老年人昼夜节律失调性睡眠-觉醒障碍研究进展  

Progress on Circadian Rhythm Sleep-Wake Disorders in the elder

作　　者：胡思帆[1,2] 刘媛[1,2] 孙洪强[1,2] 

机构地区：[1]北京大学第六医院,北京大学精神卫生研究所,北京100191 [2]国家精神心理疾病临床医学研究中心,卫生部精神卫生学重点实验室(北京大学),北京100191

出　　处：《世界睡眠医学杂志》2017年第1期41-46,共6页World Journal of Sleep Medicine

摘　　要：昼夜节律失调性睡眠-觉醒障碍(Circadian Rhythm Sleep-Wake Disorders,CRSWD)是由于昼夜时间维持与诱导系统变化或内源性昼夜节律与外部环境不同步引起的一类睡眠疾病。它以失眠和(或)白天过度嗜睡为主要临床表现,常导致有临床意义的苦恼或导致精神、躯体、社会、职业、教育或其他方面的功能损害。常见类型为睡眠-觉醒时相前移障碍、睡眠-觉醒时相延迟障碍、不规律睡眠-觉醒节律障碍、非24 h睡眠-觉醒节律障碍、倒班工作睡眠-觉醒障碍、时差变化睡眠障碍和非特殊昼夜节律性睡眠觉醒紊乱。在老年人群中,由于下丘脑视交叉上核(Suprachiasmatic Nucleus,SCN)体积和细胞数量减少、夜晚褪黑素分泌减少、外界授时因子暴露减少等共同影响了昼夜节律系统并导致了老年人群的睡眠紊乱,常见类型为睡眠-觉醒时相前移障碍和不规律睡眠-觉醒节律障碍,常用的治疗方法包括健康教育和行为指导、时间疗法、光照治疗和药物治疗。本文主要对老年人昼夜节律失调性睡眠觉醒障碍的理论基础和研究进展做一综述。Circadian Rhythm Sleep-Wake Disorders（ CRSWD） is caused by alterations of the circadian time-keeping system,its entrainment mechanisms,or a misalignment of the endogenous circadian rhythm and the external environment. The most common presenting symptoms of CRSWD are insomnia symptoms and excessive sleepiness,but their impact extending to adverse health outcomes, impairments in social, occupational and educational performance function. International classification of sleep disorders（ 3rd） suggested classification of CRSWD into seven distinct types; Advanced Sleep-Wake Phase Disorder（ ASWPD）,Delayed Sleep-Wake Phase Disorder（ DSWPD）,Irregular Sleep-Wake Rhythm Disorder（ ISWRD）,Non-24-Hour Sleep-Wake Rhythm Disorder（ N24SWD）,Shift Work Disorder,Jet Lag Disorder,and Circadian Sleep-Wake Disorder Not Otherwise Specified（ NOS）. In the elder,the reduction of SCN volume and cell number,a decreased level of melatonin,and the decreasing of zeitgeber exposure could lead to sleep disturbance,by mean of influencing circadian rhythm. ASWPD and ISWRD are the two common Circadian Rhythm SleepWake Disorders among the aged. Till now,the time exposure to bright light and exogenous melatonin primarily serve to align the timing of circadian rhythms or increase the strength of the circadian signal. Here,we will provide an overview of theoretical foundations and research progress of the CRSWD in the elder.

关 键 词：生物节律 睡眠障碍 衰老 

分 类 号：R338.5[医药卫生—人体生理学]