Validation of the Caen Chronotype Questionnaire: Exploring the added value of amplitude and correlations with actigraphy.

Abstract

Chronotype self-report instruments are time and cost-efficient measures to profile diurnal or time-of-day preferences. The Caen Chronotype Questionnaire (CCQ) captures morningness and eveningness (CCQ-ME) and a circadian amplitude dimension for diurnal variation (distinctiveness; CCQ-DI). This study extends prior multilanguage validations for the English version of the CCQ. In total, 628 participants enrolled from a UK working population (mean age 30.34 ± 8.36 years, 61.3% female) including a subset of shift workers (n = 179; mean age 27.62 ± 5.95 years, 49.2% female). A subsample of participants also wore a consumer-grade actigraph device (Fitbit Charge 4) for seven days to compare chronotype estimates with objective sleep-wake parameters (n = 22; mean age 27.05 ± 3.99 years, 81.8% female, 90.9% worked standard daytime schedules, and 9.1% worked rotating shifts). All participants completed online chronotype measures, including the CCQ and Morningness-Eveningness Questionnaire (MEQ), depressive symptoms (Patient Health Questionnaire; PHQ-9), sleep quality (Pittsburgh Sleep Quality Index; PSQI), and other outcome measures. Results from the Confirmatory Factor Analysis (CFA) offer support for a two-factor structure of the CCQ in an English-speaking sample, highlighting how individual preferences for the timing of activities is associated with chronotype (morningness-eveningness; ME) and a second subjective amplitude dimension (DI). However, in contrast with the original CCQ structure, a more parsimonious solution and best overall fit involved the reduction of the original 16-item questionnaire (8 items per factor) to 4 ME items and 5 DI items. Convergent validity with the reduced CCQ scale (rME) and the MEQ was also established. The CCQ was sensitive in discriminating differences in actigraphic sleep-wake timings between morning-and evening-oriented individuals. Regression models demonstrated that amplitude (CCQ-DI) was a significant predictor explaining most of the variance in depressive symptoms (PHQ-9) compared to other variables. Overall, the English version of the CCQ was shown to be a robust tool in estimating chronotype in a sample of adults based in the UK.