How Common is Sleeplessness and Circadian Disorder?

We don't know exactly how common different sleep disorders linked to the body's internal clock, or circadian rhythm, are.

How do you get Sleeplessness and Circadian Disorder?

Sleeplessness and Circadian Disorder can be caused by various factors, including internal issues or environmental factors. Diagnosing these sleep disorders involves carefully examining a person's history, including their sleep patterns, duration of symptoms, sleep and wake patterns, work schedule, recent travel, emotional state, medication use, attempts at self-treatment, physical cues, and any other medical issues they may have. A physical check-up may also be conducted to rule out other conditions that could contribute to or imitate insomnia, such as depression, obstructive sleep apnea, and brain disorders.

What else can Sleeplessness and Circadian Disorder be?

Alcohol use disorder, anxiety disorders, bipolar disorder, breathing-related sleep disorder, chronic obstructive pulmonary disease (COPD), depression, emphysema, hyperthyroidism (overactive thyroid), hypoparathyroidism (underactive parathyroid), obstructive sleep apnea, opioid use disorder, and posttraumatic stress disease (PTSD).

What kinds of test are needed for Sleeplessness and Circadian Disorder?

The diagnosis for these disorders is primarily based on medical history, sleep logs, and a history of repeated sleep and wake cycles that affect normal day-to-day activities. Treatment for these disorders typically involves lifestyle changes, such as good sleep hygiene, and may include interventions such as light therapy, melatonin, or medication if necessary.

What type of doctor should I see for Sleeplessness and Circadian Disorder?

You should see a sleep specialist or a doctor specializing in sleep medicine.

Sleeplessness and Circadian Disorder

What is Sleeplessness and Circadian Disorder?

Getting a good night’s sleep is very important for maintaining our health and for us to function well when we are awake. If we don’t get enough sleep, it can lead to different health issues, including diabetes, obesity, and heart disease. Lack of sleep can also reduce our job performance, increase the risk of traffic accidents, cause mood swings and problems in relationships, among other things.

The American Academy of Sleep Medicine International has classified different types of sleep disorders into seven categories: insomnia (which is the inability to sleep), sleep-related breathing disorders (issues with breathing while sleeping), central disorders of hypersomnolence (extreme daytime sleepiness), circadian rhythm sleep-wake disorders (problems with the body’s internal clock), parasomnia (abnormal behaviors during sleep), sleep-related movement disorders (unwanted movements during sleep), and other sleep disorders. This article will particularly focus on circadian rhythm sleep-wake disorders. These are conditions where your natural routine of sleep and wakefulness is disrupted.

What Causes Sleeplessness and Circadian Disorder?

The circadian system, or our internal body clock, manages our sleep patterns and is crucial for our health and wellbeing. Our body clock runs on a cycle that is just over 24 hours and is influenced mainly by light levels. It sets our sleep schedule and various other physiological activities that keep us healthy.

One of the ways to measure our circadian rhythm or internal clock is by testing the levels of melatonin and cortisol in our body and measuring body temperature. Melatonin, a hormone that helps regulate sleep, is controlled by a part of our brain called the suprachiasmatic nuclei, located in the hypothalamus.

The suprachiasmatic nuclei receive signals about light from cells in the retina of our eyes. These cells contain a pigment called melanopsin, and they send information to the brain about the intensity of light via a path known as the retinohypothalamic tract. The suprachiasmatic nuclei use this information to guide the pineal gland to release melatonin. This hormone increases in the evening with less light and peaks around 3 hours before we wake up. Receptors for melatonin are mostly found in the retina, the pituitary gland, and the suprachiasmatic nuclei. This process allows our bodies to maintain a regular sleep-wake cycle.

As we stay awake, our bodies build up a desire for sleep. Our body clock helps in fighting off this pressure to sleep and keeps us awake. The cycle of our body clock is slightly longer than an actual day. To make up for this difference, our body clock needs to adjust or ‘phase shift’, using signals called ‘zeitgebers’ – light and darkness being the strongest.

Our body clock and sleep system work together to ensure we get the right amount of sleep. Sometimes, this complex system can have problems, either because of internal issues or due to environmental factors. Such problems can lead to serious sleep disorders.

Risk Factors and Frequency for Sleeplessness and Circadian Disorder

We don’t exactly know how common different sleep disorders related to the body’s internal clock (known as circadian rhythm disorders) are.

Signs and Symptoms of Sleeplessness and Circadian Disorder

Diagnosing sleep disorders like insomnia and problems with your internal body clock (also called circadian rhythm disorders) is mostly based on carefully examining a person’s history. Knowing the specifics of someone’s sleep pattern helps doctors figure out if the problem is short-term (transient) or long-term (chronic), and if it’s a primary problem or a secondary one caused by something else. For people with insomnia, it’s important to identify if they have a hard time falling asleep, staying asleep, or if they still feel tired after sleeping. Other important factors include how long they’ve had symptoms, details about their sleep and wake pattern, how much sleep they get, whether they work night shifts, if they’ve traveled recently, their emotional state, their medication use, attempts at self-treatment, physical cues, and any other medical issues they may have.

For people with sleep issues, a physical check-up can also provide additional information. The goal of this check-up is to find out if the person has other conditions that could contribute to or imitate insomnia. These could include depression, obstructive sleep apnea (a condition where breathing stops and starts during sleep), and brain disorders. During this check-up, doctors will evaluate your body mass index (BMI), check the shape of your head and face, assess your chest, look for signs of finger clubbing (a sign of lung disease), and perform a neurological exam.

Testing for Sleeplessness and Circadian Disorder

Delayed Sleep-Wake Phase Disorder affects people who find it hard to adjust their sleep schedules. These individuals are usually not able to fall asleep or wake up at the proper times. Even if they want to, it’s difficult for them to change their sleeping habits. This usually means they lose at least two hours of sleep per night. They have trouble waking up and might feel confused or frustrated as a result. On days off, they can get enough sleep, but they might sleep far into the day. This disorder is most common in teenagers and can be linked to depression. It’s thought that teenagers’ internal body clocks often run over 24 hours, which can make the problem worse. The disorder is diagnosed based mostly on a history of repeated late sleep and wake cycles that affect normal day-to-day activities. It’s treated by making lifestyle changes such as good sleep hygiene and gradually going to bed and waking earlier. Avoiding caffeine, alcohol, nicotine, and daytime naps can help. Melatonin and light therapy may also be used if necessary.

Advanced Sleep-Wake Phase Disorder is a condition in which people feel very sleepy in the evening and wake up very early in the morning. If they don’t have to stay awake in the evening, they can get enough sleep. However, societal obligations often mean they have to stay awake longer than they want to, which can lead to sleep deprivation and excessive daytime sleepiness. It is believed that the disorder is caused by an internal body clock that runs less than 24 hours a day. This disorder is diagnosed based on medical history and sleep logs, and the main treatment is light therapy in the evening. Medication isn’t usually needed for this condition.

Irregular Sleep-Wake Rhythm Disorder is a condition where the sleep schedule is broken into several short periods of sleep and wakefulness throughout the day and night, with at least three periods of being awake lasting for at least an hour over 24 hours. It is usually found in people with dementia and can be linked to a lack of regular commitments and schedules. This condition can be helped with lifestyle changes and melatonin.

Jet Lag Disorder happens when you travel over at least two time zones in a short period of time. Symptoms include problems falling asleep, feeling sleepy during the day, and being less alert and sharp. These symptoms are usually worst the day after arriving at a new destination. The body clock adjusts to the new time zone at a rate of about 1 to 1.5 time zones per day. Traveling in an easterly direction is more difficult to adjust to than traveling west. Treatment consists of timed light exposure and melatonin. For longer trips over many time zones, starting the treatment before travel can help with the adjustment process.

Shift Work Disorder affects about a third of people working night shifts or shifts that keep changing. They may find it hard to adjust their body clocks to their sleep debts and work schedules, leading to less and lower-quality sleep. Treatment involves improving the quality and quantity of daytime sleep, maintaining good sleep hygiene, consistent sleep schedules, and optimized sleep environments. Short naps during or just before the shift might help. Using bright light during times of desired wakefulness and avoiding light during and before desired sleep times may help fine-tune the body clock to the desired schedule.

Non-24 Sleep-Wake Rhythm Disorder occurs in people whose body clocks aren’t in sync or are not regulated. This might happen in blind people, who can’t perceive light-dark cues, but it can also occur in people with normal vision. The disorder is diagnosed based on a history of inconsistent insomnia and daytime sleepiness alternating with symptom-free periods where the body clock aligns with the desired schedule. Treatment aims to regulate the body clock where possible, and Tasimelteon, a medicine that works like melatonin, is approved for the treatment of non-24 sleep-wake rhythm disorder caused by blindness.