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A sleep disorder, or somnipathy, is a medical disorder of an individual's sleep patterns. Some sleep disorders are severe enough to interfere with normal physical, mental, social and emotional functioning. Sleep disorders are frequent and can have serious consequences on patients' health and quality of life. Polysomnography and actigraphy are tests commonly ordered for diagnosing sleep disorders.
Jet lag, desynchronosis, or circadian dysrhythmia, is a temporary physiological condition that occurs when a person's circadian rhythm is out of sync with the time zone they are in, and is a typical result from travelling rapidly across multiple time zones. For example, someone travelling from New York to London, i.e. from west to east, feels as if the time were five hours earlier than local time, and someone travelling from London to New York, i.e. from east to west, feels as if the time were five hours later than local time. The phase shift when travelling from east to west is referred to as phase-delay of the circadian cycle, whereas going west to east is phase-advance of the cycle. Most travellers find that it is harder to adjust time zones when travelling east. Jet lag was previously classified as a circadian rhythm sleep disorder.
A circadian rhythm, or circadian cycle, is a natural oscillation that repeats roughly every 24 hours. Circadian rhythms can refer to any process that originates within an organism and responds to the environment. Circadian rhythms are regulated by a circadian clock whose primary function is to rhythmically co-ordinate biological processes so they occur at the correct time to maximize the fitness of an individual. Circadian rhythms have been widely observed in animals, plants, fungi and cyanobacteria and there is evidence that they evolved independently in each of these kingdoms of life.
Delayed sleep phase disorder (DSPD), more often known as delayed sleep phase syndrome and also as delayed sleep–wake phase disorder, is the delaying of a person's circadian rhythm compared to those of societal norms. The disorder affects the timing of biological rhythms including sleep, peak period of alertness, core body temperature, and hormonal cycles.
The suprachiasmatic nucleus or nuclei (SCN) is a small region of the brain in the hypothalamus, situated directly above the optic chiasm. It is the principal circadian pacemaker in mammals, responsible for generating circadian rhythms. Reception of light inputs from photosensitive retinal ganglion cells allow it to coordinate the subordinate cellular clocks of the body and entrain to the environment. The neuronal and hormonal activities it generates regulate many different body functions in an approximately 24-hour cycle.
Light therapy, also called phototherapy or bright light therapy is the exposure to direct sunlight or artificial light at controlled wavelengths in order to treat a variety of medical disorders, including seasonal affective disorder (SAD), circadian rhythm sleep-wake disorders, cancers, and skin wound infections. Treating skin conditions such as neurodermatitis, psoriasis, acne vulgaris, and eczema with ultraviolet light is called ultraviolet light therapy.
Non-24-hour sleep–wake disorder is one of several chronic circadian rhythm sleep disorders (CRSDs). It is defined as a "chronic steady pattern comprising [...] daily delays in sleep onset and wake times in an individual living in a society". Symptoms result when the non-entrained (free-running) endogenous circadian rhythm drifts out of alignment with the light–dark cycle in nature. Although this sleep disorder is more common in blind people, affecting up to 70% of the totally blind, it can also affect sighted people. Non-24 may also be comorbid with bipolar disorder, depression, and traumatic brain injury. The American Academy of Sleep Medicine (AASM) has provided CRSD guidelines since 2007 with the latest update released in 2015.
A phase response curve (PRC) illustrates the transient change in the cycle period of an oscillation induced by a perturbation as a function of the phase at which it is received. PRCs are used in various fields; examples of biological oscillations are the heartbeat, circadian rhythms, and the regular, repetitive firing observed in some neurons in the absence of noise.
Circadian rhythm sleep disorders (CRSD), also known as circadian rhythm sleep-wake disorders (CRSWD), are a family of sleep disorders which affect the timing of sleep. CRSDs arise from a persistent pattern of sleep/wake disturbances that can be caused either by dysfunction in one's biological clock system, or by misalignment between one's endogenous oscillator and externally imposed cues. As a result of this mismatch, those affected by circadian rhythm sleep disorders have a tendency to fall asleep at unconventional time points in the day. These occurrences often lead to recurring instances of disturbed rest, where individuals affected by the disorder are unable to go to sleep and awaken at "normal" times for work, school, and other social obligations. Delayed sleep phase disorder, advanced sleep phase disorder, non-24-hour sleep–wake disorder and irregular sleep–wake rhythm disorder represents the four main types of CRSD.
Shift work sleep disorder (SWSD) is a circadian rhythm sleep disorder characterized by insomnia, excessive sleepiness, or both affecting people whose work hours overlap with the typical sleep period. Insomnia can be the difficulty to fall asleep or to wake up before the individual has slept enough. About 20% of the working population participates in shift work. SWSD commonly goes undiagnosed, so it's estimated that 10–40% of shift workers have SWSD. The excessive sleepiness appears when the individual has to be productive, awake and alert. Both symptoms are predominant in SWSD. There are numerous shift work schedules, and they may be permanent, intermittent, or rotating; consequently, the manifestations of SWSD are quite variable. Most people with different schedules than the ordinary one might have these symptoms but the difference is that SWSD is continual, long-term, and starts to interfere with the individual's life.
In the study of chronobiology, entrainment refers to the synchronization of a biological clock to an environmental cycle. An example is the interaction between circadian rhythms and environmental cues, such as light and temperature. Entrainment helps organisms adapt their bodily processes with the timing of a changing environment. For example, entrainment is manifested during travel between time zones, hence why humans experience jet lag.
Norman E. Rosenthal is an American author, psychiatrist and scientist who first described seasonal affective disorder (SAD), and developed light therapy as a treatment.
Thomas Alvin Wehr is an American psychiatrist, research scientist, and author. He is a scientist emeritus and former chief of the Clinical Psychobiology branch of the National Institute of Mental Health (NIMH).
Robert Leroy Sack is an American physician and researcher specializing in sleep medicine. He is certified by the American Board of Psychiatry and Neurology and the American Board of Sleep Disorders Medicine. On the faculty of the Oregon Health & Science University since 1977, he is the medical director of its Clinical Sleep Disorders Medicine Program which he developed parallel with his research on circadian rhythms.
Charles Andrew Czeisler is a Hungarian-American physician and sleep and circadian researcher. He is a leading researcher and author in the fields of the effects of light on human physiology, circadian rhythms and sleep medicine.
Michael Terman is an American psychologist best known for his work in applying the biological principles of the circadian timing system to psychiatric treatments for depression and sleep disorders. This subspecialty is known as Chronotherapeutics.
Till Roenneberg is a professor of chronobiology at the Institute of Medical Psychology at Ludwig-Maximilian University (LMU) in Munich, Germany. Roenneberg, in collaboration with Martha Merrow, explores the impact of light on human circadian rhythms, focusing on aspects such as chronotypes and social jet lag in relation to health benefits.
Amita Sehgal is a molecular biologist and chronobiologist in the Department of Neuroscience at the Perelman School of Medicine at the University of Pennsylvania. Sehgal was involved in the discovery of Drosophila TIM and many other important components of the Drosophila clock mechanism. Sehgal also played a pivotal role in the development of Drosophila as a model for the study of sleep. Her research continues to be focused on understanding the genetic basis of sleep and also how circadian systems relate to other aspects of physiology.
Charmane Eastman is an American academic research scientist whose career has focused on studying circadian rhythms and their relationships to sleep, jet lag, and shift work. She has also studied winter depression, more properly known as seasonal affective disorder (SAD). Of special focus are the effects of bright light and melatonin on circadian rhythms.
In chronobiology, photoentrainment refers to the process by which an organism's biological clock, or circadian rhythm, synchronizes to daily cycles of light and dark in the environment. The mechanisms of photoentrainment differ from organism to organism. Photoentrainment plays a major role in maintaining proper timing of physiological processes and coordinating behavior within the natural environment. Studying organisms’ different photoentrainment mechanisms sheds light on how organisms may adapt to anthropogenic changes to the environment.
References
- ↑ Lack, Leon (2001). "Light emitting diodes can be used to phase delay the melatonin rhythm". Journal of Pineal Research. 31 (30): 350–5. doi:10.1034/j.1600-079x.2001.310410.x. PMID 11703565. S2CID 24844448.
- ↑ "Leon Lack Bio". The Conversation. Retrieved 5 November 2015.
- ↑ "Resetting the Body Clock". Flinders University. Flinders University. Retrieved 5 November 2015.
- ↑ Austin, Nigel (September 2014). "Adelaide invention to create new manufacturing success after car making demise". The Advertiser. Retrieved 5 November 2015.
- ↑ Winnings, David (November 2012). "Curing Jet Lag with Light". Wall Street Journal. Retrieved 5 November 2015.
- ↑ Lee, David. "The headband that can reset your body clock". BBC News. Retrieved 6 November 2015.
- ↑ Newlands, Murrary. "Light Therapy Glasses Can Eradicate Jet Lag: An Interview With Ben Olsen". Forbes. Retrieved 2 February 2016.
- ↑ "Wearable ring trains users to sleep better by waking them up". 10 October 2016.