A clinical approach to circadian rhythm sleep disorders

Ana Barion, Phyllis C. Zee*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

114 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)566-577
Number of pages12
JournalSleep Medicine
Volume8
Issue number6
DOIs
StatePublished - Sep 2007

Keywords

  • Advanced sleep phase disorder
  • Circadian rhythm sleep disorders
  • Delayed sleep phase disorder
  • Irregular sleep-wake rhythm
  • Jet lag syndrome
  • Non 24-h sleep-wake syndrome
  • Shift work disorder

ASJC Scopus subject areas

  • Medicine(all)

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