- Dedication
- Contributors
- 1 Sleep Medicine and Psychiatry
- 2 Sleep Architecture and Physiology
- 3 Neurobiology of Sleep and Wakefulness
- 4 Circadian Rhythms
- 5 Sleep and Cognition
- 6 Office-Based Evaluation of Sleep Disordered Patients
- 7 Clinical Applications of Technical Procedures in Sleep Medicine
- 8 Insomnia Disorder—Pathophysiology
- 9 Pharmacological Management of Insomnia
- 10 Insomnia—Behavioral Treatments
- 11 Hypersomnolence Disorders
- 12 Parasomnias
- 13 Circadian Rhythm Sleep Disorders
- 14 Sleep-Related Movement Disorders
- 15 Breathing-Related Sleep Disorders
- 16 Pediatric Sleep–Wake Disorders
- 17 Depressive Disorders
- 18 Bipolar and Related Disorders
- 19 Anxiety, Obsessive-Compulsive, and Related Disorders
- 20 Trauma- and Stressor-Related Disorders
- 21 Schizophrenia Spectrum and Other Psychotic Disorders
- 22 Substance Use Disorders
- 23 Neurodevelopmental Disorders
- 24 Delirium
- 25 Neurocognitive Disorders
- 26 Neurological Disorders
- 27 Pain Disorders
- 28 Psychotropic Medications and Sleep
- 29 Forensic Sleep Medicine
- 30 Eating Disorders
- 31 Future of Sleep Medicine and Psychiatry
- Index
(p. 402) Delirium
- Chapter:
- (p. 402) Delirium
- Author(s):
Kotaro Hatta
- DOI:
- 10.1093/med/9780190929671.003.0024
The fundamental concept of delirium is altered consciousness and its fluctuation. Sleep–wake cycle disturbance is one of the common clinical features of delirium. Evidence suggests that disturbed sleep plays a key role in pathogenesis of delirium and restoration of sleep–wake cycle provides a clinical opportunity for prevention of delirium. It is essential to evaluate clinical factors such as medical illnesses, psychiatric disorders, substance use disorders, medication side effects, and environmental factors leading to sleep disturbance in delirium. In addition, multicomponent nonpharmacologic delirium prevention interventions are effective in reducing delirium incidence and preventing falls, with trend toward decreasing length of stay, but nonsignificant reductions in mortality. Approaches to regulating functions of melatonin or orexin on sleep–wake cycle lead to pharmacological interventions, and preventive effects of melatonin receptor agonists and an orexin receptor antagonist on delirium have been shown. This evidence suggests importance of treating sleep–wake cycle disturbance to prevent delirium. More research is warranted to develop comprehensive clinical strategies, targeting sleep disturbance to predict, prevent and treat delirium.
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- Dedication
- Contributors
- 1 Sleep Medicine and Psychiatry
- 2 Sleep Architecture and Physiology
- 3 Neurobiology of Sleep and Wakefulness
- 4 Circadian Rhythms
- 5 Sleep and Cognition
- 6 Office-Based Evaluation of Sleep Disordered Patients
- 7 Clinical Applications of Technical Procedures in Sleep Medicine
- 8 Insomnia Disorder—Pathophysiology
- 9 Pharmacological Management of Insomnia
- 10 Insomnia—Behavioral Treatments
- 11 Hypersomnolence Disorders
- 12 Parasomnias
- 13 Circadian Rhythm Sleep Disorders
- 14 Sleep-Related Movement Disorders
- 15 Breathing-Related Sleep Disorders
- 16 Pediatric Sleep–Wake Disorders
- 17 Depressive Disorders
- 18 Bipolar and Related Disorders
- 19 Anxiety, Obsessive-Compulsive, and Related Disorders
- 20 Trauma- and Stressor-Related Disorders
- 21 Schizophrenia Spectrum and Other Psychotic Disorders
- 22 Substance Use Disorders
- 23 Neurodevelopmental Disorders
- 24 Delirium
- 25 Neurocognitive Disorders
- 26 Neurological Disorders
- 27 Pain Disorders
- 28 Psychotropic Medications and Sleep
- 29 Forensic Sleep Medicine
- 30 Eating Disorders
- 31 Future of Sleep Medicine and Psychiatry
- Index