Circadian-Based Therapies for Circadian Rhythm Sleep-Wake Disorders.
Circadian-Based Therapies for Circadian Rhythm Sleep-Wake Disorders.
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DOI：
10.1007/s40675-016-0052-1
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发表时间：
2016-09
影响因子：
1.8
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中科院分区：
文献类型：
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本综述总结了与昼夜节律睡眠 - 觉醒障碍治疗相关的最新进展。文中阐述了内源性昼夜节律睡眠 - 觉醒障碍的临床治疗实践指南，随后介绍了针对睡眠 - 觉醒时相延迟障碍、非24小时睡眠 - 觉醒障碍、不规则睡眠 - 觉醒障碍以及轮班工作相关睡眠障碍的最新治疗研究。文中还介绍了估计昼夜节律时相的新方法，包括通过在家采集唾液来估计暗光褪黑素起始时间、使用昼夜节律调查问卷，以及指导光照和外源性褪黑素治疗的通用规则。详细说明了光照治疗的新进展，包括睡眠期间的闪光治疗和可穿戴式光照设备。同时也探讨了咖啡因、酒精等物质以及电子平板电脑等设备在改变昼夜节律时间方面的潜在作用。最后，讨论了美国褪黑素补充剂的最新情况，以及在糖尿病前期或糖尿病患者中使用褪黑素补充剂所引发的争议。
This review summarizes recent developments relevant to the treatment of circadian rhythm sleep-wake disorders. The clinical practice guidelines for the treatment of intrinsic circadian rhythm sleep-wake disorders is described, followed by recent treatment studies for delayed sleep-wake phase disorder, non-24 hour sleep-wake disorder, irregular sleep-wake disorder and shift work. New methods to estimate circadian phase, including home saliva collection to estimate the dim light melatonin onset, circadian questionnaires and general rules to guide light and exogenous melatonin treatments are described. New developments in light treatment are detailed, including light flashes during sleep and wearable light devices. Substances such as caffeine and alcohol, and devices such as electronic tablets are also considered for their potential to shift circadian timing. Finally, an update on melatonin supplements in the US is discussed, along with the controversy surrounding the use of melatonin supplements in patients with prediabetes or diabetes.