Circadian Rhythm Sleep Disorders & Treatments

Let’s discuss the most common circadian rhythm sleep disorders, their symptoms, and some possible treatments.

The circadian rhythm is a set of biological processes that happen in animals and plants in a 24-hour cycle. It regulates a wide variety of body functions, including sleep. 

circadian rhythm sleep disorders

Circadian rhythm sleep disorders

Circadian rhythm sleep disorders can be the result of either a malfunction of the circadian rhythm, which functions as an internal body clock, or as the result of a mismatch between a person’s natural circadian rhythm and external factors such as shift work or jet lag.

Delayed Sleep Phase Syndrome (DSPS)

Common circadian rhythm sleep disorders are often referred to as “night owls,” people with delayed sleep phase syndrome feel tired and fall asleep much later than most other people since their body doesn’t release melatonin (the hormone responsible for sleep) until at least two hours later than other people. Teens and young adults are more likely to have DSPS.

If allowed to sleep late enough to get a proper 7-9 hours of sleep per night, DSPS doesn’t cause any problems. However, since people with DSPS may not fall asleep until after 2 am and would naturally wake up in the middle of the day, getting up early for school or work can cause a chronic lack of sleep along with impaired school or work performance.

People with delayed sleep phase syndrome may be perceived as unmotivated or lazy since they struggle so much with mornings, but they usually thrive in the late evenings and benefit from an unconventional schedule that allows them to stay up late and sleep in late.

Advanced Sleep Phase Syndrome (ASPS)

The opposite problem of delayed sleep phase syndrome is advanced sleep phase syndrome (ASPS), which is most commonly seen in the elderly population. People with ASPS feel tired and fall asleep earlier than other people, usually between 6-9 pm. They tend to wake between 2-5 am.

People with ASPS who resist the urge to go to bed so early often complain of early morning insomnia, not getting enough sleep, and being tired throughout the day.

Non-24-Hour Sleep-Wake Syndrome

While the circadian rhythm usually runs on a 24-hour cycle, people with non-24-hour sleep-wake syndrome have a circadian rhythm that is longer than 24 hours. This results in falling asleep and waking up later and later each day.

Non-24-hour sleep-wake syndrome is most common in people who are completely blind. It’s thought that since no light reaches the brain, the circadian rhythm runs free and sets its own schedule instead of being controlled by the regular periods of dark and light. As many as half of all people with no sight may have non-24-hour sleep-wake syndrome.

Irregular sleep-wake rhythm 

Another circadian rhythm sleep disorders is while most people have the urge to sleep for 7-9 continuous hours, those with irregular sleep-wake rhythm are naturally inclined to sleep in a series of naps throughout a 24-hour period instead of all at once. There is no regular pattern to when they nap throughout the day.

Irregular sleep-wake rhythm is very rare but tends to occur more in people with other medical problems such as dementia, brain damage, or cognitive dysfunction.

Shift-work sleep disorder

Shift work is any work schedule that falls outside the typical 9 am to 5 pm work day. Working early morning, late evening, or overnight shifts can force people to sleep at a time that doesn’t align with their natural circadian rhythm. While people who work the same shift on a regular basis can adapt to an unusual sleep schedule, working different shifts every day can cause insomnia and excessive sleepiness.

Jet lag

Jet lag is the result of traveling to a different time zone and having a circadian rhythm that is out of sync with the local time. This is worse when traveling from west to east because it’s easier to fall asleep and wake up several hours later than it is to fall asleep and wake up several hours earlier than your body is used to.

circadian rhythm sleep disorders very tired

Circadian rhythm disorder symptoms

All circadian rhythm sleep disorders have different symptoms. Symptoms include:

Delayed Sleep Phase Syndrome (DSPS)

  • Difficulty falling asleep at a “normal” time
  • Feeling tired later than other people
  • Trouble waking up early in the morning
  • Excessive daytime sleepiness
  • Sleeping a normal 7-9 hours when allowed to fall asleep and stay asleep later

Advanced Sleep Phase Syndrome (ASPS)

  • Falling asleep and waking up much earlier than others
  • Feeling sleepy in the afternoon but alert in the predawn hours
  • Not getting enough sleep
  • Early morning insomnia

Non-24-Hour Sleep-Wake Syndrome

  • Falling asleep later and later each night
  • Waking up later each day
  • Sleep schedule that seems to jump around
  • Sleep cycle drifts later and later without outside influences

Irregular sleep-wake rhythm

  • Naps off and on throughout the day
  • No regular pattern of sleeping and waking
  • Difficulty sleeping or staying awake
  • Total sleep time is not normal

Shift-work sleep disorder

  • Excessive sleepiness
  • Trouble falling asleep or staying asleep
  • Lack of energy
  • Trouble concentrating
  • Headaches
  • Irritability

Jet lag

  • Difficulty falling asleep
  • Feeling disoriented or tired
  • Unable to function normally
  • Stomach problems
  • Mild illness
  • Menstrual symptoms

Circadian rhythm hormones

The circadian rhythm affects a wide variety of hormones including melatonin, which helps you sleep. Luckily, there are things that may help restore your circadian rhythm, including possible supplementation with nicotinamide adenine dinucleotide (NAD+). NAD+ supplements have been shown to help restore the circadian rhythm in mice.

Circadian rhythm disorder treatment 

There are several different methods for treating circadian rhythm disorders. Circadian rhythm disorder treatment may include:

  • Behavior therapy involves things like maintaining regular sleep-wake times, avoiding naps, engaging in an exercise routine, and avoiding caffeine, nicotine, and stimulating activities within a few hours of bedtime.
  • Bright light therapy can be used to advance or delay sleep. A sleep specialist must walk you through the process of bright light therapy, but it can help reset your circadian clock.
  • Chronotherapy is the process of gradually shifting a sleep-wake cycle. It can take many weeks of dedication to shift to a new sleep-wake cycle and then a commitment to maintaining it.
  • Medications or supplements like sleep aids, wake-promoting agents, melatonin, and NAD+ can help adjust and maintain a proper sleep-wake schedule.


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