Disorders of the sleep-wake cycle in adults
by
Sedgwick PM Department of Addictive Behaviour,
St George's Hospital Medical School, London, UK.
Postgrad Med J 1998 Mar; 74(869):134-8

ABSTRACT

Adults have an intrinsic body clock which regulates a complex series of rhythms including sleep and wakefulness, fatigue and cognitive ability. This endogenous clock naturally runs more slowly than the solar day and is entrained to a 24-h rhythm primarily by the alternation of light and darkness. Jet lag, shift-work sleep disorder, and some of the chronic insomnias are caused by a temporal discrepancy of the body clock relative to the surrounding environment and social network. The underlying mechanisms and general management are described. Both bright light and melatonin therapy have potential in the management of these disorders. Traditionally, bright light therapy has been used to alleviate the depression associated with seasonal affective disorder. Melatonin has received much ill-formed publicity, it being claimed that it is a panacea and an 'antiageing' treatment. Both of these treatment approaches are reviewed.

SAD
Insomnia
Serotonin
Melatonin
Tryptophan
Light therapy
Winter depression
Circadian rhythms
SAD and negative ions
Vitamin D v phototherapy
Bright light plus fluoxetine (Prozac)
Light therapy with blue wavelength LEDs

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