Sleeplessness and Circadian Rhythm Disorder (cont.)
Common circadian rhythm disorder treatments can include the following behavioral and environmental therapies:
- Chronotherapy: This behavioral treatment consists of gradually shifting the sleeptime in accordance with the person's desired schedule. Thus, in DSPS, a progressive delay of
3 hours per day is prescribed, followed by strict maintenance of a regular
bedtime hour once the desired schedule is achieved. In ASPS, chronotherapy
focuses on advancing a regular bedtime hour by 2-3 hours per night for 1 week
until a desired schedule is achieved.
- Bright light therapy: Persons
with a circadian rhythm disorder respond well to light therapy, especially
bright light therapy (greater than 600 lux). To modify the phase of the
circadian rhythm,bright room light over time may also be sufficient;
however, a higher intensity of light (greater than 6000 lux over 30-60
minutes) is often necessary to accomplish significant changes in sleep cycles.
The timing of light therapy is also important because it affects the degree
and the direction of the rhythm shift. For example, for persons with ASPS,
light therapy applied in the early evening and nighttime hours delays the
cycle, whereas, for persons with DSPS, light therapy applied in the early
morning hours stimulates morning alertness and an earlier bedtime.
- Enhancing environmental cues: This part of the
treatment of a circadian rhythm disorder is important. Persons are encouraged
to keep a dark and quiet room during sleep and a well-lit room upon awakening.
Avoiding bright light exposure in the evening and enforcing regular hours for
eating and other activities also help.
- Lifestyle: Persons may respond to shifts in their active phases by exhibiting signs of sleep deprivation. For example, teenagers may have difficulty keeping late hours and getting up for an early morning class. Shift workers may have difficulty adjusting to new sleep cycles if their shifts are changed too rapidly before their bodies have had a chance to adjust.
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