Circadian Rhythm Disturbances

Circadian Rhythm is the internal body clock and it is responsible for ensuring we sleep at night and wake in the day. Within this rythm, there are two well recognised disturbances, which can dramatically affect sleep patterns.

Delayed Sleep Phase Syndrome (DSPS) - This is a disorder that causes the sleep wake cycle to be delayed by 2 or more hours. This means that instead of falling asleep at 10pm and waking at 7am, an affected person will not fall asleep until 12 midnight and then has great difficulty waking at 7am for school or work. Approximately 7% of adolescents are known to have this problem. The cause is unknown but it is definitely not a deliberate behaviour. This syndrome causes other additional problems e.g. school absences and all the known problems associated with sleep deficit.

Early Sleep Phase Syndrome (ESPS) - This is the opposite of DSPS. Children with ESPS wake inappropriately early, e.g. 4am is not unusual. They cannot get back to sleep despite being able to self sooth and settle at a reasonable bedtime.

Both DSPS and ESPS are very difficult to treat because the whole family is affected by the disorders. Therefore the affected individual, and the whole family, have to be involved in, and make considerable effort to follow, a remedial behavioural treatment plan. The treatment plan to remedy these disorders is lengthy.

Duration of Treatment
Having worked to correct the circadian rhythm to a more acceptable state, the patient and family must continue to follow the prescribed course, even after positive results have been established. This means that the family must continue with the plan for the same length of time that it took to establish a positive outcome. e.g. is it took 3 months to correct the problem, it will take a further 3+ months to ensure that the "new" revised circadian rhythm becomes accepted by the body as "normal" for that person.

Setbacks
Deviations from the plan e.g. one late night, or one early morning, during the treatment can cause the body clock and therefore the plan, to require restarting from the beginning. Some children and adolescents who experience these problems are also affected by depression, which may co-exist with behavioural problems and excessive daytime sleepiness.

Detection
There is no definitive test for these disorders. They occur in children and adolescents and rarely occur after 30 years of age. They are recognised from clear history taking and in particularly complex situations may require overnight sleep studies to rule out other disorders.

If you think your child has a problem with circadian rhythm disturbance, contact Dream-Angus.com for advice and support.