Circadian rhythm sleep disorders are a family of sleep disorders affecting the timing of sleep.
People with circadian rhythm sleep disorders are unable to sleep and wake at the times required for normal work, school, and social needs.
They are generally able to get enough sleep if allowed to sleep and wake at the times dictated by their body clocks.
Unless they have another sleep disorder, their sleep is of normal quality.
Humans have biological rhythms, known as circadian rhythms, which are controlled by a biological clock and work on a daily time scale.
Due to the circadian clock, sleepiness does not continuously increase as time passes.
Instead, the drive for sleep follows a cycle, and the body is ready for sleep and for wakefulness at different times of the day.
Types of circadian rhythm sleep disorders
Two of these disorders are extrinsic (from Latin extrinsecus, from without, on the outside) or circumstantial:
Jet lag, which affects people who travel across several time zones.
Shift work sleep disorder, which affects people who work nights or rotating shifts.
Intrinsic type
Four of them are intrinsic (from Latin intrinsecus, on the inside, inwardly), "built-in":
Delayed sleep phase disorder (DSPD), aka delayed sleep phase syndrome (DSPS), characterized by a much later than normal timing of sleep onset and offset and a period of peak alertness in the middle of the night.
Advanced sleep phase syndrome (ASPS), characterized by difficulty staying awake in the evening and difficulty staying asleep in the morning.
Non-24-hour sleep-wake syndrome (Non-24), in which the affected individual's sleep occurs later and later each day, with the period of peak alertness also continuously moving around the clock from day to day.
Irregular sleep-wake rhythm, which presents as sleeping at very irregular times, and usually more than twice per day (waking frequently during the night and taking naps during the day) but with total time asleep typical for the person's age.
Treatment for circadian rhythm sleep disorders
Possible treatments for circadian rhythm sleep disorders include:
Behavior therapy or advice about sleep hygiene where the patient is told to avoid naps, caffeine, and other stimulants. They are also told to not be in bed for anything besides sleep and sex
Bright light therapy is used to advance or delay sleep, depending on how the circadian rhythm is shifted. Patients are exposed to high-intensity light (up to 10,000 lux) for a duration of 30–60 minutes at a time, the time of day depending on whether an advance or a delay is required.
Blue blocking glasses therapy is used to block blue wavelength light from reaching the eye during evening hours so that melatonin production is increased.
Medications such as melatonin and modafinil (Provigil), or other short term sleep aids or wake-promoting agents can be beneficial; the former is a natural neurohormone responsible partly and in tiny amounts for the human body clock. Tasimelteon has been proven effective in Phase III trials.
Sleep phase chronotherapy progressively advances or delays the sleep time by 1–2 hours per day
People with circadian rhythm sleep disorders are unable to sleep and wake at the times required for normal work, school, and social needs.
They are generally able to get enough sleep if allowed to sleep and wake at the times dictated by their body clocks.
Unless they have another sleep disorder, their sleep is of normal quality.
Humans have biological rhythms, known as circadian rhythms, which are controlled by a biological clock and work on a daily time scale.
Due to the circadian clock, sleepiness does not continuously increase as time passes.
Instead, the drive for sleep follows a cycle, and the body is ready for sleep and for wakefulness at different times of the day.
Types of circadian rhythm sleep disorders
Two of these disorders are extrinsic (from Latin extrinsecus, from without, on the outside) or circumstantial:
Jet lag, which affects people who travel across several time zones.
Shift work sleep disorder, which affects people who work nights or rotating shifts.
Intrinsic type
Four of them are intrinsic (from Latin intrinsecus, on the inside, inwardly), "built-in":
Delayed sleep phase disorder (DSPD), aka delayed sleep phase syndrome (DSPS), characterized by a much later than normal timing of sleep onset and offset and a period of peak alertness in the middle of the night.
Advanced sleep phase syndrome (ASPS), characterized by difficulty staying awake in the evening and difficulty staying asleep in the morning.
Non-24-hour sleep-wake syndrome (Non-24), in which the affected individual's sleep occurs later and later each day, with the period of peak alertness also continuously moving around the clock from day to day.
Irregular sleep-wake rhythm, which presents as sleeping at very irregular times, and usually more than twice per day (waking frequently during the night and taking naps during the day) but with total time asleep typical for the person's age.
Treatment for circadian rhythm sleep disorders
Possible treatments for circadian rhythm sleep disorders include:
Behavior therapy or advice about sleep hygiene where the patient is told to avoid naps, caffeine, and other stimulants. They are also told to not be in bed for anything besides sleep and sex
Bright light therapy is used to advance or delay sleep, depending on how the circadian rhythm is shifted. Patients are exposed to high-intensity light (up to 10,000 lux) for a duration of 30–60 minutes at a time, the time of day depending on whether an advance or a delay is required.
Blue blocking glasses therapy is used to block blue wavelength light from reaching the eye during evening hours so that melatonin production is increased.
Medications such as melatonin and modafinil (Provigil), or other short term sleep aids or wake-promoting agents can be beneficial; the former is a natural neurohormone responsible partly and in tiny amounts for the human body clock. Tasimelteon has been proven effective in Phase III trials.
Sleep phase chronotherapy progressively advances or delays the sleep time by 1–2 hours per day
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