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인체의 일주기리듬

Human Circadian Rhythms

김린|조철현|이현아
대한수면의학회 (Korean Academy of Sleep Medicine)|2014.12|수면정신생리 (Sleep Medicine and Psychophysiology)|제21권 제2호|pp. 51-60

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참고문헌

키워드

인체HumanCircadian rhythm멜라토닌일주기리듬Melatonin수면-각성 주기Sleep-wake cycle
주제분류정신과학

초록

일주기리듬이란, 모든 생명체에 존재하는 생물학적 조절 인자로서, 우리가 살아가는 데 필요한 다양한 생리적, 심리적인 영역에 영향을 미친다. 이러한 일주기리듬은 melato-nin, 심부체온, cortisol 측정을 통해 알 수 있다. Melatonin은 혈액, 타액, 소변을 통해 측정 가능하며, 외부 요인에 영향을 적게 받으므로 가장 유용하게 사용될 수 있다. 심부체온은 열 생산과 열 손실의 복합적인 작용에 의해 결정되며, 중추의 일주기리듬을 측정하는 데 사용될 수 있지만 외부 요인에 의한 영향을 많이 받으므로 최근에는 그 유용성이 감소하였다. Cortisol 리듬의 다양한 특성들 또한 일주기리듬의 표지자로 사용될 수 있다. 또한 이러한 세 표지자를 조합하여 더욱 정확한 일주기리듬을 측정할 수도 있다. 이러한 표지자들은 자세, 약물, 스트레스 등과 같은 외부 요인에 영향을 받을 수 있기 때문에, 영향을 미칠 수 있는 가능한 요인들을 통제한 후에 측정하는 것이 중요하다. 수면 경향성은 일주기리듬 체계에 의해 결정되며, 수면 경향성이 가장 빨리 나타나는 순간은 야간 melatonin 분비 시작 대략 2시간 후, 그리고 심부체온이 저하될 때이다. 정상적으로는 수면-각성 주기와 체온 리듬은 안정적인 내적 위상 관계를 유지하며, 체온과 mela-tonin 일주기리듬은 빛-어둠 주기의 변화에 의해 동조를 유지한다. Melatonin 분비의 일주기리듬은 시교차상핵에서 조절되며, 빛-어둠의 자극에 따라 하루 24시간에 맞춰 동조화된다. 이 밖에도 시상하부-뇌하수체-부신 축, 소마토트로픽 축, prolactin, 시상하부-뇌하수체-갑상선 축, 혈중 insulin 등의 내분비 기능, 주관적인 각성과 졸림, 인지 및 실행 기능과 같은 활동 리듬들 또한 일주기리듬의 영향을 받아 조절된다. 이러한 생물학적 리듬들은 다양한 생리적 조절 기능의 조화에 의한 영향을 받으며, 제대로 작동할 경우에는 한 생명체가 그것이 살아가는 환경에서 최고의 기능을 발휘할 수 있도록 해 준다. 그러나 이 분야에 대한 연구는 아직까지는 제한적인 상태이다. 최근 정신과적 질환뿐 아니라 신체 질환에 있어서도 일주기리듬이 중요한 영향을 미칠 수 있다는 연구 결과들이 나오고 있으며, 국내에서도 일주기리듬과 관련된 연구 결과들이 보고되고 있다(Kim 등 2012 ; Min Gyun 등 2013). 정신과적 질환뿐 아니라 다양한 질환들에서 일주기리듬을 이용하여 질환의 원인을 밝히고, 진단과 치료에 있어서도 중요한 역할을 할 수 있을 것으로 생각되며, 이를 위해서는 향후 더 많은 연구가 필요할 것이다.

Abstract

A ‘circadian rhythm’ is a self-sustained biological rhythm (cycle) that repeats itself approximately every 24 hours. Circadian rhythms are generated by an internal clock, or pacemaker, and persist even in the absence of environmental time cues, collectively termed ‘zeitgebers.’ Although organisms generate circadian rhythms internally, they are entrained by environmental stimuli, particularly the light-dark cycle. Measurement of the endogenous melatonin rhythm provides relatively reliable surrogate way of assessing the timing of the internal circadian clock. Also, core body temperature and cortisol can be used as markers of circadian rhythms. The sleep-wake cycle, body temperature, and melatonin rhythm have a stable internal phase relationship in humans and other diurnal species. They play an important role in controlling daily behavioral rhythms including task performance, blood pressure, and synthesis and secretion of several hormones. In this review, we address not only the properties, methods of measurement, and markers of circadian rhythms, but also the physiological and psychological importance of human circadian rhythms.

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