Hypersensitivity of melatonin suppression in response to light in patients with delayed sleep phase syndrome
Hypersensitivity of melatonin suppression in response to light in patients with delayed sleep phase syndrome
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DOI：
10.1081/cbi-100103190
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发表时间：
2001-01-01
影响因子：
2.8
通讯作者：
Yamada, N
中科院分区：
文献类型：
--
作者：
Aoki, H;Ozeki, Y;Yamada, N
患有睡眠时相延迟综合征（DSPS）的患者会经历个人环境所需的日常时间表与其昼夜睡眠-觉醒模式之间的慢性不匹配，从而导致主要的学术，工作和社会问题。虽然有报道称DSPS患者存在昼夜节律起搏系统功能异常，但DSPS的病因尚未完全阐明。一个假设提出来解释为什么DSPS患者无法使他们的24小时睡眠-觉醒周期与他们的环境同步，这是因为他们可能对环境时间线索的敏感性降低，最明显的是明暗周期。因此，我们比较了褪黑激素抑制的敏感性与DSPS患者和正常对照组的光响应。研究了15例DSPS患者和年龄和性别匹配的健康对照。由于与对照组相比，预计DSPS患者的褪黑激素分泌节律延迟，因此在第一阶段确定每个受试者的褪黑激素分泌峰值时间。在第二阶段中，每个受试者暴露于强度为1000勒克斯的光2小时开始2小时之前，他或她的峰值褪黑激素分泌。通过放射免疫测定法测量每30分钟取样的唾液中的褪黑激素。在曝光期间。唾液中褪黑激素浓度的抑制依赖于光暴露的持续时间。此外，光对褪黑激素浓度的抑制作用在DSPS患者中显著大于对照组。结果表明，这种综合征患者对夜间光照过敏。因此，我们的研究结果表明，夜间光线限制对于防止DSPS患者出现睡眠期延迟很重要。
Patients with delayed sleep phase syndrome (DSPS) experience a chronic mismatch between the usual daily schedule required by the individual's environment and their circadian sleep-wake pattern, resulting in major academic, work, and social problems. Although functional abnormalities of the circadian pacemaker system have been reported in patients with DSPS, the etiology of DSPS has not been fully elucidated. One hypothesis proposed to explain why patients with DSPS fail to synchronize their 24h sleep-wake cycle to their environment is that they might have reduced sensitivity to environmental time cues, most notably light-dark cycles. Therefore, we compared the sensitivity of melatonin suppression in response to light in patients with DSPS and normal control subjects. Fifteen patients with DSPS and age- and sex-matched healthy controls were studied. As the melatonin secretion rhythm in patients with DSPS was expected to be delayed compared to the controls, the time of peak melatonin secretion was determined in each subject in the first session. In the second session, each subject was exposed to light with an intensity of 1000 lux for 2h beginning 2h prior to his or her peak melatonin secretion. Melatonin was measured by radioimmunoassay in saliva sampled every 30 minutes. during the period of light exposure. Suppression of the melatonin concentration in saliva was dependent on duration of light exposure. In addition, the suppressive effect of light on the melatonin concentration was significantly greater in patients with DSPS than in control subjects. The results suggest hypersensitivity to nighttime light exposure in patients with this syndrome. Our findings therefore suggest that evening light restriction is important for preventing patients with DSPS from developing a sleep phase delay.