Kronobiyolojide Kullanılan Psikometrik Ölçekler ve Objektif Parametreler
Özet
Sirkadiyen tercih ve kronotip, bireylerin uyku-uyanıklık döngüleri ve günlük aktiviteler için tercih ettikleri zaman dilimlerini ifade eden, sirkadiyen ritimle ilişkili önemli kavramlardır. Kronobiyoloji literatüründe sirkadiyen ritmi değerlendirmek amacıyla subjektif (öz bildirim ölçekleri) ve objektif (laboratuvar parametreleri) olmak üzere iki temel yöntem kullanılmaktadır. Subjektif yöntemler arasında en yaygın ve bilinen araç, Horne ve Östberg tarafından geliştirilen Sabahlılık-Akşamlılık Ölçeği'dir (MEQ); bu ölçek sirkadiyen tercihi "Sabah", "Akşam" veya "Ara Tip" olarak kategorize eder. Zamanla MEQ'in uzunluğuna ve öznelliğine yönelik eleştiriler doğrultusunda, rMEQ (Azaltılmış Versiyon), Birleşik Sabahlık Ölçeği (CSM), Münih Kronotip Anketi (MCTQ), çok boyutlu değerlendirme sunan MESSi ve duygudurum bozukluklarında ritim bozulmalarını ölçen Biyolojik Ritim Değerlendirme Görüşmesi (BRDG) gibi alternatif araçlar geliştirilmiştir. Diğer taraftan, sirkadiyen sistem işlevini belirlemede melatonin, kortizol, çekirdek vücut ısısı ve aktigrafi gibi objektif parametreler öne çıkmaktadır. Bu parametrelerden aktigrafi, bireylerin gerçek yaşam koşullarında, baskın olmayan bileğe takılan çok sensörlü cihazlar aracılığıyla uyku-uyanıklık kalıplarını, sirkadiyen kararlılığı ve fiziksel aktivite seviyelerini uzun süreli ve yüksek doğrulukla izleme avantajı sunarken, polisomnografiye göre daha düşük maliyetli ve pratik bir alternatif oluşturmaktadır.
Circadian preference and chronotype are significant concepts related to circadian rhythms, reflecting individuals' sleep-wake cycles and preferred times for daily activities. In chronobiology literature, subjective methods (self-report scales) and objective methods (laboratory parameters) are two primary approaches utilized to evaluate circadian rhythms. Among the subjective methods, the most prevalent and well-known instrument is the Morningness-Eveningness Questionnaire (MEQ) developed by Horne and Östberg, which categorizes circadian preference into "Morning", "Evening", or "Intermediate Type". Over time, in response to criticisms regarding the length and subjectivity of the MEQ, alternative tools such as the rMEQ (Reduced Version), Composite Scale of Morningness (CSM), Munich Chronotype Questionnaire (MCTQ), MESSi—which offers a multidimensional evaluation—and the Biological Rhythm Interview (BRI), which measures rhythm disruptions in mood disorders, have been developed. On the other hand, objective parameters such as melatonin, cortisol, core body temperature, and actigraphy stand out in determining circadian system function. Among these parameters, actigraphy offers the advantage of monitoring sleep-wake patterns, circadian stability, and physical activity levels with high accuracy and over long periods under real-life conditions via multi-sensor devices worn on the non-dominant wrist, representing a cost-effective and practical alternative to polysomnography.
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