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Updated: Dec 17, 2025

Human Circadian Phenotyping and Diurnal Performance Testing in the Real World
Published on: April 7, 2020
Evaluation of Chronotype Among Children and Associations With BMI, Sleep, Anxiety, and Depression
Bassam Eid1,2, Mary Bou Saleh3, Imad Melki1,2
1Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon.
Insights
Children with an evening chronotype experience more sleep problems and higher rates of major depression. Limiting electronic device use may help reduce circadian rhythm disturbances in children.
Area of Science:
- Pediatrics
- Sleep Medicine
- Child Psychology
Background:
- Chronotype, or an individual's natural sleep-wake pattern, can influence health and behavior in children.
- Understanding factors associated with chronotype is crucial for addressing potential health issues in pediatric populations.
Purpose of the Study:
- To investigate the relationship between chronotype, weight, sleep problems, anxiety, and depression in children aged 6-12 years.
- To identify specific sleep disturbances and mental health correlations with different chronotypes in children.
Main Methods:
- A cohort of 100 children (6-12 years) was recruited from pediatric clinics in Beirut, Lebanon.
- Validated questionnaires including the Sleep Disturbance Scale for Children (SDSC) and the Revised Child Anxiety and Depression Scale (RCADS) were administered.
- The Children's Chronotype Questionnaire (CCTQ) was used to assess chronotype.
Main Results:
- A shift towards evening chronotype was observed with increasing age, significantly associated with electronic device use.
- Children with an evening chronotype exhibited higher overall sleep disturbances, including difficulties initiating/maintaining sleep and non-restorative sleep.
- Evening chronotype was significantly linked to higher scores in the major depression domain of the RCADS.
Conclusions:
- Evening chronotype in children is associated with increased sleep disturbances and a higher prevalence of major depression.
- Recommendations include limiting electronic device use to mitigate circadian rhythm disruption.
- Early identification and treatment of sleep problems in evening-type children are essential, considering potential co-occurring depression.
Abstract:
Objectives: To evaluate possible associations between chronotype, weight, sleep problems, anxiety, and depression among children from 6 to 12 years of age. Method: One-hundred children aged between 6 and 12 years were randomly recruited in five pediatrician clinics in the capital city of Beirut, Lebanon. The protocol was approved by the ethics committee of Saint-Joseph University and Hotel-Dieu Hospital and an informed written formal consent was obtained from one of the parents. The Sleep Disturbance Scale for Children (CCTQ), the Revised Child Anxiety and Depression Scale (RCADS)-Parent version, and the Children's Chronotype Questionnaire (CCTQ) were used. Results: The majority of the sample (47%) presented an intermediate chronotype. There was a shift toward evening chronotype with increased age and a significant association between electronic devices use and an evening chronotype. Higher sleep disturbances were also observed among children with an evening chronotype. In particular, disorders of initiating and maintaining sleep, non-restorative sleep, excessive somnolence, and total SDSC were significantly higher among evening type children in our study. Finally, major depression domain scores were significantly higher among children with an evening chronotype. Conclusions: Several findings of this study are important and explain factors associated to chronotype in children. Two important future perspectives can be highlighted: limiting electronic devices use among children in an effort to reduce circadian rhythm disturbances and identifying and treating sleep problems associated with eveningness, taking into account the possible presence of major depression among this population.
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