Billiard M, Carlander B, Besset A
Service de Neurologie B, Hôpital Gui-de-Chauliac, Montpellier, France.
Pathol Biol (Paris). 1996 Jun;44(6):509-17.
Different challenges, constraints for quality of sleep and wakefulness, sleep in extreme conditions, search for a better identification of disorders of sleep and wakefulness, spur researches on the circadian rhythm of sleep and on its disorders. Any advance in that field rests on the understanding of different physiologic phenomena: the intrinsic period of our internal clock is not 24-hours but a little less than 25-hours and it must be reset daily by the Zeitgebers. A sudden phase shift provokes an external desynchronisation. In addition not all rhythms resynchronize together resulting in an internal desyncronization. There is a close relationship between quantities of total sleep and REM sleep and the time of sleep onset within the 24-hours. The propensity to sleep follows a circasemidian rhythm with a major peak during the night and a secondary peak in the midafternoon. Disorders of the circadian rhythm of sleep are of two types: related to the misalignment of the sleep-wake schedule and the synchronizer-controlled rest-activity rhythm (shift work sleep disorder and time zone change syndrome) or related to an abnormal escape of the individual rest-activity rhythm from synchronizer control (delayed sleep phase syndrome, advanced sleep phase syndrome and non 24-hour sleep-wake syndrome.
睡眠和觉醒质量面临的不同挑战、限制因素，极端条件下的睡眠，以及寻求对睡眠和觉醒障碍的更好识别，都推动了对睡眠昼夜节律及其紊乱的研究。该领域的任何进展都基于对不同生理现象的理解：我们生物钟的内在周期并非24小时，而是略少于25小时，并且必须每天由授时因子重新设定。突然的相位变化会引发外部不同步。此外，并非所有节律都会一起重新同步，从而导致内部不同步。24小时内的总睡眠时间和快速眼动睡眠时间与入睡时间之间存在密切关系。睡眠倾向遵循近半日节律，夜间有一个主要高峰，下午中段有一个次要高峰。睡眠昼夜节律紊乱有两种类型：与睡眠-觉醒时间表和同步器控制的休息-活动节律失调有关（轮班工作睡眠障碍和时区变化综合征），或与个体休息-活动节律从同步器控制中异常脱离有关（睡眠时相延迟综合征、睡眠时相提前综合征和非24小时睡眠-觉醒综合征）。
