摘要
昼夜节律性睡眠障碍(CRSD)是由于睡眠-觉醒周期与人体的24 h生物节律失调所致的一类睡眠疾病。它以失眠和(或)白天过度嗜睡,影响生活质量为主要临床表现。因内源性昼夜节律系统变化而引起者包括睡眠时相延迟综合征(DSPS)、睡眠时相前移综合征(ASPS)、非24 h节律睡眠障碍和无昼夜节律的睡眠障碍;因环境改变导致者主要包括时差和轮班相关的睡眠障碍。近年来,由于生物节律基础研究在临床睡眠医学实践中的转化应用,CRSD的发病机制进一步被明确,诊断和治疗取得了长足进展。睡眠日记、活动记录仪和褪黑素水平测定、体温检测都成为常规应用的诊断手段。光疗、褪黑素等因可以恢复正常的生物节律而得到广泛应用。针对生物节律的促睡和促醒信号靶向性开发新的药物将成为睡眠障碍药物研发的新方向。以CRSD的诊疗与研究为核心的行为睡眠医学(behavior sleep medicine)已经成形。如何利用我国丰富的病例资源,加强基础研究与临床的结合,促进我国生物节律领域的研究成果在临床医学中的转化是一个重要的课题。
Circadian rhythm sleep disorders（CRSD） are a distinct class of sleep disorders characterized by a mismatch between the ability to fall asleep and remain asleep and the 24 h circadian rhythm. CRSD can lead to insomnia and excessive daytime sleepiness, with negative influence on quality of life. International classification of sleep disorders suggested classification of CRSD into six distinct types： delayed sleep phase type, advanced sleep phase type, irregular sleep wake phase type, free-running type, jet lag type and shift work type. Recently, mechanisms of major CRSD have been understood. The diagnosis and treatment of CRSD have achieved great progress due to the successful transfer of the findings in basic research into clinical practice. Sleep log, actigraphy, melatonin measurement and 24 h body temperature are used as routing tests for the diagnosis of CRSD. Light therapy and melatonin supplement are used to restore the 24 h biological rhythm of patients. New medications targeting biological rhythm system are being developed to treat sleep disorders. Behavior sleep medicine focusing on the research and clinical management of CRSD develops. Our major challenge in China is how to use the patient resources to enhance the practice and research in CRSD area, therefore improving the transfer of basic research to clinical use.
出处
《生命科学》
CSCD
2015年第11期1448-1454,共7页
Chinese Bulletin of Life Sciences
基金
国家自然科学基金项目(81420108002)
国家重点基础研究发展计划("973"项目)(2015CB856400)
关键词
生物节律
睡眠障碍
失眠
嗜睡
circadian rhythm
sleep disorder
insomnia
sleepiness
