The self-morningness/eveningness (Self-ME): An extremely concise and totally subjective assessment of diurnal preference

Oct 11, 2015Chronobiology international

The Self-Morningness/Eveningness (Self-ME): A very short and fully subjective way to assess daily activity preferences

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Abstract

A sample of 461 subjects demonstrated significant differences in sleep-wake timing based on self-classification of diurnal preference.

Self-classifications as extremely morning, more morning than evening, more evening than morning, or extremely evening were significantly different in total scores on the Horne-Östberg questionnaire.
Significant differences in bedtimes, sleep onset, and wake-up times were observed between the different self-classification groups.
The differences in sleep-wake habits were consistent across both work and free days.
Self-MM and Self-M individuals reported higher alertness in the morning and greater sleepiness in the evening compared to Self-E and Self-EE individuals.
Self-EE and Self-E subjects reported poorer sleep quality, with average Pittsburgh Sleep Quality Index scores just above the abnormality threshold.

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The assessment of diurnal preference, or the preferred timing of sleep and activity, is generally based on comprehensive questionnaires such as the Horne-Östberg (HÖ). The aim of the present study was to assess the reliability of a subject's self-classification as extremely morning (Self-MM), more morning than evening (Self-M), more evening than morning (Self-E) or extremely evening (Self-EE) type, based on the last question of the HÖ (Self-ME). A convenience sample of 461 subjects [23.8 ± 4.7 years; 322 females] completed a full sleep-wake assessment, including diurnal preference (HÖ), night sleep quality (Pittsburgh Sleep Quality Index, PSQI), daytime sleepiness (Karolinska Sleepiness Scale, KSS), and habitual sleep-wake timing (12 d sleep diaries; n = 296). Significant differences in HÖ total score were observed between Self-ME classes, with each class being significantly different from neighboring classes (p < 0.0001). Significant differences in sleep-wake timing (bed time, try to sleep and sleep onset, wake up, and get up time) were observed between Self-ME classes. Such differences were maintained when sleep-wake habits were analysed separately on work and free days, and also in a smaller group of 67 subjects who completed the Self-ME as a stand-alone rather than as part of the original questionnaire. Significant differences were observed in the time-course of subjective sleepiness by Self-ME class in both the large and the small group, with Self-MM and Self-M subjects being significantly more alert in the morning and sleepier in the evening hours compared with their Self-E and Self-EE counterparts. Finally, significant differences were observed in night sleep quality between Self-ME classes, with Self-EE/Self-E subjects sleeping worse than their Self-MM/Self-M counterparts, and averaging just over the abnormality PSQI threshold of 5. In conclusion, young, healthy adults can define their diurnal preference based on a single question (Self-ME) in a way that reflects their sleep-wake timing, their sleepiness levels over the daytime hours, and their night sleep quality. Validation of the Self-ME across the decades and in diseased populations seems worthy.

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The self-morningness/eveningness (Self-ME): An extremely concise and totally subjective assessment of diurnal preference

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