Download CIRCADIAN rhythm disorders in malaysia

By RAJA SITI MARDHIAH RAJA AZMI
&
AFIF NUHAA JUWAHIR
CIRCADIAN RHYTHM DISORDERS
IN MALAYSIA
DEFINITION
 People with circadian rhythm sleep disorders
are unable to sleep and wake at the times
required for normal work, school, and social
needs. They are generally able to get enough
sleep if allowed to sleep and wake at the
times dictated by their body clocks.
 CIRCADIAN rhythm disorders driven by
changes in the sleep-wake cycle has been
identified as one of the major causes of
depression, the fourth most disabling
disease in Malaysia, affecting up to 10% of
the population.
 “Up to 82% of depressed patients remain
untreated due to social stigma, misdiagnosis, and
under-treatment. More depressed patients are
seen by primary care doctors than by actual
psychiatrists, and a majority of them are not
diagnosed. The remaining 18% receive
antidepressant medications, but only 10% are
adequately treated,” noted Prof Dr Mohamad
Hussain Habil, past president of the Asean
Federation for Psychiatry and Mental Health
(AFPMH) at a media workshop organised by
Servier Malaysia on “Circadian Rhythms and
Depression” in conjunction with Mental Health
Month.
 http://thestar.com.my
Normal circadian rhythms
 "morning people", who prefer to sleep and wake
early, to "owls", "evening people" or "night people",
who prefer to sleep and wake at late times. Whether
they are larks or owls, people with normal circadian
systems:
 can wake in time for what they need to do in the
morning, and fall asleep at night in time to get
enough sleep before having to get up.
 can sleep and wake up at the same time every day, if
they want to.
 will, after starting a new routine that requires their
getting up earlier than usual, start to fall asleep at
night earlier within a few days.
Circadian rhythm disorders
 disruptions in a person’s “internal body
clock” that regulates biological processes
such as brain wave activity, hormone
production, cell regeneration and other
biological activities linked to this cycle.
 change sleep-wake cycles, hormone release,
body temperature and other important bodily
functions.
Why Circadian rhythms are important in
determining human sleep patterns??
 The body’s “internal clock” controls the
production of melatonin, a hormone that
makes you sleepy.
 Since this trigger is located just above our
optic nerves, which relay information from
the eyes to the brain, it receives information
about incoming light.
 So, generally, when there is less light, our
body’s melatonin levels increase and we feel
sleepy.
Human biological clock
Type of circadian rhythm
sleep disorders
 Extrinsic type
 Two of these disorders are extrinsic (from
Latin extrinsecus, from without, on the
outside) or circumstantial:
 Jet lag, which affects people who travel
across several time zones.
 Shift work sleep disorder, which affects
people who work nights or rotating shifts
Intrinsic type
 Delayed sleep phase syndrome (DSPS), characterized by a
much later than normal timing of sleep onset and offset
and a period of peak alertness in the middle of the night.
 Advanced sleep phase syndrome (ASPS), characterized by
difficulty staying awake in the evening and difficulty staying
asleep in the morning.
 Non-24-hour sleep-wake syndrome (Non-24), in which the
affected individual's sleep occurs later and later each day,
with the period of peak alertness also continuously moving
around the clock from day to day.
 Irregular sleep-wake rhythm, which presents as sleeping at
very irregular times, and usually more than twice per day
(waking frequently during the night and taking naps during
the day) but with total time asleep typical for the person's
age.
Treatment for circadian rhythm sleep
disorders
 Possible treatments for circadian rhythm
sleep disorders include:
 Bright light therapy is used to advance or
delay sleep, depending on how the circadian
rhythm is shifted. Patients are exposed to
high-intensity light (up to 10,000 lux) for a
duration of 30–60 minutes at a time, the time
of day depending on whether an advance or a
delay is required.
 Behavior therapy where the patient is told to
avoid naps, caffeine, and other stimulants.
They are also told to not be in bed for anything
besides sleep and sex.
 Medications such as melatonin, a naturally
occurring sleep aid, or other short term sleep
aids or wake-promoting agents can be
beneficial.
 Sleep phase chronotherapy progressively
advances or delays the sleep time by 1–2 hours
per day.[5]
references
 http://thestar.com.my/health/story.asp?file=/
2011/10/23/health/9742748&sec=health
 http://en.wikipedia.org/wiki/Circadian_rhyth
m_sleep_disorder