There are four common types of Circadian Rhythm Sleep Disorders: 

• advanced phase sleep disorders 
• delayed phase sleep disorders
• jet lag
• shift-work sleep disorders

To learn more about these disorders, please read our E-Health article "Circadian Rhythm Disorders"

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Treating Circadian Rhythm Sleep Disorders

Behavior Therapy — Successful treatment of Circadian Rhythm Sleep Disorders often depends on changing certain behaviors. For example, maintaining regular sleep-wake times (even on weekends and vacations) is important, as is avoiding naps, exercising regularly (even when tired), and avoiding caffeine, nicotine and other stimulating behaviors and substances several hours before bedtime.

If you have delayed sleep phase disorder (getting sleepy only in the early morning hours and sleeping until the afternoon), you should avoid bright light in the evening. This can be done by keeping the lights dim at home at night and avoiding TV and computer screens. If you experience advanced sleep phase disorder (being sleepy in the very early evening and waking up fully rested in wee hours), increase light exposure in the evening. This can be done by keeping the lights on or, if it’s light outside, spending time outdoors when sleepiness sets in.

Bright light therapy — This is also called phototherapy and is used to advance or delay the time to go to sleep. A high-intensity light is used, and the treatment must be under the guidance of a sleep specialist. To help readjust the body clock for delayed sleep phase disorder, you are exposed to a bright light for 30 to 45 minutes in the morning. It takes up to two weeks to be effective and often requires ongoing use to maintain the new schedule. If you have advanced sleep phase disorder, bright light is used in the early evening to tell the body to stay awake for a few more hours. In both cases, repeating the treatment may be needed on occasion to maintain the new sleep schedule.

Chronotherapy — Chronotherapy literally means “time therapy.” The bedtime is advanced or delayed by 1 to 2 hours per day, depending on the disorder being treated. It can take weeks to shift to the new sleeping and waking schedule. Once it’s achieved, it requires a firm commitment to maintain it.

In the cases where other therapies don’t work, drugs are used to adjust and maintain the desired sleep/wake cycle. Drugs can promote wakefulness, and short-term sleep aids can help get you to sleep. To help with jet lag, the hormone melatonin is especially effective and is available over the counter.

Anyone with circadian rhythm sleep disorders severe enough to disturb normal daytime activities should consider discussing treatment options with their sleep specialist.

Treatment for advanced phase sleep disorder, delayed sleep phase disorder, and shift work sleep disorder are often very successful. However, ongoing success requires a firm commitment to maintain the sleep times established through therapy. Repeated sessions of light therapy are often required.

Jet lag is a temporary circadian rhythm sleep disorder and usually clears up in a few days after being in the new time zone.

Light therapy should only be done only under the supervision of a sleep medicine specialist. As with all medications, prescription drugs and over-the-counter remedies to treat sleepiness and sleeplessness carry risk.

It’s important to follow prescription regimens exactly and to let your sleep medicine team know if you are taking any over-the-counter medications to treat yourself.

Advanced sleep phase disorder, delayed sleep phase disorder, and shift work sleep disorder often place stress on relationships at work, home, and school. Failing to address sleep-wake cycle disruptions will likely continue to create unnecessary strain in these areas of your life. Treatments are effective and can make a big difference in a matter of a few days.

Unaddressed circadian rhythm disorders can adversely impact school, work, family and social interactions. If sleep-wake cycle disruptions are affecting your life, it’s important to talk with a sleep medicine specialist.