Treatment of shift work disorder and jet lag.

With the growth of the 24-hour global marketplace, a substantial proportion of workers are engaged in nontraditional work schedules and frequent jet travel across multiple time zones. Thus, shift work disorder and jet lag are prevalent in our 24/7 society and have been associated with significant health and safety repercussions. In both disorders, treatment strategies are based on promoting good sleep hygiene, improving circadian alignment, and targeting specific symptoms.

Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia.

Objective: To assess the efficacy of moderate aerobic physical activity with sleep hygiene education to improve sleep, mood and quality of life in older adults with chronic insomnia.

Methods: Seventeen sedentary adults aged >or=55 years with insomnia (mean age 61.6 [SD±4.

Sleep influences the severity of memory disruption in amnestic mild cognitive impairment: results from sleep self-assessment and continuous activity monitoring.

Sleep is important for declarative memory consolidation in healthy adults. Sleep disruptions are typical in Alzheimer disease, but whether they contribute to memory impairment is unknown. Sleep has not been formally examined in amnestic mild cognitive impairment (aMCI), which is characterized by declarative-memory deficits without dementia and can signify prodromal Alzheimer disease.

Self-reported short sleep duration and frequent snoring in pregnancy: impact on glucose metabolism.

Objective: We sought to evaluate the impact of short sleep duration (SSD) and frequent snoring (FS) on glucose metabolism during pregnancy.

Study Design: We conducted a prospective cohort study of healthy nulliparas who participated in a sleep survey study. SSD was defined as <7 hours of sleep per night and FS, as snoring >or=3 nights per week.

Neurobiology of sleep.

The neurobiology of sleep is introduced in the context of interacting wake and sleep systems. Specifically, the transitions from wake to sleep and from non-rapid eye movement to rapid eye movement sleep are discussed based on the flip-flop switch hypothesis. Regulation of wake and sleep according to the opposing homeostatic and circadian systems are also presented.

Effects of ramelteon on insomnia symptoms induced by rapid, eastward travel.

Objective: Ramelteon, an MT(1)/MT(2) melatonin receptor agonist, was evaluated for its ability to reduce sleep-onset difficulties associated with eastward jet travel.

Methods: Healthy adults (n=110) with a history of jet lag sleep disturbances were flown eastward across five time zones from Hawaii to the east coast of the US. Ramelteon 1, 4, or 8 mg or placebo was administered 5 min before bedtime (local time) for four nights.

Circadian control of mouse heart rate and blood pressure by the suprachiasmatic nuclei: behavioral effects are more significant than direct outputs.

Background: Diurnal variations in the incidence of events such as heart attack and stroke suggest a role for circadian rhythms in the etiology of cardiovascular disease. The aim of this study was to assess the influence of the suprachiasmatic nucleus (SCN) circadian clock on cardiovascular function.

Methodology/principal Findings: Heart rate (HR), blood pressure (BP) and locomotor activity (LA) were measured in circadian mutant (Vipr2(-/-)) mice and wild type littermates, using implanted radio-telemetry devices.

EEG measures index neural and cognitive recovery from sleep deprivation.

Sleep deprivation impairs many cognitive abilities, but these impairments can be reversed after a certain quantity and quality of sleep. The ability to inhibit responding is particularly susceptible to disruption after prolonged wakefulness. How recovery sleep (RS) alters brain activity, leading to improved performance on a variety of cognitive tasks, remains unclear.

Circadian Rhythm Sleep Disorder: Irregular Sleep Wake Rhythm Type.

Irregular Sleep Wake Rhythm Disorder (ISWRD) is characterized by the relative absence of a circadian pattern in an individual's sleep-wake cycle. Significant changes in circadian regulation occur with aging and with neurodegenerative diseases, such as Alzheimer's disease prevalent in older adults, which are likely to contribute to the prevalence of ISWRD seen in these populations, although ISWRD is also seen in traumatic brain injury and mental retardation populations. ISWRD is thought to result from some combination of; degeneration or decreased neuronal activity of suprachiasmatic nucleus (SCN) neurons, decreased responsiveness of the circadian clock to entraining agents such as light and activity, and decreased exposure to bright light and structured social and physical activity during the day.

Does effective management of sleep disorders reduce cancer-related fatigue?

Cancer and cancer therapy are often associated with symptoms such as fatigue and sleep disturbances, before, during and after therapy. These symptoms of fatigue and poor sleep often occur in parallel having a significant impact on the physical functioning of patients with cancer. A strong correlation between cancer-related fatigue (CRF) and sleep has been observed in several studies, suggesting that they may be reciprocally related.

Sleep disturbances in pregnancy.

Objective: To estimate the prevalence and patterns of sleep disturbances during pregnancy among healthy nulliparous women.

Methods: This was a prospective, cohort study of healthy nulliparous women, recruited between 6 and 20 weeks of gestation, who completed a baseline sleep survey at enrollment with follow-up in the third trimester. The survey was composed of the following validated sleep questionnaires: Berlin Questionnaire for Sleep Disordered Breathing, Epworth Sleepiness Scale, National Institutes of Health/International Restless Legs Syndrome Question Set, Women's Health Initiative Insomnia Rating Scale, and the Pittsburgh Sleep Quality Index.

Circadian rhythm disorders.

Circadian rhythm sleep disorders occur when individuals attempt to sleep at the wrong circadian time. The misalignment between the internal circadian timing system and the external environment is typically due to either an alteration in the functioning of the circadian timing system (e.g.

Sleep timing and circadian phase in delayed sleep phase syndrome.

Delayed sleep phase syndrome (DSPS) is a circadian rhythm sleep disorder in which the timing of the sleep episode occurs later than desired and is associated with difficulty falling asleep, problems awakening on time (e.g., to meet work or school obligations), and daytime sleepiness.

Evidence-based recommendations for the assessment and management of sleep disorders in older persons.

Sleep-related disorders are most prevalent in the older adult population. A high prevalence of medical and psychosocial comorbidities and the frequent use of multiple medications, rather than aging per se, are major reasons for this. A major concern, often underappreciated and underaddressed by clinicians, is the strong bidirectional relationship between sleep disorders and serious medical problems in older adults.

Circadian phase-shifting effects of repeated ramelteon administration in healthy adults.

Study Objectives: To assess the ability of repeated daily oral ramelteon to facilitate re-entrainment of human circadian rhythms after an imposed phase advance of the sleep-wake cycle.

Methods: A total of 75 healthy adult volunteers aged 18-45 years remained in a sleep laboratory for 6 days and 5 nights; a 5-h phase advance in their sleep-wake cycle was imposed under dim-light conditions. Oral ramelteon (1,2, 4, or 8 mg once daily for 4 days) or placebo was administered 30 min before bedtime.

Sleep patterns among rural Chinese twin adolescents.

Objective: To examine sleep patterns and influencing factors (age, gender, Tanner Stage, weekday vs. weekend, and pre-sleep activity) among rural Chinese adolescents.

Methods: This is a prospective study among 621 adolescents aged 11-20 years (341 males) using both a questionnaire and sleep diary to obtain bedtime, wake-up time, sleep latency, and total sleep time (TST).

Sleep deprivation alters functioning within the neural network underlying the covert orienting of attention.

One function of spatial attention is to enable goal-directed interactions with the environment through the allocation of neural resources to motivationally relevant parts of space. Studies have shown that responses are enhanced when spatial attention is predictively biased towards locations where significant events are expected to occur. Previous studies suggest that the ability to bias attention predictively is related to posterior cingulate cortex (PCC) activation [Small, D.

Short sleep duration and adiposity in Chinese adolescents.

Objective: To investigate the relationship between sleep duration and adiposity measurements in rural Chinese adolescents.

Methods: This report is based on a cross-sectional analysis of 500 Chinese adolescent twins. Anthropometric measurements and direct adiposity measurements using dual-energy X-ray absorptiometry (DEXA) were taken for all subjects.

A clinical approach to circadian rhythm sleep disorders.

Circadian rhythm sleep disorders are characterized by complaints of insomnia and excessive sleepiness that are primarily due to alterations in the internal circadian timing system or a misalignment between the timing of sleep and the 24-h social and physical environment. In addition to physiological and environmental factors, maladaptive behaviors often play an important role in the development of many of the circadian rhythm sleep disorders. This review will focus on the clinical approach to the diagnosis and management of the various circadian rhythm sleep disorders, including delayed sleep phase disorder, advanced sleep phase disorder, non-entrained type, irregular sleep-wake rhythm, shift work sleep disorder and jet lag disorder.

Circadian rhythm sleep disorders.

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.

Circadian rhythm sleep disorders and phototherapy.

Circadian rhythm sleep disorders are characterized by a desynchronization between the timing of the intrinsic circadian clock and the extrinsic light-dark and social/activity cycles resulting in symptoms of excessive sleepiness and insomnia. This article explores the six recognized circadian rhythm sleep disorders: delayed sleep phase syndrome, advanced sleep phase syndrome, non-24-hour sleep-wake syndrome, irregular sleep-wake pattern, shift work sleep syndrome, and time zone change syndrome. Additionally discussed are the therapeutic roles of synchronizing agents, such as light and melatonin.