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Circadian Rhythm Disorder: How Does It Affect Sleep?

written by / April 11, 2022
Circadian Rhythm Disorder - Featured

If you’ve ever had trouble sleeping, you know how debilitating it can be the following day. Work becomes an insurmountable task, everyday chores become a real slog, and life loses its luster. Yet, consistently failing to get some much-needed shut-eye over extended periods can create even more problems and develop a nasty circadian rhythm disorder.

In this article, we’ll take a closer look at what makes our “internal clock” tick, its effects on our psyche, and how best to get out of this vicious cycle of sleepless nights and sleepy days.

So, let’s not waste any more time and get straight to it!

What Is a Normal Circadian Rhythm?

It’s a self-sustaining autonomous process where a person’s body secretes hormones that regulate multiple functions at 24-hour intervals. The term “circadian” derives from the Latin circa dies, which means “about a day.”

Our internal clock is influenced by daylight and darkness at night, which can be reflected in an individual’s shifting energy levels.

That said, different people have different circadian rhythms, which can be shorter or longer than 24 hours.

What Is Our Internal Clock Made Of?

Our “internal clock” is located in our brains. Specifically, our hypothalamus. One part of it — the suprachiasmatic nucleus (SCN) — is responsible for managing our entire circadian rhythm.

The SCN secretes hormones that control various bodily functions throughout the day. Some of the most important ones are:

  • metabolism
  • sleep
  • mood
  • body temperature
  • blood pressure
  • blood sugar
  • appetite
  • melatonin secretion

Hence, a circadian rhythm sleep-wake disorder will affect all of the above, not just sleep-wake time. That is why it’s vital to restore balance as soon as possible. Likewise, any damage to the SCN will impair every other rhythm it controls, such as the diurnal, ultradian, and infradian.

How Can We Feel Our Circadian Clock at Work?

The most frequently made argument to explain our internal clock is the link between circadian rhythm and sleep. 

Feeling sleepy when it gets dark is the most obvious sign of our biological clock at work. A functioning circadian rhythm is also reflected in our shifting energy levels every 20–28 hours. 

Our internal clock is mainly influenced by daylight and darkness. Other factors like health or substance abuse also play a role.

You’ll know your internal clock is ticking in a healthy rhythm if you feel energetic, hungry, or sleepy at a specific time of day.

What Is a Circadian Rhythm Sleep Disorder?

The connection between the circadian rhythm and daylight isn’t accidental. We become less active when our bodies detect less daylight. In essence, our internal biorhythm is what regulates when we sleep and when we’re awake.

Now, a circadian rhythm disorder is essentially any disturbance in our internal clocks. These disorders aren’t uncommon and can manifest as a physical or mental illness or simply as a sleep dysfunction.

Changes in the circadian rhythm can disrupt our typical sleep-wake cycle and severely affect our life quality.

This is why NASA has been developing systems that mimic a natural daylight cycle in space to prevent astronauts from losing their internal rhythm, especially during prolonged flights and space stays.

Diagnosing a Circadian Rhythm Disorder

The bad news is that this disorder leads to insufficient, excessive, or ineffective sleep.

The good news is that modern medical equipment can record our stages of sleep and then identify any unnatural shifts in our sleep patterns to help uncover the source of the problem.

Several studies show that a broken circadian rhythm can lead to seasonal affective disorders, bipolar disorders, cardiovascular problems, kidney problems, and cancer. Hence, delayed sleep phase disorder treatment is highly advised.

Frequent and prolonged shifts in your daily routine, fatigue, and chronic stress all lead to biorhythm problems. This can begin in the form of common sleep disturbances, followed by general anxiety, increased irritability, neurological and psychological problems, and physical concerns.

What Causes a Circadian Rhythm Disorder?

Among the possible reasons behind the occurrence of this disorder, two are well established:

  • Biological factors — these are any structural or biochemical changes in the parts of the brain that are involved in sleep regulation, such as the hypothalamus.
  • Environmental factors — these are the individual factors that impact our circadian rhythm, for example, working a night shift or using a cell phone in bed.  

The underlying causes of a circadian rhythm disorder could also be grouped as follows:

  • Lifestyle — this includes frequent travel across time zones, night shift work, regularly visiting nightclubs or bars, and athletic overtraining.
  • Some physiological and non-physiological conditions — like pregnancy, severe hunger or thirst, fever, intense pain, and teeth grinding.
  • Diseases — infections (like meningitis), gastrointestinal diseases, cardiovascular diseases, headaches, hypoglycemia, brain tumors, etc., are common underlying circadian rhythm sleep problems.
  • Other sleep conditions — the most common being chronic sleep deprivation or sleep apnea.
  • Psychiatric conditions include: 
    • generalized anxiety disorder
    • obsessive-compulsive disorder 
    • post-traumatic stress disorder 
    • chronic fatigue syndrome 
    • schizophrenia 
    • bipolar disorder
    • neurological disorders (dementia, Alzheimer’s disease) 
    • emotional excitement
  • Consumption of certain substances includes: 

Types of Circadian Rhythm Sleep-Wake Disorders

Since our sleep is regulated by homeostasis, short-lived disturbances in the sleep-wake cycle don’t cause any serious problems. This “delay” is adjusted within just a few hours, and everything returns to normal.

But if your body’s sleep cycle is upset for an extended period, you may have a sleep disorder. 

Let’s take a closer look at some of these.

Delayed Sleep-Wake Phase Disorder

This type of sleep disorder is more common in young people and is characterized by delayed sleep until around 2 AM or later. In this case, one might avoid sleep deprivation by sleeping in late.

However, individuals with delayed sleep phase syndrome suffer from daytime sleepiness, which impairs their work or school performance. Because of this, patients could be considered lethargic, disinterested, or lazy.

The truth is that these “night owls” are productive and creative late at night but chronically tired for any morning duties.

Advanced Sleep Phase Disorder

This condition is the exact opposite of delayed sleep phase disorder. Some consider it a natural process of aging. What is it?

People with ASPD go to bed earlier than usual (between 6 PM and 9 PM), which leads to waking up early in the morning (between 2 AM and 5 AM). According to numerous studies, about 1% of middle-aged and elderly develop this syndrome.

People with this syndrome are the so-called “morning larks” and suffer from sleepiness in the late afternoon or early evening and insomnia in the early morning.

Irregular Sleep-Wake Rhythm Disorder

Here, the circadian rhythm is so disorganized that there’s no known sleep or wake pattern. 

This condition is typical in people with dementia or other neurodegenerative diseases, tumors, and children with intellectual disabilities.

It’s thought that this irregular sleep-wake disorder occurs when the core of our internal clock (the hypothalamus) degenerates or when it isn’t exposed to adequate day/night light patterns. The most common irregular sleep patterns side effects include insomnia, excessive daytime sleepiness, and endocrine disturbances (hormonal disbalance).

With this disorder, sleep becomes fragmented — over a 24-hour period, people may take a series of naps to get an average amount of sleep. The diagnosis is made when at least three sleep-wake episodes last between 1 and 4 hours.

Non-24-Hour Sleep-Wake Disorder

Sleep time shifts a little bit each day for people with this disorder.

The N24 sleep disorder usually occurs when there’s no light cue to guide our internal clock — hence the link between this circadian rhythm disorder and blindness. Namely, as much as 70% of blind people are affected by this disorder, although it can also occur in sighted people.

The side effects of this disorder are insomnia and daytime drowsiness, especially if this continues for several weeks.

Jet Lag

Can you change your circadian rhythm at will? Jet lag puts this question to the test. When our internal sleep and wakefulness routine conflicts with the patterns in a new time zone, it results in a temporary sleep disorder called jet lag.

It’s not unusual for an individual to have difficulties adjusting to a new time zone. The good news is that there are some tips on overcoming and avoiding jet lag.

For instance, when traveling west, you’ll be dealing with delayed sleep phase syndrome, treatment for this type of jet lag will resemble said disorder.

Traveling east is even more complicated than a westward trip because it’s easier to postpone going to sleep than to make yourself sleep earlier.

Shift Work Disorder

Not having a consistent work schedule leads to this reversible circadian rhythm sleep disorder. It’s fairly common, considering how many people work rotating shifts or work overnight.

Shift work disorder is characterized by continual and repeated sleep interruptions that result in insomnia or excessive sleepiness. It can also cause the development of more serious psychiatric problems if it persists for extended periods.

Narcolepsy

Narcolepsy could also be considered a sleep disorder related to the circadian rhythm. People with this condition experience extreme daytime drowsiness and even lethargy.

These symptoms are combined with episodes of falling asleep during the day — no matter whether a patient already had enough sleep the night before.

Circadian Rhythm Disorder Symptoms 

Most sleep disorders share the same problem — namely, sleep deprivation. The complete list of symptoms includes:

  • insomnia — the difficulty falling or staying asleep
  • excessive fatigue
  • daytime sleepiness
  • difficulty waking up or falling asleep
  • mood swings, irritability, and lethargy
  • depressive episodes
  • difficulty concentrating
  • short-term memory difficulties
  • inability to complete work or school tasks
  • stress and anxiety
  • Impaired social life and relationships

Depending on the severity of these symptoms, a prompt circadian rhythm disorder medication treatment might be necessary. A potent OTC sleep medication might do the trick for some less severe ones.

Yet, before you start looking for a cure, rule out any other underlying medical conditions that might be causing it. These disorders are difficult to diagnose.

Moreover, a diagnosis should be made solely by a sleep specialist who offers individual treatment. Before your appointment, it’s a good idea to prepare a sleep log for your last two weeks, and don’t forget to describe your sleep history in detail.

Risk Factors

What type of people are more likely to suffer from circadian rhythm disorder? Unfortunately, lots of people fit the bill. Let’s take a closer look:

  • older people are prone to advanced sleep rhythm
  • adolescents are more prone to delayed circadian rhythm
  • people with neurological diseases have a harder time regulating their sleep-wake cycle
  • all shift workers have trouble sleeping
  • people with mood disorders like depression and bipolar disorder
  • frequent flyers
  • people who abuse drugs, caffeine, and alcohol
  • individuals in nursing homes and people who have little to no sun exposure
  • the blind

Circadian Rhythm Sleep Disorder Treatments

A balanced circadian rhythm is crucial for regulating vital bodily processes, so timely diagnosis and treatment are highly advisable. 

For one, cognitive behavioral therapy for insomnia (CBT-I) can help you find the root cause of your disorder. At least 70% of insomniacs who received this treatment showed an improvement in all sleep outcomes, according to one study.

Light therapy is yet another popular treatment method used to gradually modify the sleep-wake cycle and bring it back within normal parameters.

The therapy consists of exposure of the patients to bright light for time intervals that the specialists will decide, depending on the severity of your symptom.

Best part is, you can supplement this treatment for a delayed circadian rhythm sleep disorder with a simple melatonin supplement.

Melatonin is the brain’s way of communicating that it’s time for sleep. It surges in the evening and gets us ready for bedtime. If you don’t get a lot of sunlight during the day, which is essential for melatonin production, natural sleep aids can help fix this deficiency.

Overall, there’s no shortage of sleep aids on today’s market. From essential oils that help you relax to special teas and edibles that make you sleepy, there’s something for everyone.

Medication

Due to their numerous side effects, benzodiazepines, hypnotics, and other sleep medications should be used only as a last resort and never without a doctor’s prescription.

How do I reset my circadian rhythm with medication?

Sleeping pills and other sleep-wake cycle modifiers — like heavily caffeinated supplements — can help you synchronize your natural clock and put you back on schedule (so to speak).

However, these are used only for the most severe cases when other forms of treatment have failed and your sleep disorder has been rampaging for extended periods. If left unchecked, you risk developing psychological issues — hence why medication is used.

Sleep-inducing CBD oils are a far better alternative to opiates and are much safer. Nevertheless, you need to make sure you use the correct and proper dosage when using either of these unless you want to take a trip to the emergency room.

Lifestyle Changes

So, there are basically two approaches to circadian rhythm disorder treatment — either delaying sleep (daytime naps in particular) after a restless night and getting to bed earlier or waking up sooner.

To help you do that, there are a few lifestyles changes you can try, including the following:

  • Soothe the nervous system with soft light so you can fall asleep at a convenient and proper time.
  • Adjust your bedtime gradually.
  • Consistently wake up at the same time.
  • Avoid conflicts and stressful or emotional situations.
  • Start a new hobby.
  • Play a sport, run, or go swimming during the day.
  • Try yoga, pilates, or stretching.
  • Consider psychotherapy.
  • Perhaps visit a health resort or SPA.
  • Go to the cinema, the theater, a concert, or another event you enjoy.
  • Take a walk in nature or go on a trip.

Conclusion

Despite the wide range of sleep medications available, managing sleep disorders can be quite a challenge.

Every disruption in the circadian rhythm requires a different approach both for identification and treatment. The main goal is to normalize the circadian biorhythm and avoid developing a new sleep disorder.

FAQs

What is a circadian rhythm and how does it affect sleep?

Controlled by the body’s so-called biological clock, the circadian rhythm refers to the physiological and mental cyclical changes the body undergoes throughout the day. 

The eyes’ photosensitive retinal cells contain melanopsin pigment, which responds to light. One of their functions is to “restart” the circadian rhythm upon detecting light.

Unfortunately, these cells also respond to shortwave LED light (blue and green), widely used in TVs, tablets, laptops, and mobile phones.

Because so many people use their devices right before bed, they feel drained and unprepared for the day in the morning. They can also have problems falling asleep, eventually messing up their circadian rhythm.

What happens if your circadian rhythm is out of whack?

Our biological clock, also called our “circadian rhythm,” primarily manages our sleep/wake cycle. Most people notice that they experience different levels of drowsiness throughout the day or that they have trouble falling asleep during the night.

The circadian rhythm works alongside other bodily functions, such as body temperature regulation, hormone secretion, urine production, and blood pressure changes. If there’s a problem with the internal rhythm, we can expect variations in these processes, as well.

How do you fix circadian rhythm disorder?

When you need to tweak your sleep schedule for some reason, there are a few simple life hacks that you can do, including:

  • maintaining good sleep hygiene
  • regular exercise
  • avoiding alcohol and caffeine
  • exposing yourself to sunlight during the day
  • limiting air travel and late-night outings

How do I fix my internal clock?

There are a few things you can do if your internal clock is thrown off:

  • A short daytime nap won’t significantly affect your circadian rhythm, but it can have a pretty rejuvenating effect.
  • Regulate your diet — eat moderately so that you neither overeat nor feel hungry.
  • Monitor your sleep — watch whether you’re sleepy all day or just at certain times.

How long does it take to reset your circadian rhythm?

Depending on the severity of your sleep disorder, it can take anywhere between a few days to a couple of months. The most important thing is to start treatment the moment you notice symptoms occurring. 

Note that you need to stay consistent with your treatment; otherwise, you risk relapsing and beginning from scratch.

Best delayed sleep phase syndrome treatment options?

To successfully treat your sleep disorder, you must first figure out what’s causing it. Once you do that, you can try some of the following methods:

  • cognitive behavioral therapy
  • prescription medication
  • over-the-counter medication
  • natural sleep aids 
  • light therapy

Note that severe cases of circadian rhythm disorder require professional consultation. Self-diagnosis and self-treatment can further impede recovery time and only make things worse.

At medical school, it was easy to realize that sleep is crucial while studying during the many sleepless nights I spent. As a new mom, when the lack of sleep became even more evident, this was the real moment when I started appreciating the benefits of a good night’s sleep. Since sleeping is so essential to our health and immune system, I took it upon myself to educate people on different aspects of sleep by sharing the valuable information I have learned.


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