Treatment for the Four Types of Circadian Rhythm Disorders

Almost everyone knows a few "early-birds," early to bed and early to rise, a few "night-owls," the ones who are still up at two am but will not be seen again until ten the next morning, and plenty of people that fall in between the two extremes. These terms are colloquial ways to refer to a person's circadian rhythm, an individual's biological clock that runs on a 24-hour schedule. A normal person maintains approximately the same rhythm from day to day and is able to accomplish what is necessary during their waking hours while still getting enough sleep to begin again the next day. However, people with circadian rhythm disorders may be unable to get the necessary amount of sleep to function or have unusual sleep patterns. According to the Diagnostic and Statistical Manual of Mental Disorders, circadian rhythm disorders can be broken down into four categories: jet lag type, shift work type, delayed sleep phase type, and unspecified type.

In the jet lag type, a person's circadian rhythm is quite literally out-of-sync with the world around him due to a flight across multiple time zones, while in the shift work type, a person often has difficulty immediately following a shift change as his body is not adapted to the new schedule.

The delayed sleep phase type describes people who continually put off, or delay, sleep, often due to some form of stress. The unspecified type is used to describe people who do not fit into any of the above three categories. Circadian rhythm disorders of the shift work types are the easiest to deal with. One suggestion is to force the adjustment as quickly as possible. Immediately upon starting a new shift, attempt to start going sleep at the new desired time and getting up at the new awakening time, rather than gradually easing into it. In the beginning, there will likely be periods of less sleep than usual, but given consistency, a person's circadian rhythm is usually quick to adapt. Although attempting to ease into it may seem more logical, it actually takes a great deal longer since the body has no immediate need to shift.

The jet lag type of circadian rhythm disorders can be dealt with in a similar manner as the shift work type if the intent is to remain at the destination for a week or more. This means not taking a nap as soon as the plane arrives but attempting to fit into what the local community is doing at that time of day. However, for a short two-to-three day trip, if possible it would be best to schedule meetings or sightseeing at a time that is convenient in both the source and destination time zones. In a case where the two time zones are twelve hours apart, that may be difficult, but by allowing one's body to maintain its normal rhythm as much as possible rather than trying to force it to adjust only to have to readjust again two days later, a person can maintain a much healthier circadian rhythm.

For someone suffering from the delayed sleep phase type of circadian rhythm disorders, modifying one's behavior can often help. Setting a schedule in advance is a good example of this. If at X o'clock every night the lights go out without an attempt to do "one more thing" or read "one more page," the body adapts to that and it will become easier to fall asleep at that time as time goes by. Reducing napping during the day is also beneficial. Once the body is on a schedule, it also becomes easier to awaken the next morning.

The unspecified type of circadian rhythm disorders are the most difficult to deal with since they do not have an obvious cause. In one of the more insidious types, a person's circadian rhythm can be slight more or slightly less than 24 hours, which can leave that person continually adjusting because their personal biological rhythm does not align with a day. In this case, the best thing to do is speak to a doctor rather than trying to self-treat. There are medications that can help, as well as therapies that can delay ones sleep schedule by some amount of time which can help "reset" a person who has shifted if necessary, but this is not something that should be attempted alone.

Sources:

Web MD Sleep Disorders
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