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Objective: Mental health and substance use disorders are commonly associated with disrupted sleep and circadian rest-activity rhythms. How these disorders in combination relate to sleep and circadian organization is not well studied. We provide here the first quantitative assessment of sleep and rest-activity rhythms in inpatients with complex concurrent disorders, taking into account categories of substance use (stimulant vs. stimulant and opioid use) and psychiatric diagnosis (psychotic disorder and mood disorder). We also explore how sleep and rest-activity rhythms relate to psychiatric functioning. Methods: A total of 44 participants (10 female) between the age of 20–60 years (median = 29 years) wore wrist accelerometers over 5–70 days and completed standardized questionnaires assessing chronotype and psychiatric functioning (fatigue, psychiatric symptom severity, and impulsiveness). To examine potential influences from treatment, we computed (1) length of stay; (2) days of abstinence from stimulants and opioids as a measure of withdrawal; and (3) a sedative load based on prescribed medications. Results: Participants exhibited a sustained excessive sleep duration, frequent nighttime awakenings, and advanced rest-activity phase related to sedative load. Sleep disruptions were elevated in participants with a history of opioid use. Patients with a psychotic disorder showed the longest sleep and most fragmented and irregular rest-activity patterns. Non-parametric circadian rhythm analysis revealed a high rhythm amplitude by comparison with population norms, and this was associated with greater psychiatric symptom severity. Psychiatric symptom severity was also associated with greater fatigue and later MCTQ chronotype. Conclusions: This pilot study provides initial information on the prevalence and severity of sleep and circadian rhythm disturbances in individuals with severe concurrent disorders. The results underline the need for further studies to start to understand the role of sleep in the disease and recovery process in this understudied population. [ABSTRACT FROM AUTHOR]

Sleep is systematically modulated by chronotype in day-workers. Therefore, investigations into how shift-work affects sleep, health, and cognition may provide more reliable insights if they consider individual circadian time (chronotype). The Munich ChronoType Questionnaire (MCTQ) is a useful tool for determining chronotype. It assesses chronotype based on sleep behavior, specifically on the local time of mid-sleep on free days corrected for sleep debt accumulated over the workweek (MSFsc). Because the original MCTQ addresses people working standard hours, we developed an extended version that accommodates shift-work (MCTQShift). We first present the validation of this new version with daily sleep logs (n = 52) and actimetry (n = 27). Next, we evaluated 371 MCTQShift entries of shift-workers (rotating through 8-h shifts starting at 0600 h, 1400 h, and 2200 h). Our results support experimental findings showing that sleep is difficult to initiate and to maintain under the constraints of shift-work. Sleep times are remarkably stable on free days (on average between midnight and 0900 h), so that chronotype of shift-workers can be assessed by means of MSF—similar to that of day-workers. Sleep times on free-days are, however, slightly influenced by the preceding shift (displacements <1 h), which are smallest after evening shifts. We therefore chose this shift-specific mid-sleep time (MSFE) to assess chronotype in shift-workers. The distribution of MSFE in our sample is identical to that of MSF in day-workers. We propose conversion algorithms for chronotyping shift-workers whose schedules do not include free days after evening shifts. [ABSTRACT FROM AUTHOR]

Sleep is systematically modulated by chronotype in day-workers. Therefore, investigations into how shift-work affects sleep, health, and cognition may provide more reliable insights if they consider individual circadian time (chronotype). The Munich ChronoType Questionnaire (MCTQ) is a useful tool for determining chronotype. It assesses chronotype based on sleep behavior, specifically on the local time of mid-sleep on free days corrected for sleep debt accumulated over the workweek (MSFsc). Because the original MCTQ addresses people working standard hours, we developed an extended version that accommodates shift-work (MCTQShift). We first present the validation of this new version with daily sleep logs (n = 52) and actimetry (n = 27). Next, we evaluated 371 MCTQShift entries of shift-workers (rotating through 8-h shifts starting at 0600 h, 1400 h, and 2200 h). Our results support experimental findings showing that sleep is difficult to initiate and to maintain under the constraints of shift-work. Sleep times are remarkably stable on free days (on average between midnight and 0900 h), so that chronotype of shift-workers can be assessed by means of MSF—similar to that of day-workers. Sleep times on free-days are, however, slightly influenced by the preceding shift (displacements <1 h), which are smallest after evening shifts. We therefore chose this shift-specific mid-sleep time (MSFE) to assess chronotype in shift-workers. The distribution of MSFE in our sample is identical to that of MSF in day-workers. We propose conversion algorithms for chronotyping shift-workers whose schedules do not include free days after evening shifts. [ABSTRACT FROM AUTHOR]