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Sleep Medicine Specialists: Behavioral Sleep Medicine Clinic
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What are Circadian Rhythm Disorders?
Circadian rhythm disorders are a collection of sleep disorders that lead to people experiencing symptoms of insomnia and excessive daytime sleepiness or fatigue. Common circadian rhythm disorders include delayed sleep phase syndrome, advanced sleep phase syndrome, and shift work sleep disorder.
Delayed Sleep Phase Syndrome (DSPS)-DSPS is most common in our teens or early 20's. Frequently, college students develop delayed sleep phase syndrome. The symptoms of DSPS include an inability to get to sleep before 2 AM and when free of societal constraints, the person would prefer to sleep until 10 AM or later. People with DSPS may report being owl's and not larks or having a preference for nighttime instead of morning. DSPS may be treated behaviorally using sleep scheduling techniques and/or bright light therapy. The goal of treatment is to resynchronize the circadian clock with the desired 24 hour light/dark cycle. Treatment gains can often be achieved within a couple of weeks of treatment.
Advanced Sleep Phase Syndrome (ASPS)-ASPS is most common in the elderly who develop a pattern of going to bed earlier and earlier in the evening. Characteristic signs of ASPS include a tendency to go to bed more than 3 hours earlier than societal norms. Individual's with ASPS will often report irresistible sleepiness in the late afternoon or early evening. They also report frequent early morning awakenings and excessive daytime sleepiness or fatigue. ASPS may be treated behaviorally using sleep scheduling techniques and/or bright light therapy. The goal of treatment is to resynchronize the circadian clock with the desired 24 hour light/dark cycle. Treatment gains can often be achieved with a couple of weeks of treatment.
Shift Work Sleep Disorder (SWSD)-In SWSD, symptoms arise because the individual is attempting to wake and sleep at times that are inconsistent with their biological/circadian clock. People with SWSD will report working shift work and present with symptoms of insomnia including difficulty getting to sleep, staying asleep or non-refreshing sleep. SWSD may be treated behaviorally using sleep scheduling techniques and/or bright light therapy. The goal of treatment is to reset the circadian clock to fit the patient's work schedule. Although scheduling techniques and use of bright light can relieve some of the sleep disturbance associated with shift-work, sleep may not fully recover. People generally differ in their ability to adapt to shift work and for some the best recommendation is to find a job that does not require shift work.
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