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20-September-2008 10:08:30 - rhythm sleep disorder Circadian rhythm sleep disorder Classification and external resources ICD-10 G47.2 ICD-9 327.3 MeSH D021081 Circadian rhythm sleep disorders are a family of sleep disorders affecting, among other things, the timing of sleep. People with circadian rhythm sleep disorders are unable to sleep and wake at the times required for normal work, school, and social needs. They are generally able to get enough sleep if allowed to sleep and wake at the times dictated by their body clocks. Unless they have another sleep disorder, their sleep is of normal quality. Humans, like most animals and plants, have biological rhythms, known as circadian rhythms, which are controlled by a biological clock and work on a daily time scale. These affect body temperature, alertness, appetite, hormone secretion etc. as well as sleep timing. Due to the circadian clock, sleepiness does not continuously increase as time passes. A person's desire and ability to fall asleep is influenced by both the length of time since the person woke from an adequate sleep homeostasis, and by internal circadian rhythms. Thus, the body is ready for sleep and for wakefulness at different times of the day. Contents 1 Types of circadian rhythm sleep disorders 1.1 Extrinsic type 1.2 Intrinsic type 2 Normal circadian rhythms 3 Circadian rhythm abnormalities 4 See also 5 References 6 External links Types of circadian rhythm sleep disorders The circadian rhythm sleep disorders are: Extrinsic type Jet lag, which affects people who travel across several time zones. Shift work sleep disorder, which affects people who work nights or rotating shifts. Intrinsic type Delayed sleep phase syndrome DSPS, which causes a much later than normal timing of sleep onset and offset and a period of peak alertness in the middle of the night. Advanced sleep phase syndrome ASPS, which causes difficulty staying awake in the evening and staying asleep in the morning. Non-24-hour sleep-wake syndrome Non-24, which causes the affected individual's sleep to occur later and later each day, with the period of peak alertness also continuously moving around the clock from day to day. Irregular sleep-wake pattern, which presents as sleeping at very irregular times, and usually more than once per day waking frequently during the night and taking naps during the day but with total time asleep typical for the person's age. Normal circadian rhythms Among people with healthy circadian clocks, there is a continuum of chronotypes from larks or morning people who prefer to sleep and wake early, to owls who prefer to sleep and wake at late times. Whether they are larks or owls, people with normal circadian systems: can wake in time for what they need to do in the morning, and fall asleep at night in time to get enough sleep before having to get up. can sleep and wake up at the same time every day, if they want to. will, after starting a new routine which requires they get up earlier than usual, start to fall asleep at night earlier within a few days. For example, someone who is used to sleeping at 1 am and waking up at 9 a.m. begins a new job on a Monday, and must get up at 6 a.m. to get ready for work. By the following Friday, the person has begun to fall asleep at around 10 p.m., and can wake up at 6 a.m. feeling well-rested. This adaptation to earlier sleep/wake times is known as advancing the sleep phase. Healthy people can advance their sleep phase by about one hour each day. Researchers have placed volunteers in caves or special apartments for several weeks without clocks or other time cues. Without time cues, the volunteers tended to go to bed an hour later and to get up about an hour later each day. These experiments appeared to demonstrate that the free-running circadian rhythm in humans was about 25 hours long. However, these volunteers were allowed to control artificial lighting and the light in the evening caused a phase delay. More recent research shows that adults of all ages free-run at an average of 24 hours and 11 minutes. To maintain a 24 hour day/night cycle, the biological clock needs regular environmental time cues, e.g. sunrise, sunset, and daily routine. Time cues keep the normal human circadian clock aligned with the rest of the world.1 Circadian rhythm abnormalities Non-24-hour sleep-wake syndrome and other persistent circadian rhythm sleep disorders are believed to be caused by an inadequate ability to reset the sleep/wake cycle in response to environmental time cues. These individuals' circadian clocks might have an unusually long cycle, and/or might not be sensitive enough to time cues. People with DSPS, more common than Non-24, do entrain to nature's 24 hours, but are unable to sleep and awaken at socially preferred times, sleeping instead, for example, from 4 a.m. to noon. According to doctors Cataletto and Hertz at WebMD, Altered or disrupted sensitivity to zeitgebers is probably the most common cause of circadian rhythm disorder.2 As of October 1, 2005, the diagnostic codes for circadian rhythm sleep disorders were changed from the 307-group to the 327-group in the Diagnostic and Statistical Manual of Mental Disorders, Fourth ion, Text Revision DSM-IV-TR. The DSM updated to agree with the International Classification of Diseases ICD-9. The new codes reflect the moving of these disorders from the Mental Disorders section to the Neurological section in the ICD.3 See also Chronobiology Chronotype Light therapy Melatonin Phase response curve Sleep diary Sleep medicine Zeitgeber References ^ National Institutes of Health. Sleep - Information about Sleep. Retrieved on 2007-01-28. ^ Cataletto, Mary E.; Hertz, Gila Updated 2005-09-07. Sleeplessness and Circadian Rhythm Disorder Free registration required. eMedicine from WebMD. Retrieved on 2008-07-20. ^ First, Michael B. 2005. New Diagnostic Codes for Sleep Disorders. American Psychiatric Association. Retrieved on 2008-08-08. External links Circadian Rhythm Sleep Disorder on Psychnet-UK An American Academy of Sleep Medicine Review: Circadian Rhythm Sleep Disorders: Part I, Basic Principles, Shift Work and Jet Lag Disorders. PDF, 24 pages. November 2007. An American Academy of Sleep Medicine Review: Circadian Rhythm Sleep Disorders: Part II, Advanced Sleep Phase Disorder, Delayed Sleep Phase Disorder, Free-Running Disorder, and Irregular Sleep-Wake Rhythm. PDF, 18 pages. November 2007. v d e Sleep Sleep stages Rapid eye movement sleep · Non-rapid eye movement sleep · Slow-wave sleep Brain waves Beta wave · Delta wave · Gamma wave · Theta wave Sleep disorders Advanced sleep phase syndrome · Automatic behavior · Bruxism · Circadian rhythm sleep disorder · Delayed sleep phase syndrome · Dyssomnia · Excessive daytime sleepiness · Hypersomnia · Insomnia · Narcolepsy · Night terror · Nocturia · Nocturnal myoclonus · Non-24-hour sleep-wake syndrome · Ondine's curse · Parasomnia · Sleep apnea · Sleep deprivation · Sleepeating · Sleeping sickness · Sleeptalking · Sleepwalking Benign phenomena Dream · Exploding head syndrome · False awakening · Hypnagogia · Hypnic jerk · Lucid dream · Nightmare · Nocturnal emission · Sleep paralysis · Somnolence Related topics Bed Bunk bed, Four poster bed, Futon, Hammock, Mattress · Bed bug · Bedding · Bedroom · Bedtime · Bedtime toy · Bedtime story · Chronotype · Dream journal · Jet lag · Lullaby · Nightwear · Polyphasic sleep · Power nap · Siesta · Sleep and learning · Sleep debt · Sleep diary · Sleep inertia · Sleep medicine · Sleepover · Snoring · Sleep and creativity v d e Pathology of the nervous system, primarily CNS G00-G47, 320-349 Inflammatory Meningitis Arachnoiditis - Encephalitis - Myelitis - Encephalomyelitis Acute disseminated - Tropical spastic paraparesis - Cavernous sinus thrombosis Systemic atrophies Huntington's disease - Spinocerebellar ataxia Friedreich's ataxia, Ataxia telangiectasia, Herary spastic paraplegia - Spinal muscular atrophy: Werdnig-Hoffman - Kugelberg-Welander - Fazio-Londe - MND ALS, PMA, PBP, PP, PLS Extrapyramidal and movement disorders Parkinson's disease - Neuroleptic malignant syndrome - Postencephalitic parkinsonism - Pantothenate kinase-associated neurodegeneration - Progressive supranuclear palsy - Striatonigral degeneration - Dystonia/Dyskinesia Spasmodic torticollis, Meige's, Blepharospasm - Essential tremor - Myoclonus - Lafora - Chorea Choreoathetosis - Restless legs - Stiff person Other degenerative/ demyelinating diseases dementia: Alzheimer's - Pick's - Dementia with Lewy bodies - Frontotemporal lobar degeneration mitochondrial disease: Leigh's demyelinating: Multiple sclerosis - Devic's - Central pontine myelinolysis - Transverse myelitis - Marchiafava-Bignami disease - CAMFAK syndrome - Alpers' Seizure/epilepsy Focal - Generalised - Status epilepticus - Myoclonic epilepsy Headache Migraine Familial hemiplegic - Cluster - Vascular - Tension Vascular Transient ischemic attack Amaurosis fugax, Transient global amnesia Cerebrovascular disease MCA, ACA, PCA, Foville's, Millard-Gubler, Lateral medullary, Weber's, Lacunar stroke Sleep disorders Insomnia - Hypersomnia - Sleep apnea Obstructive, Ondine's curse - Narcolepsy - Cataplexy - Kleine-Levin - Circadian rhythm sleep - Delayed sleep phase - Advanced sleep phase Intracranial hypertension Hydrocephalus Normal pressure - Idiopathic intracranial hypertension Other encephalopathy Brain herniation - Cerebral edema - Reye's Other spinal cord disease Syringomyelia - Syringobulbia - Morvan's syndrome - Spinal cord compression Retrieved from http://en..org/wiki/Circadian_rhythm_sleep_disorder Categories: Sleep disorders | Circadian rhythms | Clinical neurophysiology | Sleep physiology Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages 日本語 Norsk bokmål Norsk nynorsk Română Simple English This page was last modified on 10 August 2008, at 19:21
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