Yamadera W, Sasaki M, Itoh H, Ozone M, Ushijima S
Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan.
Psychiatry Clin Neurosci. 1998 Jun;52(3):311-6. doi: 10.1046/j.1440-1819.1998.00395.x.
The clinical data of 86 cases of primary circadian rhythm sleep disorder (primary CRSD) were retrospectively examined and compared to 40 cases of secondary circadian rhythm sleep disorder (secondary CRSD), who had presented with some kind of psychiatric or medical disorder, and had exhibited sleep-wake rhythm disorders that were judged to be secondary CRSD based on sleep logs. The comparison of cases found that: (i) the mean age at first presentation to the clinic was significantly younger for primary CRSD compared to secondary CRSD; (ii) more secondary CRSD cases were unemployed than were Primary CRSD cases; (iii) more cases in the secondary CRSD group had a clear trigger for sleep-wake rhythm disorder onset than cases in the primary CRSD group; and (iv) the types of sleep-wake rhythm disorders in the primary CRSD group consisted of delayed sleep phase syndrome (DSPS), 72 (83.7%), non-24 pattern, 11 (12.8%), and irregular, 3 (3.5%). In the secondary CRSD group there were 25 (62.5%) cases of DSPS pattern, 1 (2.5%) of non-24 pattern and 14 (35.0%) with irregular pattern. The 56 (65.1%) cases with primary CRSD showed good response to vitamin B12 and bright light therapy; however, 28 (70.0%) cases with secondary CRSD did not respond to such therapies.
回顾性检查了86例原发性昼夜节律睡眠障碍（原发性CRSD）的临床资料，并与40例继发性昼夜节律睡眠障碍（继发性CRSD）进行比较，后者患有某种精神或医学疾病，且根据睡眠日志显示出被判定为继发性CRSD的睡眠-觉醒节律障碍。病例比较发现：（i）与继发性CRSD相比，原发性CRSD首次就诊时的平均年龄显著更小；（ii）继发性CRSD组失业的病例比原发性CRSD组更多；（iii）继发性CRSD组中比原发性CRSD组有更多病例有明确的睡眠-觉醒节律障碍发作诱因；（iv）原发性CRSD组的睡眠-觉醒节律障碍类型包括延迟睡眠相位综合征（DSPS）72例（83.7%）、非24小时模式11例（12.8%）和不规则模式3例（3.5%）。继发性CRSD组中DSPS模式25例（62.5%）、非24小时模式1例（2.5%）和不规则模式14例（35.0%）。56例（65.1%）原发性CRSD病例对维生素B12和强光疗法反应良好；然而，28例（70.0%）继发性CRSD病例对这些疗法无反应。
