Navigation Links
Practice parameters discuss the evaluation, treatment of circadian rhythm sleep disorders
Date:11/1/2007

WESTCHESTER, Ill. Practice parameters published in the November 1 issue of the journal SLEEP are a guide to the appropriate assessment and treatment of circadian rhythm sleep disorders (CRSDs). The standards will have a positive impact on professional behavior, patient outcomes and possibly health care costs.

The AASMs Standards of Practice Committee, who developed the practice parameters, commissioned content experts in CRSDs to review and grade evidence in the peer-reviewed scientific literature regarding the assessment and treatment of CRSDs.

The following are highlights of recommendations for the evaluation and therapy of CRSDs:

Standards (generally accepted patient-care strategies that reflects a high degree of clinical certainty):

  • Polysomnography rules out another primary sleep disorder in patients with symptoms suggestive of both a CRSD and another primary sleep disorder, but not for the diagnosis of CRSDs.

  • Planned napping before or during the night shift, as well as timed light exposure in the work environment and light restriction in the morning, all improve alertness and performance among night shift workers.

  • Melatonin administered at the appropriate time reduces symptoms of jet lag and improves sleep following travel across multiple time zones.

Guidelines (patient-care strategies that reflects a moderate degree of clinical certainty):

  • The use of a sleep log or diary assesses patients with a suspected CRSD.

  • Actigraphy assists in the evaluation of patients suspected of CRSDs. In addition, actigraphy is useful as an outcome measure in evaluating the response to treatment for CRSDs.

  • Melatonin promotes daytime sleep among night shift workers. Modafinil enhances alertness during the night shift for a shift work sleep disorder.

  • Morning light exposure is indicated in the treatment of a delayed sleep phase disorder.

Options (patient-care strategies that which reflect uncertain clinical use):

  • For a shift work sleep disorder, caffeine improves ones alertness during the night shift.

  • When time at destination is expected to be brief, keeping home-based sleep hours, rather than adopting destination sleep hours, may reduce sleepiness and jet lag symptoms. In addition, the combination of morning exposure to bright light and shifting the sleep schedule one hour earlier each day for three days prior to eastward travel may lessen symptoms of jet lag.

  • Prescribed sleep/wake scheduling, timed light exposure, or timed melatonin administration serve as treatments for patients with advanced sleep phase disorder.

  • Chronotherapy may be useful for a delayed sleep phase disorder, as well as properly timed melatonin administration.

  • Sleep logs are useful for assessment in patients with a free-running circadian rhythm sleep disorder (FRD).

  • Circadian phase markers are useful to determine circadian phase and confirm the diagnosis of FRD in sighted and unsighted patients. In addition, prescribed sleep/wake scheduling as a method to improve circadian rhythms may be useful for therapy of FRD in sighted individuals. Further, circadian phase shifting by timed light exposure or timed melatonin administration may be used to treat FRD in sighted and blind individuals.

  • Daytime light exposure may improve circadian rest-activity rhythms and consolidation of sleep and wake in nursing home residents with dementia and irregular sleep-wake rhythm disorder.

The expanding science of circadian rhythm biology and a growing literature in human clinical research on CRSDs prompted the AASM to convene a task force of experts to write a review of this important topic, said Timothy I. Morgenthaler, MD, of the Mayo Clinic in Rochester, Minn., one of the committee members. These practice parameters reflect the state of knowledge at the time of development and will be reviewed, updated and revised as new information becomes available.


'/>"/>

Contact: Jim Arcuri
jarcuri@aasmnet.org
708-492-0930
American Academy of Sleep Medicine
Source:Eurekalert

Related medicine news :

1. Indian Nationals with Foreign Medical Degrees can now practice in India
2. Researchers Feel The Need For Standards Of Practice In Immunoglobulin Therapy
3. AIDS control requires co-coordinated move regarding safe sexual practices
4. Woodruff Foundation Grant To Support Doctorate Of Nursing Practice Program
5. What nurses learn is not what they practice
6. Female Foeticide Practiced More By Educated People
7. Dr Death Faces Malpractice Case In Australia
8. Dentistry Practiced 9,000 Years Ago In Western Pakistan
9. Transformed Transforms Physician Centered Practice To Patient Centered One
10. Court Warns People Who Practice Unhealthy Sexual Traits
11. Mayo Clinic and Indian Health Service Form Clinical Practice Collaboration
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... , ... Yisrayl Hawkins, Pastor and Overseer at The House of Yahweh, has ... least understood books in the Holy Scriptures, Revelation. The Book of Revelation paints a ... centuries. Many have tossed it off as mere rubbish, but Yisrayl Hawkins says that ...
(Date:10/12/2017)... ... October 12, 2017 , ... ... healthcare compliance program management, will showcase a range of technology and learning solutions ... Living (NCAL) Convention and Expo to be held October 14–18, 2017 at the ...
(Date:10/12/2017)... ... October 12, 2017 , ... The American College of Medical Informatics (ACMI) ... FACMI, during the Opening Session of AMIA’s Annual Symposium in Washington, D.C. AMIA’s ... Morris F. Collen, a pioneer in the field of medical informatics, this prestigious award ...
(Date:10/12/2017)... ... October 12, 2017 , ... Leading pediatric oncology experts at Children’s ... the 49th Congress of the International Society of Paediatric Oncology (SIOP) Oct. ... Center for Cancer and Blood Disorders at Children’s National, and Stephen P. Hunger, ...
(Date:10/12/2017)... , ... October 12, 2017 , ... ... latest in wound care advancements to physician colleagues, skilled nursing facility medical directors ... "Navigating the Treacherous Waters of Wound Care." , "At many of these conferences ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... 2, 2017 Halo Labs announces the European launch of ... the HORIZON at MIBio 2017 in Cambridge, U.K ... particulate matter in biopharmaceutical samples with unprecedented speed and sensitivity while ... technique Backgrounded Membrane Imaging. ... HORIZON subvisible particle analysis system ...
(Date:9/27/2017)... and NEW YORK , Sept. 27, 2017  DarioHealth ... and big data solutions, today announced that its MyDario product is expected ... local TV listings for when The Dr. Oz Show airs in your ... The nine-time Emmy ... ...
(Date:9/22/2017)... 2017 AVACEN Medical (AVACEN) announced that its ... helping those with the widespread pain associated with fibromyalgia ... in Essex, England commented, "I ... experiencing no sleep at all, tremendous pain, with every ... recommend [the AVACEN 100] enough, how this has and ...
Breaking Medicine Technology: