Circadian Rhythm Sleep Disorders

Abstract

The circadian rhythm sleep disorders define the clinical conditions where sleep–wake rhythm is disrupted despite optimum environmental and social conditions. They occur as a result of the changes in endogenous circadian hours or non-compatibility of environmental factors or social life with endogenous circadian rhythm. The sleep–wake rhythm is disrupted continuously or in repeating phases depending on lack of balance between internal and external cycles. This condition leads to functional impairments which cause insomnia, excessive sleepiness or both in people. Application of detailed sleep anamnesis and sleep diary with actigraphy record, if possible, will be sufficient for diagnosis. The treatment aims to align endogenous circadian rhythm with environmental conditions. The purpose of this article is to review pathology, clinical characteristics, diagnosis and treatment of circadian rhythm disorder.

Keywords

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Sirkadiyen Ritim Uyku Bozuklukları

Abstract

Sirkadiyen ritim uyku bozuklukları, çevresel ve sosyal koşullara uygun olan uyku-uyanıklık ritminin bozulduğu klinik durumları tanımlar. Endojen sirkadiyen saatteki değişimler ya da çevresel veya sosyal yaşantının, endojen sirkadiyen ritme göre uyumsuzluğu sonucunda oluşurlar. Uyku-uyanıklık ritmi, içsel ve dışsal döngüler arasındaki dengesizliklere bağlı olarak devamlı veya tekrarlayıcı tarzda bozulur. Bu durum kişide uykusuzluk, aşırı uykuluk ya da her ikisine de neden olarak fonksiyonel kayıplara yol açar. Ayrıntılı uyku anamnezi ve uyku günlüğünün mümkün ise aktigrafi kaydı ile birlikte uygulanması tanı için yeterlidir. Tedavide endojen sirkadiyen ritmin çevresel koşullar ile uyumlu hale gelmesi amaçlanır. Bu yazıda sirkadiyen ritim uyku bozukluklarının patofizyolojisi, klinik özellikleri, tanı ve tedavilerinin gözden geçirilmesi amaçlanmıştır.

Keywords

• Sirkadiyen ritim bozuklukları, uyku bozuklukları, melatonin

References

1. Abbott SM, Reid KJ, Zee PC (2015) Circadian rhythm sleep-wake disorders. Psychiatr Clin North Am, 38:805-823.
2. Abe T, Inoue Y, Komada Y, Nakamura M, Asaoka S, Kanno M et al. (2011) Relation between morningness-eveningness score and depressive symptoms among patients with delayed sleep phase syndrome. Sleep Med, 12:680-684.
3. American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA, American Psychiatric Association.
4. American Academy of Sleep Medicine (AASM) (2014) The International Classification of Sleep Disorders, Third Edition. Darien, IL, American Academy of Sleep Medicine.
5. Ancoli-Israel S, Schnierow B, Kelsoe J, Fink R (2001) A pedigree of one family with delayed sleep phase syndrome. Chronobiol Int, 18:831-840.
6. Ancoli-Israel S, Martin JL, Kripke DF, Marler M, Klauber MR (2002) Effect of light treatment on sleep and circadian rhythms in demented nursing home patients. J Am Geriatr Soc, 50:282-289.
7. Aoki H, Ozeki Y, Yamada N (2001) Hypersensitivity of melatonin suppression in response to light in patients with delayed sleep phase syndrome. Chronobiol Int, 18:263-271.
8. Barion A, Zee PC (2007) A clinical approach to circadian rhythm sleep disorders. Sleep Med, 8: 566-577.

9. Boivin DB, James FO (2002) Circadian adaptation to night-shift work by judicious light and darkness exposure. J Biol Rhythms, 17:556-567.
10. Campbell SS, Dawson D, Anderson MW (1993) Alleviation of sleep maintenance insomnia with timed exposure to bright light. J Am Geriatr Soc, 41:829-836.
11. Crowley SJ, Lee C, Tseng CY, Fogg LF, Eastman CI (2003) Combinations of bright light, scheduled dark, sunglasses, and melatonin to facilitate circadian entrainment to night shift work. J Biol Rhythms, 18:513-523.
12. Czeisler CA, Richardson GS, Coleman RM, Zimmerman JC, Moore-Ede MC, Dement WC et al. (1981) Chronotherapy: resetting the circadian clocks of patients with delayed sleep phase insomnia. Sleep, 4:1-21.
13. Czeisler CA, Allan JS, Strogatz SH, Ronda JM, Sánchez R, Ríos CD et al. (1986) Bright light resets the human circadian pacemaker independent of the timing of the sleep-wake cycle. Science, 233:667-671.
14. Czeisler CA, Walsh JK, Roth T, Hughes RJ, Wright KP, Kingsbury L et al. (2005) Modafinil for excessive sleepiness associated with shift-work sleep disorder. N Engl J Med, 353:476-486.
15. Çalıyurt O (2001) Duygudurum bozuklukları ve biyolojik ritm. Duygudurum Dizisi, 5:209-214.
16. Dahlitz M, Alvarez B, Vignau J, English J, Arendt J, Parkes JD (1991) Delayed sleep phase syndrome response to melatonin. Lancet, 337:1121-1124.
17. Drake CL, Roehrs T, Richardson G, Walsh JK, Roth T (2004). Shift work sleep disorder: prevalence and consequences beyond that of symptomatic day workers. Sleep, 27:1453-1462.
18. Duffy JF, Czeisler CA (2002) Age-related change in the relationship between circadian period, circadian phase, and diurnal preference in humans. Neurosci Lett, 318:117-120.
19. Eastman CI, Gazda CJ, Burgess HJ, Crowley SJ, Fogg LF (2005) Advancing circadian rhythms before eastward flight: a strategy to prevent or reduce jet lag. Sleep, 28:33-44.
20. Gooley JJ, Saper CB (2005) Anatomy of the mammalian circadian system. In Principles and Practice of Sleep Medicine. (Eds MH Kryger, T Roth, WC Dement): 335-350. Philadelphia: Elsevier Saunders.
21. Herxheimer A, Waterhouse J (2003) The prevention and treatment of jet lag. BMJ, 326:296-297.
22. Hohjoh H, Takasu M, Shishikura K, Takahashi Y, Honda Y, Tokunaga K (2003) Significant association of the arylalkylamine N- acetyltransferase (AA-NAT) gene with delayed sleep phase syndrome. Neurogenetics, 4:151-153.
23. Jamieson AO, Zammit GK, Rosenberg RS, Davis JR, Walsh JK (2001) Zolpidem reduces the sleep disturbance of jet lag. Sleep Med, 2:423-430.
24. Jones CR, Campbell SS, Zone SE, Cooper F, DeSano A, Murphy PJ et al. (1999) Familial advanced sleep-phase syndrome: a short- period circadian rhythm variant in humans. Nat Med, 5:1062-1065.
25. Lack L, Wright H (1993) The effect of evening bright light in delaying the circadian rhythms and lengthening the sleep of early morning awakening insomniacs. Sleep, 16:436-443.
26. Lewy AJ, Ahmed S, Jackson JM, Sack RL (1992) Melatonin shifts human circadian rhythms according to a phase-response curve. Chronobiol Int, 9:380-392.
27. Lewy AJ, Bauer VK, Hasler BP, Kendall AR, Pires ML, Sack RL (2001) Capturing the circadian rhythms of free-running blind people with 0.5 mg melatonin. Brain Res, 918:96-100.
28. Lu BS, Zee PC (2006) Circadian rhythm sleep disorders. Chest, 130:1915-1923.
29. Martinez D, Lenz Mdo C (2010) Circadian rhythm sleep disorders. Indian J Med Res, 131:141-149.
30. Mishima K, Tozawa T, Satoh K, Saitoh H, Mishima Y (2005) The 3111T/C polymorphism of hClock is associated with evening preference and delayed sleep timing in a Japanese population sample. Am J Med Genet B Neuropsychiatr Genet, 133B:101- 104.
31. Moldofsky H, Musisi S, Phillipson EA (1986) Treatment of a case of advanced sleep phase syndrome by phase advance chronotherapy. Sleep, 9:61-65.
32. Moline ML, Pollak CP, Monk TH, Lester LS, Wagner DR, Zendell SM et al. (1992) Age-related differences in recovery from simulated jet lag. Sleep, 15:28-40.
33. Moore-Ede MC, Richardson GS (1985) Medical implications of shift-work. Annu Rev Med, 36:607-617.
34. Morgenthaler TI, Lee-Chiong T, Alessi C, Friedman L, Aurora RN, Boehlecke B et al. (2007) Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. An American Academy of Sleep Medicine report. Sleep, 30:1445- 1459.
35. Mundey K, Benloucif S, Harsanyi K, Dubocovich ML, Zee PC (2005) Phase-dependent treatment of delayed sleep phase syndrome with melatonin. Sleep, 28:1271-1278.
36. Nagtegaal JE, Kerkhof GA, Smits MG, Swart AC, Van Der Meer YG (1998) Delayed sleep phase syndrome: A placebo-controlled cross-over study on the effects of melatonin administered five hours before the individual dim light melatonin onset. J Sleep Res, 7:135-143.
37. Nagtegaal JE, Laurant MW, Kerkhof GA, Smits MG, van der Meer YG, Coenen AM (2000) Effects of melatonin on the quality of life in patients with delayed sleep phase syndrome. J Psychosom Res, 48:45-50.
38. Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV (2004) Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep, 27:1255-1273.
39. Ozaki S, Uchiyama M, Shirakawa S, Okawa M (1996) Prolonged interval from body temperature nadir to sleep offset in patients with delayed sleep phase syndrome. Sleep, 19:36-40.
40. Paine SJ, Fink J, Gander PH, Warman GR (2014) Identifying advanced and delayed sleep phase disorders in the general population: a national survey of New Zealand adults. Chronobiol Int, 31:627-636.
41. Pereira DS, Tufik S, Louzada FM, Benedito-Silva AA, Lopez AR, Lemos NA et al. (2005) Association of the length polymorphism in the human Per3 gene with the delayed sleep-phase syndrome: does latitude have an influence upon it? Sleep, 28:29-32.
42. Pillar G, Shahar E, Peled N, Ravid S, Lavie P, Etzioni A (2000) Melatonin improves sleep-wake patterns in psychomotor retarded children. Pediatr Neurol, 23:225-228.
43. Regestein QR, Monk TH (1995) Delayed sleep phase syndrome: a review of its clinical aspects. Am J Psychiatry, 152:602-608.
44. Reid KJ, Jaksa AA, Eisengart JB, Baron KG, Lu B, Kane P et al. (2012) Systematic evaluation of axis-I DSM diagnoses in delayed sleep phase disorder and evening-type circadian preference. Sleep Med, 13:1171-1177.
45. Rosenthal NE, Joseph-Vanderpool JR, Levendosky AA, Johnston SH, Allen R, Kelly KA et al. (1990) Phase-shifting effects of bright morning light as treatment for delayed sleep phase syndrome. Sleep, 13:354-361.
46. Sack RL, Hughes RJ, Edgar DM, Lewy AJ (1997) Sleep promoting effects of melatonin: at what dose, in whom, under what conditions, and by what mechanisms? Sleep, 20:908-915.
47. Sack RL, Brandes RW, Kendall AR, Lewy AJ (2000) Entrainment of free-running circadian rhythms by melatonin in blind people. N Engl J Med, 343:1070-1077.
48. Sack RL, Auckley D, Auger RR, Carskadon MA, Wright KP, Vitiello MV et al. (2007) Circadian rhythm sleep disorders: part II, advanced sleep phase disorder, delayed sleep phase disorder, free-running disorder, and irregular sleep-wake rhythm. an American Academy of Sleep Medicine review. Sleep, 30:1484-1501.
49. Saxvig IW, Pallesen S, Wilhelmsen-Langeland A, Molde H, Bjorvatn B (2012) Prevalence and correlates of delayed sleep phase in high school students. Sleep Med, 13:193-199.
50. Schrader H, Bovim G, Sand T (1993) The prevalence of delayed and advanced sleep phase syndromes. J Sleep Res, 2:51-55.
51. Schwartz JRL, Roth T (2006) Shift work sleep disorder: burden of illness and approaches to management. Drugs, 66:2357-2370.
52. Selvi Y, Özdemir PG, Özdemir O, Aydın A, Beşiroğlu L (2010) Sağlık çalışanlarında vardiyalı çalışma sisteminin sebep olduğu genel ruhsal belirtiler ve yaşam kalitesi üzerine etkisi. Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi, 23:238-243.
53. Selvi Y, Beşiroğlu L, Aydın A (2011) Kronobiyoloji ve duygudurum bozuklukları. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry, 3:368-386.
54. Sevim S (2011) Sirkadyen Ritim Bozuklukları. In Uyku Fizyolojisi ve Hastalıkları (Eds H Kaynak, S Ardıç):325-332. İstanbul, Nobel Matbaacılık.
55. Shirayama M, Shirayama Y, Iida H, Kato M, Kajimura N, Watanabe T et al. (2003) The psychological aspects of patients with delayed sleep phase syndrome (DSPS). Sleep Med, 4:427-433.
56. Singer C, Tractenberg RE, Kaye J, Schafer K, Gamst A, Grundman M et al. (2003) A multicenter, placebo-controlled trial of melatonin for sleep disturbance in Alzheimer's disease. Sleep, 26:893-901.
57. Sivertsen B, Pallesen S, Stormark KM, Bİe T, Lundervold AJ, Hysing M (2013) Delayed sleep phase syndrome in adolescents: prevalence and correlates in a large population based study. BMC Public Health, 13:1163.
58. Suhner A, Schlagenhauf P, Höfer I, Johnson R, Tschopp A, Steffen R (2001) Effectiveness and tolerability of melatonin and zolpidem for the alleviation of jet lag. Aviat Space Environ Med, 72:638-646.
59. Szymusiak R, McGinty D (2008) Hypothalamic regulation of sleep and arousal. Ann N Y Acad Sci, 1129:275-286.
60. Toh KL, Jones CR, He Y, Eide EJ, Hinz WA, Virshup DM et al. (2001) An hPer2 phosphorylation site mutation in familial advanced sleep phase syndrome. Science, 291:1040-1043.
61. Uchiyama M, Okawa M, Shibui K, Liu X, Hayakawa T, Kamei Y et al. (2000) Poor compensatory function for sleep loss as a pathogenic factor in patients with delayed sleep phase syndrome. Sleep, 23:553-558.
62. Van Geijlswijk IM, Korzilius HPLM, Smits MG (2010) The use of exogenous melatonin in delayed sleep phase disorder: a meta- analysis. Sleep, 33:1605-1614.
63. Wagner DR (1996) Disorders of the circadian sleep-wake cycle. Neurol Clin, 14:651-670.
64. Wagner DR (1999) Circadian rhythm sleep disorders. Curr Treat Options Neurol, 1:299-308.
65. Walsh JK, Muehlbach MJ, Schweitzer PK (1995) Hypnotics and caffeine as countermeasures for shiftwork-related sleepiness and sleep disturbance. J Sleep Res, 4:80-83.
66. Witting W, Kwa IH, Eikelenboom P, Mirmiran M, Swaab DF (1990) Alterations in the circadian rest-activity rhythm in aging and Alzheimer’s disease. Biol Psychiatry, 27: 563-572.
67. Xu Y, Padiath QS, Shapiro RE, Jones CR, Wu SC, Saigoh N et al. (2005) Functional consequences of a CKIdelta mutation causing familial advanced sleep phase syndrome. Nature, 434:640-644.
68. Yazaki M, Shirakawa S, Okawa M, Takahashi K (1999) Demography of sleep disturbances associated with circadian rhythm disorders in Japan. Psychiatry Clin Neurosci, 53:267-268.
69. Yetkin (2007) Uyku bozukluklarında tedavi. In Psikofarmakoloji, 3. Baskı (Ed N Yüksel): 351-363. Ankara, MN Medikal & Nobel.
70. Zee PC, Manthena P (2007) The brain’s master circadian clock: implications and opportunities for therapy of sleep disorders. Sleep Med Rev, 11:59-70.
71. Zee PC, Vitiello MV (2009) Circadian Rhythm sleep disorder: irregular sleep wake rhythm type. Sleep Med Clin, 4:213-218.
72. Zee PC, Attarian H, Videnovic A (2013) Circadian rhythm abnormalities. Continuum : Lifelong Learning in Neurology, 19(1):132- 147.
73. Zhu L, Zee PC (2012) Circadian rhythm sleep disorders. Neurol Clin, 30:1167-1191. Erhan Akıncı, Uzm.Dr., Buca Seyfi Demirsoy Devlet Hastanesi, İzmir; Fatma Özlem Orhan, Doç. Dr., Kahra- manmaraş Sütçü İmam Üniversitesi Kahramanmaraş