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

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

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