Circadian Rhythm Sleep Disorders: Part II, Advanced Sleep Phase Disorder, Delayed Sleep Phase Disorder, Free-running Disorder, and Irregular Sleep-wake Rhythm. An American Academy of Sleep Medicine Review

Overview

Journal Sleep

Publisher Oxford University Press

Specialty Psychiatry

Date 2007 Nov 29

PMID 18041481

Citations 142

Authors

Robert L Sack

Dennis Auckley

R Robert Auger

Mary A Carskadon

Kenneth P Wright Jr

Michael V Vitiello

Irina V Zhdanova

Affiliations

Soon will be listed here.

Abstract

Objective: This the second of two articles reviewing the scientific literature on the evaluation and treatment of circadian rhythm sleep disorders (CRSDs), employing the methodology of evidence-based medicine. We herein report on the accumulated evidence regarding the evaluation and treatment of Advamced Sleep Phase Disorder (ASPD), Delayed Sleep Phase Disorder (DSPD), Free-Running Disorder (FRD) and Irregular Sleep-Wake Rhythm ISWR).

Methods: A set of specific questions relevant to clinical practice were formulated, a systematic literature search was performed, and relevant articles were abstracted and graded.

Results: A substantial body of literature has accumulated that provides a rational basis the evaluation and treatment of CRSDs. Physiological assessment has involved determination of circadian phase using core body temperature and the timing of melatonin secretion. Behavioral assessment has involved sleep logs, actigraphy and the Morningness-Eveningness Questionnaire (MEQ). Treatment interventions fall into three broad categories: 1) prescribed sleep scheduling, 2) circadian phase shifting ("resetting the clock"), and 3) symptomatic treatment using hypnotic and stimulant medications.

Conclusion: Circadian rhythm science has also pointed the way to rational interventions for CRSDs and these treatments have been introduced into the practice of sleep medicine with varying degrees of success. More translational research is needed using subjects who meet current diagnostic criteria.

Citing Articles

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Readjustment of circadian clocks by exercise intervention is a potential therapeutic target for sleep disorders: a narrative review.

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Insomnia and other sleep disorders in adolescence.

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Selecting, implementing and evaluating control and placebo conditions in light therapy and light-based interventions.

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