Richardson G S, Malin H V
Sleep Disorders Service, Brigham & Women's Hospital, Boston, MA 02115, USA.
J Clin Neurophysiol. 1996 Jan;13(1):17-31. doi: 10.1097/00004691-199601000-00003.
The prediction that abnormalities of circadian clock function in humans would manifest principally as sleep/wake disruption led to the description of the first circadian sleep/wake disorders almost 20 years ago. Since then, formal classification of sleep pathology has expanded this category to include six specific disorders. In this review, the physiology of mammalian circadian clocks is summarized with emphasis on the role of light and hormonal signals in circadian adjustment and entrainment. Each of the circadian sleep disorders-time zone change (jet lag) syndrome, shift work sleep disorder, irregular sleep/wake pattern, delayed sleep phase syndrome, advanced sleep phase syndrome, and non-24-h sleep wake disorder-is reviewed. Presenting characteristics, approaches to diagnosis, models of pathophysiology, and methods of treatment are summarized for each sleep disorder. Developments in the understanding of circadian physiology offer promise for important advances in the diagnosis and treatment of these sleep disorders.
大约20年前，人们预测人类昼夜节律钟功能异常主要表现为睡眠/觉醒紊乱，这导致了首批昼夜节律睡眠/觉醒障碍的描述。从那时起，睡眠病理学的正式分类将这一类别扩展到包括六种特定障碍。在这篇综述中，总结了哺乳动物昼夜节律钟的生理学，重点是光和激素信号在昼夜节律调节和同步中的作用。对每种昼夜节律睡眠障碍——时区变化（时差）综合征、轮班工作睡眠障碍、不规则睡眠/觉醒模式、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-觉醒障碍——进行了综述。总结了每种睡眠障碍的表现特征、诊断方法、病理生理学模型和治疗方法。对昼夜节律生理学认识的进展为这些睡眠障碍的诊断和治疗取得重要进展带来了希望。
