Circadian Rhythms Sleep Disorder Syndrome

The term circadian comes from Latin words that literally mean around the day. There are patterns of brain wave activity, hormone production, cell regeneration, and other biological activities linked to this 24-hour cycle.

Circadian rhythm disorders are disruptions of the natural biological cycles that control how people are attuned to night and day. As a person sleeps, the various psychological process of a human body figuratively put into an apparent arrest and some parts of our system that were mostly exploited can be replenished for future use.

Most people function on a circadian rhythm of about 24 hours, which is controlled by the internal biological clock in the brain. Shifting into or out of daylight savings time, traveling across time zones (which can cause jet lag), or working at a job that involves late evening or nighttime work can affect the body's circadian rhythm. However, factors outside the body, especially bright light, help to set the internal clock to the day cycle time schedule appropriate to where the person is.

In a person with a circadian rhythm disorder, the body is unable to maintain its normal rhythm. The natural sleep schedule changes so that the person is out of phase with day and night.

Causes of circadian rhythm disorder

There are many factors which cause circadian rhythm disorders, including following:

  • Shift work
  • Pregnancy
  • Time zone changes
  • Medications
  • Changes in routine

Types of circadian rhythm disorder

  • Jet Lag or Rapid Time Zone Change Syndrome: This syndrome consists of symptoms including excessive sleepiness and a lack of daytime alertness in people who travel across time zones.
  • Shift Work Sleep Disorder: This sleep disorder affects people who frequently rotate shifts or work at night
  • Delayed Sleep Phase Syndrome (DSPS): This is a disorder of sleep timing. People with DSPS tend to fall asleep at very late times and have difficulty waking up in time for work, school, or social engagements.
  • Advanced Sleep Phase Syndrome: Advanced sleep phase syndrome is a disorder in which the major sleep episode is advanced in relation to the desired clock time. This syndrome results in symptoms of evening sleepiness, an early sleep onset, and waking up earlier than desired.
  • Non 24-Hour Sleep Wake Disorder: Non 24-hour sleep wake disorder is a condition in which an individual has a normal sleep pattern but lives in a 25-hour day. Throughout time the person's sleep cycle will be affected by inconsistent insomnia that occurs at different times each night. People will sometimes fall asleep at a later time and wake up later, and sometimes fall asleep at an earlier time and wake up earlier.

Genetics of circadian rhythm disorder

Circadian rhythm is probably governed by a balance of phosphorylation of different proteins, and in a normal, healthy twenty-four-hour clock, many proteins are being phosphorylated by casein kinas one epsilon, and it's the balance of one protein versus another that produces the normal rhythm.

The discovery of the mutant hPer2 gene's role in altering human circadian rhythm represents only the first such finding, and there will likely be many others to come, as a indication, that many families have now been identified with FASPS that do not show the same mutation. Further studies of such rare syndromes will likely yield important insights into the human circadian machinery, with potentially practical clinical benefits.

Familial advanced sleep-phase syndrome (FASPS)

Research shows that a mutation in a gene called hPer2 is responsible for familial advanced sleep-phase syndrome (FASPS). This syndrome typically causes sleep onset around 7 p.m. and spontaneous awakening around 2 a.m. This was a seminal observation, and nobody else had ever recognized the syndrome. One problem with distinguishing a familial circadian disorder is that there are wide normal variations in sleep patterns, with some of us being 'morning larks,' some of us 'night owls,' and many of us somewhere between. These variations are presumably complex, involve contributions from multiple genes, and are also influenced by environmental factors. Advanced sleep-phase syndrome is common among the elderly—who tend to fall asleep and wake earlier as they age

Delayed sleep phase syndrome and early bedtime and early awakening

Chronic insomnia may reflect a disturbance in the normal circadian sleep-wake rhythm. Two common circadian rhythm disturbances are advanced sleep-phase syndrome (early bedtime and early awakening) and delayed sleep-phase syndrome (late bedtime and late awakening). Advanced sleep-phase syndrome may be corrected through exposure to bright light for two hours during the evening, which may shift the body's circadian timing mechanism and delay the onset of sleep until a typical bedtime. In contrast, delayed sleep-phase syndrome may be treated by exposure to bright light in the morning.

A great many elderly people show these kinds of problems, and many adolescents have the opposite problem—delayed sleep phase syndrome—in which insomnia prevents them from getting to sleep at a reasonable time. A thorough understanding of the human circadian system could lead to drugs to allow travelers and nightshift workers to avoid potentially hazardous fatigue.

Treatment of circadian rhythm disorder

Common precautions

Circadian rhythm disorders are treated based on the kind of disorder that is present. The goal of treatment is to fit a person’s sleep pattern into a schedule that can allow the person to meet the demands of a desired lifestyle. Since the presence and absence of light affects our sleeping/waking schedule. With these in mind, keep yourself committed to your schedule to rest and sleep and set aside things which are not really important. If the room is kept dark and gloomy as possible it eases the patient to him to sleep. Colorful objects stimulate one’s senses and disrupt sleep. Room should be ventilated and air-conditioned.

Sleep directly affects our body temperature as we sleep our body temperature drops and allows the neurotransmitter melatonin to be produced at a rapid pace. Keeping those things in mind one should not forget to seek medical help when it is necessary.

Thru Chronotherapy

Therapy usually combines proper sleep hygiene techniques and external stimulus therapy such as bright light therapy or chronotherapy. Chronotherapy is a behavioral technique in which the bedtime is gradually and systematically adjusted until a desired bedtime is achieved. Bright-light therapy is designed to reset a person’s circadian rhythm to a desired pattern. When combined, these therapies may produce significant results in people with circadian rhythm disorders.

Thru Photo Therapy

A number of companies sell portable home phototherapy products that can be used for circadian rhythm disorders, including jet lag. Typically, the lights used to treat these conditions are full-spectrum or cool-white fluorescent tubes that produce 2,500-lux illumination to the eyes, which is about five times the level of normal indoor lighting. Outdoor light, even on overcast days, provides sufficient illumination, but patients must be committed to scheduling outdoor activities at the times necessary to affect their circadian rhythm disorder.


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