Sex differences in the association between chronotype and anxiety: A nationwide population study

🎖️ Top 10% JournalJan 10, 2026Journal of psychiatric research

How morning or evening preference relates to anxiety differently in men and women: A nationwide study

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Anxiety was reported by 12.2% of women and 7.4% of men in a cohort of 2838 individuals aged 20-59 years.

Women exhibited a higher prevalence of anxiety compared to men.
The evening chronotype group had the highest anxiety prevalence at 15.3%.
In men, those with a morning chronotype had a significantly lower risk of anxiety than those with an intermediate chronotype.
No significant difference in anxiety risk was observed for evening-type men.
For women, chronotype did not show a significant association with anxiety.

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BACKGROUNDS: This study aimed to investigate potential sex differences in the association between anxiety and chronotype.

METHODS: Nationwide population-based data were analyzed from 2838 individuals aged 20-59 years who participated in the Circannual Change in Headache and Sleep Study. The chronotype was scored using the Morningness-Eveningness Questionnaire, and anxiety levels were assessed using the Generalized Anxiety Disorder-7 scale. Covariates included sociodemographic factors, depression, employment status, alcohol consumption, current smoker, body mass index, insomnia severity, and average sleep duration.

RESULTS: In this cohort (mean age = 40.5 ± 11.1 years, 1424 women [50.2 %]. 1414 men [49.8 %]), anxiety was more commonly reported by women (12.2 %) than men (7.4 %), with the evening chronotype group showing the highest anxiety prevalence (15.3 %). After adjusting for covariates, men with a morning chronotype showed a significantly lower risk of anxiety than did those with an intermediate chronotype, however, no significant difference in anxiety risk was observed for evening-type men. Among women, chronotype was not significantly associated with anxiety.

CONCLUSIONS: Differences in the chronotype-anxiety association were observed between men and women. Specifically, having a morning chronotype may reduce the risk of anxiety in men, whereas this protective effect was not observed in women. These findings suggest the need for sex-specific chronotype-targeted approaches for the prevention and management of anxiety.

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