circadian rhythm sleep disorder

WordNet

1. be able to accommodate for sleeping; "This tent sleeps six people"
2. be asleep (同)kip, slumber, log Z''s, catch some Z''s
3. a period of time spent sleeping; "he felt better after a little sleep"; "there wasnt time for a nap" (同)nap
4. a natural and periodic state of rest during which consciousness of the world is suspended; "he didnt get enough sleep last night"; "calm as a child in dreamless slumber" (同)slumber
5. a torpid state resembling deep sleep (同)sopor
6. bring disorder to (同)disarray
7. a physical condition in which there is a disturbance of normal functioning; "the doctor prescribed some medicine for the disorder"; "everyone gets stomach upsets from time to time" (同)upset
8. a disturbance of the peace or of public order
9. recurring at regular intervals (同)regular recurrence
10. the basic rhythmic unit in a piece of music; "the piece has a fast rhythm"; "the conductor set the beat" (同)beat, musical rhythm
11. the arrangement of spoken words alternating stressed and unstressed elements; "the rhythm of Frosts poetry" (同)speech rhythm
12. of or relating to biological processes occurring at 24-hour intervals; "circadian rhythms"
13. the suspension of consciousness and decrease in metabolic rate
14. the state of being asleep

PrepTutorEJDIC

1. 〈U〉『眠り』,『睡眠』[『状態』] / 〈C〉《a sleep》一眠り[の時間] / 〈U〉永眠,死 / 〈U〉(一時的な手足などの)無感覚,しびれ;冬眠(hibernation) / 〈U〉目やに / 『眠る』 / 『文眠なる』,(死んで)葬られている / 〈人〉‘を'泊める[設備がある] / 《a+形容詞+sleepを目的語にして》…‘を'眠る
2. 〈U〉『無秩序』,混乱,乱雑(confusion) / 《しばしば複数形で》(社会的・政治的な)粉争,騒動 / 〈C〉(肉体的・精神的な)不調,異常,障害 / …‘の'秩序を乱す / 〈心身〉‘に'異常を起こさせる
3. 〈U〉『律動,リズム』;韻律 / 〈C〉(特定の)リズム
4. (約24時間周期の)生物学的サイクルの

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/12/04 18:34:28」(JST)

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Circadian rhythm sleep disorder
Classification and external resources
ICD-10	G47.2
ICD-9	327.3, 780.55
MeSH	D021081

Circadian rhythm sleep disorders are a family of sleep disorders affecting, among other things, the timing of sleep. People with circadian rhythm sleep disorders are unable to sleep and wake at the times required for normal work, school, and social needs. They are generally able to get enough sleep if allowed to sleep and wake at the times dictated by their body clocks. Unless they also have another sleep disorder, their sleep is of normal quality.

Humans, like most animals and plants, have biological rhythms, known as circadian rhythms, which are controlled by a biological clock and work on a daily time scale. These affect body temperature, alertness, appetite, hormone secretion etc. as well as sleep timing. Due to the circadian clock, sleepiness does not continuously increase as time passes. A person's desire and ability to fall asleep is influenced by both the length of time since the person woke from an adequate sleep, and by internal circadian rhythms. Thus, the body is ready for sleep and for wakefulness at different times of the day.

Sleep researcher Yaron Dagan states that "[t]hese disorders can lead to harmful psychological and functional difficulties and are often misdiagnosed and incorrectly treated due to the fact that doctors are unaware of their existence."

Types of circadian rhythm sleep disorders

Extrinsic type

One of these disorders is extrinsic (from Latin extrinsecus, from without, on the outside) or circumstantial:

• Shift work sleep disorder, which affects people who work nights or rotating shifts.

Intrinsic type

Four of them are intrinsic (from Latin intrinsecus, on the inside, inwardly), "built-in":

• Delayed sleep phase disorder (DSPD), aka delayed sleep phase syndrome (DSPS), characterized by a much later than normal timing of sleep onset and offset and a period of peak alertness in the middle of the night.
• Advanced sleep phase disorder (ASPD), aka advanced sleep phase syndrome (ASPS), characterized by difficulty staying awake in the evening and difficulty staying asleep in the morning.
• Non-24-hour sleep–wake disorder (non-24), in which the affected individual's sleep occurs later and later each day, with the period of peak alertness also continuously moving around the clock from day to day.
• Irregular sleep–wake rhythm, which presents as sleeping at very irregular times, and usually more than twice per day (waking frequently during the night and taking naps during the day) but with total time asleep typical for the person's age.

Normal circadian rhythms

Typical features of a normal cicadian rhythm, including a bedtime of 22:00.

Among people with healthy circadian clocks, there is a continuum of chronotypes from "larks", "morning people", who prefer to sleep and wake early, to "owls", "evening people" or "night people", who prefer to sleep and wake at late times. Whether they are larks or owls, people with normal circadian systems:

• can wake in time for what they need to do in the morning, and fall asleep at night in time to get enough sleep before having to get up.
• can sleep and wake up at the same time every day, if they want to.
• will, after starting a new routine that requires their getting up earlier than usual, start to fall asleep at night earlier within a few days. For example, someone used to sleeping at 1 a.m. and waking up at 9 a.m. begins a new job on a Monday, and must get up at 6 a.m. to get ready for work. By the following Friday, the person has begun to fall asleep at around 10 p.m., and can wake up at 6 a.m. feeling well-rested. This adaptation to earlier sleep/wake times is known as "advancing the sleep phase." Healthy people can advance their sleep phase by about one hour each day.

Researchers have placed volunteers in caves or special apartments for several weeks without clocks or other time cues. Without time cues, the volunteers tended to go to bed an hour later and to get up about an hour later each day. These experiments appeared to demonstrate that the "free-running" circadian rhythm in humans was about 25 hours long. However, these volunteers were allowed to control artificial lighting and the light in the evening caused a phase delay. More recent research shows that adults of all ages free-run at an average of 24 hours and 11 minutes. To maintain a 24-hour day/night cycle, the biological clock needs regular environmental time cues or Zeitgebers, e.g., sunrise, sunset, and daily routine. Time cues keep the normal human circadian clock aligned with the rest of the world.

Circadian rhythm abnormalities

Non-24-hour sleep–wake disorder and other persistent circadian rhythm sleep disorders are believed to be caused by an inadequate ability to reset the sleep/wake cycle in response to environmental time cues. These individuals' circadian clocks might have an unusually long cycle, and/or might not be sensitive enough to time cues. People with DSPS (Delayed sleep phase disorder), more common than Non-24, do entrain to nature's 24 hours, but are unable to sleep and awaken at socially preferred times, sleeping instead, for example, from 4 a.m. to noon. According to doctors Cataletto and Hertz at WebMD, "Altered or disrupted sensitivity to zeitgebers is probably the most common cause of circadian rhythm disorder."

Circadian rhythm abnormalities are also extremely common in ADHD, especially in the form of delayed sleep (sleep initiation insomnia). It has been genetically linked by findings of polymorphism in genes in common between those apparently involved in ADHD and those involved in the circadian rhythm and a high proportion of DSPD among those with ADHD, however no specific or further cause-effect relationship has been proven.

As of October 1, 2005, the diagnostic codes for circadian rhythm sleep disorders were changed from the 307-group to the 327-group in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). The DSM updated to agree with the International Classification of Diseases (ICD-9). The new codes reflect the moving of these disorders from the Mental Disorders section to the Neurological section in the ICD.

Treatment for circadian rhythm sleep disorders

Possible treatments for circadian rhythm sleep disorders include:

• Behavior therapy or advice about sleep hygiene where the patient is told to avoid naps, caffeine, and other stimulants. They are also told to not be in bed for anything besides sleep and sex.
• Bright light therapy is used to advance or delay sleep, depending on how the circadian rhythm is shifted. Patients are exposed to high-intensity light (up to 10,000 lux) for a duration of 30–60 minutes at a time, the time of day depending on whether an advance or a delay is required.
• Blue blocking glasses therapy is used to block blue wavelength light from reaching the eye during evening hours so that melatonin production is increased.
• Medications such as melatonin and modafinil (Provigil), or other short term sleep aids or wake-promoting agents can be beneficial; the former is a natural neurohormone responsible partly and in tiny amounts for the human body clock. Tasimelteon has been proven effective in Phase III trials.
• Sleep phase chronotherapy progressively advances or delays the sleep time by 1–2 hours per day.

See also

• Chronobiology
• Chronotype
• Phase response curve
• Sleep diary
• Sleep medicine

References

External links

• Circadian Sleep Disorders Organization
• An American Academy of Sleep Medicine Review: Circadian Rhythm Sleep Disorders: Part I, Basic Principles, Shift Work and Jet Lag Disorders. PDF, 24 pages. November 2007.
• An American Academy of Sleep Medicine Review: Circadian Rhythm Sleep Disorders: Part II, Advanced Sleep Phase Disorder, Delayed Sleep Phase Disorder, Free-Running Disorder, and Irregular Sleep–Wake Rhythm. PDF, 18 pages. November 2007.
• An American Academy of Sleep Medicine Report: Practice Parameters for the Clinical Evaluation and Treatment of Circadian Rhythm Sleep Disorders, November 1, 2007
• NASA Sleep–Wake Actigraphy and Light Exposure During Spaceflight-Long Experiment
• An active mailing list for peer support and information

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 睡眠障害の分類 classification of sleep disorders
• 2. 不眠症の病型 types of insomnia
• 3. 過度な日中の眠気を有する患者へのアプローチ approach to the patient with excessive daytime sleepiness
• 4. 睡眠不足および睡眠障害のパフォーマンスおよび安全性リスク performance and safety risks of sleep deprivation and sleep disorders
• 5. メラトニンの生理学および臨床使用 physiology and clinical use of melatonin

English Journal

• The personality profile of young adults with delayed sleep phase disorder.

• Wilhelmsen-Langeland A1, Saxvig IW, Pallesen S, Nordhus IH, Vedaa O, Sørensen E, Bjorvatn B.
• Behavioral sleep medicine.Behav Sleep Med.2014 Nov 2;12(6):481-92. doi: 10.1080/15402002.2013.829063. Epub 2013 Nov 27.
• Delayed sleep phase disorder (DSPD) is a circadian rhythm sleep disorder characterized by a substantial delay in the major sleep period, resulting in difficulties falling asleep and awakening at a socially desirable time in the morning. This study is the first to investigate the NEO-Personality Inve
• PMID 24283705

• Out of synch with society: an update on delayed sleep phase disorder.

• Nesbitt AD1, Dijk DJ.
• Current opinion in pulmonary medicine.Curr Opin Pulm Med.2014 Nov;20(6):581-7. doi: 10.1097/MCP.0000000000000095.
• PURPOSE OF REVIEW: Delayed sleep phase disorder is the most common of the circadian rhythm sleep disorders. Its treatment involves exploiting the intrinsic biological properties of the circadian pacemaker to advance biological rhythms, most notably the sleep-wake cycle, to a time which affords the i
• PMID 25160887

• Hypothalamic Alterations in Huntington's Disease Patients: Comparison with Genetic Rodent Models.

• van Wamelen DJ1, Aziz NA, Roos RA, Swaab DF.
• Journal of neuroendocrinology.J Neuroendocrinol.2014 Nov;26(11):761-75. doi: 10.1111/jne.12190.
• Unintended weight loss, sleep and circadian disturbances and autonomic dysfunction are prevalent features of Huntington's disease (HD), an autosomal dominantly inherited neurodegenerative disorder caused by an expanded CAG repeat sequence in the HTT gene. These features form a substantial contributi
• PMID 25074766

Japanese Journal

• 概日リズム睡眠障害の病態生理研究の動向

• 肥田 昌子,三島 和夫
• 日本生物学的精神医学会誌 = Japanese journal of biological psychiatry 22(3), 165-170, 2011-09-25
• NAID 10029785827

• Importance of regular lifestyle with daytime bright light exposure on circadian rhythm sleep-wake disorders in pervasive developmental disorders

• TAKASU Nana N.,TOICHI Motomi,NAKAMURA Wataru
• The Japanese dental science review 47(2), 141-149, 2011-08-01
• NAID 10029547947

Related Links

• Circadian rhythm sleep disorder - ScienceDaily: News ...

Circadian rhythm sleep disorders are a family of sleep disorders affecting the timing of sleep. People with circadian rhythm sleep disorders are unable to sleep and wake at the times required for normal work, school, and ...

• Circadian rhythm sleep disorder - definition of Circadian ...

Circadian rhythm sleep disorder synonyms, Circadian rhythm sleep disorder antonyms. Information about Circadian rhythm sleep disorder in the free online English dictionary and encyclopedia. Circadian rhythm sleep disorder ...

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★リンクテーブル★

リンク元	「概日リズム睡眠障害」「advanced sleep phase syndrome」「shift-work sleep disorder」
関連記事	「disorder」「sleep」「sleeping」「circadian」「rhythm」

「概日リズム睡眠障害」

　　[★]

英

circadian rhythm sleep disorder

同

睡眠覚醒スケジュール障害 sleep-wake schedule disorder

関

睡眠相前進症候群、睡眠相後退症候群、交代勤務睡眠障害

「advanced sleep phase syndrome」

　　[★] 睡眠相前進症候群

• (病名)睡眠相前進症候群

関

circadian rhythm sleep disorder、delayed sleep phase syndrome、shift-work sleep disorder

「shift-work sleep disorder」

　　[★]

• 交代勤務睡眠障害

関

advanced sleep phase syndrome、circadian rhythm sleep disorder、delayed sleep phase syndrome

「disorder」

　　[★]

• 障害：個人的苦痛や機能の障害があるので「疾病」とは言えるものの、その背景にある臓器障害がもう一つはっきりしない場合に用いられる。(PSY.9)

• n.

• an untidy state; a lack of order or organization (⇔order)
• violent behaviour of large groups of people
• an illness that cause a part of the body to stop functioning correctly

• 注意

disease <> illness <> disorder

• vt.

• 乱す、乱雑にする。(人)の(心身の)調子を狂わせる。

• vi.

　 　 　 　

「sleep」

　　[★]

• n.

• 睡眠、眠り、活動休止

• adj.
• vi.
• vi.

関

insomnia

PHP

• sleep ( $seconds )：seconds で与えられた秒数ぶんプログラムの実行を遅延させる。

　 　 　 　 　 　

「sleeping」

　　[★]

• n.

• 就寝、就眠

関

bedtime、nyctinastic

　 　

「circadian」

　　[★]

• adj.

• 概日性の、日周性の

　 　

「rhythm」

　　[★]

• n.

• リズム