Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48105, USA.
Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48105, USA.
Sleep Med Clin. 2023 Mar;18(1):21-30. doi: 10.1016/j.jsmc.2022.09.004.
The circadian system plays a key role in the sleep-wake cycle. A mismatch between the behavioral timing of sleep and the circadian timing of sleepiness/alertness can contribute to insomnia. Patients who report primarily difficulty falling asleep or early morning awakenings may benefit from circadian interventions administered adjunctively to cognitive-behavioral therapy for insomnia. Specific circadian interventions that clinicians may consider include bright light therapy, scheduled dim light, blue-blocking glasses, and melatonin. Implementation of these interventions differs depending on the patient's insomnia subtype. Further, careful attention must be paid to the timing of these interventions to ensure they are administered correctly.
昼夜节律系统在睡眠-觉醒周期中起着关键作用。睡眠行为时间与困倦/警觉的昼夜节律时间不匹配可能会导致失眠。报告主要入睡困难或清晨早醒的患者可能会受益于在认知行为疗法治疗失眠的基础上辅助进行昼夜节律干预。临床医生可能会考虑的具体昼夜节律干预措施包括亮光疗法、定时暗光、蓝光阻断眼镜和褪黑素。这些干预措施的实施因患者的失眠亚型而异。此外，必须密切关注这些干预措施的时间安排，以确保正确实施。
