Natural light and darkness, as well as internal hormone production, are all synced to provide a 24-hour biological clock for most people. The circadian rhythm is a 24-hour cycle that plays a vital influence in our sleep cycle.
It’s a category of illnesses that are linked to the body’s internal clock malfunctions or misalignments: circadian rhythm sleep-wake disorders. If you’re traveling, you’re more likely to suffer from jet lag than if you’re stuck in an office all day.
What Is Circadian Rhythm?
Different physiological functions require the circadian rhythm to function properly. Body temperature, eating and digesting, and hormone activity are all regulated by this rhythm. It is not just for sleep. The suprachiasmatic nucleus (SCN) is the brain’s primary circadian clock and is formed of a cluster of proteins (SCN). This clock resets every 24 hours, or “entrains,” in a healthy adult, based on light and dark cycles. During the day, a healthy individual will progressively become increasingly fatigued, and by the time it becomes dark, they will be feeling sleepy.
The sleep cycle of a person alters and develops as they grow older. Because of this, teenagers tend to stay up later than younger children and adults. As we age, our circadian rhythms shift earlier in the day.
What Is a Circadian Rhythm Sleep Disorder?
As defined by the International Classification of Sleep Disorders (ICSD), a circadian rhythm sleep-wake disorder occurs when the body’s internal timekeeping system has been altered, the clock cannot entrain roughly every 24 hours, or a misalignment between the clock and a person’s external environment.
What Are the Symptoms of a Circadian Rhythm Sleep Disorder?
Even though the signs and symptoms of various conditions can vary, the most common one is a persistent need for sleep during the day. The inability to get to sleep or stay asleep is another prevalent symptom of these conditions.
A formal diagnosis of a circadian rhythm sleep-wake disorder requires particular criteria, such as:.
- Chronic or recurring sleep problems due to changes in the individual’s internal circadian rhythm or misalignments between their desired or required work or social schedule and their circadian rhythm.
- Insomnia and/or excessive daytime sleepiness are also signs of this condition.
- Individuals who suffer clinically significant distress or impairments in their mental, physical, social, professional, or academic performance as a result of sleep disorders are said to be suffering from insomnia.
These criteria show that circadian rhythm sleep disturbances can cause major health implications, such as difficulties at work or school and an increased risk of workplace or vehicular accidents.
Types of Circadian Rhythm Sleep-Wake Disorders
Circadian rhythm sleep-wake disorders can be broken down into the following categories:
Delayed and Advanced Sleep-Wake Phase Disorders
Disruption of the circadian rhythm by more than two hours is referred to as delayed sleep-wake phase disorder (DSWD). It can be difficult to fall asleep at night and wake up sooner in the morning if a person’s circadian rhythm is out of whack.
Sleep deprivation is common among those with this illness, especially if they have to get up early for school or work. According to the American Psychiatric Association, the prevalence rate for young adults and adolescents is between 7 and 16 percent.
Advanced sleep-wake phase disorder, on the other hand, causes the person to fall asleep and get up more than two hours earlier than they would like. This condition is more common among the elderly.
A patient must have symptoms for at least three months before being diagnosed with a delayed or advanced sleep-wake phase disorder. If individuals are permitted to sleep when they want, they must also report an increase in quality and duration of sleep (rather than a schedule dictated by work or other obligations).
Irregular Sleep-Wake Rhythm Disorder
Inconsistent sleep patterns without a regular rhythm or synchronization with the day-night cycle characterize this condition. Sleep deprivation and excessive daytime sleepiness can both be a result of irregular sleep patterns. Neurodevelopmental or neurodegenerative disorders like Parkinson’s, Alzheimer’s, or Huntington’s disease are the most common causes of irregular sleep-wake rhythm disturbance. Children with disabilities have also been found to be affected by this illness.
This disease often results in short intervals of sleep lasting fewer than four hours. The upshot is that those with irregular sleep-wake cycle disorder commonly nap during the day. Alzheimer’s patients who suffer sundowning, a state of restlessness, agitation, or disorientation that occurs at or around sunset, may have more difficulty getting a good night’s sleep.
Non-24-Hour Sleep-Wake Rhythm Disorder
If your body’s internal clock doesn’t reset every 24 hours, you have non-24-hour sleep-wake rhythm disorder, also known as free-running disorder. So, over the course of several days or weeks, a person’s typical sleep cycle is frequently disrupted while their body adjusts to the new schedule. The severity of symptoms can be affected by a person’s schedule and whether their responsibilities interfere with their sleep cycle.
When a person’s sleep patterns don’t match up with the demands of their social and professional lives, they may suffer from insomnia and excessive daytime sleepiness. A person with this disease will have little, if any, sleep disturbances if their schedule is in sync with sleep periods.
People who are completely blind are the primary victims of this condition. Due to the little amount of light a completely blind person can see, they are unable to tell the time of day. They are unable to maintain a 24-hour cycle as a result of their irregular internal clock. Experts estimate that half of all blind people suffer from a non-24-hour sleep-wake rhythm issue, which affects 50 to 80 percent of those who are blind. Symptoms must be present for at least three months before a diagnosis can be made.
Shift Work Disorder
Insomnia and excessive daytime sleepiness are common symptoms of shiftwork disorder, which affects people whose occupations force them to work at night. There are a variety of shifts that qualify as “shift work,” but shift work disorder is most common among those who work overnight or early in the morning on a regular basis. Day and night shifts that alternate might also cause sleep difficulties and fatigue during the day.
People with shift work disorder typically miss one to four hours of sleep every 24 hours, making it difficult to adjust to a new schedule once the shift begins.
Those who suffer from this disorder are at an increased risk of getting into a car accident while driving in the wee hours of the morning or at their workplace.
They may also suffer from ulcers and self-medicate with alcohol or narcotics to get adequate sleep. As much as 38 percent of shift workers are said to suffer from this disease. It affects people of all sexes and ethnicities, regardless of their race or ethnicity.
After flying across various time zones, most people suffer from jet lag. During this transition period, a person’s internal clock needs to be synchronized with local time, which is defined by sleep difficulties and daytime tiredness. One to two days following the journey, jet lag symptoms might last for up to a week or more.
Unless the plane crosses two or more time zones, eastbound travel usually results in more severe jet lag than westbound travel. Northbound and southbound travel, on the other hand, usually results in little to no jet lag.
For many people, one day of adjustment is required for each time zone traversed; for others, the intensity of symptoms might vary greatly.
While most cases of jet lag aren’t life-threatening, poor sleep hygiene following a travel can send people into a tailspin. Insomnia and other more severe sleep problems might develop if symptoms persist.
Other Circadian Rhythm Sleep Disorders
These kinds of disorders are frequently linked to underlying medical issues.
Symptoms including insomnia and excessive daytime sleepiness are similar to those of other circadian rhythm sleep disorders, however individuals do not match the diagnostic criteria.
These are extremely rare situations that necessitate specialized treatment from a physician or sleep specialist.
What causes circadian rhythm sleep disorders?
Continuous or irregular sleep patterns are the root cause of circadian rhythm sleep disorders. Internal or external factors (such as social or job obligations) might mess with your “internal body clock,” causing it to malfunction or misalign with the rest of your schedule, causing sleep patterns to be disrupted. Work, school, and social interactions are all hampered as a result of the circadian incongruity.
Circadian rhythm sleep disorders can be brought on by a variety of factors, including the following:
- Shift changes are frequent.
- The effects of jet lag.
- Changes in bedtime and waking times are common.
- Damage to the brain caused by illnesses such as stroke, dementia, head injury, and intellectual disability.
- Long durations of inability to see due to a lack of solar exposure.
- A few medications.
- Unhealthy sleeping patterns (lack of practices, habits and other factors that promote good quality sleep).
- a person who is in their later years.
How are circadian rhythm sleep disorders diagnosed?
Diagnosing problems of the circadian rhythm can be difficult, necessitating the assistance of a sleep specialist.
You will be asked to keep a sleep diary for one to two weeks by your healthcare professional, who will gather information about your sleep and work schedule history. Other sleep and medical diseases will be ruled out by your doctor, such as narcolepsy, which is sometimes mistaken for delayed sleep phase disorder.
A wristwatch-like device (known as an actigraph) is typically used in conjunction with a sleep diary to record sleep and wake activities over a period of days or weeks. Sleep studies, both overnight and during the day, are sometimes necessary. It is important to conduct a sleep study that is specific to the patient’s sleep habits. A shift worker, for example, might have a “overnight” sleep study done during the day. Other important tests include taking your temperature and checking your melatonin levels.
Circadian Rhythm Sleep Disorder Treatment
Diagnosis and treatment of circadian rhythm sleep problems vary per patient. As a general rule, most treatments stress the need of excellent sleeping habits and a regular sleep-wake pattern. Entrainment can be improved and sleep deprivation reduced for those who suffer from these diseases by incorporating these variables into their routines.
Melatonin supplements may be used to treat circadian rhythm sleep disorders. It is recommended that these supplements be prescribed by a doctor and taken at specified times in order to produce the sense of tiredness. The circadian rhythm and entrainment schedule can be efficiently reoriented with the use of well-timed melatonin dosages. Before taking melatonin, see a doctor to make sure you’re healthy enough to do so.
People with delayed sleep-wake phase disorder can benefit from bright light exposure in the morning, whereas those with advanced sleep-wake phase disorder can benefit from the same treatment in the evening. It is possible to modify the circadian rhythm by using this form of light therapy.
Timed light exposure during shifts can be beneficial for shift workers with shift work disorder. They can also benefit from a prework nap and moderate caffeine intake throughout their shifts. It is also possible to use coping skills to stay awake and sleep during the day. Avoiding bright light throughout the day, limiting exposure to bright light at work, and creating a conducive sleeping environment are just a few of these tactics. The use of melatonin supplements or hypnotics as daytime sleep aids does not correct circadian misalignment and is only a short-term solution.
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