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

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

Research output: Contribution to journalArticle

291 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1484-1501
Number of pages18
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
Sleep Wake Disorders

Keywords

  • Circadian rhythm sleep disorders

ASJC Scopus subject areas

  • Physiology

Cite this

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. / 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. 1484-1501.

Research output: Contribution to journalArticle

Sack, Robert ; Auckley, Dennis ; Auger, R. Robert ; Carskadon, Mary A. ; Wright, Kenneth P. ; Vitiello, Michael V. ; Zhdanova, Irina V. / 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. In: Sleep. 2007 ; Vol. 30, No. 11. pp. 1484-1501.
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