Does Circadian Preference Determine Risk for Developing Alcohol Use Disorder amongst Undergraduate and Pre-University Students? A Cross-Sectional Study

Aims: To determine the relationship between circadian preference and risk for developing alcohol use disorder among medical students and pre-university students.

Study Design: An analytical cross sectional study was conducted among non-Muslim undergraduate students of a private medical institution in Melaka, Malaysia.

Place and Duration of Study: Melaka, Malaysia from September to October 2014.

Methodology: 250 participants were selected by using multistage sampling method, 223 students participated (89.2% resposnse rate). Sociodemographical data, assessment of circadian preference by International Journal Chronobiology (IJC) and WHO Alcohol Use Disorder Identification Test were collected using a structured questionnaire. Bivariate analysis, chi-square test, Fisher Exact test and multiple logistic regression analysis were calculated.

Results: Out of 223 non-Muslim undergraduate students, 60.09% were having intermediate type, 21.97% were having evening type and 17.94% were having morning type of circadian preference. Only 17.04% of the participants were having moderate, high and addictive alcohol consumption risk; among them 7.9% were addictive and 10.5% were high risk. Participants with evening type of circadian preference were 4.5 times more likely to be associated with a higher risk for developing alcohol use disorder as compared to participants with morning type of circadian preference (OR 4.5, 95% CI 1.2-17.0, P=0.02). After adjusted for age, gender, ethnicity, hostel and monthly allowance, evening type of circadian preference and risk for developing alcohol use disorder were not significantly associated to each other.

Conclusion: Circadian preference was significantly associated to the risk for developing alcohol use disorder among the undergraduate and pre-university students in bi-variate analysis without considering other factors such as age, gender, ethnicity and monthly allowance. However, no significant association were found among each of the factors that were being compared. This was because there was a confounding variable which was gender affecting the result. In our study, male students had a higher risk in developing AUD and male students were more likely to have evening type of cicadian preference. We should provide adequate counseling about sleep hygiene, healthy sleep-wake cycle and encourage students to develop morning type of circadian preference in order to reduce the risk of developing alcohol use disorder.