CIRCADIAN RHYTHM DISORDERS
Short term disorders:
Chronic disorders:
The circadian rhythm disorder often misdiagnosed as ADHD:
The most common circadian rhythm disorder is really just a bad habit
Jet lag
- Temporary condition from changing time zones in a short period of time.
- Your internal clock usually can't be adjusted more than one hour ahead or behind per week.
- Your internal clock is still in the old time zone while your body is in the new one.
- Symptoms of jet lag include:
insomnia (can't fall asleep, can't stay asleep or can't get back
hypersomnia (no matter how much sleep you get, it isn't
- Jet lag effects everyone differently and to different degrees.
- It is usually more pronounced when travel is to the east rather than the west.
- Reason: it is easier to lengthen a circadian phase than to shorten it.
- Moving your internal clock ahead an hour or two per week by moving your bedtime and risetime forward (later) is the best way to head off jet lag, but our schedules generally do not allow for this.
- So the best you can do if you are traveling east, is to try and sleep on the flight and go to bed at the new time zone's bedtime.
- Chances are your trip will be short enough (i.e., less than 5 weeks if you travelled forward or backward 5 time zones) that you'll be home before your body has finished adjusting and you'll experience the worst of the jet lag after you're home again.
- If the trip is really short, the jet lag will be minimum.
- Bright light therapy (2,500-10,000 Lux) has been found to be useful to help speed recovery from jet lag. For example, if you have trouble going to bed early enough to get enough sleep, get exposure to as much bright light as possible early in the morning - around 6 AM; if you are having trouble staying awake in the evening, fight the urge to bed before 10 pm and get the bright light exposure in the evening (6-8 PM). Avoid it in the morning until your clock has been successfully re-set.
- There are those who believe that melatonin, a hormone produced by the pineal gland, can help with jet lag by synchronizing circadian rhythms in humans.
- The theory is that melatonin taken in the evening will advance rhythms, taken in the morning will delay rhythms. However, more studies are needed to actually prove melatonin's effect, if any, on human circadian rhythm and to determine if it is truly effective in treating circadian rhythm disorders. It must be noted that the production, purity, dosing, etc. of melatonin is not regulated by the FDA, so consistency, safety and other standards may be lacking or questionable.
Resetting your rhythm or turning your "clock" around
- Old habits die hard, especially those that deal with sleep.
- Changing a bedtime takes a lot of desire and dedication.
- To get more sleep, start going to bed 1/2 hour to 1 hour earlier every night. Get up at the same time every morning. Do this for one week. Push your bedtime back by 1/2 hour every week until you no longer feel tired during the day.
- If you have trouble going to bed earlier than you're used to, get exposure to as much bright light as possible early in the morning - 6 AM is ideal.
- Four times a week, get at least 20 minutes of some vigorous exercise no later than 6 pm - preferably aerobic in nature, such as a brisk walk.
- Turn the lights down at 9 pm and avoid stimulating activities, conversations or TV shows.
- Develop a relaxing bedtime routine that involves any or all of the following:
warm bath or shower about an hour before sleeptime
no food or drink except a light snack of tryptophan
a massage (a do-it -yourself foot rub can't be beat)
Shift work sleep disorder
- Man is meant to sleep after dark, not work.
- Shiftwork creates a chronic condition in which the internal circadian rhythm is out of sync with the external time cues of day and night / light and dark.
an increased incidence of illness
insomnia (can't fall asleep, stay asleep or get back to sleep)
hypersomnia (no matter how much sleep you get, it isn't
medical / psychiatric illness
stress from the negative social impact
increased incidence of breast cancer
- Bright light therapy (2,500-10,000 Lux) has been found to be useful to help re-set the internal clock and therefore the circadian rhythm. For example, if you have trouble going to bed early enough to get enough sleep, get exposure to as much bright light as possible early in the morning - 6 AM; if you are having trouble staying awake in the evening, don't go to bed before 10 pm and get the bright light exposure in the evening (6-8 PM). Avoid it in the morning until your clock has been successfully re-set. This has been successful in helping people adjust to coming on / going off shiftwork.
- There are those who believe that melatonin, a hormone produced by the pineal gland, can help with shift work sleep disorders by synchronizing circadian rhythms in humans. The theory is that melatonin taken in the evening will advance rhythms, taken in the morning will delay rhythms. However, more studies are needed to actually prove melatonin's effect, if any, on human circadian rhythm and to determine if it is truly effective in treating circadian rhythm disorders. It must be noted that the production, purity, dosing, etc. of melatonin is not regulated by the FDA, so consistency, safety and standards may be questionable.
Seasonal Affective Disorder (SAD)
- symptoms occur every year in the fall or winter.
- they include that people with SAD:
- Bright light therapy (2,500-10,000 Lux) has been found to be useful to help re-set the internal clock and therefore the circadian rhythm. For example, if you have trouble going to bed early enough to get enough sleep, get exposure to as much bright light as possible early in the morning - 6 AM; if you are having trouble staying awake in the evening, don't go to bed before 10 pm and get the bright light exposure in the evening (6-8 PM). Avoid it in the morning until your clock has been successfully re-set. This has been successful in treating Seasonal Affective Disorder.
Delayed Sleep Phase Syndrome
- Usually only directly effects adolescents. It makes them want to go to bed later (delayed sleep), sleep normally and get up later, if allowed. It is not a social thing, it is a circadian rhythm thing. They don't necessarily stay up late because they want to; they may actually find it difficult or impossible to sleep if they go to bed earlier.
- A few states have given in to mother nature and have legislated against high school start times earlier than 9 am. Unfortunately, most states have ignored or remained ignorant of the circadian rhythm effect and continue to start high school at 7:30 or 8 am and elementary school at 8:30 or 9 am, rather than reversing the times. Both ages would benefit from reversed start times in terms of the potential increase in their learning ability.
- Such changes are multi-faceted, but leaving start times as they have been, results in sleep deprivation of our adolescent population and the inherent loss of alertness, reflexes, etc., which then leads to loss of classroom alertness and learning potential, as well as increased risk of motor vehicle accidents. There are more teenagers killed in the U.S. annually from fatigue related motor vehicle accidents than from alcohol related motor vehicle accidents.
- Some youngsters are even mistakenly diagnosed as having ADHD, due to the fact that their fatigue results in hyperactive behavior, just like an over-tired baby. They need to be evaluated and treated for any physical connection to their excessive fatigue such as OSA (obstructive sleep apnea), in combination with extensive behavior modification therapy and implementation of sleep hygiene.
- A Personal Sleep Trainer could help verify the true cause of the disruptive behavior and suggest a plan of treatment.
- Bright light therapy (2,500-10,000 Lux) has been found to be useful to help re-set the internal clock and therefore the circadian rhythm. For example, if you have trouble going to bed early enough to get enough sleep, get exposure to as much bright light as possible early in the morning - 6 AM.
- There are those who believe that melatonin, a hormone produced by the pineal gland, can help synchronize circadian rhythms in humans. The theory is that melatonin taken in the morning will delay rhythms. However, more studies are needed to actually prove melatonin's effect, if any, on human circadian rhythm and to determine if it is truly effective in treating circadian rhythm disorders.
- It must be noted that the production, purity, dosing, etc. of melatonin is not regulated by the FDA, so consistency, safety and standards may be questionable.
Advanced Sleep Phase Syndrome
- Usually develops in older people and often runs in families.
- This circadian rhythm disorder results in excessive sleepiness in the early evening with a resultant tendency to go to bed earlier (advancing the sleep time) and undesired awakening early in the morning.
- Exercise, late in the afternoon / early evening, is useful in delaying the sleep time.
- Bright light therapy (2,500-10,000 Lux) has been found to be useful to help re-set the internal clock and therefore the circadian rhythm. For example, if you are having trouble staying awake in the evening, don't go to bed before 10 pm and get the bright light exposure in the evening (6-8 PM). Avoid it in the morning until your clock has been successfully re-set.
- There are those who believe that melatonin, a hormone produced by the pineal gland, can help synchronize circadian rhythms in humans. The theory is that melatonin taken in the morning will delay rhythms. However, more studies are needed to actually prove melatonin's effect, if any, on human circadian rhythm and to determine if it is truly effective in treating circadian rhythm disorders.
- It must be noted that the production, purity, dosing, etc. of melatonin is not regulated by the FDA, so consistency, safety and standards may be questionable.
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