scholarly journals Circadian Rhythm Disorders

2021 ◽  
Author(s):  
Ajay Sampat ◽  
Armand Ryden
Keyword(s):  
Circadian Rhythm ◽  
Treatment Strategies ◽  
Sleep Medicine ◽  
Wake Time ◽  
Shift Work Disorder ◽  
Rhythm Disorder ◽  
Delayed Sleep ◽  
Basic Treatment ◽  
Circadian Rhythm Disorders

Circadian rhythm disorders are a group of sleep conditions that involve a misalignment of an individual’s internal timekeeping system with that of one’s desired sleep-wake time. This desynchrony can compromise sleep health as well as the functioning of other organ system, and significantly diminish one’s quality of life. There are six well-defined circadian rhythm disorders that can be classified as either intrinsic or extrinsic, based on the underlying factors that contribute to the condition. Intrinsic circadian disorders include the following: 1) advanced sleep-wake phase disorder, 2) delayed sleep-wake phase disorder, 3) irregular sleep-wake rhythm disorder, and 4) non-24-hour sleep-wake rhythm disorder. The two circadian disorders caused by external factors include 1) shift work disorder, and 2) jet lag disorder, both of which are due to behaviorally mediated misalignments of circadian system. This chapter serves to summarize these disorders, guide clinicians towards screening and evaluation of these conditions, and introduce basic treatment strategies that can be applied by non-sleep medicine clinicians.

Circadian Disorders, Insomnia, and Parasomnias

2021 ◽  
pp. 1208-1216
Author(s):  
Brynn K. Dredla ◽  
Vichaya Arunthari
Keyword(s):  
Circadian Rhythm ◽  
Shift Work ◽  
Poor Quality ◽  
Sleep Phase ◽  
Delayed Sleep Phase Disorder ◽  
Delayed Sleep Phase ◽  
Sleep Schedule ◽  
Delayed Sleep ◽  
Circadian Rhythm Disorders

Circadian rhythm disorders have misalignment between the desired sleep schedule and the circadian (24-hour) sleep-wake rhythm. Many persons experience this misalignment with jet lag. Other common circadian rhythm disorders include delayed sleep-phase disorder, advanced sleep-phase disorder, and shift-work sleep disorder. Insomnia is one of the most common medical concerns, and its prevalence increases with age. Patients may have difficulty initiating sleep or maintaining sleep and generally have a poor quality of sleep. Causes of insomnia are multifactorial.

Management of insomnia and circadian rhythm sleep–wake disorders

2020 ◽  
pp. 1167-1178
Author(s):  
Simon D. Kyle ◽  
Alasdair L. Henry ◽  
Colin A. Espie
Keyword(s):  
Circadian Rhythm ◽  
Evidence Based ◽  
Sleep Wake Disorders ◽  
Insomnia Disorder ◽  
Cognitive Behavioural ◽  
Melatonin Administration ◽  
Evidence Based Treatments ◽  
Rhythm Disorder ◽  
Delayed Sleep ◽  
Behavioural Therapies

Insomnia disorder and circadian rhythm sleep–wake disorders (CRSWDs) are prevalent and impairing sleep disorders and often co-present with psychiatric disorder. Insomnia is characterized by difficulty with initiation and/or maintenance of sleep, driven primarily by cognitive behavioural processes. CRSWDs manifest because of alterations to the endogenous circadian clock (intrinsic) or as a consequence of environmental circumstances (extrinsic). This chapter reviews evidence-based treatments for the management of insomnia and intrinsic CRSWDs (delayed sleep–wake phase disorder, advanced sleep–wake phase disorder, non-24-hour sleep–wake disorder, irregular sleep–wake rhythm disorder). The chapter covers cognitive behavioural therapies, sleep-promoting hypnotics, phototherapy, and exogenous melatonin administration. The chapter also highlight gaps in the existing clinical science and reflects on emergent therapeutic approaches.

scholarly journals Circadian tau differences and rhythm associations in delayed sleep–wake phase disorder and sighted non-24-hour sleep–wake rhythm disorder

SLEEP ◽  
2020 ◽  
Author(s):  
Gorica Micic ◽  
Nicole Lovato ◽  
Sally A Ferguson ◽  
Helen J Burgess ◽  
Leon Lack
Keyword(s):  
Circadian Rhythm ◽  
Core Body Temperature ◽  
Sleep Onset ◽  
Phase Relationship ◽  
Biological Rhythms ◽  
Circadian Phase ◽  
Behavioral Rhythm ◽  
Rhythm Disorder ◽  
Dim Light ◽  
Delayed Sleep

Abstract Study Objectives We investigated biological and behavioral rhythm period lengths (i.e. taus) of delayed sleep–wake phase disorder (DSWPD) and non-24-hour sleep–wake rhythm disorder (N24SWD). Based on circadian phase timing (temperature and dim light melatonin onset), DSWPD participants were dichotomized into a circadian-delayed and a circadian non-delayed group to investigate etiological differences. Methods Participants with DSWPD (n = 26, 17 m, age: 21.85 ± 4.97 years), full-sighted N24SWD (n = 4, 3 m, age: 25.75 ± 4.99 years) and 18 controls (10 m, age: 23.72 ± 5.10 years) participated in an 80-h modified constant routine. An ultradian protocol of 1-h “days” in dim light, controlled conditions alternated 20-min sleep/dark periods with 40-min enforced wakefulness/light. Subjective sleepiness ratings were recorded prior to every sleep/dark opportunity and median reaction time (vigilance) was measured hourly. Obtained sleep (sleep propensity) was derived from 20-min sleep/dark opportunities to quantify hourly objective sleepiness. Hourly core body temperature was recorded, and salivary melatonin assayed to measure endogenous circadian rhythms. Rhythm data were curved using the two-component cosine model. Results Patients with DSWPD and N24SWD had significantly longer melatonin and temperature taus compared to controls. Circadian non-delayed DSWPD had normally timed temperature and melatonin rhythms but were typically sleeping at relatively late circadian phases compared to those with circadian-delayed DSWPD. Conclusions People with DSWPD and N24SWD exhibit significantly longer biological circadian rhythm period lengths compared to controls. Approximately half of those diagnosed with DSWPD do not have abnormally delayed circadian rhythm timings suggesting abnormal phase relationship between biological rhythms and behavioral sleep period or potentially conditioned sleep-onset insomnia.

scholarly journals The Intersection of Cultural Characteristics and Genetics on the Prevalence of Delayed Sleep Phase Syndrome in Brazilian and Japanese Adults

2020 ◽  
Vol 1 (4) ◽  
pp. 1-6
Author(s):  
Abram Estafanous ◽  
Karim Sedky
Keyword(s):  
Circadian Rhythm ◽  
Environmental Changes ◽  
Clock Genes ◽  
Cultural Characteristics ◽  
Sleep Phase ◽  
Delayed Sleep Phase Syndrome ◽  
Japanese Adults ◽  
Delayed Sleep Phase ◽  
Rhythm Disorder ◽  
Delayed Sleep

Delayed sleep phase syndrome (DSPS) is a circadian rhythm disorder where individuals experience difficulty modifying the time they go to sleep and wake up in response to environmental changes. The circadian rhythm itself is regulated by a variety of clock genes, and various other genes (e.g., AA-NAT gene, CKIϵ gene) code for proteins that regulate clock genes. Various polymorphisms of the clock gene influencers have been shown to increase susceptibility to DSPS. This paper seeks to examine how certain cultural characteristics (e.g., napping, timing of meals, exposure to artificial light) and the presence of the AA-NAT gene (G619A polymorphism) and the CKIϵ gene (S408N polymorphism) influence the prevalence of DSPS amongst Japanese and Brazilian populations.

Abstract 13133: Impact of Circadian Rhythm Disorders on Reparative Angiogenesis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kazuhito Tsuzuki ◽  
Yuuki Shimizu ◽  
Zhongyue Pu ◽  
Junya Suzuki ◽  
Shukuro Yamaguchi ◽  
...  
Keyword(s):  
Circadian Rhythm ◽  
Clock Genes ◽  
Blood Perfusion ◽  
Jet Lag ◽  
Double Knockout ◽  
Tissue Ischemia ◽  
Circadian Rhythm Disorder ◽  
Rhythm Disorder ◽  
Reparative Angiogenesis ◽  
Circadian Rhythm Disorders

Introduction: Circadian rhythm disorder seen in shift-worker or jet-lag is major social health concerns in advanced industrialized countries. The aim of this study was to examine if circadian rhythm disorders would influence on angiogenesis and blood perfusion recovery in a mouse model of hind limb ischemia (HLI). Methods and Results: First, we established a jet-lag model in C57BL/6J (wild type; WT) mice (8-10 weeks old, N=10 for each) using a light controlled isolation box. Mice were exposed to advanced 8-hr light phase once every 4 days in a jet-lag group as previously described. Conversely, control mice were kept a regular condition of LD 12:12 (12-hr light and 12-hr dark). Then, we surgically induced HLI in each group. The results showed that the condition jet-lag deteriorated capillary formation detected by CD31-immunohistochemistry at post-operative day (POD) 28 and tissue blood perfusion recovery demonstrated by laser Doppler perfusion imaging (LDPI) in HLI. The expression of clock genes (i.e. Clock, Bmal1, Per2, Cry1 and 2 ) in ischemic muscles were regulated by jet-lag condition at POD7.Next, we examined whether inhibition of clock gene had any effects on angiogenesis. For this study, we focused on Cryptochrome ( Cry ), which is well known as one of the core-loop forming clock genes producing circadian rhythm in mammals. Our loss-of-function study revealed that the abilities of proliferation, migration and tube formation were significantly inhibited by CRY1 and CRY2 double knockdown in HUVECs. Interestingly, although the knockdown of CRY1 and CRY2 changed the mRNA expression of PERIOD2 , it did not affect those of BMAL1 and CLOCK in HUVECs. Finally, we tested if Cry1 and Cry2 double knockout ( Cry1/2 -DKO) mice of HLI models displayed worse blood perfusion recoveries with deterioration of angiogenesis. Cry1/2 -DKO mice were reported to display circadian rhythm disorder in previous reports. As results, compared with control WT mice, Cry1/2 -DKO mice revealed suppressed capillary density and tissue blood perfusion recovery in HLI model. Conclusion: Our data suggest that a maintenance of circadian rhythm plays an important role in reparative angiogenesis of the tissue ischemia model.

scholarly journals Sleep Characteristics, Neighborhood Factors, Function, Mood, and Well-Being in Older Adults With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 618-619
Author(s):  
Miranda McPhillips ◽  
Nancy Hodgson
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Circadian Rhythm ◽  
Well Being ◽  
Neighborhood Environment ◽  
Neighborhood Factors ◽  
People With Dementia ◽  
The Relationship ◽  
Circadian Rhythm Disorders

Abstract The number of people with dementia is increasing worldwide. Circadian rhythm disorders and sleep problems are very common in this population and can have profound effects on well-being. Healthy Patterns Clinical Trial (NCT03682185) is a home-based activity intervention designed to improve circadian rhythm disorders and quality of life in people with dementia and their family caregivers. This symposium is designed to discuss the relationship between sleep characteristics and neighborhood environment, function, and psychological well-being in people with dementia. All analyses in this session were conducted on baseline data from participants enrolled in the Healthy Patterns Clinical Trial. We enrolled 170 individuals (67% female), aged (73.35 ± 8.74) with mean Clinical Dementia Rating (CDR) scores of (0.74 ± 0.51). Session 1 describes the role of neighborhood factors as influencing factors affecting sleep. Session 2 focuses on the relationship between sleep and mood. Session 3 focuses on the relationship between sleep and function. Session 4 focuses on the relationship between sleep and quality of life. Implications for future research and intervention development for people with dementia will be discussed.

830 Combined Phototherapy and Melatonin for treatment of Circadian Rhythm Disorder in a Patient with Cornelia de Lange Syndrome

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A323-A324
Author(s):  
Hina Emanuel ◽  
Amee Revana ◽  
Tue Te ◽  
Kevin Kaplan
Keyword(s):  
Circadian Rhythm ◽  
Sleep Disorders ◽  
Low Dose ◽  
Light Therapy ◽  
Response To Therapy ◽  
Cornelia De Lange Syndrome ◽  
Wake Time ◽  
History Of ◽  
Cornelia De Lange ◽  
Circadian Rhythm Disorders

Abstract Introduction Cornelia de Lange syndrome (CdLS) is a rare genetic disorder characterized by variable physical, cognitive, and behavioral characteristics. Sleep disturbances have been frequently reported in CdLS including insomnia, sleep-disordered breathing, intrinsic sleep disorders, and circadian rhythm disorders (CRDs). The characterization and prevalence of CRDs in CdLS remain ill- defined. We report a case of a 13-year-old female with CdLS presenting with advanced sleep wake phase disorder (ASWPD). Report of case(s) A 13-year-old female with a past medical history of CdLS, developmental delay, bilateral cleft palate status post repair presents with inability to fall asleep at night and excessive daytime sleepiness.(EDS) Her sleep history consists of going to bed at 4 pm with no delayed sleep onset. She wakes at 2:30 am which has occurred since infancy. Mother reports the patient will remain awake from 2:30 am until she goes to school at 7:30 am. History is consistent with EDS and sleeping during the day while at school. Total sleep time of approximately 11–12 hours was reported in 24-hour period. History of obstructive sleep apnea, parasomnias, insomnia, restless leg syndrome, and psychotropic medications were not reported. Patient was treated with timed low dose melatonin therapy 0.5 mg at 4 pm and bright light therapy using 10,000 lux for 30 minutes at 7 am and 4 pm. Dim lights starting at 7:30 pm with structured scheduled sleep hygiene ensuring consistent bedtime at 9:30 pm. A consistent wake time at 7 am and no naps during the day was recommended. Follow up visits report successful response to therapy with attainment of desired sleep wake rhythm (bedtime at 9:30 pm and wake time at 7 am) and resolution of sleepiness during the day. Our patient was able to be weaned off of melatonin and light therapy and her circadian rhythm remained entrained. Conclusion Patients with disorder such as CdLS are at risk for circadian rhythm disorders. Our patient responded well to treatment with combined timed phototherapy and low dose melatonin therapy. Better knowledge and characterization of typology of CRDs in CdLS patients could permit a more specific therapeutic approach to sleep disorders in this population. Support (if any) None

Sleep and circadian rhythm disorders

2020 ◽  
pp. 753-770
Author(s):  
Kirstie Anderson ◽  
Zheyu Xu ◽  
Urs Mosimann ◽  
Bradley Boeve
Keyword(s):  
Circadian Rhythm ◽  
Sleep Disorders ◽  
Treatment Strategies ◽  
Clinical History ◽  
Sleep Apnoea ◽  
Sleep Physiology ◽  
Obstructive Sleep ◽  
Physical Disorders ◽  
Physiological Sleep ◽  
Circadian Rhythm Disorders

This chapter reviews the most common sleep disorders in older adults and their treatment. It begins with a brief review of sleep physiology and then gives an outline on how to take a comprehensive sleep history. There are physiological sleep changes related to ageing, but sleep disorders are not part of normal ageing and are often associated with mental or physical disorders, pain, and neurodegenerative disease. The most common sleep disorders include insomnia, obstructive sleep apnoea, restless legs syndrome, REM sleep behaviour disorder, excessive daytime somnolence, and circadian rhythm disorders. An in-depth clinical history, including if possible, bed-partner’s information, is the key to diagnosis. Patients need to be informed about the physiological sleep changes and the principles of sleep hygiene. Many sleep disorders have effective therapies and patients will benefit from pharmacological and nonpharmacological treatment strategies.

scholarly journals Whoever Wanted to Catch a Worm, Anyway?

2019 ◽  
pp. 345-363
Author(s):  
Robert Hiensch ◽  
Neomi Shah
Keyword(s):  
Circadian Rhythm ◽  
Young Adulthood ◽  
Sleep Onset ◽  
Strict Adherence ◽  
Sleep Inertia ◽  
Sleep Diaries ◽  
Hygiene Practices ◽  
Rhythm Disorder ◽  
Delayed Sleep ◽  
Circadian Physiology

Delayed sleep/wake phase disorder (DSWPD) is the most common circadian rhythm disorder. It is characterized by persistently delayed sleep onset and wake times relative to conventional norms. Individuals usually present in young adulthood with symptoms of sleep-onset insomnia, sleep inertia, and excessive daytime sleepiness due to sleep deprivation when societal commitments require significantly earlier than desired sleep and wake times. Sleep quality itself is normal. The diagnosis can usually be made by history and sleep diaries. The exact cause of DSWPD is unknown, but genetics, abnormal circadian physiology, and perpetuating behaviors all contribute. Treatment consists of morning phototherapy and evening melatonin at times individualized to the patient’s circadian rhythm. Strict adherence to standard sleep hygiene practices increases the chance of success.

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