Division of Child Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of Pulmonary Medicine and the Sleep Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Center for Circadian Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
Division of Pulmonary Medicine and the Sleep Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Center for Circadian Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Semin Pediatr Neurol. 2023 Dec;48:101091. doi: 10.1016/j.spen.2023.101091. Epub 2023 Oct 3.
Circadian Rhythm Sleep-Wake Disorders (CRSWDs) are important sleep disorders whose unifying feature is a mismatch between the preferred or required times for sleep and wakefulness and the endogenous circadian drives for these. Their etiology, presentation, and treatment can be different in pediatric patients as compared to adults. Evaluation of these disorders must be performed while viewed through the lens of a patient's comorbid conditions. Newer methods of assessment promise to provide greater diagnostic clarity and critical insights into how circadian physiology affects overall health and disease states. Effective clinical management of CRSWDs is multimodal, requiring an integrated approach across disciplines. Therapeutic success depends upon appropriately timed nonpharmacologic and pharmacologic interventions. A better understanding of the genetic predispositions for and causes of CRSWDs has led to novel clinical opportunities for diagnosis and improved therapeutics.
昼夜节律睡眠-觉醒障碍（CRSWD）是一类重要的睡眠障碍，其共同特征是睡眠和觉醒的偏好或需求时间与内源性昼夜节律驱动之间不匹配。与成人相比，小儿患者的病因、表现和治疗可能有所不同。评估这些疾病时，必须通过患者合并症的角度来看待。评估的新方法有望提供更明确的诊断，并深入了解昼夜生理如何影响整体健康和疾病状态。CRSWD 的有效临床管理是多模式的，需要跨学科的综合方法。治疗的成功取决于适时的非药物和药物干预。对 CRSWD 的遗传易感性和病因的更好理解为诊断和改善治疗带来了新的临床机会。
