Journal
SLEEP MEDICINE
Volume 8, Issue 6, Pages 566-577Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.sleep.2006.11.017
Keywords
cireadian rhythm sleep disorders; delayed sleep phase disorder; advanced sleep phase disorder; non 24-h sleep-wake syndrome; irregalar sleep-wake rhythm; shift work disorder; jet lag syndrome
Categories
Funding
- NHLBI NIH HHS [R01 HL069988-01A1, K07 HL003891-05, R01 HL069988] Funding Source: Medline
- NIA NIH HHS [P01 AG011412-030001, P01 AG011412] Funding Source: Medline
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [R01HL069988, K07HL003891] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [P01AG011412] Funding Source: NIH RePORTER
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Circadian rhythm sleep disorders are characterized by complaints of insomnia and excessive sleepiness that are primarily due to alterations in the internal circadian timing system or a misalignment between the timing of sleep and the 24-h social and physical environment. In addition to physiological and environmental factors, maladaptive behaviors often play an important role in the development of many of the circadian rhythm sleep disorders. This review will focus on the clinical approach to the diagnosis and management of the various circadian rhythm sleep disorders, including delayed sleep phase disorder, advanced sleep phase disorder, non-entrained type, irregular sleep-wake rhythm, shift work sleep disorder and jet lag disorder. Diagnostic tools such as sleep diaries and wrist activity monitoring are often useful in confirming the diagnosis. Because behavioral and environmental factors often are involved in the development of these conditions, a multimodal approach is usually necessary. Interventions include sleep hygiene education, timed exposure to bright light as well as avoidance of bright light at the wrong time of the day and pharmacologic approaches, such as melatonin. However, it should be noted that the use of melatonin is not an FDA-approved indication for the treatment of circadian rhythm sleep disorders. (c) 2007 Elsevier B.V. All rights reserved.
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