[Circadian rhythm sleep disorder].
Primary pathophysiology of circadian rhythm sleep disorders(CRSDs) is a misalignment between the endogenous circadian rhythm phase and the desired or socially required sleep-wake schedule, or dysfunction of the circadian pacemaker and its afferent/efferent pathways. CRSDs consist of delayed sleep phase type, advanced sleep phase type, free-running type, irregular sleep-wake type, shift work type and jet lag type. Chronotherapy using strong zeitgebers (time cues), such as bright light and melatonin/ melatonin type 2 receptor agonist, is effective when administered with proper timing. Bright light is the strongest entraining agent of circadian rhythms. Bright light therapy (appropriately-timed exposure to bright light) for CRSDs is an effective treatment option, and can shift the sleep-wake cycle to earlier or later times, in order to correct for misalignment between the circadian system and the desired sleep-wake schedule. Timed administration of melatonin, either alone or in combination with light therapy has also been shown to be useful in the treatment of CRSDs.
Department of Psychophysiology, National Institute of Mental Health, National Center for Neurology and Psychiatry.
Kazuo
K
Mishima
D006801:Humans; D008550:Melatonin / Q000378:metabolism; D010789:Phototherapy / Q000379:methods; D044094:Receptors, Melatonin / Q000378:metabolism; D012890:Sleep / Q000502:physiology; D020178:Sleep Disorders, Circadian Rhythm / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D014805:Vitamin B 12 / Q000627:therapeutic use
D044094:Receptors, Melatonin; D008550:Melatonin; D014805:Vitamin B 12