The dim light melatonin onset (DLMO) is the most reliable measure of central circadian timing in humans. However, it is not always possible to measure the DLMO because sample collection has to occur in the hours before usual sleep onset, it requires staff support and considerable participant effort, and it is relatively expensive. Questionnaires that ask people about the timing of their behavior, such as their sleep, may provide an easier and less expensive estimate of circadian timing. The objective of this analysis was to compare the MEQ score derived from the Morningness-Eveningness Questionnaire (MEQ) and the MSF_sc derived from the Munich ChronoType Questionnaire (MCTQ) to the DLMO in the largest sample to date ( N = 60). Our hypothesis was that MSF_sc would correlate more highly with the DLMO than MEQ score. Our sample of 36 healthy controls and 24 patients with delayed sleep phase disorder ranged in age from 18 to 62 years. All participants slept at times of their own choosing for a week before the assessment of their DLMO. The DLMO correlated significantly with both the MEQ score ( r = −0.70, p < 0.001) and MSF_sc ( r = 0.68, p < 0.001). A linear regression using MEQ, MSF_sc, and age to predict the DLMO explained 60% of the DLMO variance. The strongest predictor of the DLMO was MSF_sc (beta = 0.51, p = 0.001), followed by MEQ (beta = −0.41, p = 0.004), and age (beta = 0.26, p = 0.013). The beta values for MSF_sc and MEQ score were not statistically different from each other. Nonetheless, around a 4-h range in the DLMO was observed at a given MEQ score and a given MSF_sc, indicating that neither questionnaire should be exclusively used to time light or exogenous melatonin treatment, as this could result in the mistiming of these treatments relative to the DLMO, thereby potentially worsening circadian misalignment.

Little is known about human entrainment under natural conditions, partly due to the complexity of human behavior, torn between biological and social time and influenced by zeitgebers (light–dark cycles) that are progressively “polluted” (and thereby weakened) by artificial light. In addition, data about seasonal variations in sleep parameters are scarce. We, therefore, investigated seasonal variation in cross-sectional assessments of sleep/wake times of 9765 subjects from four European populations (EGCUT = Estonian Genome Centre, University of Tartu in Estonia; KORA = Cooperative Health Research in the Region of Augsburg in Germany; KORCULA = The Korcula study in Croatia; and ORCADES = The Orkney Complex Disease Study in Scotland). We identified time-of-year dependencies for the distribution of chronotype (phase of entrainment assessed as the mid-sleep time point on free days adjusted for sleep deficit of workdays) in cohorts from Estonia (EGCUT) and Germany (KORA). Our results indicate that season (defined as daylight saving time – DST and standard zonetime periods – SZT) specifications of photoperiod influence the distribution of chronotype (adjusted for age and sex). Second, in the largest investigated sample, from Estonia (EGCUT; N = 5878), we could detect that seasonal variation in weekly average sleep duration was dependent on individual chronotype. Later chronotypes in this cohort showed significant variation in their average sleep duration across the year, especially during DST (1 h advance in social time from the end of March to end of October), while earlier chronotypes did not. Later chronotypes not only slept less during the DST period but the average chronotype of the population assessed during this period was earlier than during the SZT (local time for a respective time zone) period. More in detail, hierarchical multiple regression analyses showed that, beyond season of assessment (DST or SZT), social jetlag (SJl; the discrepancy between the mid sleep on free and work days – which varied with age and sex) contributed to a greater extent to the variation in sleep duration than chronotype (after taking into account factors that are known to influence sleep duration, i.e. age, sex and body mass index). Variation in chronotype was also dependent on age, sex, season of assessment and SJl (which is highly correlated with chronotype – SJl was larger among later chronotypes). In summary, subjective assessments of sleep/wake times are very reliable to assess internal time and sleep duration (e.g. reproducing sleep duration and timing tendencies related to age and sex across the investigated populations), but season of assessment should be regarded as a potential confounder. We identified in this study photoperiod (seasonal adaptation) and SJl as two main factors influencing seasonal variation in chronotype and sleep duration. In conclusion, season of assessment, sex and age have an effect on epidemiological variation in sleep duration, chronotype and SJl, and should be included in studies investigating associations between these phenotypes and health parameters, and on the development of optimal prevention strategies.

Circadian clocks of adolescents typically run late—including sleep times—yet adolescents generally are expected at school early in the morning. Due to this mismatch between internal (circadian) and external (social) times, adolescents suffer from chronic sleep deficiency, which, in turn, affects academic performance negatively. This constellation affects students’ future career prospects. Our study correlates chronotype and examination performance. In total, 4734 grades were collected from 741 Dutch high school students (ages 11-18 years) who had completed the Munich ChronoType Questionnaire to estimate their internal time. Overall, the lowest grades were obtained by students who were very late chronotypes (MSF_sc > 5.31 h) or slept very short on schooldays (SD_w < 7.03 h). The effect of chronotype on examination performance depended on the time of day that examinations were taken. Opposed to late types, early chronotypes obtained significantly higher grades during the early (0815-0945 h) and late (1000-1215 h) morning. This group difference in grades disappeared in the early afternoon (1245-1500 h). Late types also obtained lower grades than early types when tested at the same internal time (hours after MSF_sc), which may reflect general attention and learning disadvantages of late chronotypes during the early morning. Our results support delaying high school starting times as well as scheduling examinations in the early afternoon to avoid discrimination of late chronotypes and to give all high school students equal academic opportunities.