Main Article Content

Navneet Kumar Kaushik
Anju Sharma
Amandeep Kaur
Jyoti Rana
Pushpa Lamba


Chronotype, Indian/South Asian, medical students, mornigness-eveningness preference, overweight/obesity


Background: Differences in preference for sleep-wake habit and physical or mental performance across individuals underlies the concept of morningness-eveningness/chronotype. Chronotype have been found to influence diverse aspects of one’s life. To date few studies have explored the morningness-eveningness preferences particularly among Indian student populations.

Aims and objectives: To fill this knowledge gap, the present study was conducted to determine the circadian preferences of Indian medical students. In addition, association between chronotype and body mass index (BMI) was also investigated.

Methods: The study followed cross-sectional, observational design was conducted on 110 apparently healthy medical undergraduates of either gender (82 males, 28 females) at a government medical college in Southern Haryana, India. Demographic and anthropometric information of the participants was collected. A well-validated instrument, Morningness-Eveningness Questionnaire (MEQ), was used to identify participant’s chronotype. Frequency distribution of the sample in relation to chronotype was determined. Association between chronotype and overweight was evaluated using Pearson’s Chi-square test. P < 0.05 was considered statistically significant.

Results: The study showed that around two-fifth of the students could be classified as belonging to the two extreme typologies i.e., morning- or evening type. Females exhibited greater predisposition for morningness, though differences were not significant (p = 0.55). Average body mass index (BMI) did not differ significantly across chronotypes; however, association between chronotype and overweight was found to be significant (χ2 = 15.91, p = 0.003). Overweight students were much more likely to be evening-oriented than being morning type in comparison to normal weight participants [Odd’s ratio 95% CI (adjusted for effect of gender): 2.16 (0.82 – 5.71)]

Conclusion: Frequency distribution in relation to chronotype among Indian medical student population is similar to worldwide figures reported in literature, with major fraction of the population belonging to the intermediate/neutral chronotype. Being evening-oriented predisposes to overweight/obesity but this relationship needs to be explored using a multivariate approach to arrive at a definite conclusion.

Abstract 79 | pdf Downloads 50


1. Horne JA and Östberg O. A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. Int J Chronobiol 1976; 4(2): 97–110.
2. Lipnevich AA, Credè M, Hahn E, et al. How distinctive are morningness and eveningness from the big five factors of personality? A meta-analytic investigation. J Pers Soc Psychol 2017; 112(3): 491–509.
3. Bonaconsa M, Malpeli G, Montaruli A, Carandente F, Grassi-Zucconi G, Bentivoglio M. Differential modulation of clock gene expression in the suprachiasmatic nucleus, liver and heart of aged mice. Exp Gerontol 2014; 55:70–9.
4. Adan A, Archer SN, Hindalgo MP, Di Milia L, Natale V, Randler C. Circadian typology: A comprehensive review. Chronobiol Int 2012;29(9):1153–75.
5. Gaina A, Sekine M, Kanayama H, Takashi Y, Hu L, Sengoku K, et al. Morning–evening preference: Sleep pattern spectrum and lifestyle habits among Japanese junior high school pupils. Chronobiol Int 2006; 23:607–21.
6. Crowley SJ, Acebo C, Carskadon MA. Sleep, circadian rhythms, and delayed phase in adolescence. Sleep Med 2007; 8:602–12.
7. Adan A, Natale V. Gender differences in morningness–eveningness preference. Chronobiol Int 2002; 19:709–20.
8. Randler C. Age and gender differences in morningness–eveningness during adolescence. J Genetic Psychol 2011; 172:302–8.
9. Schmidt C, Collette C, Cajochen C, Peigneux P. A time to think: Circadian rhythms in human cognition. Cognitive Neuropsychol 2007; 24:755–89.
10. Bonato M, Agnello L, Galasso L, Montaruli A, Roveda E, Merati G, et al. Acute modification of cardiac autonomic function of high-intensity interval training in collegiate male soccer players with different chronotype: a cross-over study. J Sports Sci Med 2017; 16(2):286–94.
11. Tsaousis I. Circadian preferences and personality traits: A meta-analysis. Eur J Personality 2010; 24:356–73.
12. Kivelä L, Papadopoulos M, and Antypa N. Chronotype and psychiatric disorders. Curr Sleep Med Rep 2018; 4(2):94–103.
13. Hidalgo MP, Caumo W, Posser M, Coccaro SB, Camozzato AL, Chaves ML. Relationship between depressive mood and chronotype in healthy subjects. Psychiatry Clin Neurosci 2009; 63:283–90.
14. Fabbian F, Zucchi B, De Giorgi A, Tiseo R, Boari B, Salmi R, et al. Chronotype, gender and general health. Chronobiol Int 2016;33(7):863–82.
15. Enright T and Refinetti R. Chronotype, class times, and academic achievement of university students. Chronobiol Int 2017; 34(4): 445–450.
16. Önder I, Beşoluk S, İskender M, Masal E, Demirhan E. Circadian preferences, sleep quality and sleep patterns, personality, academic motivation and academic achievement of university students. Learn Individ Differ 2014; 32:184–92.
17. Onyper SV, Thacher PV, Gilbert JW, Gradess SG. Class start times, sleep, and academic performance in college: a path analysis. Chronobiol Int 2012; 29(3):318–35.
18. Organization., World Health WHO factsheet on obesity and overweight: World Health Organization fact sheet, 2020.
19. Adan A, Archer SN, Hidalgo MP, di Milia L, Natale V, Randler C. Circadian typology: A comprehensive review. Chronobiol Int 2012; 29(9):1153-75.
20. Montaruli A, Castelli L, Galasso L, Mulè A, Bruno E, Esposito F, et al. Effect of chronotype on academic achievement in a sample of Italian University students. Chronobiol Int 2019; 36(11):1482-95.
21. Arifuddin MK, Shashiraj HK, Kavitha BS. Morningness- Eveningness Preferences among First Year Medical students. Sch Int J Anat Physio 2021; 4(3):32-34.
22. Randler C. Gender differences in morningness–eveningness assessed by self-report questionnaires: A meta-analysis. Personality and Individ Diff 2007; 43:1667–75.
23. World Obesity Federation, World Obesity Atlas 2023.
24. Sun X, Gustat J, Bertisch S, Redline S, Bazzano L. The association between sleep chronotype and obesity among black and white participants of the Bogalusa Heart Study. Chronobiol Int 2020; 37(1):123-34.
25. Arora T, Taheri S. Associations among late chronotype, body mass index and dietary behaviors in young adolescents. Int J Obes 2015; 39:39–44.
26. Anothaisintawee T, Lertrattananon D, Thamakaison S, Thakkinstian A, Reutrakul S. The relationship among morningness-eveningness, sleep duration, social jetlag, and body mass index in Asian patients with prediabetes. Front Endocrinol 2018; 9:435.
27. Merikanto I, Kronholm E, Peltonen M, Laatikainen T, Lahti T, Partonen T. Relation of chronotype to sleep complaints in the general Finnish population. Chronobiol Int 2012; 29(3):311–7.
28. Cappuccio FP, Taggart FM, Kandala NB, Currie A, Peile E, Stranges S, et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep 2008; 31(5):619–26.
29. Lucassen EA, Zhao X, Rother KI, Mattingly MS, Courville AB, Jonge LD, et al. Evening chronotype is associated with changes in eating behavior, more sleep apnea, and increased stress hormones in short sleeping obese individuals. Plos One 2013; 8(3):e56519.
30. Harb A, Levandovski R, Oliveira C, Caumo W, Allison KC, Stunkard A, et al. Night eating patterns and chronotypes: A correlation with binge eating behaviors. Psychiatry Res 2012; 200(2-3):489–93.
31. Baron KG, Reid KJ, Kern AS, Zee PC. Role of sleep timing in caloric intake and BMI. Obesity 2011; 19:1374–81.
32. Pabst SR, Negriff S, Dorn LD, Susman EJ, Huang B. Depression and anxiety in adolescent females: the impact of sleep preference and body mass index. J Adolesc Health 2009; 44:554–60.
33. Digdon NL, Howell AJ. College students who have an eveningness preference report lower self-control and greater procrastination. Chronobiol Int 2008; 25(6):1029–46.
34. Fonken LK, Workman JL, Walton JC, Weil JM, Morris JS, Haim A, et al. Light at night increases body mass by shifting the time of food intake. Proc Natl Acad Sci USA 2010; 107(43):18664–9.
35. Cipolla-Neto J, Amaral FG, Afeche SC, Tan DX, Reiter RJ, et al. Melatonin, energy metabolism, and obesity: a review. J Pineal Res 2014; 56(4):371–81.
36. Scheer FA, Hilton MF, Mantzoros C, Shea SA. Adverse metabolic and cardiovascular consequences of circadian misalignment. Proc Natl Acad Sci USA 2009; 106(11):4453–8.
37. Lane JM, Vlasac I, Anderson SG, Kyle SD, Dixon WG, Bechtold DA, et al. Genome-wide association analysis identifies novel loci for chronotype in 100,420 individuals from the UK Biobank. Nat Commun 2016; 7:10889.