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)... (PRWEB) , ... October 13, 2017 , ... ... established the certification process to promote standards of excellence for the field of ... scheduled for March 22 – 25, 2018 in Orlando, Florida at the Omni ...
(Date:10/13/2017)... ... 2017 , ... Many families have long-term insurance that covers care for a ... waiver for care if the client has a cognitive impairment diagnosis. , “What ... is often waived, so the benefits from their insurance start immediately,” said Mechell Vieira, ...
(Date:10/13/2017)... ... October 13, 2017 , ... Talented host, actor Rob Lowe, ... in a new episode of "Success Files," which is an award-winning educational program ... investigates each subject in-depth with passion and integrity. , Sciatica occurs when the ...
(Date:10/12/2017)... ... October 12, 2017 , ... CitiDent and ... apnea using cutting-edge Oventus O2Vent technology. As many as 18 million Americans ... frequent cessation in breathing. Oral appliances can offer significant relief to about 75 ...
(Date:10/12/2017)... ... October 12, 2017 , ... Asante, ... post-acute health care, have expanded their existing home health joint venture through an ... has been operating a joint venture home health company with Asante, delivering clinically ...
Breaking Medicine News(10 mins):
(Date:10/4/2017)... OBP Medical , a leading ... today announced regulatory approval from Brazil,s ... Nacional de Vigilância Sanitária (ANVISA)) to market ... with integrated LED light source and smoke evacuation ... of a tissue pocket or cavity during surgical ...
(Date:10/2/2017)... 2, 2017  AllianceRx Walgreens Prime, the combined central ... and pharmacy benefit manager Prime Therapeutics LLC (Prime), today ... included the unveiling of new signage at its headquarters ... as at a few other company-owned facilities across the ... patients, some of whom will begin to see the ...
(Date:9/28/2017)... 28, 2017 Hill-Rom Holdings, Inc. (NYSE: HRC), ... call and webcast on Friday, November 3, 2017, beginning ... ending at approximately 8:30 a.m. (CDT) / 9:30 a.m. ... 2017 financial performance and guidance for 2018, Hill-Rom executives ... enhance operational performance, and long-range financial outlook through 2020. ...
Breaking Medicine Technology: