When administered to humans the pineal honnone me\atonin can phase shift a number of circadian rhythms. This property has prompted the investigation of exogenous melatonin in sleep disorders known to have an underlying chronophysiological basis (i.e. circadian rhythm sleep disorders). Both in field and simulated studies of jet lag and shift work suitably timed melatonin improved sleep and, in s...

PURPOSE This article reviews the recent advances in understanding of the fundamental properties of circadian rhythms and discusses the clinical features, diagnosis, and treatment of circadian rhythm sleep disorders (CRSDs). RECENT FINDINGS Recent evidence strongly points to the ubiquitous influence of circadian timing in nearly all physiologic functions. Thus, in addition to the prominent sle...

WASHINGTON – Proposed DSM-5 criteria for sleep-wake disorders include dropping the DSM-IV’s “primary insomnia” diagnosis in favor of “insomnia disorder,” and decreasing use of the term “not otherwise specified.” The changes reflect a move away from the need to make casual attribution between coexisting disorders and also the overall DSM-5 shift toward more data-driven diagnostic criteria, said ...

Medication is indicated for only a limited number of children's sleep disorders. However, correctly chosen and supervised, pharmacological treatment may be justified and helpful. For a given sleep problem it is important to identify the underlying cause (or sleep disorder) which often calls for treatment of a non-medication type. Where medication is appropriate, cautious use and careful review ...

Studies in adult mammals (rats, cats, mice, and humans) have revealed a surprising regularity in the duration of sleep and wake bouts. In particular, wake bout durations exhibit a power-law distribution whereas sleep bout durations exhibit an exponential distribution. Moreover, in rodents, sleep bouts exhibit an exponential distribution at all ages examined, whereas wake bout durations exhibit ...

Increased attention to the prevalence of excessive sleepiness has led to a clear need to treat this symptom, thus reinforcing the need for a greater understanding of the neurobiology of sleep and wakefulness. Although the physiological mechanisms of sleep and wakefulness are highly interrelated, recent research reveals that there are distinct differences in the active brain processing and the s...

The Grand Challenge for Sleep and Chronobiology in the Neurology/Neuroscience domains for the twenty-first century is to improve our understanding of the complex relationships between sleep, wake, and chronobiology in healthy subjects and in patients with neurological disorders. Sleep disorders are very common and often disabling conditions that can be isolated or associated with neurological d...

BACKGROUND AND PURPOSE To determine the frequency and severity of disorders of sleep and wake and their relation to the quality of life (QoL) in patients who have survived an episode of subarachnoid hemorrhage (SAH). METHODS In a prospectively collected, consecutive series of 89 patients, 83 patients completed validated and frequently used questionnaires for the assessment of disorders of sle...

There is a strong association between sleep-related problems and neurologic diseases. Neurologic diseases of the CNS can directly cause sleep problems when sleep-wake mechanisms associated with the ascending reticular activating system are involved. The major sleep disorders associated with neurologic problems are outlined in the International Classification of Sleep Disorders, 2nd edition, as ...

The aim of this manuscript is to describe the procedures, recommendations, findings and value of the diagnostic methods used in sleep disorders, including questionnaires, actigraphy, polysomnography and the multiple sleep latency test. Specific questionnaires, including those evaluating sleep quality, hypersomnolence, respiratory sleep disorders and sleep-wake cycle are generally used to screen...