Baron Kelly Glazer, Reid Kathryn J
Feinberg School of Medicine, Northwestern University , Chicago, Illinois USA.
Int Rev Psychiatry. 2014 Apr;26(2):139-54. doi: 10.3109/09540261.2014.911149.
Circadian rhythms are near 24-h patterns of physiology and behaviour that are present independent of external cues including hormones, body temperature, mood, and sleep propensity. The term 'circadian misalignment' describes a variety of circumstances, such as inappropriately timed sleep and wake, misalignment of sleep/wake with feeding rhythms, or misaligned central and peripheral rhythms. The predominance of early research focused on misalignment of sleep to the biological night. However, discovery of clock genes and the presence of peripheral circadian oscillators have expanded the definitions of misalignment. Experimental studies conducted in animal models and humans have provided evidence of potential mechanisms that link misalignment to negative outcomes. These include dysregulation of feeding behaviours, changes in appetite stimulating hormones, glucose metabolism and mood. This review has two foci: (1) to describe how circadian misalignment has been defined and evaluated in laboratory and field experiments, and (2) to describe evidence linking different types of circadian misalignment to increased risk for physical (cardiovascular disease, diabetes, obesity, cancer) and psychiatric (depression, bipolar, schizophrenia, attention deficit) disorders. This review will describe the role of circadian misalignment as a risk factor for disease in the general population and in clinical populations, including circadian rhythm sleep disorders and psychiatric disorders.
昼夜节律是近24小时的生理和行为模式，其存在独立于包括激素、体温、情绪和睡眠倾向在内的外部线索。“昼夜节律失调”一词描述了多种情况，如睡眠时间和起床时间不当、睡眠/觉醒与进食节律失调，或中枢和外周节律失调。早期研究主要集中在睡眠与生物夜间的失调。然而，生物钟基因的发现以及外周昼夜节律振荡器的存在扩展了失调的定义。在动物模型和人类中进行的实验研究提供了将失调与负面结果联系起来的潜在机制的证据。这些包括进食行为失调、食欲刺激激素变化、葡萄糖代谢和情绪变化。本综述有两个重点：（1）描述在实验室和现场实验中如何定义和评估昼夜节律失调，（2）描述将不同类型的昼夜节律失调与身体（心血管疾病、糖尿病、肥胖、癌症）和精神（抑郁症、双相情感障碍、精神分裂症、注意力缺陷）疾病风险增加联系起来的证据。本综述将描述昼夜节律失调作为一般人群和临床人群（包括昼夜节律睡眠障碍和精神疾病）疾病风险因素的作用。
