Terman M, Lewy A J, Dijk D J, Boulos Z, Eastman C I, Campbell S S
Department of Psychiatry, Columbia University and New York State Psychiatric Institute, NY 10032, USA.
J Biol Rhythms. 1995 Jun;10(2):135-47. doi: 10.1177/074873049501000206.
Advanced and delayed sleep phase disorders, and the hypersomnia that can accompany winter depression, have been treated successfully by appropriately timed artificial bright light exposure. Under entrainment to the 24-h day-night cycle, the sleep-wake pattern may assume various phase relationships to the circadian pacemaker, as indexed, for example, by abnormally long or short intervals between the onset of melatonin production or the core body temperature minimum and wake-up time. Advanced and delayed sleep phase syndromes and non-24-h sleep-wake syndrome have been variously ascribed to abnormal intrinsic circadian periodicity, deficiency of the entrainment mechanism, or--most simply--patterns of daily light exposure insufficient for adequate phase resetting. The timing of sleep is influenced by underlying circadian phase, but psychosocial constraints also play a major role. Exposure to light early or late in the subjective night has been used therapeutically to produce corrective phase delays or advances, respectively, in both the sleep pattern and circadian rhythms. Supplemental light exposure in fall and winter can reduce the hypersomnia of winter depression, although the therapeutic effect may be less dependent on timing.
通过适时的人工强光照射，已成功治疗了睡眠相位提前和延迟障碍，以及可能伴随冬季抑郁症出现的嗜睡症。在与24小时昼夜周期同步的情况下，睡眠-觉醒模式可能与昼夜节律起搏器呈现出各种相位关系，例如，通过褪黑素分泌开始或核心体温最低点与起床时间之间异常长或短的间隔来衡量。睡眠相位提前和延迟综合征以及非24小时睡眠-觉醒综合征被分别归因于内在昼夜节律异常、同步机制缺陷，或者——最简单地说——日常光照模式不足以进行充分的相位重置。睡眠时间受潜在昼夜节律相位的影响，但社会心理因素也起着重要作用。在主观夜间的早期或晚期暴露于光线下，已被用于治疗，分别在睡眠模式和昼夜节律中产生校正性的相位延迟或提前。秋冬季节补充光照可以减轻冬季抑郁症的嗜睡症状，尽管治疗效果可能不太依赖于光照时间。
