın örneklemi 309 adölesan (n=309) oluşturmaktadır. Veriler, Kişisel Bilgi Formu, Premenstrual Sendrom Ölçeği ve Çocuklar için Sabah-Akşam Ölçeği kullanılarak toplanmıştır.
Bulgular: Kronotip puanları arttıkça sosyal jetlag süresi (β: -0,457; p<0,001) ve premenstrual sendrom puanı (β: -0,342; p<0,001) azaldı, premenstrual sendrom puanındaki artışın sosyal jetlag üzerinde bir etkisi olmadı (β: 0,096; p>0,05). Aracılık etkisi analiz edildiğinde, premenstrual sendrom puanı kronotip ve sosyal jetlag arasındaki etkileşime aracılık etmedi (%95 CI [-0,073; 0,006]; p>0,05).
Sonuç: Kronotip sosyal jetlag ve premensrüel sepmtopları etkilerken, premensrüel sepmtopların sosyal jetlag üzerinde bir etkisi yoktur. Ayrıca, premensrüel sepmtoplar kronotip ile sosyal jetlag arasındaki ilişkiye aracılık etmez. Bu ilişkide “Premenstrual semptomlar aracı mıdır?” sorusuna daha kapsamlı bir şekilde yanıt verebilmek için, farklı kültürel ve sosyo-demografik özellikler ile ruhsal, kültürel ve hükümet politikalar/ı göz önünde bulundurularak benzer çalışmaların farklı bölgelerde gerçekleştirilmesi önerilmektedir.
References
- Arslan M, Deniz FN (2024) Investigating the associations between chronotype, physical activity, premenstrual syndrome, hunger, and food choice among Turkish women. Psychol Health Med, doi: 10.1080/13548506.2024.2439136..
- Armini NKA, Zahriya AN, Hidayati L, Dewi KI (2022) Physical activity and anxiety with complaints of PMS in adolescents during the COVID-19 pandemic. Int J Public Health Sci, 11:601-606.
- Baron RM, Kenny DA (1986) The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol, 51:1173.
- Buddhabunyakan N, Kaewrudee S, Chongsomchai C, Soontrapa S, Somboonporn W, Sothornwit J (2017) Premenstrual syndrome (PMS) among high school students. Int J Womens Health, 9:501-505.
- Carskadon MA, Vieira C, Acebo C. (1993) Association between puberty and delayed phase preference. Sleep, 16:258-262.
- Chan NY, Li SX, Wing YK (2021) Are adolescents sleeping less and worse than before? Lancet Reg Health West Pac, 11:100167.
- Conzatti M, Perez AV, Maciel RF, De Castro DH, Sbaraini M, Wender MCO (2021) Sleep quality and excessive daytime sleepiness in women with premenstrual syndrome. Gynecol Endocrinol, 37:945-949.
- Crouse JJ, Carpenter JS, Song YJC, Hockey SJ, Naismith SL, Grunstein RR et al. (2021) Circadian rhythm sleep–wake disturbances and depression in young people: implications for prevention and early intervention. Lancet Psychiatry, 8:813-823.
- Dutta A, Sharma A (2021) Prevalence of premenstrual syndrome and premenstrual dysphoric disorder in India: a systematic review and meta-analysis. Health Promot Perspect, 11:161.
- Feliciano EMC, Rifas-Shiman SL, Quante M, Redline S, Oken E, Taveras EM (2019) Chronotype, social jet lag, and cardiometabolic risk factors in early adolescence. JAMA Pediatr, 173:1049-1057.
- Gençdoğan B (2006) Premenstrual sendrom için yeni bir ölçek. Turkiye’de Psikiyatri, 8:81-87.
- Hayes AF (2017) Introduction to Mediation, Moderation, and Conditional Process Analysis, 2nd Ed. New York, Guilford.
- Hennegan J, Winkler IT, Bobel C, Keiser D, Hampton J, Larsson G et al. (2021) Menstrual health: a definition for policy, practice, and research. Sex Reprod Health Matters, 29:31-38.
- Itriyeva K (2022) Premenstrual syndrome and premenstrual dysphoric disorder in adolescents. Curr Probl Pediatr Adolesc Health Care, 52:101187.
- Jehan S, Auguste E, Hussain M, Pandi-Perumal SR, Brzezinski A, Gupta R et al. (2016) Sleep and premenstrual syndrome. J Sleep Med Disord, 3:1061.
- Jeong D, Lee H, Kim J (2023) Effects of sleep pattern, duration, and quality on premenstrual syndrome and primary dysmenorrhea in korean high school girls. BMC Womens Health, 23:456.
- Jung HN, Suh D, Jeong WC, Ryu J, Kim YM, Yoon S, Kim H (2023) Associations of chronotype and insomnia with menstrual problems in newly employed nurses at university hospitals in the Republic of Korea. Ann Occup Environ Med, 35:e30.
- Kim T, Jang SJ (2022) Shift nurses’ social jetlag, anxiety, and premenstrual symptoms: a cross-sectional study. Collegian, 29:477-483.
- Komada Y, Ikeda Y, Sato M, Kami A, Masuda C, Shibata S (2019) Social jetlag and menstrual symptoms among female university students. Chronobiol Int, 36:258-264.
- Lee H, Kim S, Kang SH, Chung H, Choi J, So H et al. (2016) Association of premenstrual syndrome and premenstrual dysphoric disorder with depression, sleep quality and sleep pattern in the Korean female high-school students. Anxiety and Mood, 12:113-118.
- Magnusdottir S, Magnusdottir I, Gunnlaugsdottir AK, Hilmisson H, Hrolfsdottir L, Paed AEEM (2024) Sleep duration and social jetlag in healthy adolescents. association with anxiety, depression, and chronotype: a pilot study. Sleep Breath, 28:1541-1551.
- Malone SK, Zemel B, Compher C, Souders M, Chittams J, Thompson AL et al. (2016) Social jet lag, chronotype and body mass index in 14–17-year-old adolescents. Chronobiol Int, 33:1255-1266.
- Matsumoto T, Egawa M, Kimura T, Hayashi T (2019) A potential relation between premenstrual symptoms and subjective perception of health and stress among college students: a cross-sectional study. Biopsychosoc Med, 13:26.
- Meers JM, Nowakowski S (2020) Sleep, premenstrual mood disorder, and women’s health. Curr Opin Psychol, 34:43-49.
- Michels KA, Mendola P, Schliep KC, Yeung EH, Ye A, Dunietz GL et al. (2020) The influences of sleep duration, chronotype, and nightwork on the ovarian cycle. Chronobiol Int, 37:260-271.
- Nexha A, Caropreso L, de Azevedo Cardoso T, Suh JS, Tonon AC, Frey BN. (2024) Biological rhythms in premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. BMC Women's Health, 24:551.
- Otsuka Y, Kaneita Y, Spira AP, Mojtabai R, Itani O, Jike M et al (2021) Trends in sleep problems and patterns among Japanese adolescents: 2004 to 2017. Lancet Reg Health West Pac, 9:100107.
- Önder İ, Beşoluk Ş (2013) Adaptation of the morningness eveningness scale for children into Turkish. Biol Rhythm Res, 44:313-323.
- Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB et al. (2016) Our future: a lancet commission on adolescent health and wellbeing. Lancet, 387:2423-2478.
- Qu Y, Li T, Xie Y, Tao S, Yang Y, Zou L et al (2023) Association of chronotype, social jetlag, sleep duration and depressive symptoms in Chinese college students. J Affect Disord, 320:735-741.
- Roenneberg T, Pilz LK, Zerbini G, Winnebeck EC (2019) Chronotype and social jetlag: a (self-) critical review. Biology, 8:54.
- Ryu A, Kim TH (2015) Premenstrual syndrome: A mini review. Maturitas, 82:436-440.
- Sommer M, Torondel B, Hennegan J, Phillips-Howard PA, Mahon T, Motivans A et al. (2021) How addressing menstrual health and hygiene may enable progress across the sustainable development goals. Glob Health Action, 14:1920315.
- Tarokh L, Saletin JM, Carskadon MA (2016) Sleep in adolescence: Physiology, cognition and mental health. Neurosci Biobehav Rev, 70:182-188.
- Taillard J, Sagaspe P, Philip P, Bioulac S (2021) Sleep timing, chronotype and social jetlag: impact on cognitive abilities and psychiatric disorders. Biochem Pharmacol, 191:114438.
- Uekata S, Kato C, Nagaura Y, Eto H, Kondo H (2019) The impact of rotating work schedules, chronotype, and restless legs syndrome/Willis-Ekbom disease on sleep quality among female hospital nurses and midwives: a cross-sectional survey. Int J Nurs Stud, 95:103-112.
- Uslu E, Özsaban A (2022) Sirkadiyen saat ile sosyal saat uyuşmazlığı: sosyal jetlag. Journal of Turkish Sleep Medicine, 7:70-74.
- Uslu E, Özsaban A, Çağan Ö (2021) Social jetlag in adolescents: From a nursing perspective. J Child Adolesc Psychiatr Nurs, 34:276-282.
- Wang L, Yan Y, Qiu H, Xu D, Zhu J, Liu J, Li H (2022) Prevalence and risk factors of primary dysmenorrhea in students: a meta-analysis. Value Health, 25:1678-1684.
- Wittmann M, Dinich J, Merrow M, Roenneberg T. (2006) Social jetlag: misalignment of biological and social time. Chronobiol Int, 23:497-509.
- Wilbur J, Morrison C, Iakavai J, Shem J, Poilapa R, Bambery L et al. (2022) “The weather is not good”: exploring the menstrual health experiences of menstruators with and without disabilities in Vanuatu. Lancet Reg Health West Pac, 18:100325.
- Yue L, Cui N, Jiang L, Cui N (2023) Screen use before sleep and emotional problems among adolescents: preliminary evidence of mediating effect of chronotype and social jetlag. J Affect Disord, 328:175-182.
- Zhu MQ, Oliveros H, Marín C, Mora-Plazas M, Villamor E (2023) Is the association of chronotype with adolescent behavior problems mediated through social jetlag? Chronobiol Int, 40:864-873.
There are 43 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Child and Adolescent Development |
| Journal Section | Research |
| Authors | |
| Early Pub Date | May 4, 2025 |
| Publication Date | |
| Submission Date | February 19, 2025 |
| Acceptance Date | May 4, 2025 |
| Published in Issue | Year 2025 Volume: 17 Issue: Supplement 1 |
|
 Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. |
