Lewy A J, Sack R L, Blood M L, Bauer V K, Cutler N L, Thomas K H
Department of Psychiatry, Oregon Health Sciences University, Portland 97201-3098, USA.
Ciba Found Symp. 1995;183:303-17; discussion 317-21. doi: 10.1002/9780470514597.ch15.
Measuring the dim light melatonin onset (DLMO) is a useful and practical way to assess circadian phase position in humans. As a marker for the phase and period of the endogenous circadian pacemaker, the DLMO has been shown to advance with exposure to bright light in the morning and to delay with exposure to bright light in the evening. This 'phase response curve' (PRC) to light has been applied in the treatment of winter depression, jet lag and shift work, as well as circadian phase sleep disorders. Exogenous melatonin has phase-shifting effects described by a PRC that is about 12 h out of phase with the PRC to light. That is, melatonin administration in the morning causes phase delays and in the afternoon causes phase advances. All of the circadian phase disorders that have been successfully treated with appropriately timed exposure to bright light can be treated with appropriately scheduled melatonin administration. Melatonin administration is more convenient and therefore may be the preferred treatment.
测量暗光褪黑素起始时间（DLMO）是评估人体昼夜节律相位位置的一种有用且实用的方法。作为内源性昼夜节律起搏器的相位和周期标志物，DLMO已被证明在早晨暴露于强光下会提前，而在晚上暴露于强光下会延迟。这种对光的“相位响应曲线”（PRC）已应用于冬季抑郁症、时差反应和轮班工作以及昼夜节律相位睡眠障碍的治疗。外源性褪黑素具有相位转移作用，其PRC与对光的PRC相差约12小时。也就是说，早晨服用褪黑素会导致相位延迟，下午服用则会导致相位提前。所有已通过适当时间暴露于强光成功治疗的昼夜节律相位障碍都可以通过适当安排褪黑素给药来治疗。褪黑素给药更方便，因此可能是首选治疗方法。
