Circadian Rhythm Disorders

Circadian rhythms are physical processes maintained by sunlight and other time cues that keep the sleep-wake patterns on a consistent 24-hour schedule. Circadian functions include body temperature, hormone levels, and the sleep-wake cycle. In healthy people, the circadian rhythms rise and fall throughout the day and night to signal wakefulness or sleepiness. Timing of circadian rhythms can differ from person to person. Some people naturally have later rhythms and while others have earlier rhythms. Circadian rhythm disorders generally occur when there is a mismatch between an individual’s natural circadian timing and their intended sleep-wake schedule.

What are some of the circadian rhythm disorders that BSM specialists treat?

Delayed Sleep Phase Syndrome (DSPS) can affect people of all ages but most commonly occurs in teenagers and young adults. Roughly 7% of people in both age groups struggle to fall asleep until very late at night and have difficulty getting out of bed in the morning. Many people with DSPS consider themselves to be “night owls.” They may have significant problems with getting up to go to school, going to work and may struggle with daytime sleepiness. This may make it difficult to function in society.

Advanced Sleep Phase Syndrome (ASPS) is most common, but not limited to older adults. People with ASPS start feeling sleepy in the early afternoon. They often wake up too early and cannot go back to sleep. Symptoms may go unrecognized since ASPS rarely interferes with life except for social events or business meetings in the early evening.

Shift Work causes workers to get less sleep during the day than day workers who sleep at night. Night shift worker’s sleep is often patchy because the brain is set to be awake during the daytime. People who work rotating shifts often have difficulty getting enough sleep, since adjusting to the changing work schedule can be quite challenging.

Jet Lag is a common sleep problem that occurs whenever someone travels between time zones. Symptoms include indigestion, daytime sleepiness, insomnia, poor concentration, and irritability. Some people can adjust quickly, but others need many days to adjust.

How do Behavioral Sleep Medicine Specialists Treat Circadian Rhythm Disorders?

BSM practitioners offer specialized, research-based programs to help address circadian rhythm disorders. The experience of sleep disturbance is unique to each person and is related to many factors including life circumstances, coping styles, and biological predispositions. Treatment is formulated based upon each patient’s unique experience.

Depending on the problem, treatment may include:

• Education about both the sleep drive and circadian rhythms and how they interact
• Use of natural or artificial bright light at to help reset the biological clock
• Learning strategies to help you fall asleep faster and get out of bed in the morning or stay awake later at night.
• Use of melatonin
• Changing current sleep patterns to better fit your biological clock
• Systematically changing bedtimes and waketimes over several weeks until the desired timing of sleep and wake is acheived

Although each person’s situation is different, treatment can generally be completed in 3-6 sessions.