Circadian Rhythm Sleep Disorder

Sufferers of circadian rhythm sleep disorder often misuse alcohol and stimulants. Types of the condition include the following.

• Delayed sleep phase disorder (DSP). People with DSP fall asleep late every night and therefore wake up in the late morning or afternoon on a regular basis.

• Advanced phase sleep disorder (ASP). People with ASP typically wake up between 2am and 5pm and go to sleep between 6pm and 9pm.

• Jet lag disorder. Jet lag disorder, also known as time zone change syndrome, occurs when you travel by plane across many time zones. As a result, your internal clock expects to be awake and asleep at different times.

• Shift work disorder. Shift work disorder occurs because your work schedule requires you to work when your internal body clock expects to be asleep and go to sleep when your body expects to be awake.

• Free running (nonentrained) type. People with free running (nonentrained) type have sleep times that shift a little later each day.

• Irregular sleep-wake rhythm. People with irregular sleep-wake rhythm take naps off and on over a 24-hour period.

The prevalence of a circadian rhythm sleep disorder in the general population is unknown, but DSP is more common in teens and young adults and ASP occurs more frequently as people age.

Irregular sleep-wake rhythm is more likely to occur in people who have little exposure to light and participate in few social activities, such as nursing home patients. The free-running type is common in people who are blind.

Should I See a Sleep Specialist?

In addition to insomnia and excessive daytime sleepiness, circadian sleep disorders can cause depression, disrupt social schedules, put stress on personal relationships, and impair work performance.

To avoid becoming isolated and having trouble maintaining relationships and responsibilities in your life because you sleep and wake up at different times than your friends and family members, see your doctor or a sleep specialist for treatment.

The goal of treatment for circadian sleep disorder is to ensure that you sleep for one long period at night and stay awake for one long period in the daytime.

Treatment may include lifestyle changes, such as strategically scheduling naps, adjusting exposure to daylight, and making changes to daily routines.

Your provider will teach you about good sleep hygiene and advise on developing healthy sleep habits. He or she may recommend bright-light therapy and exercise to assist you in resetting your internal clock.

In addition, medications, such as hypnotics or stimulants, may be prescribed to help you stay awake or fall asleep. A supplement of Melatonin, a hormone produced by the brain at night, may also help to alleviate the symptoms of circadian sleep disorder.

Sources: American Academy of Sleep Medicine: http://www.aasmnet.org/resources/factsheets/crsd.pdfhttp://www.sleepeducation.com/Disorder.aspx?id=63; Stanford University: http://www.stanford.edu/~dement/circadian.html;Merck Manuals: http://www.merckmanuals.com/professional/sec16/ch215/ch215c.html.

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