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[昼夜节律性睡眠障碍的诊断与治疗]

[Diagnosis and treatment in circadian rhythm sleep disorders].

作者信息

Murakami Junichi, Imai Makoto, Yamada Naoto

机构信息

Department of Psychiatry, Shiga University of Medical Science.

出版信息

Nihon Rinsho. 2012 Jul;70(7):1155-60.

Abstract

Circadian rhythm sleep disorders (CRSD) are characterized by misalignment between major sleep episode and desired sleep phase, or symptoms associated with internal desynchronization between endogenous circadian rhythm and overt sleep-wake rhythm. Endogenous circadian rhythm is mainly regulated by master circadian clock located in the suprachiasmatic nucleus. Light entrains the circadian clock according to a phase-response curve. Furthermore, social time cue affects human sleep-wake rhythm. Instructions concerning sleep hygiene including light environment play fundamental role for the treatment in CRSD. In addition, light therapy and oral melatonin administration have application to delayed sleep phase type. Diagnostic classification and treatment in each types of CRSD are reviewed in this article.

摘要

昼夜节律性睡眠障碍(CRSD)的特征是主要睡眠时段与期望的睡眠阶段不一致,或与内源性昼夜节律和明显的睡眠-觉醒节律之间的内部不同步相关的症状。内源性昼夜节律主要由位于视交叉上核的主昼夜节律时钟调节。光线根据相位反应曲线调节昼夜节律时钟。此外,社会时间线索会影响人类的睡眠-觉醒节律。包括光照环境在内的睡眠卫生指导对CRSD的治疗起着重要作用。此外,光疗和口服褪黑素适用于延迟睡眠相位类型。本文综述了每种类型CRSD的诊断分类和治疗方法。

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