Spotlight on Advanced sleep-wake phase disorder

In this article, Dr. Hrayr Attarian and Dr. Tresa Zacharias of Northwestern University discuss the pathophysiology and treatment of this circadian rhythm sleep disorder. Hallmarks of this disorder include an advance in the habitual bedtime and wake time by several hours. The early morning awakening seen in this disorder may be mistaken for insomnia or depression. This is the first circadian rhythm sleep disorder for which a genetic cause was demonstrated. Current treatment primarily depends on the use of evening light therapy; however, timed melatonin may theoretically be efficacious, but further trials are needed.

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