Diagnosis of circadian rhythm sleep disorders (original) (raw)

Circadian rhythm sleep disorders: An update

Sleep and Biological Rhythms, 2009

The primary symptom of circadian rhythm sleep disorders (CRSDs) is the inability to sleep during the desired sleep time. CRSDs are divided into two broad classes: (i) disorders not related to forced alterations of the sleep-wake schedule or light-dark cycle (including advanced sleep phase disorder [ASPD], delayed sleep phase disorder [DSPD], non-entrained type [NET], and irregular sleep-wake rhythm [ISWR]); and (ii) disorders related to forced alterations of the sleep-wake schedule or light-dark cycle (including shift work sleep disorder [SWSD], jet lag disorder [JLD], and CRSDs related to diseases and medications). DSPD and ASPD are the common primary circadian rhythm disorders. We discuss the recent developments in the pathogenesis, diagnosis, and management of CRSDs.

Circadian Rhythm Sleep Disorders

There have been remarkable advances in our understanding of the molecular, cellular and physiological mechanisms underlying the regulation of circadian rhythms, as well as the impact of circadian dysfunction on health and disease. This information has transformed our understanding of the effect of circadian rhythm sleep disorders (CRSD) on health, performance and safety. CRSDs are caused by alterations of the central circadian time-keeping system, or a misalignment of the endogenous circadian rhythm and the external environment. In this section, we provide a review of circadian biology and discuss the pathophysiology, clinical features, diagnosis, and treatment of the most commonly encountered CRSDs in clinical practice.

Circadian rhythm sleep disorders (CRSD)

Sleep Medicine Reviews, 2002

Circadian Rhythm Sleep Disorders (CRSD) are a group of sleep disorders characterized by a malsynchronization between a person's biological clock and the environmental 24-h schedule. These disorders can lead to harmful psychological and functional difficulties and are often misdiagnosed and incorrectly treated due to the fact that doctors are unaware of their existence. In the following review we describe the characteristics of CRSD, their diagnosis, treatment as well as their relationship to psychopathology, psychotropic drugs and head trauma. 

Circadian Rhythm Sleep Disorders*

CHEST Journal, 2006

The authors have worked to ensure that all information in this book is accurate at the time of publication and consistent with general psychiatric and medical standards, and that information concerning drug dosages, schedules, and routes of administration is accurate at the time of publication and consistent with standards set by the U.S. Food and Drug Administration and the general medical community. As medical research and practice continue to advance, however, therapeutic standards may change. Moreover, specific situations may require a specific therapeutic response not included in this book. For these reasons and because human and mechanical errors sometimes occur, we recommend that readers follow the advice of physicians directly involved in their care or the care of a member of their family. Books published by American Psychiatric Publishing, Inc., represent the views and opinions of the individual authors and do not necessarily represent the policies and opinions of APPI or the American Psychiatric Association.

Disorders of the sleep-wake cycle in adults

Postgraduate Medical Journal, 1998

Adults have an intrinsic body clock which regulates a complex series of rhythms including sleep and wakefulness, fatigue and cognitive ability. This endogenous clock naturally runs more slowly than the solar day and is entrained to a 24-h rhythm primarily by the alternation of light and darkness. Jet lag, shift-work sleep disorder, and some of the chronic insomnias are caused by a temporal discrepancy of the body clock relative to the surrounding environment and social network. The underlying mechanisms and general management are described. Both bright light and melatonin therapy have potential in the management of these disorders. Traditionally, bright light therapy has been used to alleviate the depression associated with seasonal affective disorder. Melatonin has received much illformed publicity, it being claimed that it is a panacea and an 'antiageing' treatment. Both of these treatment approaches are reviewed.

Circadian Rhythm Sleep Disorders: Part I, Basic Principles, Shift Work and Jet Lag Disorders

Sleep, 2007

Evotec and Cephalon and has participated in speaking engagements for World Class and Cephalon. Dr. Wright has received research support from and has participated in speaking engagements for Cephalon and Takeda, and has consulted for Takeda. Dr. Vitiello is on the speakers bureau for Takeda. Drs. Auger and Zhdanova have indicated no financial conflicts of interest.

Circadian Rhythm Sleep Disorder: Irregular Sleep Wake Rhythm Type

Sleep Medicine Clinics, 2009

Most physiologic, hormonal, and behavioral processes, most notably the sleep-wake cycle, exhibit nearly 24-hour (circadian) rhythms. These endogenous circadian rhythms are generated by the suprachiasmatic nucleus (SCN), a paired nucleus in the hypothalamus of the brain. 1-3 In humans, light is the strongest entraining agent for the circadian clock, 4 but nonphotic stimuli such as physical activity 5 and endogenous melatonin 6 also can alter the timing of circadian rhythms. In addition to its role in the timing and synchronization of biologic rhythms, the circadian pacemaker promotes alertness during the day and thus facilitates the consolidation of nocturnal sleep and daytime wakefulness across the 24hour cycle. 7-11 Significant changes in circadian regulation occur with aging and probably contribute to the higher prevalence of irregular sleep-wake rhythm disorder (ISWRD) in older adults. ISWRD is characterized by the relative absence of a circadian pattern in an individual's sleep-wake cycle. Common age-associated changes in circadian rhythm are the decreases in the amplitude of physiologic (eg, core body temperature) and hormonal circadian rhythms. 12-16 These age-related changes may be the result of degeneration or decreased neuronal activity of SCN neurons, decreased responsiveness of the circadian clock to entraining agents such as light, and decreased exposure to bright light and structured social and physical activity during the day. 17-20 Alterations in the central regulation of circadian rhythms when combined with the decreased levels of light exposure and social/physical activity levels probably contribute to the increased prevalence of ISWRD in older adults. This tendency toward increased prevalence of ISWRD is often further exaggerated in older adults who have neurodegenerative disorders, such as Alzheimer's disease. 21 Clinical Features and Diagnosis ISWRD is characterized by the lack of a clearly defined circadian sleep-wake rhythm in which sleeping and waking periods are distributed in at

Workshop report. Circadian rhythm sleep–wake disorders: gaps and opportunities

Sleep, 2021

This White Paper presents the results from a workshop cosponsored by the Sleep Research Society (SRS) and the Society for Research on Biological Rhythms (SRBR) whose goals were to bring together sleep clinicians and sleep and circadian rhythm researchers to identify existing gaps in diagnosis and treatment and areas of high-priority research in circadian rhythm sleep–wake disorders (CRSWD). CRSWD are a distinct class of sleep disorders caused by alterations of the circadian time-keeping system, its entrainment mechanisms, or a misalignment of the endogenous circadian rhythm and the external environment. In these disorders, the timing of the primary sleep episode is either earlier or later than desired, irregular from day-to-day, and/or sleep occurs at the wrong circadian time. While there are incomplete and insufficient prevalence data, CRSWD likely affect at least 800,000 and perhaps as many as 3 million individuals in the United States, and if Shift Work Disorder and Jet Lag are i...