Circadian Rhythm Sleep Disorders

by | Last updated Apr 22, 2022

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Do your sleeping patterns have you feeling a bit off? It could be you’re falling asleep too early or getting into a routine of waking several hours later than normal. In some cases, such as when traveling to a totally different timezone, need for adjustment is expected. In other cases, the adjustment is sudden, such as when becoming pregnant or a new job that requires different working hours.

How is feeling “thrown off” associated with sleep? Well, you could be affected by one of six types of circadian rhythm sleep disorder. They can affect anyone, yet shift workers, teens, and travelers are especially susceptible. Each type of the disorder is associated with our internal clocks.

When we sleep and when we stay awake is associated with our “internal clock.” Our body has a master clock in an area of the brain called the suprachiasmatic nucleus (SCN). The clock is synchronized with a 24-hour sleep-wake cycle associated with brain waves, cell regrowth, and hormonal production.

Our circadian rhythm is regulated by the visual cues our brain receives from light and dark times of day, keeping our body synchronized with the 24 hours in each day..

If you have ever owned a watch that is a bit slow or too fast, you realize over a period that it’s way off. Your internal clock can be thrown off too, resulting in periods of unwanted wakefulness or sleepiness. Such symptoms relate to an array of circadian sleep disorders. Those who work varied hours, going through menopause, or are pregnant are especially among those who experience symptoms.

Circadian rhythm sleep disorders are caused by casual or continuous disruption to one’s sleep patterns. The malfunction or sense of being “thrown off” could be internal, having to do with one’s circadian rhythm, or it can be due to a misalignment between one’s internal clock and a change in one’s external environment  – being pregnant, shift change at work, new school responsibility (sports, club). A number of situations can trigger the variety of circadian sleep disorders.

Symptoms of Circadian Sleep Disorders

So what happens if your circadian rhythm feels out of whack? Signs and severity of circadian sleep disorders vary. However, many circadian sleep disorder symptoms occur because a person is not getting enough quality sleep. This could be because times may vary in getting to bed due to kids, chores, a changing work schedule, etc. It’s recommended that adults get 7-9 hours of sleep.

Being watchful of signs ensures a sleep disorder is properly diagnosed and treated. Undiagnosed sleep disorders can lead to other health complications and interfere with daily functioning.

Be aware of the following circadian sleep disorder symptoms:

  • Consistent difficulty falling asleep, staying asleep, or both
  • Excessive daytime sleepiness or sleepiness during shift work
  • Fatigue and exhaustion
  • Lethargy
  • Decreased alertness and difficulty concentrating
  • Impaired judgment and trouble controlling mood and emotions
  • Aches and pains, including headaches
  • Stomach problems, in people who have jet lag disorder

Types of Circadian Rhythm Sleep Disorders

There are six recognized types of circadian rhythm sleep disorders:

1. Delayed sleep phase disorder (DSP)

People with DSP tend to goto sleep late so they wake up more than two hours later than normal. According to the American Academy of Sleep Medicine,  this is common among young adults and adolescents for they comprise  7-16% of those suffering from the disorder. An example of DSP would be going to sleep after midnight and waking up in the late morning or afternoon.

2. Advanced sleep phase disorder (ASP)

People with ASP are the “morning types.” They go to sleep early in the evening and wake up early in the morning.This is more common among older adults, and  the likelihood of developing ASPcan increase with age. An example of ASP would be going to sleep at 6 or 7 pm and waking up at 3 or 4 am.

3. Shift work disorder

Shift work disorder happens when work shifts frequently rotate between day and night. Having this type of schedule can alter a person’s circadian rhythm. People with shift work disorder can develop insomnia and can be at higher risk of developing other sleep disorder conditions, like sleep apnea.

4. Jet lag disorder

Jet lag disorder happens when traveling to countries with different time zones. Some have difficulty adjusting to a new schedule. Gradually adjusting your sleep-wake times is one way to treat jet lag disorder.

5. Irregular sleep-wake

Irregular sleep-wake disorder happens when a person’s sleep-wake cycle is undefined. People with chronic insomnia fall into this category and can experience excessive sleepiness during the day.

6. Non-Entrained or non-24-hour sleep-wake disorder

Non-entrained or non-24-hour sleep-wake disorder happens when sleep and wake times have the same length; however, the circadian clock is not 24 hours long in this case. The sleep-wake cycle of those with non-24 changes every day.  Sleep-wake times could be delayed by one or two hours each day. This is more common in blind people because most of those who are blind have no light perception.

Can You Reset Your Circadian Rhythm?

You can ‘reset’ your internal clock through better sleeping and living habits. For example, regular exercise, going to bed and rising at the same times, and avoiding blue light are a few habits to adopt. There are many reasons for your internal clock to get out of whack, yet focusing on getting quality sleep helps retune the clock.

How long it takes for the reset depends on what was causing the disruption. It usually takes one day per time zone regarding jet lag. For a condition such as DSPS, it could take one or two months.

In a 2009 study, rats who experienced prolonged interruption in circadian rhythm gained weight and took longer to solve newly presented puzzles. The findings have “implications for humans.” Researchers also found the mice that underwent disruption had shrunken brains and less complex neurons in the prefrontal cortex.

Treatment Options

Those seeking treatment are first diagnosed through an in-lab sleep study. After proper diagnosis and measure of the severity of the sleep disorder, a physician may suggest a number of treatment plans

Lifestyle and behavior therapy includes adopting a regular pattern of going to bed and waking up – even on weekends. This helps regulate one’s internal clock and seeks to improve the quality of sleep. Other lifestyle suggestions include engaging in regular exercise, avoiding alcohol, and avoiding naps.

Bright light therapy may be used under the guidance of a doctor. The treatment seeks to synchronize one’s internal clock with the 24-hour clock of their external environment. We recommend specialty bulbs and lamps from Biologic Lighting.

Melatonin or other over-the-counter or prescribed medications may help adjust one’s sleep-wake cycle. For example, melatonin can be used to treat jet lag.

Chronotherapy involves shifting your bed and wake times in order to achieve the desired schedule. Hours are shifted as needed and then the sleeper must adhere to that optimal sleep-wake cycle.

Changing one’s bedroom environment helps. Consider making the room darker upon going to sleep, for example. Also, setting the right room temperature helps the body cool down as you sleep.

Diagnosis of Circadian Rhythm Sleep Disorder

Sleep habits influence our health and lifestyle. People with circadian rhythm sleep disorders can have insomnia, depression, stressed relationships, sleep loss, and more.

The way we sleep may also help or hurt our longevity. Sleep may become more complicated as we age; there are lifestyle changes or practices we can introduce into our daily lives  to help us sleep.

If you’re having trouble with your sleep and can identify yourself with any of the circadian rhythms sleep disorders, we invite you to get in contact with Sleep Centers of Middle Tennessee.

We are sleep experts and can help you regulate your sleep. We have three convenient locations:





Society for Neuroscience. “Disruption Of Circadian Rhythms Affects Both Brain And Body, Mouse Study Finds.” ScienceDaily. ScienceDaily, 28 October 2009.

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