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Sleep Disorders in Older Adults
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Armando Miciano, David Berbrayer
Research is needed to define the timing, duration, and optimal light wavelength of BLT for older adults with advanced sleep-phase disorder. Multicenter, placebo-controlled, randomized studies are necessary to determine the efficacy, safety, and tolerability of long-term therapy with bright light in older adults. Placebo-controlled, randomized clinical trials of the efficacy and safety of melatonin receptor agonists are required in the treatment of irregular sleep-wake disorder (ISWD) in patients with dementia. Basic research to understand the pathophysiology of CRSDs, including the role of genetics, is also a priority. Multicenter trials are needed of the safety and efficacy of pharmacologic therapies in older adults with parasomnias, such as RBD. Trials should be conducted for clonazepam, melatonin, and dopamine agonists. Research is necessary to elucidate the relationship between RBD and PD.
Expressions of circadian clock genes represent disease activities of RA patients treated with biological DMARDs
Published in Modern Rheumatology, 2020
Kenta Kaneshiro, Kohsuke Yoshida, Kanta Morii, Yuto Oketani, Koto Uchida, Arisa Yaekura, Ikumi Okumura, Teppei Hashimoto, Yoshiko Kawasaki, Nao Shibanuma, Yoshitada Sakai, Akira Hashiramoto
As described above, clock genes maintain an elaborate relationship with each other, and operate an order indispensable to keep the homeostasis of human body. Indeed, disorders of circadian operation have been reported to initiate disease onset including cancer, sleep disorder, cardiovascular disease, psychosis and metabolic disease [5–7]. In colorectal carcinoma, expressions of Per2 is associated with tumor size and survival ratio [8]. Although, lacking a rhythmical expression [9], RORα is required for differentiation of T helper 17 cell [10] and negatively regulates the inflammatory response through proinflammatory cytokine Interleukin (IL)-6 and IL-8 in rat smooth muscle cells [11]. E4bp4 was also required for development of natural killer (NK) cell, and the subcutaneous cancer in Smad3 knockout mice was suppressed by activated NK cells through E4BP4-mediated pathway [12,13]. Moreover, a mutation of serine 662 amino acid into glycine 662 in PER was reported to be responsible for familial advanced sleep phase disorder [14].
Impact of an Individually Tailored Light Mask on Sleep Parameters in Older Adults With Advanced Phase Sleep Disorder
Published in Behavioral Sleep Medicine, 2020
Mariana G. Figueiro, Philip D. Sloane, Kimberly Ward, David Reed, Sheryl Zimmerman, John S. Preisser, Seema Garg, Christopher J. Wretman
Among the many physiological changes in sleep that accompany the aging process is a tendency for older adults to go to sleep and wake up earlier than younger adults. This process, which is termed phase advancement, is responsible for the average healthy older adult’s sleep-wake cycle being approximately 60 min earlier than that of healthy younger adults (Kramer, Kerkhof, & Hofman, 1999; Kripke et al., 2005; Yoon et al., 2003). In some older persons, this physiological shift is especially large, and early evening sleep onset and early morning wakening adversely affect the individual’s quality of life, a condition that is referred to as advanced sleep phase disorder (Palmer et al., 2003).