Inpatient phase-advance therapy for delayed sleep–wake phase disorder: a retrospective study

Inpatient phase-advance therapy for delayed sleep–wake phase disorder: a retrospective study

Masahiro Takeshima,1 Tetsuo Shimizu,2 Masaru Echizenya,3 Hiroyasu Ishikawa,1,4 Takashi Kanbayashi1 1Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan; 2Mental Health and Welfare Center, Akita, Japan; 3Echizenya Sleep and Mental Clinic, Akita, Japan; 4Departmen...

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Autores principales: Takeshima M, Shimizu T, Echizenya M, Ishikawa H, Kanbayashi T
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2018
Materias:
delayed sleep-wake phase disorder
chronotherapy
sleep disorders
Circadian rhythm sleep disorders
Psychiatry
RC435-571
Neurophysiology and neuropsychology
QP351-495
Acceso en línea:https://doaj.org/article/a5fe275ff35f41b39c774e9a2c237b1b
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spelling oai:doaj.org-article:a5fe275ff35f41b39c774e9a2c237b1b2021-12-02T05:08:18ZInpatient phase-advance therapy for delayed sleep–wake phase disorder: a retrospective study1179-1608https://doaj.org/article/a5fe275ff35f41b39c774e9a2c237b1b2018-10-01T00:00:00Zhttps://www.dovepress.com/inpatient-phase-advance-therapy-for-delayed-sleep-wake-phase-disorder--peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Masahiro Takeshima,1 Tetsuo Shimizu,2 Masaru Echizenya,3 Hiroyasu Ishikawa,1,4 Takashi Kanbayashi1 1Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan; 2Mental Health and Welfare Center, Akita, Japan; 3Echizenya Sleep and Mental Clinic, Akita, Japan; 4Department of Neuropsychiatry, Nakadori Rehabilitation Hospital, Akita, Japan Purpose: The efficacy of inpatient phase-advance therapy among patients with delayed sleep–wake phase disorder (DSWPD) has not been adequately investigated because response rates are considered low. We aimed to examine the efficacy of such treatment in this patient population.Patients and methods: The present retrospective study included data from 66 patients with DSWPD who had been admitted to Akita University Hospital for inpatient phase-advance therapy between September 1, 2005, and April 30, 2018. DSWPD was diagnosed based on the International Classification of Sleep Disorders, 3rd edition, criteria using electronic medical records. We examined remission rates during inpatient therapy as well as relapse rates at the time of the first outpatient examination following discharge. Univariate analysis was performed to investigate predictive factors for postinpatient therapy relapse.Results: The rate of DSWPD remission over the course of inpatient phase-advance therapy was 100% (95% CI: 95.6%–100%), with a median duration of 1 day (IQR: 1–2 days; range: 1–9 days) until remission. The rate of relapse following discharge was 45.8% (95% CI: 32.7%–59.2%). Univariate analysis indicated that the rate of relapse was significantly higher for minors (under 18) than adults (18 and over), for those whose age at onset was below 16 years than for those whose age at onset was 16 or above, and for those with relatively low motivation for their occupation (P=0.0339, P=0.0136, and P<0.001, respectively).Conclusion: The rate of DSWPD remission under inpatient phase-advance therapy was remarkably high (100%), while the rate of relapse after discharge was ~50%. Further studies are required to determine the long-term prognosis of inpatient therapy, risk factors for relapse, and the types of treatment most effective for preventing relapse. Keywords: delayed sleep–wake phase disorder, chronotherapy, sleep disorders, circadian rhythm sleep disordersTakeshima MShimizu TEchizenya MIshikawa HKanbayashi TDove Medical Pressarticledelayed sleep-wake phase disorderchronotherapysleep disordersCircadian rhythm sleep disordersPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 10, Pp 327-333 (2018)
institution DOAJ
collection DOAJ
language EN
topic delayed sleep-wake phase disorder
chronotherapy
sleep disorders
Circadian rhythm sleep disorders
Psychiatry
RC435-571
Neurophysiology and neuropsychology
QP351-495
spellingShingle delayed sleep-wake phase disorder
chronotherapy
sleep disorders
Circadian rhythm sleep disorders
Psychiatry
RC435-571
Neurophysiology and neuropsychology
QP351-495
Takeshima M
Shimizu T
Echizenya M
Ishikawa H
Kanbayashi T
Inpatient phase-advance therapy for delayed sleep–wake phase disorder: a retrospective study
description Masahiro Takeshima,1 Tetsuo Shimizu,2 Masaru Echizenya,3 Hiroyasu Ishikawa,1,4 Takashi Kanbayashi1 1Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan; 2Mental Health and Welfare Center, Akita, Japan; 3Echizenya Sleep and Mental Clinic, Akita, Japan; 4Department of Neuropsychiatry, Nakadori Rehabilitation Hospital, Akita, Japan Purpose: The efficacy of inpatient phase-advance therapy among patients with delayed sleep–wake phase disorder (DSWPD) has not been adequately investigated because response rates are considered low. We aimed to examine the efficacy of such treatment in this patient population.Patients and methods: The present retrospective study included data from 66 patients with DSWPD who had been admitted to Akita University Hospital for inpatient phase-advance therapy between September 1, 2005, and April 30, 2018. DSWPD was diagnosed based on the International Classification of Sleep Disorders, 3rd edition, criteria using electronic medical records. We examined remission rates during inpatient therapy as well as relapse rates at the time of the first outpatient examination following discharge. Univariate analysis was performed to investigate predictive factors for postinpatient therapy relapse.Results: The rate of DSWPD remission over the course of inpatient phase-advance therapy was 100% (95% CI: 95.6%–100%), with a median duration of 1 day (IQR: 1–2 days; range: 1–9 days) until remission. The rate of relapse following discharge was 45.8% (95% CI: 32.7%–59.2%). Univariate analysis indicated that the rate of relapse was significantly higher for minors (under 18) than adults (18 and over), for those whose age at onset was below 16 years than for those whose age at onset was 16 or above, and for those with relatively low motivation for their occupation (P=0.0339, P=0.0136, and P<0.001, respectively).Conclusion: The rate of DSWPD remission under inpatient phase-advance therapy was remarkably high (100%), while the rate of relapse after discharge was ~50%. Further studies are required to determine the long-term prognosis of inpatient therapy, risk factors for relapse, and the types of treatment most effective for preventing relapse. Keywords: delayed sleep–wake phase disorder, chronotherapy, sleep disorders, circadian rhythm sleep disorders
format article
author Takeshima M
Shimizu T
Echizenya M
Ishikawa H
Kanbayashi T
author_facet Takeshima M
Shimizu T
Echizenya M
Ishikawa H
Kanbayashi T
author_sort Takeshima M
title Inpatient phase-advance therapy for delayed sleep–wake phase disorder: a retrospective study
title_short Inpatient phase-advance therapy for delayed sleep–wake phase disorder: a retrospective study
title_full Inpatient phase-advance therapy for delayed sleep–wake phase disorder: a retrospective study
title_fullStr Inpatient phase-advance therapy for delayed sleep–wake phase disorder: a retrospective study
title_full_unstemmed Inpatient phase-advance therapy for delayed sleep–wake phase disorder: a retrospective study
title_sort inpatient phase-advance therapy for delayed sleep–wake phase disorder: a retrospective study
publisher Dove Medical Press
publishDate 2018
url https://doaj.org/article/a5fe275ff35f41b39c774e9a2c237b1b
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AT shimizut inpatientphaseadvancetherapyfordelayedsleepndashwakephasedisorderaretrospectivestudy
AT echizenyam inpatientphaseadvancetherapyfordelayedsleepndashwakephasedisorderaretrospectivestudy
AT ishikawah inpatientphaseadvancetherapyfordelayedsleepndashwakephasedisorderaretrospectivestudy
AT kanbayashit inpatientphaseadvancetherapyfordelayedsleepndashwakephasedisorderaretrospectivestudy
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