Circadian rhythm sleep disorders: Part I, basic principles, shift work and jet lag disorders: An American Academy of Sleep Medicine review

Robert Sack, Dennis Auckley, R. Robert Auger, Mary A. Carskadon, Kenneth P. Wright, Michael V. Vitiello, Irina V. Zhdanova

Research output: Contribution to journalArticle

362 Citations (Scopus)

Abstract

Objective: This the first of two articles reviewing the scientific literature on the evaluation and treatment of circadian rhythm sleep disorders (CRS-Ds), employing the methodology of evidence-based medicine. In this first part of this paper, the general principles of circadian biology that underlie clinical evaluation and treatment are reviewed. We then report on the accumulated evidence regarding the evaluation and treatment of shift work disorder (SWD) and jet lag disorder (JLD). 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 SWD and JLD. 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 shift-ing ("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 the SWD and JLD, 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.

Original languageEnglish (US)
Pages (from-to)1460-1483
Number of pages24
JournalSleep
Volume30
Issue number11
StatePublished - Nov 1 2007

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Circadian Rhythm Sleep Disorders
Sleep
Medicine
Therapeutics
Actigraphy
Literature
Translational Medical Research
Evidence-Based Medicine
Melatonin
Circadian Rhythm
Body Temperature
Hypnotics and Sedatives

Keywords

  • Circadian rhythm sleep disorders

ASJC Scopus subject areas

  • Physiology

Cite this

Sack, R., Auckley, D., Auger, R. R., Carskadon, M. A., Wright, K. P., Vitiello, M. V., & Zhdanova, I. V. (2007). Circadian rhythm sleep disorders: Part I, basic principles, shift work and jet lag disorders: An American Academy of Sleep Medicine review. Sleep, 30(11), 1460-1483.

Circadian rhythm sleep disorders : Part I, basic principles, shift work and jet lag disorders: An American Academy of Sleep Medicine review. / Sack, Robert; Auckley, Dennis; Auger, R. Robert; Carskadon, Mary A.; Wright, Kenneth P.; Vitiello, Michael V.; Zhdanova, Irina V.

In: Sleep, Vol. 30, No. 11, 01.11.2007, p. 1460-1483.

Research output: Contribution to journalArticle

Sack, R, Auckley, D, Auger, RR, Carskadon, MA, Wright, KP, Vitiello, MV & Zhdanova, IV 2007, 'Circadian rhythm sleep disorders: Part I, basic principles, shift work and jet lag disorders: An American Academy of Sleep Medicine review', Sleep, vol. 30, no. 11, pp. 1460-1483.
Sack R, Auckley D, Auger RR, Carskadon MA, Wright KP, Vitiello MV et al. Circadian rhythm sleep disorders: Part I, basic principles, shift work and jet lag disorders: An American Academy of Sleep Medicine review. Sleep. 2007 Nov 1;30(11):1460-1483.
Sack, Robert ; Auckley, Dennis ; Auger, R. Robert ; Carskadon, Mary A. ; Wright, Kenneth P. ; Vitiello, Michael V. ; Zhdanova, Irina V. / Circadian rhythm sleep disorders : Part I, basic principles, shift work and jet lag disorders: An American Academy of Sleep Medicine review. In: Sleep. 2007 ; Vol. 30, No. 11. pp. 1460-1483.
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