Light therapy' is established worldwide as the treatment of choice for seasonal affective disorder. It is also successfuly used in nonseasonal depression, as well as for many other psychiatric and neurologic illnesses, and in sleep medicine. Wake therapy is the fastest antidepressant known. Imaging studies show that both methods share neurobiological substrates with antidepressants, but act much faster. 'Chronotherapeutics' the combination of light and wake therapy achieves rapid results and, by reducing residual symptoms, also minimises relapse. Written by three prominent clinical and research experts in biological rhythms, this manual aims to broaden knowledge and practical application of these non-pharmacologic interventions for bipolar and unipolar disorders. Clinical understanding is deepened by an explanation of the circadian timing system and sleep regulatory mechanisms which underlie the novel treatment strategy. The step-by-step guide and description of the interventions in centers throughout the world provides clear hands-on instructions, supported by a solid body of clinical research. The first edition of 'Chronotherapeutics for Affective Disorders' has kindled a network of psychiatrists and psychologists who are actively introducing these treatments for their inpatients and outpatients. This manual is also essential reading for primary care physicians, sleep medicine specialists and health care administrators.
In nature, many physical processes are governed by the passage of time. The study of these processes - chronobiology - reveals rhythmic patterns which may be yearly, monthly, daily or more frequent. Novel drug delivery systems are currently being delivered that will release varying quantities of a drug at optimum times to coincide with these rhythmic patterns.Chronotherapeutics considers the pharmaceutical and therapeutic implications associated with biological clocks. The book presents a comprehensive discussion of specific diseases that are time dependent, and the drugs and new drug formulations that can be used as treatments.Written by leading international experts in the field, Chronotherapeutics provides up-to-date information on chronobiology for non-chronobiologists in pharmaceutical and medical sciences. Peter Redfern is Professor of Pharmacology at the University of Bath, UK.
"Reset Your Inner Clock reveals a powerful program that recalibrates our internal clocks that can be decimated by the modern demands of a 24/7 lifestyle"--
An enlightened approach to insomnia, depressed mood, fatigue, and other sleep-related problems of everyday life, harnessing the power of light therapy to reset the natural clock. Sleep problems and depressed mood often go hand in hand, forming a frustrating cycle. Michael Terman, PhD, has devoted his career to studying the brain functions that feed these disorders. His discoveries in chronotherapy have been widely recognized as game-changers by the medical establishment, and his 2010 New York Times op-ed, "Sleeping (or Not) by the Wrong Clock," shot to number one on the paper's list of most-forwarded online articles. In Chronotherapy, Terman and McMahan reveal the heart of his findings, a powerful program that recalibrates our internal clocks—our exquisitely designed, natural sensitivity to the timing and brightness of light exposure, which are often decimated by the modern demands of a 24/7 lifestyle. Beginning with a questionnaire to pinpoint problem areas, Terman helps readers decipher when their natural internal night is. The treatment process can then start, incorporating the power of natural light and, when necessary, supplemental light therapy. His approach has brought relief to thousands of sleep sufferers, as well as those burdened by bipolar disorder, seasonal affective disorder, depression, sleep disorders due to around-the-clock work schedules, and other impediments to vibrant health. For the first time, his findings are now available for a general audience, sharing the essential elements of chronobiology in clear, authoritative, scientifically grounded chapters that are easy to apply to a variety of situations. Chronotherapy chapters include: PART ONE: TIME, SLEEP, AND RHYTHMS Chapter 1: External vs. Internal Time The clock on the wall measures twenty-four hours every day, but the clock in your brain runs a little different. How can you help them work together? Chapter 2: The Pressure to Sleep The longer you stay awake, the more pressure you feel to sleep. But what if your inner clock says it is not yet ready for sleep? Chapter 3: Owls, Larks, and Hummingbirds What kind of "bird" are you? And once you know, how can that help you figure out when best to get stuff done? PART TWO: TIME, LIGHT, AND THE BRAIN Chapter 4: Getting Light into the Brain How do your eyes pass signals to your inner clock, and what makes those signals so important? Chapter 5: Getting Light Wrong Seeing light and being in darkness are basic daily experiences. But what happens when they come at the wrong times, and why does that have such negative consequences for mood, alertness, and sleep? Chapter 6: Geography and Time East or west, south or north, how can where you live have such a huge impact on your mood and sleep? PART THREE: INTERVENTIONS Chapter 7: Healing Light How can light help you solve your sleep problems, have more energy, and feel more positive about life? Chapter 8: Nighttime Meds and Melatonin Do you rely on pills to get to sleep? They may not work, and may be bad for you. But a new approach based on the brain’s inner clock holds great promise. Chapter 9: Hospitalized with Depression When someone becomes so depressed they need to go to the hospital, what promise does chronotherapy offer for a quick turnaround and continued improvement? Chapter 10: Beyond Light: The Charge in the Air What is it about spending a day at the beach that gives you such a lift? And how can you use new technology to bring home feeling of wellbeing? PART FOUR: STAGES OF LIFE Chapter 11: The Promise of Pregnancy You are going to have a baby! How can chronotherapy help you through the next nine months? Chapter 12: Strategies for Babies and Children When your baby or child sleeps well and feels good, you feel better too. How can chronotherapy help you reach this goal? Chapter 13: The Challenges of Adolescence As a teen, why do you feel the need to stay up so late and sleep so late? What are the consequences? What simple steps can you take to put your life on a smoother course? Chapter 14: In Later Years Does getting older have to mean being tired, sleeping badly, and feeling down? How to reverse these trends by using light. PART FIVE: CHRONOTHERAPY IN YOUR LIFE Chapter 15: Coping with Shift Work What if your job puts you on duty when your inner clock says you should be asleep? How can chronotherapy help you stay awake, alert, and in a decent mood? Chapter 16: Racing the Clock, Racing the Sun How chronotherapy prepares you for a trip and helps you recover from jet lag as quickly as possible. Chapter 17: Chronobiology in the Home and Workplace How will the collaboration of chronobiologists and architects transform the places you live, work, and learn? Chapter 18: Dawn of a Circadian Science Why is mainstream medicine so slow to put the insights of chronotherapy into practice?
Advances in sleep medicine research are improving our clinical work for individuals with sleep problems. The aim of this book is to educate psychiatrists and other mental health professionals about the importance of understanding sleep disorders, including their bidirectional relationship with psychiatric conditions. This book consists of six major sections with seventeen chapters. It is led off by an introduction on the function of sleep, its neurophysiology, and types of sleep problems. Since insomnia represents a common and significant challenge for patients with psychiatric disorders, its clinical presentation and treatments are reviewed in the second section. Cognitive behavioral therapy for insomnia (CBT-I), mindfulness-based CBT, acceptance and commitment therapy (ACT), and the medication management of insomnia are reviewed. A third section addresses sleep related breathing disorders. The pathology of sleep apnea, its treatments, and therapeutic modalities to address non-compliance with positive pressure ventilation are reviewed. Other sleep disorders such as hypersomnia, circadian rhythm disorders, movement disorders and parasomnias are discussed in the fourth section. Since features of sleep disorders can vary by age, gender, and trauma history, a fifth section discusses the unique sleep problems associated with children, women, older adults, and veterans. The book concludes with a final section discussing how sleep disorders and psychiatric conditions overlap. We hope this book highlights the importance of understanding and addressing comorbid sleep disorders among individuals with psychiatric conditions. We are confident that this book will be valuable in helping clinicians improve the management of sleep disorders in their clinical practice.
The diagnosis of mental illness is frequently accompanied by sleep problems; conversely, people experiencing sleep problems may subsequently develop mental illness. Sleep and Mental Illness looks at this close correlation and considers the implications of research findings that have emerged in the last few years. Additionally, it surveys the essential concepts and practical tools required to deal with sleep and co-morbid psychiatric problems. The volume is divided into three main sections: basic science, neuroendocrinology, and clinical science. Included are over 30 chapters on topics such as neuropharmacology, insomnia, depression, dementia, autism, and schizophrenia. Relevant questionnaires for the assessment of sleep disorders, including quality-of-life measurement tools, are provided. There is also a summary table of drugs for treating sleep disorders. This interdisciplinary text will be of interest to clinicians working in psychiatry, behavioral sleep medicine, neurology, pulmonary and critical care medicine.
In this book, leading experts in the field review how circadian rhythms impact the brain. An essential function of mammalian life is the exploitation of the regularities provided by the 24-hour cycle of day and night. The development and evolution of circadian clock mechanisms have allowed us to optimally adapt our behavior and physiology to the external world. Not surprisingly, a growing body of evidence links the disruption of circadian rhythms by genetic, lifestyle and environmental factors to illnesses of the brain. In the first section of the book, readers will learn about the molecular and anatomic architecture of circadian function in mammals. The ways in which environmental disruptions and misalignments can influence such mechanisms and therefore impair brain function and health status are also addressed. In the second part, the focus shifts to those brain regions responsible for brain function and the body-wide regulation of circadian function. Amongst others, special attention is paid to the role of astrocytes and the brain’s reward and hyprocretin / orexin systems. The book concludes with an extensive discussion on the consequences of circadian rhythm dysfunction. Several chapters present the latest findings on Attention Deficit Hyperactivity Disorder, schizophrenia, autism spectrum disorder, drug abuse and mood disorders. Written by auhorities in the field, the book provides a state-of-the-art review of the latest findings on circadian clocks in the brain and highlights their potentially far-reaching impacts on our health and well-being. As such, it is essential reading for all neuroscientists and clinicians seeking to understand the intricate connections between circadian rhythms and brain health and illness.
The fully updated second edition of this popular handbook concisely summarises all current knowledge about delirium in critically ill patients and describes simple tools the bedside clinician can use to prevent, diagnose and manage delirium. Chapters discuss new developments in assessing risk and diagnosis, crucial discoveries regarding delirium and long-term cognitive outcomes, and dangers of sedation and death. Updated management advice reflects new evidence about antipsychotics and delirium. This book explains how to minimise the risks of delirium, drugs to avoid, drugs to use and when to use them, as well as current theories regarding pathophysiology, different motoric subtypes leading to missed diagnosis, and the adverse impact of delirium on patient outcomes. While there are still unanswered questions, this edition contains all the available answers. Illustrated with real-life case reports, Delirium in Critical Care is essential reading for trainees, consultants and nurses in the ICU and emergency department.
