15 August 2020 Authors: Ana Catarina Franco e Carla Bentes Our body has an internal clock that makes you feel drowsier at night and more awake and alert during the day. This natural sleep-wake rhythm is called circadian rhythm . When the circadian rhythm changes, there may be a circadian rhythm disorder . What are the symptoms of a circadian rhythm disorder? Most people with a circadian rhythm disorder have or more of the following symptoms : Difficulty falling asleep; Difficulty in maintaining sleep; Non-restorative sleep; Excessive daytime sleepiness; Difficulty performing the usual tasks. Disruption of circadian rhythm can have a major impact on day-to-day activities. Types of circadian rhythm disorders There are 6 types of circadian rhythm disturbances: Circadian rhythm phase advance; Circadian rhythm phase delay; Circadian rhythm with non-24 hour cycle; Irregular circadian rhythm; Jet lag; Disruption due to shift work. The first four refer mainly to intrinsic mechanism changes in. The last two result from external effects. Circadian rhythm phase advance These people with this disorder tend to go to bed earlier than most, typically between 6 pm and 9 pm, and wake up early, between 2 am and 5 am. There is a physiological tendency for phase advance progression to occur with age. Circadian rhythm phase delay These people tend to go to bed later than most and wake up later or find it very difficult to wake up at the time that is most common for most people. Adolescents and young adults tend to follow this pattern. Circadian rhythm with non-24 hour cycle Typically, people with this disorder are unable to recognize the light trails that signal circadian rhythms. They have variable, irregular cycles. They often fall asleep more and more later, until they eventually fall asleep during the day. Dementia and blindness can be factors that contribute to this change. Irregular circadian rhythm A person with this disorder does not sleep for extended periods. On the contrary, he takes short naps during the day. Some neurological diseases, such as dementia, can contribute to this change. Jet-lag Anyone can have jet-lag and this occurs when there is a trip to an area with a different time zone. The greater the time difference, the more significant the symptoms may be. Jet-lag can also be more pronounced with trips to the east. Disruption due to shift work This disorder can occur in people who work in shifts. It happens especially when there is night work because the person is awake during the time when he should sleep and then try to sleep when he would be more alert. Diagnosis The diagnosis of a circadian rhythm disorder is essentially clinical . However, in some cases, in addition to clinical history, several self-reported and objective measures may be used, including sleep diaries, actigraphy and melatonin medication. Sleep tests (polysomnography) are not routinely used in the diagnosis of circadian rhythm disorders, except when there is a suspicion of a sleeping illness, such as obstructive sleep apnea. Treatment of circadian rhythm disorders Treatment varies with the disorder and the person affected and may include non-pharmacological and pharmacological measures. A good sleep hygiene is essential in either case. Read about what you should do and what you should not do to improve your sleep . The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
