Challenges and Gaps in the Treatment of Advanced Sleep Phase Disorder: A Call for Further Research and Understanding

Abstract

People with circadian rhythm disturbances are at an elevated risk of mental disorders, and conversely, those with mental disorders are more susceptible to the circadian disruption. A steady circadian cycle of sleep and wakefulness that is phase-shifted relative to the prior local solar time may be characterized by a short endogenous circadian period. Advanced sleep-wake phase disorder (ASPD) is characterized by a substantial advancement of the sleep-wake cycle phase, followed with sleep-related symptoms. ASPD is a challenging sleep-wake disorder to manage, with current treatment options varying in efficacy and potential side effects. Further research is needed to identify effective treatment options and to elucidate the underlying mechanisms of ASPD. More research is needed to better understand the underlying mechanisms of ASPD and the molecular and metabolic changes associated with aging that may contribute to the development of the disorder.

Kod ljudi sa poremećajima cirkadijalnog ritma postoji povećan rizik od mentalnih poremećaja i, obrnuto, ljudi sa mentalnim poremećajima podložniji su cirkadijalnim poremećajima. Stalan cirkadijalni ciklus spavanja i buđenja koji se fazno pomera prema prethodnom lokalnom solarnom vremenu može se karakterisati kratkim endogenim cirkadijalnim periodom. Poremećaj uznapredovale faze spavanja‒buđenja (engl. advanced sleep phase disorder ‒ ASPD) odlikuje znatno napredovanje faze ciklusa spavanja‒buđenja, praćeno simptomima vezanim za spavanje. ASPD je izazovan poremećaj spavanja‒buđenja, jer ga nije lako regulisati, a trenutne opcije lečenja razlikuju se po efikasnosti i potencijalnim neželjenim efektima. Potrebna su dalja istraživanja da bi se pronašle efikasne opcije lečenja i razjasnili osnovni mehanizmi ASPD-a. Kako bi se bolje razumeli osnovni mehanizmi ASPD-a, kao i molekularne i metaboličke promene povezane sa starenjem koje mogu doprineti razvoju ovog poremećaja, neophodno je sprovesti dodatna istraživanja.