Ritmo circadiano (turnos, luz, melatonina)

Why / when / how

Caring for the circadian rhythm helps improve falling asleep and sleep quality, particularly when the sleep phase is delayed, and it seeks to mitigate the disruption associated with shift work. The certainty of the evidence for the critical outcomes is low. That is why the recommendation is conditional in favor, because the balance between benefits and risks is favorable, though with lower certainty.

Cautions

Before intervening on sleep, assess the patient's habits, context, and treatments, and rule out sleep disorders that require specific study and management, such as obstructive apnea and restless legs syndrome. Use medications for sleeping with caution and in a limited way, prioritizing behavioral measures. Advise seeking professional evaluation in the presence of warning signs such as dangerous daytime sleepiness, snoring with breathing pauses, and persistent insomnia that does not improve, and refer to the specialist when appropriate. Reassess the response periodically.

Quantitative evidence