Oregon Health & Science University, 3181 Southwest Sam Jackson Road, Portland, OR 97239, USA.
Curr Psychiatry Rep. 2009 Dec;11(6):459-65. doi: 10.1007/s11920-009-0070-5.
Recent refinements in methodology allow chronobiological researchers to answer the following questions: is there circadian misalignment in sleep and mood disturbances, and, if so, is it of the phase-advance or phase-delay type? Measurement of the dim light melatonin onset-to-midsleep interval, or phase-angle difference, in sleep and mood disorders should answer these questions. Although the phase-advance hypothesis of affective disorders was formulated three decades ago, recent studies suggest that many, if not all, mood disturbances have a circadian misalignment component of the phase-delay type, operationally defined as a delay in the dim light melatonin onset relative to the sleep/wake cycle. Phase-delayed disorders can be treated with bright light in the morning and/or low-dose melatonin in the afternoon/evening. Phase-advanced disorders can be treated with bright light in the evening and/or low-dose melatonin in the morning.
睡眠和情绪障碍是否存在昼夜节律失调，如果存在，是相位提前还是相位延迟类型？在睡眠和情绪障碍中测量褪黑素开始到睡眠中期的暗光时间，或相位角差异，应该可以回答这些问题。尽管情感障碍的相位提前假说早在三十年前就已提出，但最近的研究表明，许多（如果不是全部）情绪障碍都存在昼夜节律失调成分，其相位延迟类型可以通过相对睡眠/觉醒周期延迟褪黑素开始的暗光时间来定义。可以通过早上的强光和/或下午/晚上的低剂量褪黑素治疗相位延迟障碍。可以通过晚上的强光和/或早上的低剂量褪黑素治疗相位提前障碍。
