Circadian rhythm sleep disorders

Circadian rhythm sleep disorders are a group of sleep disorders that result from disruptions to the body's natural 24-hour sleep-wake cycle, also known as the circadian rhythm. The circadian rhythm is regulated by the hypothalamus in the brain and is influenced by external cues, such as light exposure and social activities.

Types

There are several types of circadian rhythm sleep disorders, including:

• Delayed sleep phase disorder: where the individual has a natural tendency to fall asleep and wake up later than desired, leading to difficulties in getting up in the morning and functioning during the day.
• Advanced sleep phase disorder: where the individual has a natural tendency to fall asleep and wake up earlier than desired, leading to difficulties staying awake in the evening.
• Non-24-hour sleep-wake disorder: where the individual's sleep schedule is not in sync with the 24-hour day-night cycle, causing insomnia and excessive daytime sleepiness.
• Irregular sleep-wake disorder: where the individual has no consistent sleep schedule and sleeps at irregular times throughout the day and night.

Causes

The causes of circadian rhythm sleep disorders can include genetic factors, exposure to light at night, shift work, travel across time zones, and certain medical conditions, such as depression and Parkinson's disease.

Diagnosis

Diagnosis of circadian rhythm sleep disorders involves a detailed medical and sleep history, physical examination, and assessment of sleep patterns using actigraphy (a wrist-worn device that records movement) or polysomnography (a sleep study).

Treatment

Treatment of circadian rhythm sleep disorders involves resetting the body's internal clock by adjusting light exposure, sleep schedule, and other behaviors. Light therapy, where the individual is exposed to bright light in the morning, and dark therapy, where the individual minimizes exposure to light in the evening, can be helpful. In some cases, medications, such as melatonin, can be used to regulate the sleep-wake cycle.

Professional help

It is important to seek medical evaluation for symptoms of circadian rhythm sleep disorders as proper treatment can help improve sleep quality, reduce excessive daytime sleepiness, and improve overall quality of life.

Reference

1. American Academy of Sleep Medicine. (2021). International Classification of Sleep Disorders, Third Edition (ICSD-3). Darien, IL: American Academy of Sleep Medicine.
2. Lockley, S. W., Skene, D. J., & Arendt, J. (1999). Relationship between melatonin rhythms and visual loss in the blind. Brain, 122(7), 1193-1202.
3. Partch, C. L., Green, C. B., Takahashi, J. S., & Bass, J. (2014). The molecular basis of circadian timekeeping. Annual Review of Cell and Developmental Biology, 30, 475-506.

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