CIRCADIAN-RHYTHM SLEEP DISORDERS IN ADOLESCENTS - CLINICAL-TRIALS OF COMBINED TREATMENTS BASED ON CHRONOBIOLOGY

Delayed sleep phase syndrome (DSPS) and non-24-h sleep-wake rhythm are circadian rhythm sleep disorders that are common in adolescents. Most patients have difficulty adjusting to school life, poor class attenda nce or refuse to go to school. Since a treatment has not been establis hed, the present paper is presented to propose a strategy for treating circadian rhythm sleep disorders in adolescents, based on our clinica l studies. Twenty subjects (12 males and eight females, mean age 16.2 +/- 1.7 years) participated in the study. The onset of sleep disorder occurred between the ages of 11 and 17. The most common factors affect ing the onset of disorders were changes in social environment. The sub jects kept a sleep-log for the periods before and during treatments. T he treatments were based on chronobiology: resetting the daily life sc hedule, chronotherapy, regulation of the lighting environment, methylc obalamin, and/or melatonin. Bright light exposure was successful in 10 patients, of whom four were treated with methylcobalamin. Melatonin t reatment was successful in two patients tone with and one without chro notherapy). Thirteen of the 20 patients were successfully, treated wit h therapies based on chronobiology. After consideration of these resul ts, a step-by-step procedure of combined treatments for the circadian rhythm sleep disorders is proposed.