scholarly journals Circadian Rhythm Sleep–Wake Disorders: a Contemporary Review of Neurobiology, Treatment, and Dysregulation in Neurodegenerative Disease

2021 ◽  
Author(s):  
Tyler A. Steele ◽  
Erik K. St Louis ◽  
Aleksandar Videnovic ◽  
R. Robert Auger
2021 ◽  
Vol 23 (5) ◽  
Author(s):  
Niall M. McGowan ◽  
Kate E. A. Saunders

Abstract Purpose of Review We review the recent evidence suggesting that circadian rhythm disturbance is a common unaddressed feature of borderline personality disorder (BPD); amelioration of which may confer substantial clinical benefit. We assess chronobiological BPD studies from a mechanistic and translational perspective and highlight opportunities for the future development of this hypothesis. Recent Findings The emerging circadian phenotype of BPD is characterised by a preponderance of comorbid circadian rhythm sleep-wake disorders, phase delayed and misaligned rest-activity patterns and attenuated amplitudes of usually well-characterised circadian rhythms. Such disturbances may exacerbate symptom severity, and specific maladaptive personality dimensions may produce a liability towards extremes in chronotype. Pilot studies suggest intervention may be beneficial, but development is limited. Summary Endogenous and exogenous circadian rhythm disturbances appear to be common in BPD. The interface between psychiatry and chronobiology has led previously to novel efficacious strategies for the treatment of psychiatric disorders. We believe that better characterisation of the circadian phenotype in BPD will lead to a directed biological target for treatment in a condition where there is a regrettable paucity of accessible therapies.


PLoS ONE ◽  
2016 ◽  
Vol 11 (7) ◽  
pp. e0159578 ◽  
Author(s):  
Yoshikazu Takaesu ◽  
Yuichi Inoue ◽  
Akiko Murakoshi ◽  
Yoko Komada ◽  
Ayano Otsuka ◽  
...  

Author(s):  
Simon D. Kyle ◽  
Alasdair L. Henry ◽  
Colin A. Espie

Insomnia disorder and circadian rhythm sleep–wake disorders (CRSWDs) are prevalent and impairing sleep disorders and often co-present with psychiatric disorder. Insomnia is characterized by difficulty with initiation and/or maintenance of sleep, driven primarily by cognitive behavioural processes. CRSWDs manifest because of alterations to the endogenous circadian clock (intrinsic) or as a consequence of environmental circumstances (extrinsic). This chapter reviews evidence-based treatments for the management of insomnia and intrinsic CRSWDs (delayed sleep–wake phase disorder, advanced sleep–wake phase disorder, non-24-hour sleep–wake disorder, irregular sleep–wake rhythm disorder). The chapter covers cognitive behavioural therapies, sleep-promoting hypnotics, phototherapy, and exogenous melatonin administration. The chapter also highlight gaps in the existing clinical science and reflects on emergent therapeutic approaches.


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