Skip to main content
Springer Nature Link
Log in

Association between chronotype preference and sleep characteristics in insomnia patients

  • Psychiatrics • Original Article
  • Published:
Save article
View saved research
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Purpose

The relationship between chronotype preference and subjective sleep perception, objective sleep parameters, rest-activity rhythms (RAR), as well as light exposure rhythms (LER) in insomnia patients remains insufficiently clarified. This study aimed to explore the differences in nocturnal and diurnal sleep characteristics, RAR and LER between morning-type and intermediate-type insomnia patients, and to screen subjective and objective influencing factors associated with chronotype preference.

Methods

A total of 62 enrolled insomnia patients were divided into morning-type and intermediate-type groups according to the Morningness-Eveningness Questionnaire (MEQ). All participants completed relevant subjective scales including the Sleep Hygiene Practice Scale (SHPS) and underwent 7-day continuous wrist actigraphy monitoring. RAR and LER non-parametric indicators were calculated via R software. Group differences in demographic data, subjective sleep scales, and actigraphy-derived nocturnal and diurnal variables were compared, and multivariate linear regression was performed to identify predictors of MEQ scores.

Results

Compared with intermediate-type patients, morning-type insomnia patients were significantly older, with poorer subjective sleep quality and more irrational sleep beliefs, and showed higher daytime rhythm stability and more regular activity patterns (all P < 0.05). No significant inter-group differences were observed in most objective sleep parameters. Multivariate linear regression analysis confirmed that SHPS score and the timing of the most active 10 h (M10) were independent influencing factors of chronotype preference.

Conclusions

Chronotype preference is closely correlated with age, subjective sleep perception, sleep hygiene level and rest-activity rhythm characteristics. Attention should be paid to individual chronotype characteristics in clinical insomnia management, optimizing sleep hygiene and regulating daily activity rhythm patterns may help improve sleep status in insomnia patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+
from $39.99 /Month
  • Starting from 10 chapters or articles per month
  • Access and download chapters and articles from more than 300k books and 2,500 journals
  • Cancel anytime
View plans

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Explore related subjects

Discover the latest articles, books and news in related subjects, suggested using machine learning.

Data availability

The datasets obtained and analyzed during the current study are available upon request to the corresponding author.

References

  1. Spielman AJ, Caruso LS, Glovinsky PB (1987) A behavioral perspective on insomnia treatment. Psychiatr Clin North Am 10(4):541–553

    Article  CAS  PubMed  Google Scholar 

  2. Meyer N et al (2022) Circadian rhythms and disorders of the timing of sleep. Lancet 400(10357):1061–1078

    Article  PubMed  Google Scholar 

  3. Oosterman JE, Wopereis S, Kalsbeek A (2020) The Circadian Clock, Shift Work, and Tissue-Specific Insulin Resistance. Endocrinology 161(12)

  4. Merikanto I et al (2024) Stability of morningness/eveningness and changes in sleep and mental health during mid-adulthood. Health Psychol 43(7):515–527

    Article  PubMed  Google Scholar 

  5. Li SX et al (2018) Eveningness chronotype, insomnia symptoms, and emotional and behavioural problems in adolescents. Sleep Med 47:93–99

    Article  CAS  PubMed  Google Scholar 

  6. Alvaro PK, Roberts RM, Harris JK (2014) The independent relationships between insomnia, depression, subtypes of anxiety, and chronotype during adolescence. Sleep Med 15(8):934–941

    Article  PubMed  Google Scholar 

  7. Mao B et al (2024) Associations of chronotype with anxiety, depression and insomnia among general adult population: A cross-sectional study in Hubei, China. J Affect Disord 351:250–258

    Article  PubMed  Google Scholar 

  8. Hashemipour S, Yazdi Z, Mahabad N (2020) Association of Evening Chronotype with Poor Control of Type 2 Diabetes: Roles of Sleep Duration and Insomnia Level. Int J Endocrinol Metab 18(3):e99701

    Article  PubMed  PubMed Central  Google Scholar 

  9. Üzer A, Yücens B (2020) The effect of circadian preferences on insomnia severity and depressive symptoms via sleep hygiene in older adults with depression and healthy controls. Psychogeriatrics 20(6):871–879

    Article  PubMed  Google Scholar 

  10. Li J et al (2021) Demographic characteristics associated with circadian rest-activity rhythm patterns: a cross-sectional study. Int J Behav Nutr Phys Act 18(1):107

    Article  PubMed  PubMed Central  Google Scholar 

  11. Montaruli A et al (2021) Biological Rhythm and Chronotype: New Perspectives in Health. Biomolecules 11(4)

  12. Fossion R et al (2017) Multiscale adaptive analysis of circadian rhythms and intradaily variability: Application to actigraphy time series in acute insomnia subjects. PLoS ONE 12(7):e0181762

    Article  PubMed  PubMed Central  Google Scholar 

  13. Roh HW et al (2022) Associations of actigraphy derived rest activity patterns and circadian phase with clinical symptoms and polysomnographic parameters in chronic insomnia disorders. Sci Rep 12(1):4895

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Kim SJ et al (2020) Association of rest-activity and light exposure rhythms with sleep quality in insomnia patients. Chronobiol Int 37(3):403–413

    Article  PubMed  Google Scholar 

  15. Liu XC et al (1996) Reliability and Validity of the Pittsburgh Sleep Quality Index. Chin J Psychiatry (2): 103–107

  16. Bai CJ et al (2018) Reliability and Validity of the Insomnia Severity Index in Clinical Insomnia Patients. Chin J Practical Nurs 34(28):2182–2186

    Google Scholar 

  17. Li-li P et al (2011) Reliability and Validity of the Simplified Chinese Version of the Epworth Sleepiness Scale. Chin J Otorhinolaryngol Head Neck Surg 46(1):49

    Google Scholar 

  18. Xu B, Yang LJ, Li ZJ (2019) Reliability and Validity of the Chinese Version of the Dysfunctional Beliefs and Attitudes about Sleep Scale. J Capital Med Univ 40(5):665–670

    Google Scholar 

  19. Fu SX, Ou HX, Lu SH (2014) Reliability and Validity of the Brief Sleep Beliefs and Attitudes Scale. Chin J Behav Med Brain Sci 23(4):369–371

    Google Scholar 

  20. Wang J et al (2022) The potency of psychiatric questionnaires to distinguish major mental disorders in Chinese outpatients. Front Psychiatry 13:1091798

    Article  PubMed  PubMed Central  Google Scholar 

  21. Carciofo R, Song N (2019) The Chinese Morningness-Eveningness-Stability-Scale improved (MESSi): validity, reliability, and associations with sleep quality, personality, affect and life satisfaction. Chronobiol Int 36(8):1036–1046

    Article  PubMed  Google Scholar 

  22. Malhotra RK, Scoring AASM (2024) Manual 3: a step forward for advancing sleep care for patients with obstructive sleep apnea. J Clin Sleep Med 20(5):835–836

    Article  PubMed  PubMed Central  Google Scholar 

  23. Buysse DJ et al (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213

    Article  CAS  PubMed  Google Scholar 

  24. Bastien CH, Vallières A, Morin CM (2001) Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2(4):297–307

    Article  PubMed  Google Scholar 

  25. Johns MW (1992) Reliability and factor analysis of the Epworth Sleepiness Scale. Sleep 15(4):376–381

    Article  CAS  PubMed  Google Scholar 

  26. Espie CA et al (2000) Insomniacs’ attributions. psychometric properties of the Dysfunctional Beliefs and Attitudes about Sleep Scale and the Sleep Disturbance Questionnaire. J Psychosom Res 48(2):141–148

    Article  CAS  PubMed  Google Scholar 

  27. Yang CM et al (2010) Maladaptive sleep hygiene practices in good sleepers and patients with insomnia. J Health Psychol 15(1):147–155

    Article  PubMed  Google Scholar 

  28. Li HJ et al (2015) Validation of the nonmotor symptoms questionnaire for Parkinson’s disease: results from a Chinese pilot study. Int J Neurosci 125(12):929–935

    Article  PubMed  Google Scholar 

  29. Blume C, Santhi N, Schabus M (2016) nparACT’ package for R: A free software tool for the non-parametric analysis of actigraphy data. MethodsX 3:430–435

    Article  PubMed  PubMed Central  Google Scholar 

  30. Gonçalves BS et al (2015) A fresh look at the use of nonparametric analysis in actimetry. Sleep Med Rev 20:84–91

    Article  PubMed  Google Scholar 

  31. Kolberg E et al (2021) The Effect of Bright Light Treatment on Rest-Activity Rhythms in People with Dementia: A 24-Week Cluster Randomized Controlled Trial. Clocks Sleep 3(3):449–464

    Article  PubMed  PubMed Central  Google Scholar 

  32. Arslan S et al (2023) Nutrition status and diet quality in healthcare professionals with different chronotypes: a comparative study. Biol Rhythm Res 54(4):452–466

    Article  CAS  Google Scholar 

  33. Ryu H et al (2018) Validation of the Munich ChronoType Questionnaire in Korean Older Adults. Psychiatry Investig 15(8):775–782

    Article  PubMed  PubMed Central  Google Scholar 

  34. Sok SR, Choi JY (2010) [Factors influencing sleep of elderly women]. J Korean Acad Nurs 40(1):119–126

    Article  PubMed  Google Scholar 

  35. Farajnia S et al (2012) Evidence for neuronal desynchrony in the aged suprachiasmatic nucleus clock. J Neurosci 32(17):5891–5899

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Arslan S et al (2026) The relationship between sleep quality and hedonic hunger in individuals with overweight and obesity: A comparative study. Sleep Epidemiol 6:100133

    Article  Google Scholar 

  37. Rezaie L et al (2018) Paradoxical insomnia and subjective-objective sleep discrepancy: A review. Sleep Med Rev 40:196–202

    Article  PubMed  Google Scholar 

  38. Magnin M et al (2010) Thalamic deactivation at sleep onset precedes that of the cerebral cortex in humans. Proc Natl Acad Sci U S A 107(8):3829–3833

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Ballesio A et al (2020) Effects of Presleep Cognitive Intrusions on Subjective Sleep and Next-Day Cognitive Performance in Insomnia. Behav Ther 51(5):688���699

    Article  PubMed  Google Scholar 

  40. Ancoli-Israel S et al (2003) The role of actigraphy in the study of sleep and circadian rhythms. Sleep 26(3):342–392

    Article  PubMed  Google Scholar 

  41. Glavin EE et al (2021) Relationships between sleep, exercise timing, and chronotype in young adults. J Health Psychol 26(13):2636–2647

    Article  PubMed  Google Scholar 

  42. Sławińska M, Stolarski M, Jankowski KS (2019) Effects of chronotype and time of day on mood responses to CrossFit training. Chronobiol Int 36(2):237–249

    Article  PubMed  Google Scholar 

  43. Refinetti R (2019) Chronotype Variability and Patterns of Light Exposure of a Large Cohort of United States Residents. Yale J Biol Med 92(2):179–186

    PubMed  PubMed Central  Google Scholar 

  44. Arslan S et al (2025) The relationship between caffeine consumption and self-reported sleep quality among healthcare professionals. Adv Integr Med 12(4):100553

    Article  Google Scholar 

Download references

Acknowledgements

We extend our heartfelt gratitude to the all the participants and staffs in who contribution to this project and we also thank the editor and reviewers for the positive and constructive comments regarding our paper.

Funding

This work was supported by The National Key R&D Program of China (grant no. 2021YFC2501400). The sponsor had no role in the design or conduct of this research.

Author information

Authors and Affiliations

  1. Department of Geriatric Medicine, Tangdu Hospital, The Fourth Military Medical University, Xi ’an, 710038, China

    Yi Wang & Menglong Dong

  2. Sleep Medicine Center, Department of Neurology, Tangdu Hospital, The Fourth Military Medical University, Xi ’an, 710038, China

    Yi Wang, Xianchao Zhao, Jiafeng Ren, Liping Zhang, Mengmeng Fan, Zhifeng Lin, Yiqing Yang, Qi Wu & Jin-Xiang Cheng

  3. Brain Hospital, Xi’an People’s Hospital (Xi’an Fourth Hospital), Xi ’an, 710004, China

    Changjun Su

Authors
  1. Yi Wang
    View author publications

    Search author on:PubMed Google Scholar

  2. Menglong Dong
    View author publications

    Search author on:PubMed Google Scholar

  3. Xianchao Zhao
    View author publications

    Search author on:PubMed Google Scholar

  4. Jiafeng Ren
    View author publications

    Search author on:PubMed Google Scholar

  5. Liping Zhang
    View author publications

    Search author on:PubMed Google Scholar

  6. Mengmeng Fan
    View author publications

    Search author on:PubMed Google Scholar

  7. Zhifeng Lin
    View author publications

    Search author on:PubMed Google Scholar

  8. Yiqing Yang
    View author publications

    Search author on:PubMed Google Scholar

  9. Qi Wu
    View author publications

    Search author on:PubMed Google Scholar

  10. Jin-Xiang Cheng
    View author publications

    Search author on:PubMed Google Scholar

  11. Changjun Su
    View author publications

    Search author on:PubMed Google Scholar

Contributions

Conceptualization: Yi Wang, Xianchao Zhao, Jiafeng Ren, Jin-xiang Cheng; Methodology: Menglong Dong, Yi Wang, Jiafeng Ren, Zhifeng Lin, Yiqing Yang, Qi Wu; Formal analysis and investigation: Menglong Dong, Liping Zhang, Mengmeng Fan, Yi Wang, Jiafeng Ren; Writing original draft preparation: Menglong Dong, Yi Wang; Writing review and editing: Menglong Dong, Yi Wang, Jin-xiang Cheng; Funding acquisition: Jin-xiang Cheng; Resources: Changjun Su; Software: Yi Wang, Menglong Dong: Supervision: Jin-xiang Cheng, Changjun Su. All authors contributed to the study conception and design and approved the final manuscript.

Corresponding authors

Correspondence to Jin-Xiang Cheng or Changjun Su.

Ethics declarations

Ethical Committee Permission

This study was approved by the Ethics Committee of Tangdu hospital, The Fourth Military Medical University. Informed consent was obtained from all participants, and we are committed to strictly protecting patient privacy. All procedures were conducted in accordance with the Declaration of Helsinki and its subsequent amendments, or with similar ethical standards.

Informed consent

Not applicable.

Disclosure of potential conflicts of interest

All authors certify that they have no conflict of interest to declare.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary Material 1 (DOCX 14.1 KB) (download DOCX )

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, Y., Dong, M., Zhao, X. et al. Association between chronotype preference and sleep characteristics in insomnia patients. Sleep Breath 30, 269 (2026). https://doi.org/10.1007/s11325-026-03814-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • DOI: https://doi.org/10.1007/s11325-026-03814-9

Keywords