Circadian Rhythm Sleep Disorders: Types, Symptoms and Management (2022)


What are circadian rhythm sleep disorders?

Circadian rhythm sleep disorders are a group of sleep disorders that all share the common feature of a disruption in the timing of sleep. Circadian in Latin means “around or approximately” (circa) “a day” (diem). Circadian rhythm is the name given to your body’s 24-hour “internal clock.” This internal clock controls your body’s sleep-wake cycle.

Helping to “set your internal clock” during a 24-hour day is the visual cue of light – specifically, its brightness/type of light, amount of time exposed to light, and when exposed to light. Light is transmitted through your eyes and into a specific “control center” of your brain. There are other influencers of your body’s internal clock, however, including melatonin (a hormone released in your brain that plays a role in sleep), physical activity and social behaviors. Your age can also influence your sensitivity to the sleep-wake cycle.

Circadian rhythm sleep disorders involve one of these problems:

  • You have a difficult time falling asleep.
  • You struggle to stay asleep and often wake up several times during the sleep cycle.
  • You wake up too early and can’t go back to sleep.

What are the more common types of circadian rhythm sleep disorders?

The common types of circadian rhythm sleep disorders include:

Delayed Sleep Phase Disorder: If you have this sleep disorder, you go to sleep and wake up more than two hours later than what is typically considered a normal sleep-wake cycle. For example, you're a “night owl” who may not be able to fall asleep until 2 a.m. or later, but then sleep in until as late as 3 p.m.

Other common features of delayed sleep phase disorder are:

(Video) Circadian Rhythm Sleep Disorder

  • You're often most alert, productive and creative late at night.
  • If forced to get up early, you are sleepy during the day.
  • You're often perceived as lazy, unmotivated, or a poor performer who is always late for morning responsibilities.
  • Is most commonly seen in adolescents and young adults.
  • May run in families.

Advanced Sleep Phase Disorder: If you have this sleep disorder, you fall asleep in the early evening (6 p.m. to 9 p.m.) and wake up in the early morning (2 a.m. to 5 a.m.).

Other common features of advanced sleep phase disorder are:

  • You typically complain of early morning awakening or insomnia and are sleepy in the late afternoon or early evening.
  • Is most commonly seen in the middle age and older adults.
  • May run in families.

Jet Lag: If you have this sleep disorder, your body’s internal clock has been disturbed from long air travel time to a destination that is two or more time zones different from your home. This sleep-wake cycle disruption makes it difficult to adjust and function in the new time zone. Eastward travel is more difficult than westward travel because it is easier to delay sleep than to advance sleep.

Common features of jet lag are:

  • Change in appetite.
  • Changes in gastrointestinal (stomach and bowel) function.
  • General tiredness.
  • General feeling of discomfort or uneasiness and mood disturbance.

Shift Work Disorder: You may have this sleep disorder if you frequently rotate shifts or work at night. These work schedules conflict with your body’s natural circadian rhythm, making it difficult to adjust to the change. Shift work disorder is identified by a constant or recurrent pattern of sleep interruption that results in insomnia or excessive sleepiness.

Other common features of shift work disorder are:

  • Ongoing tiredness.
  • General feeling of discomfort or uneasiness, mood disorder.
  • Gastrointestinal problems.
  • Decreased sex drive.

Other health risks include increased risk of alcohol and substance abuse, weight gain, high blood pressure, heart disease and breast and endometrial cancer. This sleep disorder is most commonly seen in people who have night or early morning shifts.

(Video) Circadian rhythm sleep phase disorders - VCE Psychology

Irregular sleep-wake rhythm: This sleep disorder has an undefined sleep-wake cycle. You may take several naps during a 24-hour period. Symptoms include ongoing (chronic) insomnia, excessive sleepiness or both. This disorder is more commonly seen in people with neurological conditions such as dementia, in nursing home residents, in children with intellectual disabilities and in those with traumatic injuries to the brain.

Non-24-hour sleep-wake syndrome: If you have this sleep disorder, you keep your same length of sleep and awake time, but your “internal clock” is longer than 24 hours. When this is the case, the actual sleep-wake cycle changes every day, with the time being delayed one to two hours each day. This disorder occurs most commonly in blind people.

Symptoms and Causes

What causes circadian rhythm sleep disorders?

Circadian rhythm sleep disorders are caused by continuous or occasional disruption of sleep patterns. The disruption results from either a malfunction in your “internal body clock” or a mismatch between your “internal body clock” and the external environment (for example, social and work requirements), which affects the timing and duration of sleep. This circadian mismatch causes problems functioning at work, school and in social activities.

Situations that can trigger a circadian rhythm sleep disorder include:

  • Frequent changes in work shift.
  • Jet lag.
  • Frequent changes in time to go to bed and time to wake up.
  • Brain damage resulting from such medical conditions as stroke, dementia, head injury intellectual disabilities.
  • Blindness or lack of exposure to sunlight for long periods of time.
  • Certain drugs.
  • Poor sleep hygiene (lack of practices, habits and other factors that promote good quality sleep).
  • Older age.

What are the symptoms of circadian rhythm sleep disorders?

Symptoms of circadian rhythm sleep disorders include:

  • Insomnia (difficulty falling asleep or staying asleep).
  • Excessive daytime sleepiness.
  • Difficulty waking up in the morning.
  • Sleep loss.
  • Depression.
  • Stress in relationships.
  • Poor work/school performance.
  • Inability to meet social obligations.

Diagnosis and Tests

How are circadian rhythm sleep disorders diagnosed?

The diagnosis of circadian rhythm sleep disorders can be challenging and often requires a consultation with a sleep specialist.

Your healthcare specialist will gather information about your sleep and work schedule history and ask you to keep a sleep diary for one to two weeks. Your healthcare provider will also exclude other sleep and medical disorders, including narcolepsy, which often mimics delayed sleep phase disorder.

Sleep diaries are often used together with a wrist watch-like device (called an actigraph) that records sleep and wake activity over the course of days to weeks. Sometimes overnight and daytime sleep studies may be required. Sleep studies are tailored to address the sleep pattern of the individual. For example, an ‘overnight’ sleep study might be performed during the day in a shift worker. Measuring body temperature and melatonin levels are other useful tests.

(Video) Sleep Wake Disorders Part 2: Breathing Related and Circadian Rhythm Sleep Disorders

Management and Treatment

How are circadian rhythm sleep disorders treated?

Treatment options for circadian rhythm sleep disorders vary based on the type of disorder and the degree to which it affects your quality of life. Your healthcare provider will develop a personalized treatment plan, which improves your chance of success. Most treatment plans require a combination of approaches.

Treatment options include:

Lifestyle and behavior therapy: This approach encourages changes to improve sleep and to develop good sleep habits. Good sleep habits include maintaining regular sleep-wake times (even on weekends and vacations); avoiding naps (exception: shift workers); developing a regular routine of exercise (avoid high-intensity exercise within one hour of bedtime); and avoiding alcohol, caffeine, nicotine, and stimulating activities within several hours of bedtime.

(Video) Circadian rhythm disorders

Bright light therapy: Bright light therapy is used to advance or delay sleep. The timing of this treatment is critical and requires guidance from a sleep specialist. Bright light therapy works by resetting the circadian clock to be more in sync with the earth’s cycle of light and dark. A high intensity light (2,000 to 9,500 lux) is required and the duration and timing of exposure varies from one to two hours.

Exposure to bright light in the morning may help you if you have a delayed sleep disorder. You should also decrease your exposure to light in the evening and during the night by reducing indoor lighting and avoiding bright TV and computer screens. Exposure to bright light in the evening may help if you have advanced sleep disorder.

Medications: Medications such as melatonin (available over-the-counter), wake-promoting agents (such as modafinil [Provigil®]) or caffeine, and short-term sleep aids may be used to adjust and maintain the sleep-wake cycle to the desired schedule. Tasimelteon (Hetlioz®) is approved to treat non-24-hour sleep-wake disorder.

Chronotherapy: This therapy approach uses progressive advancement or delay (three hours every two days) of sleep time depending on the type and the severity of the disorder. This type of therapy requires a firm commitment by you and your partner, as it can take weeks to successfully shift the sleep-wake cycle. Once the desired schedule is achieved, you have to keep this regular sleep-wake schedule.

Outlook / Prognosis

Circadian rhythm sleep disorders are caused by continuous or occasional disruption of sleep patterns. There are many types of circadian rhythm sleep disorders. Each has its own features. Treatments are based on the type of sleep disorder you have and the degree to which it affects the quality of your life. Never hesitate to contact your healthcare provider if you experience any changes in your sleep pattern or have any questions about your treatment or other treatment options.


What are the symptoms of circadian rhythm disorders? ›

You may have symptoms such as extreme daytime sleepiness, decreased alertness, and problems with memory and decision-making. To diagnose a circadian rhythm disorder, your doctor may ask about your sleep habits and may suggest a sleep study and some other diagnostic tests.

What are the 4 circadian rhythms? ›

Each type of biological rhythm has a certain name to show how long it lasts:
  • Diurnal (night and day)
  • Circadian (24 hours)
  • Ultradian (less than 24 hours)
  • Infradian/Circalunar (1 month)
  • Circannual (1 year)
28 Jun 2021

What is the treatment for circadian rhythm sleep disorder? ›

The most common treatments are healthy lifestyle changes, bright light therapy, and melatonin. Often, your doctor will recommend a combination of these treatments. We lead or sponsor many studies on sleep disorders, including circadian rhythm disorders.

What are the 5 types of sleep disorders? ›

Key Sleep Disorders – Sleep and Sleep Disorders
  • Insomnia. Insomnia is characterized by an inability to initiate or maintain sleep. ...
  • Narcolepsy. ...
  • Restless Legs Syndrome (RLS) ...
  • Sleep Apnea.

What are 3 circadian rhythms examples? ›

There are many examples of circadian rhythms, such as the sleep-wake cycle, the body-temperature cycle, and the cycles in which a number of hormones are secreted.

What is the cause of circadian rhythm? ›

Circadian rhythm is influenced by light and dark, as well as other factors. Your brain receives signals based on your environment and activates certain hormones, alters your body temperature, and regulates your metabolism to keep you alert or draw you to sleep.

What are the 4 sleep types? ›

People typically fall into one of four chronotype categories: the bear, the wolf, the lion, and the dolphin. Each chronotype is loosely based on the relative animal's sleep patterns and habits, so let's dive in to discover which chronotype you most closely align with.

How many types of circadian rhythm are there? ›

There are four biological rhythms: circadian rhythms: the 24-hour cycle that includes physiological and behavioral rhythms like sleeping. diurnal rhythms: the circadian rhythm synced with day and night. ultradian rhythms: biological rhythms with a shorter period and higher frequency than circadian rhythms.

What is the most common circadian rhythm disorder? ›

What are the more common types of circadian rhythm sleep disorders? The common types of circadian rhythm sleep disorders include: Delayed Sleep Phase Disorder: If you have this sleep disorder, you go to sleep and wake up more than two hours later than what is typically considered a normal sleep-wake cycle.

What is the best treatment for sleeping disorder? ›

Basic tips:
  • Stick to a sleep schedule. Keep your bedtime and wake time consistent from day to day, including on weekends.
  • Stay active. ...
  • Check your medications. ...
  • Avoid or limit naps. ...
  • Avoid or limit caffeine and alcohol and don't use nicotine. ...
  • Don't put up with pain. ...
  • Avoid large meals and beverages before bed.
15 Oct 2016

What are common treatments for sleep disorders? ›

How are sleep disorders treated?
  • Counseling: Some sleep specialists recommend cognitive behavior therapy. ...
  • Medications and/or supplements.
  • Practice sleep hygiene such as keeping a regular sleep schedule.
  • Get regular exercise.
  • Minimize noise.
  • Minimize light.
  • Manage the temperature so that you're comfortable.
23 Dec 2020

What are the 7 types of sleep disorders? ›

Most Researched Sleep Disorders
  • Insomnia.
  • Sleep Apnea.
  • Narcolepsy.
  • Restless Leg Syndrome (RLS)
  • Parasomnias.
  • REM Sleep Behavior Disorder.
  • Non-24-Hour Sleep Wake Disorder.
  • Excessive Sleepiness.
28 Sept 2022

What are the 6 types of sleep disorders? ›

Here's a look at the six categories of sleep disorders and how you can get better rest.
  • Lack of sleep. Insomnia sufferers have a hard time falling or staying asleep and often feel drowsy. ...
  • Snoring and sleep apnea. ...
  • Circadian rhythm disorders. ...
  • Movement disorders. ...
  • Parasomnias. ...
  • Too much sleep.
15 Jun 2022

What are 5 examples of rhythm? ›

English poetry employs five basic rhythms of varying stressed (/) and unstressed (x) syllables. The meters are iambs, trochees, spondees, anapests and dactyls.

What are the two types of rhythms? ›

Regular rhythm – elements are repeated exactly in an evenly spaced arrangement. Flowing rhythm – movement is suggested through repeating organic shapes or through irregular repetition of repeating elements.

What part of the brain controls sleep? ›

The hypothalamus, a peanut-sized structure deep inside the brain, contains groups of nerve cells that act as control centers affecting sleep and arousal.

What are the effects of circadian rhythm? ›

Circadian rhythms are cycles in the body that occur roughly across 24 hours. In humans, circadian rhythms cause physical and mental changes in the body, including feelings of wakefulness and sleep. However, several issues may alter these circadian rhythms, which could lead to sleep disruptions or other health issues.

How do you test for circadian rhythm? ›

Actigraphy, a portable device that records movement, can be used to measure the sleep/wake cycle or circadian patterns objectively over extended periods of time.

What are the 3 functions of sleep? ›

Research has shown that adequate sleep helps to improve memory and learning, increase attention and creativity, and aid in making decisions. When an individual has had insufficient sleep, physical changes occur in the brain, which alter the activity and function of the brain.

What are the 4 steps to sleeping? ›

This means resist the urge to take a nap during the day, too. Wind down appropriately. Avoid large meals before bed, which may trigger heartburn. Don't exercise within several hours before bed or do other activities that raise core body temperature, such as taking a hot shower or using a sauna.

What type is the best sleep? ›

Scientists agree that sleep is essential to health, and while stages 1 to 4 and REM sleep are all important, deep sleep is the most essential of all for feeling rested and staying healthy.

What hormone regulates circadian rhythms? ›

Melatonin is an important hormone in circadian synchronization. This hormone is involved in many biological and physiological regulations in the body. It is an effective hormone for human biorhythm (circadian rhythm). The main role of this hormone is to maintain the biological clock and to adjust the body rhythm [25].

What time is circadian rhythm? ›

The circadian clock has an internally driven 24-hour rhythm that tends to run longer than 24 hours but resets every day by the sun's light/dark cycle. Taking melatonina supplements can also shift the timing of the body's “clock.”

What are the most common causes of sleep problems? ›

Common causes of chronic insomnia include:
  • Stress. Concerns about work, school, health, finances or family can keep your mind active at night, making it difficult to sleep. ...
  • Travel or work schedule. ...
  • Poor sleep habits. ...
  • Eating too much late in the evening.
15 Oct 2016

What is the first step in the treatment of sleep disorders? ›

The first step in a treatment plan should aim to change sleep habits and address any issues that may be causing sleep problems or conditions. Often times working to eliminate stress, address medical conditions or switch from any medication that causes sleeplessness can restore healthy sleep patterns.

What are the symptoms and treatments of sleep disorders? ›

Some of the signs and symptoms of sleep disorders include excessive daytime sleepiness, irregular breathing or increased movement during sleep. Other signs and symptoms include an irregular sleep and wake cycle and difficulty falling asleep.

What drug is used to treat anxiety and sleep disorders? ›

These medications slow normal brain function, which is why they are used to treat anxiety and sleep disorders. Below are types of CNS depressants: Benzodiazepines: Examples of this type of medication include diazepam (Valium), alprazolam (Xanax), triazolam (Halcion), and estazolam (ProSom).

Who treats sleeping disorder? ›

A sleep specialist is a doctor who diagnoses and treats sleep disorders. Most sleep specialists train in internal medicine, psychiatry, pediatrics, or neurology during residency. After completing residency, they complete a fellowship program in sleep medicine.

What are the 3 types of insomnia? ›

Insomnia is most often classified by duration: Transient insomnia - Less than one month. Short-term insomnia – Between one and six months. Chronic insomnia – More than six months.

How do doctors treat sleep disorders? ›

Medical treatment for sleep disturbances might include any of the following:
  • sleeping pills.
  • melatonin supplements.
  • allergy or cold medication.
  • medications for any underlying health issues.
  • breathing device or surgery (usually for sleep apnea)
  • a dental guard (usually for teeth grinding)
9 Sept 2017

What are the two most common sleep disorders? ›

3 Most Common Sleep Disorders
  • Insomnia and Narcolepsy. Insomnia, or the chronic inability to fall or remain asleep, is by far the most common sleep disorder. ...
  • Sleep Apnea. ...
  • Restless Leg Syndrome.

What happens when your circadian rhythm is out of whack? ›

The World Health Organization has proclaimed that disrupted circadian rhythms are a probable carcinogen. The latest research, published in the journal Science Advances, describes that when the circadian clock gets off track it implicates a cancer-signature gene known as HSF1 that can trigger lung tumors.

How many circadian rhythms are there? ›

These 24-hour rhythms are driven by a circadian clock, and they have been widely observed in animals, plants, fungi and cyanobacteria. The term circadian comes from the Latin circa, meaning "around", and dies, meaning "day".

Which hormone maintains the body's circadian rhythm? ›

Melatonin is an important hormone in circadian synchronization. This hormone is involved in many biological and physiological regulations in the body. It is an effective hormone for human biorhythm (circadian rhythm). The main role of this hormone is to maintain the biological clock and to adjust the body rhythm [25].

What gland controls circadian rhythm? ›

The pineal gland receives adrenergic innervation, which activates a cascade of circadian events that leads to the nightly formation of melatonin from serotonin. Serotonin is present at high levels in the pineal gland during the day and increases further at night in the absence of melatonin formation (Sun et al., 2002).

How do I get my circadian rhythm back to normal? ›

How to reset your circadian rhythm
  1. Have a routine. If you've been going to bed at all different hours of the night, try setting up a schedule and sticking with it. ...
  2. Exercise. ...
  3. Avoid alcohol and caffeine in the evening. ...
  4. Limit screen time. ...
  5. Avoid naps. ...
  6. Gradually move your bedtime.
17 Dec 2021

How can I improve my circadian rhythm? ›

5 Tips for Improving Your Circadian Rhythm
  1. Create a sleep schedule. One of the easiest ways to improve your circadian rhythm is to go to bed at the same time every night. ...
  2. Limit stimuli. Make sure your room is dark and quiet when you're ready to sleep. ...
  3. Exercise earlier in the day. ...
  4. Avoid caffeine. ...
  5. Bright light therapy.
7 Jun 2021

Can stress change your circadian rhythm? ›

Every day, people from all walks of life experience stress of various degrees. A new study found that when stress has disrupted the circadian rhythm, the body's internal clock, it can increase the risk of developing metabolic diseases.

What age does circadian rhythm start? ›

The newborn infant develops the components of circadian rhythm postnatally. A rhythm of cortisol develops at 8 weeks of age, melatonin and sleep efficiency develop at approximately 9 weeks, and body temperature rhythm and that of circadian genes develop at 11 weeks.

What happens to your body during circadian rhythm? ›

The regulation of sleep is processed by the homeostatic physiology of the circadian rhythm, the sleep/wake cycle. Circadian rhythm is the 24-hour internal clock in our brain that regulates cycles of alertness and sleepiness by responding to light changes in our environment.

What is the difference between insomnia and circadian rhythm disorder? ›

Patients with circadian rhythm disorders are commonly mislabelled as having insomnia, but the two conditions are managed very differently, Dr Evelyn Lewin writes. The internal body clock of a person with a circadian rhythm disorder is out of sync with their desired social clock.


1. Sleep Cycle, Dreams, & Sleep Disorders [AP Psychology Unit 2 Topic 9] (2.9)
(Mr. Sinn)
2. Understanding Circadian Rhythms: Understanding Sleep Disorders
(Coalition for the Life Sciences)
3. Exploring Sleep Disorders | Alon Avidan, MD | UCLAMDChat
(UCLA Health)
4. Delayed Sleep Phase: Everything You Need To Know
(Medical Centric)
5. 2 What are circadian rhythm sleep disorders
(Circadian Disorders)
6. Psychiatry Review: Circadian Rhythm Sleep-wake disorders
(Shrinks In Sneakers)

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