• 신경정신의학
• /
• 제57권4호
• /
• pp.276-286
• /
• 2018

Circadian rhythm is a periodic and continuous change in physiological, behavioral, and mental characteristics that occurs in most organisms on the Earth, because the Earth rotates in a 24-hour cycle. The circadian system regulates daily rhythms of physiology and behavior, such as the sleep/wake cycle, body temperature, hormonal secretion, and mood. The influence of circadian rhythm is very powerful, but limited research has addressed its effects. However, many recent studies have shown that circadian dysregulation may play an important role in the pathogenesis of bipolar disorder. This review study examined current and noteworthy studies, including the authors' own works, and proposes a possible clinical application of bipolar disorder based on evidence that circadian rhythm dysregulation in bipolar disorder may be a key pathogenetic mechanism.

• 수면정신생리
• /
• 제22권1호
• /
• pp.5-10
• /
• 2015

The secretion of melatonin exhibits a circadian rhythm entrained with the sleep-wake cycle. An alteration of this secretory rhythm has been found in various psychiatric disorders. This review summarizes the regulation of melatonin and its relationship to the circadian rhythm, major depressive disorder, bipolar disorder, seasonal affective disorder, Alzheimer's disease and autism. The review also looks at the effect of melatonin and melatonin agonist on sleep and symptoms of depression, bipolar disorder and seasonal affective disorder. In Alzheimer's disease, the circadian rhythm alterations are associated with the change of melatonin levels and melatonin receptors. It has been reported that melatonin and melatonin synthetic enzyme levels decrease in autism spectrum disorder.

• Journal of Korean Biological Nursing Science
• /
• 제19권1호
• /
• pp.48-54
• /
• 2017

Purpose: This study was done to identify the influence of severity of drinking problem, circadian rhythm and sleep quality in patients with alcohol use. Methods: A descriptive study design was utilized. Data were collected using self-report questionnaires from 139 patients with alcohol use disorder who were admitted to a psychiatric hospital in D city, Korea. The questionnaires included Alcohol Use Disorders Identification Test (AUDIT), Composite Scale of Morningness (CMS), Pittsburgh Sleep Quality Index (PSQI), and Korea sleep scale A. Data were analyzed using descriptive statistics, Pearson's correlation coefficients, and multiple regressions using the SPSS 20.0 program. Results: There was significant correlations among severity of problem drinking, circadian rhythm, sleep quality and sleep disorder. The significant factors influencing sleep disorder were severity of problem drinking(${\beta}=.12$, p= .042), circadian rhythm(${\beta}=-.14$, p= .039) and sleep quality(${\beta}=.63$, p= < .001). This model explained 56% of variance in sleep disorder(F = 57.34, p= < .001). Conclusion: The results of this study suggest that the development of sleep intervention programs for alcohol use disorder patients needs to consider severity of alcohol use, circadian rhythm and sleep quality, and sleep assessment and intervention are needed the early stage of the treatment and recovery process.

• 수면정신생리
• /
• 제29권2호
• /
• pp.40-44
• /
• 2022

Bipolar disorders are a group of mood disorders characterised by relapsing mood episodes throughout the course of illness. Patients with bipolar disorders commonly present with various sleep problems. Patients in a manic episode generally show decreased need of sleep and those in a depressed episode frequently complain about hypersomnia. Current literature even points to evidence that patients with bipolar disorder in euthymic state may still show signs of sleep disturbances when compared to the general population. Clinicians may also note intricate interactions between changes of circadian rhythm and evolution of mood episodes in patients with bipolar disorder. Also, commonly prescribed medications which plays a crucial role in treatment of bipolar disorders including mood stabilisers and antipsychotic medications often cause significant weight gain over time. Being a risk factor of sleep apnoea, weight gain can predispose the patient to develop sleep apnoea. In this narrative review, we summarised current evidence and literature regarding characteristics of circadian rhythm and comorbid sleep apnoea in patients with bipolar disorder. We also present literature regarding implications of circadian disturbance and comorbid sleep apnoea in managing patients with bipolar disorder.

• Molecules and Cells
• /
• 제40권7호
• /
• pp.450-456
• /
• 2017

Mammalian physiology and behavior are regulated by an internal time-keeping system, referred to as circadian rhythm. The circadian timing system has a hierarchical organization composed of the master clock in the suprachiasmatic nucleus (SCN) and local clocks in extra-SCN brain regions and peripheral organs. The circadian clock molecular mechanism involves a network of transcription-translation feedback loops. In addition to the clinical association between circadian rhythm disruption and mood disorders, recent studies have suggested a molecular link between mood regulation and circadian rhythm. Specifically, genetic deletion of the circadian nuclear receptor Rev-$erb{\alpha}$ induces mania-like behavior caused by increased midbrain dopaminergic (DAergic) tone at dusk. The association between circadian rhythm and emotion-related behaviors can be applied to pathological conditions, including neurodegenerative diseases. In Parkinson's disease (PD), DAergic neurons in the substantia nigra pars compacta progressively degenerate leading to motor dysfunction. Patients with PD also exhibit non-motor symptoms, including sleep disorder and neuropsychiatric disorders. Thus, it is important to understand the mechanisms that link the molecular circadian clock and brain machinery in the regulation of emotional behaviors and related midbrain DAergic neuronal circuits in healthy and pathological states. This review summarizes the current literature regarding the association between circadian rhythm and mood regulation from a chronobiological perspective, and may provide insight into therapeutic approaches to target psychiatric symptoms in neurodegenerative diseases involving circadian rhythm dysfunction.

• 동의신경정신과학회지
• /
• 제31권3호
• /
• pp.213-223
• /
• 2020

본 논문은 제2형 양극성 장애 환자에게 한의학적 변증체계와 함께 IPSRT의 심리 치료 기법을 적용한 증례이다. 제2형 양극성 장애 환자에게 한의치료와 IPSRT를 4개월간 병용한 결과, 환자의 사회적 리듬, 우울증 및 대인관계 능력이 개선되었으며 4개월후 추적조사에서도 호전상태가 유지되었다. 향후 양극성 장애 환자에 대한 높은 근거수준의 한의 임상연구 수행과 한의표준임상진료지침의 개발 등을 통해 양극성장애에 한의치료가 보다 활발히 활용되기를 기대한다.

• 수면정신생리
• /
• 제20권1호
• /
• pp.10-14
• /
• 2013

Sleep disturbances are commonly encountered problems in cancer patients. Sleep has a role in maintenance of immunity, metabolism, and quality of life but little has been known about the prevalence, risk factors, and effects on prognosis of sleep disturbances in patients with cancer. Also little attention has been made on proper assessment and management of sleep disorders in these patients. Recently, there have been some reports that sleep disorders are related with development of many cancers such as breast, colorectal, prostate, and endometrial cancers. An intermittent hypoxia and a disruption of circadian rhythm are considered as one of the possible mechanisms of cancer developments. More aggressive evaluation and meticulous management of sleep disturbances in cancer patients are essential to improve quality of life as well as prognosis.

• 수면정신생리
• /
• 제19권2호
• /
• pp.59-62
• /
• 2012

Borderline personality disorder (BPD) is characterized by identity and interpersonal problem, affective dysregulation and pervasive severe impulsivity. Although sleep disturbances are not primary symptoms of BPD, they are important aspects of this disorder. However, clinicians and researchers did not give much attention to the sleep symptoms of BPD yet. Measured by nocturnal polysomnography, increased sleep latency as well as reduced total sleep time and sleep efficiency, and 'depression-like' REM abnormalities (i.e., reduced REM latency and increased REM density) are found in BPD patients. Co-morbid sleep disorders such as chronic insomnia, nightmare disorder or circadian rhythm sleep disorder associated with BPD have been reported. Clinicians should focus on the sleep complaints of BPD patients, and carefully manage such symptoms with sleep hygiene education, cognitive psychotherapy or light therapy.

• 수면정신생리
• /
• 제30권1호
• /
• pp.13-21
• /
• 2023

The Seasonal Affective Disorder (SAD) is a disorder characterized by prolonged periods of depression and various physical and psychological symptoms experienced during specific seasons, typically winter. In this review aims to provide a comprehensive overview of SAD with a specific focus on psychophysiological aspects. Through the review from ancient times to the present, this paper explores the characteristics, causes, and underlying mechanisms of SAD. Particularly, it comprehensively reviews the research findings on the relationship between external factors such as light, sunlight, climate, and their association with SAD. Furthermore, the paper discusses the interplay between SAD and psychophysiological changes, along with the latest research trends in treatment and prevention strategies. By combining theoretical and practical perspectives on SAD, this article aims to provide a holistic understanding and offer suggestions for future research directions and clinical interventions.

• 수면정신생리
• /
• 제16권2호
• /
• pp.56-60
• /
• 2009

Excessive daytime sleepiness in childhood might be abnormal phenomenon and often related to the sleep disorders or insufficient sleep duration. The most common cause of excessive daytime sleepiness would be insufficient sleep. However, narcolepsy, idiopathic hypersomnia, circadian rhythm sleep disorders, medication, medical illness and other sleep disorders that could cause insomnia and poor quality of sleep also result in excessive daytime sleepiness. The misdiagnosed and untreated excessive daytime sleepiness in childhood can lead to serious developmental and educational problem.