Habitual light exposure relative to circadian timing in delayed sleep-wake phase disorder.
Habitual light exposure relative to circadian timing in delayed sleep-wake phase disorder.
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与睡眠-觉醒时相延迟障碍的昼夜节律时间相关的习惯性光照。
作者：
Wilson4th,John;Reid,KathrynJ;Braun,RosemaryI;Abbott,SabraM;Zee,PhyllisC
研究目的 比较褪黑激素时间（一种经过充分验证的内源性昼夜节律阶段标记）以及患有延迟性睡眠觉醒时相障碍 (DSWPD) 和中间睡眠型对照的成年人的习惯性光照模式。方法 12 名患有 DSWPD 的个体（5 名女性，平均年龄：31.1）和 12 名年龄匹配的对照者（6 名女性，平均年龄：33.6）接受了至少 7 天的光照和活动监测后进行住院治疗，抽血评估褪黑激素分泌时间（计算为弱光褪黑激素起始时间 — DLMO）。然后将习惯性的光暴露模式与人类对光的相位响应曲线 (PRC) 进行比较。结果相对于时钟时间，DSWPD 个体的光暴露模式比对照组晚，但他们的光暴露模式相对于 DLMO 更早。根据人类对光的 PRC 数据，与对照组相比，DSWPD 患者每天的光照暴露量较少。主要差异出现在提前窗口的后期部分，其中与对照组相比，DSWPD 患者接触到的相同持续时间和强度的光脉冲较少。 结论提前光暴露的减少可能在 DSWPD 患者睡眠-觉醒时间延迟的发展和持续中发挥作用。在前进窗口的后期增强光照代表了一种创新和补充策略，有可能提高 DSWPD 中亮光治疗的有效性。
Study ObjectivesTo compare melatonin timing, a well-validated marker for endogenous circadian phase, and habitual light-exposure patterns in adults with delayed sleep-wake phase disorder (DSWPD) and intermediate chronotype controls.MethodsTwelve individuals with DSWPD (five females, mean age: 31.1) and 12 age-matched controls (six females, mean age: 33.6) underwent a minimum of 7 days of light and activity monitoring followed by an inpatient hospital stay, where blood was taken to assess melatonin timing (calculated as dim light melatonin onset—DLMO). Habitual light-exposure patterns were then compared with a human phase-response curve (PRC) to light.ResultsRelative to clock time, individuals with DSWPD had a later light-exposure pattern compared with controls, but their light-exposure pattern was earlier relative to DLMO. According to the human PRC to light, individuals with DSWPD had less daily advancing light exposure compared with controls. The primary difference was seen in the late portion of the advancing window, in which individuals with DSWPD were exposed to fewer pulses of light of equivalent duration and intensity compared with controls.ConclusionsDiminished advancing light exposure may play a role in the development and perpetuation of delayed sleep-wake timing in individuals with DSWPD. Enhancing light exposure during the later portion of the advancing window represents an innovative and complementary strategy that has the potential to improve the effectiveness of bright light therapy in DSWPD.
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