TY - JOUR
T1 - Circadian rhythm sleep disorders
T2 - Part I, basic principles, shift work and jet lag disorders: An American Academy of Sleep Medicine review
AU - Sack, Robert L.
AU - Auckley, Dennis
AU - Auger, R. Robert
AU - Carskadon, Mary A.
AU - Wright, Kenneth P.
AU - Vitiello, Michael V.
AU - Zhdanova, Irina V.
PY - 2007/11/1
Y1 - 2007/11/1
N2 - 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.
AB - 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.
KW - Circadian rhythm sleep disorders
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U2 - 10.1093/sleep/30.11.1460
DO - 10.1093/sleep/30.11.1460
M3 - Article
C2 - 18041480
AN - SCOPUS:35648987668
SN - 0161-8105
VL - 30
SP - 1460
EP - 1483
JO - Sleep
JF - Sleep
IS - 11
ER -