Advanced Sleep-phase Syndrome

Imagine that every evening, you get very sleepy by 7pm and you are done sleeping at 2 am. How would such a schedule affect your social life like going to the movies in the evening with your family; and what would you do in the wee hours of the night when the world is asleep ? Well, there are few people in the world who suffer from this non-chosen schedule. They have what is called “advanced sleep phase syndrome” because their sleep and wake rhythm is earlier than most people (advanced). It is common in the elderly, though not so severe. However, the more severe cases are seen in families and have genetic basis (chromosome 2).

 Our tendencies for sleeping and waking are largely managed by innate biological clocks. These clocks can shift our rhythms of sleep and wake earlier or perhaps later. Individuals who sleep too early (advanced) secrete melatonin earlier than other individuals. Their core body temperature drops sooner than others as well. Both of these differences contribute to the earlier schedule. Melatonin is secreted by a tiny gland that sits in the middle of our brain and partly controls our sleep; it shifts it earlier and makes you sleepy. The drop in body temperature is part of falling asleep, so if it happened sooner, you are more likely to fall asleep.

Advanced sleep phase syndrome is not dangerous or unhealthy. These individuals can still get their adequate hours of sleep and wake up feeling well. It can, however affect their social life. In the elderly, advanced wake times can be frustrating and can lead to insomnia.

Management

  • Light therapy in the later afternoon or evening hours will “push” their sleepy time to the later hours. A special light called the Lux lamp can be purchased on-line to accomplish this task.
  • Melatonin (about 1 to 5 mg) in the morning can also shift the rhythm earlier.
  • Exercise in the late evening can also help the individual stay awake.
  • Sleeping pills are not indicated for this situation.
  •  If your situation is severe, you might want to consult a sleep specialist who has experience in circadian rhythm disorders.