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Right arrow Contemporary Reviews in Sleep Medicine
(Chest. 2006;130:1915-1923.)
© 2006 American College of Chest Physicians

Circadian Rhythm Sleep Disorders*

Brandon S. Lu, MD and Phyllis C. Zee, MD, PhD

* From the Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL.

Correspondence to: Phyllis C. Zee, MD, PhD, Northwestern, University, Feinberg School of Medicine, 710 North Lake Shore Dr, Eleventh Floor, Abbott Hall, Chicago, IL 60611; e-mail: p-zee{at}northwestern.edu

Abstract

Humans exhibit endogenous circadian rhythms that are regulated by the master circadian clock of the body, the suprachiasmatic nucleus. These endogenous circadian rhythms are aligned to the outside world by social and environmental cues. Circadian rhythm sleep disorders (CRSD) occur when there is an alteration of the internal timing mechanism or a misalignment between sleep and the 24-h social and physical environment. CRSD are often underrecognized yet should be considered in the differential of patients presenting with symptoms of insomnia and/or hypersomnia. Because behavioral and environmental factors often are involved in the development and maintenance of these conditions, a multimodal treatment approach of behavioral and/or pharmacologic approaches is usually required to synchronize a patient’s circadian rhythm to the 24-h environment, consolidate sleep, and improve alertness. Rapid advances in our understanding of the physiologic, cellular, and molecular basis of circadian rhythm and sleep regulation will likely lead to improved diagnostic tools and treatments for CRSD.

Key Words: circadian rhythm • circadian rhythm sleep disorders






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