Circadian Rhythm Sleep Disorders

Reviewed Jan 19, 2017

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Summary

  • Certain sleep patterns conflict with daytime duties.
  • Teens are more prone to going to bed late, and they may not get enough sleep.
  • Sleep specialist can help treat circadian rhythm sleep disorders.

The body clock

There are two systems in the body that control sleep. Sleep/wake homeostasis tells us that our need for sleep is building throughout the day. It also tells us when it is time to sleep and how much. Our circadian biological clock controls alertness and fatigue during the day. This rhythm brings the strongest urges to sleep between 2 a.m. to 4 a.m. and 1 p.m. to 3 p.m. If you are low on sleep, the fatigue will be more intense at those times.

The clock is run by a part of the brain that reacts to light and dark signals. When light hits, the clock gets a signal that it is time to wake up. Signals also trigger changes that help us feel awake, such as a rise in body temperature. This light also delays release of melatonin. This is a hormone linked to sleep, so it spikes at night.

Circadian rhythm sleep disorders

Some people who have routine shifts in sleep patterns and timing really have a disorder.

Delayed sleep phase disorder

People with delayed sleep phase disorder (DSPD) are not able to fall asleep and rise at “normal” times. They may go to sleep very late, into the early morning hours, and then not be able to wake up until much later the next day. Needs are met for the amount and quality of sleep, but the timing is delayed.

The tendency for DSPD can be passed down in families. Lifestyle habits such as late night computer use can also cause DSPD.

DSPD is more common among young adults and is often seen in teens. In fact, the melatonin spike for teens happens later at night than it does for people of other ages. So, it can be hard for teens to fall asleep before 11 p.m. This can make it hard for them to get enough sleep before an early start to school. And if teens haven’t had enough, their strongest urges to sleep can run until 9 a.m. or 10 a.m. This can make for very cranky mornings and poor performance at school. If you have a teen with these patterns, you can try to:

  • Dim the lights at night
  • Bring bright light into the room as soon as possible in the morning
  • Work with a sleep specialist to shift sleep schedules

Advanced sleep phase disorder

People who have advanced sleep phase disorder (ASPD) go to bed and wake earlier than most other people. It is most common among older people. People with ASPD who have to perform tasks at night may not get enough sleep. It may be passed down in families.

Irregular sleep-wake disorder

Irregular sleep-wake disorder involves a poorly defined cycle. People who have it may have 3 or more periods of sleep within 24 hours, none of which are long like a typical nighttime sleep. Naps are common with this rare disorder. People might wake at night to work and catch up on sleep during the day. But this pattern is not restful.

Jet lag disorder

Jet lag can alter the light signals sent to the brain when going between time zones. It can make it hard to think clearly and perform well. Some people cope better than others with the change, although it can be harder for older adults. It is also harder to adjust the further the travel distance. It is important to stick with healthy sleep habits on the go. For instance, no matter how tired, skip caffeine so you can sleep when it's time.

Shift work disorder

Keeping long and/or irregular hours can disrupt your body clock. For shift workers, this can pose a big challenge. Schedules can run late into the night and early morning, causing a loss of up to four hours of sleep. The result is that it can be hard to think clearly and perform well. There is also a higher rate of accidents, missed work days and depression. Shift workers are also at higher risk for ulcers, heart disease, diabetes and other health conditions. It is vital that shift workers talk to family members about needing daytime sleep.

Getting help

If you are sleepy during the day or have any of the sleep patterns described here, talk to your doctor. Your doctor may refer you to a sleep specialist or center for more tests and treatment. You will likely need to track your sleep with a log or actigraph, a tool used to monitor activity. This will help your doctor understand your sleep/wake patterns. You will also need to work with your doctor to treat other health conditions you may have.

Research has shown promise for a few treatment options. Experts are still collecting data to figure out what works best. Talk with your doctor or sleep specialist about:

  • Light therapy
  • Chronotherapy, which means shifting schedules around bedtime and rising with the help of a doctor
  • Melatonin as a pill
  • Medicines called hypnotics

Talk to your doctor about your options to help get your sleep back on track.

Resources

Cleveland Clinic Sleep Disorders Center
http://my.clevelandclinic.org/services/neurological_institute/sleep-disorders-center

National Sleep Foundation
www.sleepfoundation.org

By Sarah Stone
Source: National Sleep Foundation, http://sleepfoundation.org/sleep-topics/sleep-drive-and-your-body-clock, http://sleepdisorders.sleepfoundation.org/chapter-5-circadian-rhythm-sleep-disorders/delayed-sleep-phase-type/definition/what-is-delayed-phase-sleep-disorder/ and http://sleepfoundation.org/sleep-disorders-problems/alzheimers-disease-and-sleep; The Cleveland Clinic, http://my.clevelandclinic.org/services/neurological_institute/sleep-disorders-center/disorders-conditions/hic-circadian-rhythm-disorders and http://my.clevelandclinic.org/services/neurological_institute/sleep-disorders-center/disorders-conditions/hic-delayed-sleep-phase-syndrome; Ines Campos, Costa et al. (2013) "Aging, Circadian Rhythms and Depressive Disorders: a Review." American Journal of Neurodegenerative Disease, Volume 2(4):228-246.
Reviewed by Gary R. Proctor, MD, Associate Chief Medical Officer, Beacon Health Options

Summary

  • Certain sleep patterns conflict with daytime duties.
  • Teens are more prone to going to bed late, and they may not get enough sleep.
  • Sleep specialist can help treat circadian rhythm sleep disorders.

The body clock

There are two systems in the body that control sleep. Sleep/wake homeostasis tells us that our need for sleep is building throughout the day. It also tells us when it is time to sleep and how much. Our circadian biological clock controls alertness and fatigue during the day. This rhythm brings the strongest urges to sleep between 2 a.m. to 4 a.m. and 1 p.m. to 3 p.m. If you are low on sleep, the fatigue will be more intense at those times.

The clock is run by a part of the brain that reacts to light and dark signals. When light hits, the clock gets a signal that it is time to wake up. Signals also trigger changes that help us feel awake, such as a rise in body temperature. This light also delays release of melatonin. This is a hormone linked to sleep, so it spikes at night.

Circadian rhythm sleep disorders

Some people who have routine shifts in sleep patterns and timing really have a disorder.

Delayed sleep phase disorder

People with delayed sleep phase disorder (DSPD) are not able to fall asleep and rise at “normal” times. They may go to sleep very late, into the early morning hours, and then not be able to wake up until much later the next day. Needs are met for the amount and quality of sleep, but the timing is delayed.

The tendency for DSPD can be passed down in families. Lifestyle habits such as late night computer use can also cause DSPD.

DSPD is more common among young adults and is often seen in teens. In fact, the melatonin spike for teens happens later at night than it does for people of other ages. So, it can be hard for teens to fall asleep before 11 p.m. This can make it hard for them to get enough sleep before an early start to school. And if teens haven’t had enough, their strongest urges to sleep can run until 9 a.m. or 10 a.m. This can make for very cranky mornings and poor performance at school. If you have a teen with these patterns, you can try to:

  • Dim the lights at night
  • Bring bright light into the room as soon as possible in the morning
  • Work with a sleep specialist to shift sleep schedules

Advanced sleep phase disorder

People who have advanced sleep phase disorder (ASPD) go to bed and wake earlier than most other people. It is most common among older people. People with ASPD who have to perform tasks at night may not get enough sleep. It may be passed down in families.

Irregular sleep-wake disorder

Irregular sleep-wake disorder involves a poorly defined cycle. People who have it may have 3 or more periods of sleep within 24 hours, none of which are long like a typical nighttime sleep. Naps are common with this rare disorder. People might wake at night to work and catch up on sleep during the day. But this pattern is not restful.

Jet lag disorder

Jet lag can alter the light signals sent to the brain when going between time zones. It can make it hard to think clearly and perform well. Some people cope better than others with the change, although it can be harder for older adults. It is also harder to adjust the further the travel distance. It is important to stick with healthy sleep habits on the go. For instance, no matter how tired, skip caffeine so you can sleep when it's time.

Shift work disorder

Keeping long and/or irregular hours can disrupt your body clock. For shift workers, this can pose a big challenge. Schedules can run late into the night and early morning, causing a loss of up to four hours of sleep. The result is that it can be hard to think clearly and perform well. There is also a higher rate of accidents, missed work days and depression. Shift workers are also at higher risk for ulcers, heart disease, diabetes and other health conditions. It is vital that shift workers talk to family members about needing daytime sleep.

Getting help

If you are sleepy during the day or have any of the sleep patterns described here, talk to your doctor. Your doctor may refer you to a sleep specialist or center for more tests and treatment. You will likely need to track your sleep with a log or actigraph, a tool used to monitor activity. This will help your doctor understand your sleep/wake patterns. You will also need to work with your doctor to treat other health conditions you may have.

Research has shown promise for a few treatment options. Experts are still collecting data to figure out what works best. Talk with your doctor or sleep specialist about:

  • Light therapy
  • Chronotherapy, which means shifting schedules around bedtime and rising with the help of a doctor
  • Melatonin as a pill
  • Medicines called hypnotics

Talk to your doctor about your options to help get your sleep back on track.

Resources

Cleveland Clinic Sleep Disorders Center
http://my.clevelandclinic.org/services/neurological_institute/sleep-disorders-center

National Sleep Foundation
www.sleepfoundation.org

By Sarah Stone
Source: National Sleep Foundation, http://sleepfoundation.org/sleep-topics/sleep-drive-and-your-body-clock, http://sleepdisorders.sleepfoundation.org/chapter-5-circadian-rhythm-sleep-disorders/delayed-sleep-phase-type/definition/what-is-delayed-phase-sleep-disorder/ and http://sleepfoundation.org/sleep-disorders-problems/alzheimers-disease-and-sleep; The Cleveland Clinic, http://my.clevelandclinic.org/services/neurological_institute/sleep-disorders-center/disorders-conditions/hic-circadian-rhythm-disorders and http://my.clevelandclinic.org/services/neurological_institute/sleep-disorders-center/disorders-conditions/hic-delayed-sleep-phase-syndrome; Ines Campos, Costa et al. (2013) "Aging, Circadian Rhythms and Depressive Disorders: a Review." American Journal of Neurodegenerative Disease, Volume 2(4):228-246.
Reviewed by Gary R. Proctor, MD, Associate Chief Medical Officer, Beacon Health Options

Summary

  • Certain sleep patterns conflict with daytime duties.
  • Teens are more prone to going to bed late, and they may not get enough sleep.
  • Sleep specialist can help treat circadian rhythm sleep disorders.

The body clock

There are two systems in the body that control sleep. Sleep/wake homeostasis tells us that our need for sleep is building throughout the day. It also tells us when it is time to sleep and how much. Our circadian biological clock controls alertness and fatigue during the day. This rhythm brings the strongest urges to sleep between 2 a.m. to 4 a.m. and 1 p.m. to 3 p.m. If you are low on sleep, the fatigue will be more intense at those times.

The clock is run by a part of the brain that reacts to light and dark signals. When light hits, the clock gets a signal that it is time to wake up. Signals also trigger changes that help us feel awake, such as a rise in body temperature. This light also delays release of melatonin. This is a hormone linked to sleep, so it spikes at night.

Circadian rhythm sleep disorders

Some people who have routine shifts in sleep patterns and timing really have a disorder.

Delayed sleep phase disorder

People with delayed sleep phase disorder (DSPD) are not able to fall asleep and rise at “normal” times. They may go to sleep very late, into the early morning hours, and then not be able to wake up until much later the next day. Needs are met for the amount and quality of sleep, but the timing is delayed.

The tendency for DSPD can be passed down in families. Lifestyle habits such as late night computer use can also cause DSPD.

DSPD is more common among young adults and is often seen in teens. In fact, the melatonin spike for teens happens later at night than it does for people of other ages. So, it can be hard for teens to fall asleep before 11 p.m. This can make it hard for them to get enough sleep before an early start to school. And if teens haven’t had enough, their strongest urges to sleep can run until 9 a.m. or 10 a.m. This can make for very cranky mornings and poor performance at school. If you have a teen with these patterns, you can try to:

  • Dim the lights at night
  • Bring bright light into the room as soon as possible in the morning
  • Work with a sleep specialist to shift sleep schedules

Advanced sleep phase disorder

People who have advanced sleep phase disorder (ASPD) go to bed and wake earlier than most other people. It is most common among older people. People with ASPD who have to perform tasks at night may not get enough sleep. It may be passed down in families.

Irregular sleep-wake disorder

Irregular sleep-wake disorder involves a poorly defined cycle. People who have it may have 3 or more periods of sleep within 24 hours, none of which are long like a typical nighttime sleep. Naps are common with this rare disorder. People might wake at night to work and catch up on sleep during the day. But this pattern is not restful.

Jet lag disorder

Jet lag can alter the light signals sent to the brain when going between time zones. It can make it hard to think clearly and perform well. Some people cope better than others with the change, although it can be harder for older adults. It is also harder to adjust the further the travel distance. It is important to stick with healthy sleep habits on the go. For instance, no matter how tired, skip caffeine so you can sleep when it's time.

Shift work disorder

Keeping long and/or irregular hours can disrupt your body clock. For shift workers, this can pose a big challenge. Schedules can run late into the night and early morning, causing a loss of up to four hours of sleep. The result is that it can be hard to think clearly and perform well. There is also a higher rate of accidents, missed work days and depression. Shift workers are also at higher risk for ulcers, heart disease, diabetes and other health conditions. It is vital that shift workers talk to family members about needing daytime sleep.

Getting help

If you are sleepy during the day or have any of the sleep patterns described here, talk to your doctor. Your doctor may refer you to a sleep specialist or center for more tests and treatment. You will likely need to track your sleep with a log or actigraph, a tool used to monitor activity. This will help your doctor understand your sleep/wake patterns. You will also need to work with your doctor to treat other health conditions you may have.

Research has shown promise for a few treatment options. Experts are still collecting data to figure out what works best. Talk with your doctor or sleep specialist about:

  • Light therapy
  • Chronotherapy, which means shifting schedules around bedtime and rising with the help of a doctor
  • Melatonin as a pill
  • Medicines called hypnotics

Talk to your doctor about your options to help get your sleep back on track.

Resources

Cleveland Clinic Sleep Disorders Center
http://my.clevelandclinic.org/services/neurological_institute/sleep-disorders-center

National Sleep Foundation
www.sleepfoundation.org

By Sarah Stone
Source: National Sleep Foundation, http://sleepfoundation.org/sleep-topics/sleep-drive-and-your-body-clock, http://sleepdisorders.sleepfoundation.org/chapter-5-circadian-rhythm-sleep-disorders/delayed-sleep-phase-type/definition/what-is-delayed-phase-sleep-disorder/ and http://sleepfoundation.org/sleep-disorders-problems/alzheimers-disease-and-sleep; The Cleveland Clinic, http://my.clevelandclinic.org/services/neurological_institute/sleep-disorders-center/disorders-conditions/hic-circadian-rhythm-disorders and http://my.clevelandclinic.org/services/neurological_institute/sleep-disorders-center/disorders-conditions/hic-delayed-sleep-phase-syndrome; Ines Campos, Costa et al. (2013) "Aging, Circadian Rhythms and Depressive Disorders: a Review." American Journal of Neurodegenerative Disease, Volume 2(4):228-246.
Reviewed by Gary R. Proctor, MD, Associate Chief Medical Officer, Beacon Health Options

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