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Circadian rhythm sleep disorders: part II, advanced sleep phase disorder, delayed sleep phase disorder, free-running disorder, and irregular sleep-wake rhythm. An American Academy of Sleep Medicine review.

機譯：晝夜節(jié)律性睡眠障礙：第二部分，晚期睡眠階段性疾病，延遲睡眠階段性疾病，自由奔跑性疾病和不規(guī)則的睡眠-覺醒節(jié)奏。美國睡眠醫(yī)學學會評論。

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OBJECTIVE: This the second of two articles reviewing the scientific literature on the evaluation and treatment of circadian rhythm sleep disorders (CRSDs), employing the methodology of evidence-based medicine. We herein report on the accumulated evidence regarding the evaluation and treatment of Advamced Sleep Phase Disorder (ASPD), Delayed Sleep Phase Disorder (DSPD), Free-Running Disorder (FRD) and Irregular Sleep-Wake Rhythm ISWR). METHODS: A set of specific questions relevant to clinical practice were formulated, a systematic literature search was performed, and relevant articles were abstracted and graded. RESULTS: A substantial body of literature has accumulated that provides a rational basis the evaluation and treatment of CRSDs. Physiological assessment has involved determination of circadian phase using core body temperature and the timing of melatonin secretion. Behavioral assessment has involved sleep logs, actigraphy and the Morningness-Eveningness Questionnaire (MEQ). Treatment interventions fall into three broad categories: 1) prescribed sleep scheduling, 2) circadian phase shifting ("resetting the clock"), and 3) symptomatic treatment using hypnotic and stimulant medications. CONCLUSION: Circadian rhythm science has also pointed the way to rational interventions for CRSDs and these treatments have been introduced into the practice of sleep medicine with varying degrees of success. More translational research is needed using subjects who meet current diagnostic criteria.
機譯：目的：這是兩篇文章的第二篇，它采用循證醫(yī)學方法回顧了關于晝夜節(jié)律性睡眠障礙（CRSD）的評估和治療的科學文獻。我們在此報告了有關評估和治療高級睡眠相障礙（ASPD），延遲性睡眠相障礙（DSPD），自由運行障礙（FRD）和不規(guī)則睡眠-覺醒節(jié)律ISWR的累積證據(jù)。方法：制定了一系列與臨床實踐相關的特定問題，進行了系統(tǒng)的文獻檢索，并對相關文章進行了摘要和分級。結果：大量文獻積累為CRSD的評估和治療提供了合理的基礎。生理評估涉及利用核心體溫和褪黑激素分泌的時機確定晝夜節(jié)律。行為評估涉及睡眠記錄，書法，晨睡晚間問卷（MEQ）。治療干預措施可分為三大類：1）規(guī)定的睡眠時間表，2）晝夜節(jié)律相移（“重置時鐘”），和3）使用催眠藥和刺激藥的對癥治療。結論：晝夜節(jié)律科學也指出了對CRSD進行合理干預的方法，并且這些治療已被引入睡眠醫(yī)學的實踐中，并取得了不同程度的成功。使用滿足當前診斷標準的主題，需要進行更多的翻譯研究。

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