Everything You Need to Know about Circadian Rhythm Sleep Disorder

What is Circadian Rhythm and How Does It Affect Your Sleep?

• Michael W. Young, Jeffrey C. Hall and Michael Rosbash has won the prestigious Nobel Prize award in Physiology Medicine in 2017. Their discovery focuses on “molecular mechanism controlling circadian rhythm” in fruit flies.

• National Library of Medicine has supported researchers for their “phenotyping circadian rhythms in mice” in 2015.

• Another researcher in 2018, also studied mammalian circadian nature of physiology and behavior.

What are the Main Types of Circadian Rhythm Disorder?

• Advanced Sleep Phase Disorder (ASP): also known as advanced sleep phase syndrome. This is more common in middle-aged and elderly people who go to bed earlier than average, between 6pm and 9pm and morning wake-cycle from 2am to 5am. The sleep pattern can affect your sleep-wake time, resulting in afternoon sleepiness, whereas naps are more likely to occur in between and may affect your bedtime sleeping hours. In order to delay the onset and offset sleep, ASP can be treated with light therapy, chronotherapy, melatonin administration, or hypnotics. Despite the fact that there is no evidence of efficacy, it is still best to consult your healthcare provider.

• Delayed Sleep Phase Disorder (DSPD): also known as delayed sleep phase syndrome or delayed sleep-wake phase disorder. If you describe yourself as a “night owl”, then you are highly susceptible to this type of circadian rhythm sleep disorder. People in this condition sleep later than usual and thus wake up late or have to drag themselves out of bed. According to some studies, the majority of patients with this disorder have clinical depression or psychological issues. If this condition worsens, it can lead to chronic insomnia. This disorder is also linked to attention deficit hyperactivity disorder (ADHD), Obesity and Obsessive-Compulsive Disorder (OCD).

• Irregular Sleep-Wake Disorder (ISWD): also known as invisible disability. This disorder is normally characterized by excessive naps throughout the day. People in this condition has the higher tendency of being isolated and home-bound due to irregular pattern of sleep and wake hours. ISWD is a rare condition which has been linked to a variety of neurological conditions such as dementia, brain damage, and other mental health disorders. To diagnose ISWD, your doctor will typically conduct a thorough review of your medical history as well as a neurological exam. You will also be observed for several weeks and may be asked to log your wake-sleep pattern using actigraphy. This disorder can be treated with good sleep hygiene, melatonin consumption, and behavioral counseling.

• Jet lag disorder: also known as time zone change syndrome or desynchronosis. It is most common in intercontinental flights, such as travelling from Sydney to Bahrain will took you almost 18 hours with a time difference of 7 to 8 hours, when it’s 3AM/4AM in Sydney your body detects Bahrain timings of 8PM. Another example is Los Angeles to HongKong flights, whereas Hongkong is 15 hours ahead of Los Angeles. Due to each time cross, your body needs to adjust. Jetlag normally can be fixed in a day or two, it can be longer depending on the time zone.

• Shift Work Sleep Disorder (SWSD): this form of circadian rhythm disorder occurs when your sleep-wake cycle is disrupted. This man-made problem has affected especially people who are on shiftwork, such as early-morning shifts (e.g. starting at 4 am in the morning), night and evening shifts (e.g. night owl) or rotational shifts. This disorder typically starts with short term symptoms such as excessive sleep, anxiety, insomnia, headache, fatigue and lack of energy, while long term effect can lead to chronic insomnia, cardiovascular disease, cancer, depression, obesity, diabetes, high blood pressure, gastrointestinal problems, weakened immune system, menstrual irregularity and fertility problems. This can be treated by taking sleep supplements, using light therapy, limiting caffeine consumption, especially before bed, and practicing good sleep hygiene.

• Non-24-hour sleep-wake disorder (N24): also known as N24SWD or hypernychthemeral syndrome or free-running disorder, this is one of the more severe cases of circadian rhythm disorder. This condition is found in people whose brains can’t acknowledge lightning or have shown to be supersensitive to light which leads to irregular sleep patterns. N24 is commonly seen in blind people due to a lack of light perception or a lack of light response. Also, this disorder has been linked to some sleep disorder such as idiopathic hypersomnia, narcolepsy and Kleine-Levin syndrome, bipolar disorder, depression, traumatic brain injury, Mendelian inheritance, and hormone imbalances. Treatment for N24 involves light therapy and dark therapy or a combination of both.

What are the Symptoms of a Circadian Rhythm Sleep Disorder?

• Excessive daytime sleepiness or periodic night insomnia

• People suffering from this disorder face issues in falling and staying asleep. A few of them have difficulty in both

• Circadian rhythm sleep disorder makes it difficult to stay awake and alert during the day

• Fatigue, exhaustion, and lethargy are common while suffering from this condition

• Inability to concentrate

• Mood swings and Irritability

• Affects lower cognitive ability or selective attention

• Headaches

• Those suffering from jet lag frequently experience stomach problems

Who is at Risk for a Circadian Rhythm Sleep Disorder?

• Congestive heart failure

• Thyroid Disorder (Hyperthyroidism or Graves Disease)

• Dementia

• Chronic obstructive pulmonary disease

• Chronic pain syndromes

• Intellectual Disability or Cognitive Impairment

How is a Circadian Rhythm Sleep Disorder Treated?

Depressant Medication

Home Care

• Indulge in quiet activities before settling in bed. For instance, reading

• Avoid tea, coffee, nicotine, and other stimulants before sleeping

• Keep away from bright lights

• Ensure that your room is well ventilated, comfy, and quiet

• Choose a comfortable bed mattress

• Use dim lights before bedtime

• Bright light therapy is also best for circadian rhythm

• Practice good-sleep hygiene

• Aromatic or calming scents can also be used to induce sleep

• Avoid unnecessary naps

• Keep your gadget away at least 2 hours before bedtime

Summary