Circadian Rhythm Disorders, the Good and the Bad

Our sleep and awake cycles are controlled by an internal clock known as our circadian rhythm (circa is Latin for “about” and “dies” is “day” made into an adjective). Normally, we sleep when it’s dark outside and arise when it starts getting light. This is a typical circadian rhythm pattern, but some of us suffer from circadian rhythm disorders, either temporary or long-term.

Short-term circadian rhythm disorders can arise from jet leg or changes in work shifts. Long-term disorders include delayed sleep phase syndrome (DSP) — you eventually fall asleep but wake up too late — and advanced sleep phase syndrome (ASP) — you eventually fall asleep but awake too early.

Even though both DSP and ASP are termed “disorders,” people with DSP and ASP can still get normal sleep, according to the American Academy of Sleep Medicine (AASM), which notes: “People with DSP tend to be ‘evening types’ who typically stay awake until 1 a.m. or later and wake-up in the late morning or afternoon. If able to go to bed at the preferred late time on a regular basis, a person with DSP will have a very stable sleep pattern.”

Similarly, people with ASP are “morning types” who can adjust to a waking-early life-style and function perfectly well, if the demands of their lives (work, family and the like) allow it. ASP tends to hit middle-aged and older adults and worsens as we age, but only one percent of all adults suffer from it.

Jet lag worsens as the number of time zones traversed increases; it also affects people more severely when traveling eastward rather than westward. Jet lag symptoms also tend to increase with age.

Work-shift disorder affects people who have to work while others are asleep. Many who work night shifts and early-morning shifts find it difficult to sleep during the day.

Some of the effects of sleep disorders include, obviously, loss of sleep and excessive daytime sleepiness, plus insomnia, depression, impaired work performance, disrupted social schedules and stressed relationships.

Depending on the type of sleep disorder, various treatments and hygienal approaches are available.

First is a life-style change. If working the night shift is ruining your sleep and your social life, try getting a new job. For other disorders, increasing your exposure to daylight will help reset your circadian clock.

Closely connected to life-style change is good sleep hygiene. We’ve written about good sleep hygiene on many occasions, but it all starts with going to bed and arising at the same times each day, even on the weekends, and it also involves a good bedroom environment and attention to food and drink habits.

Bright light therapy is often used to synchronize your body clock. Medications can be prescribed to help both with falling asleep and with getting up on time. Melatonin, the body’s naturally produced sleep hormone, can also be taken in tablet form to help the sleep cycle.

Except for jet lag or night shift problems that can be solved with time, or a change in jobs, you should definitely consult with a sleep professional if you’re experiencing difficulties getting a good night’s rest and as a result your days suffer.

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