 |
 |
Frequently Asked Questions
Circadian disorders are abnormalities in the body's internal "clock," which regulates when the body gets sleepy and when it's ready to wake up.
Insomnia is a label often mistakenly given to any difficulty in sleeping, even by doctors who can't find another diagnosis to fit. Many, perhaps most people have some trouble with insomnia at some point in their adult lives, but if there is no underlying physical or psychological problem, it is a temporary condition. True circadian disorders are characterized by their permanence. Preliminary research indicates that there is a genetic component to circadian disorders, i.e., they are at least partly and perhaps wholly hereditary.
No. Left to your own devices, you'd sleep and wake up just fine, but at the "wrong" times. The most common circadian disorder is probably delayed sleep phase syndrome (DSPS), which causes a delay of several hours in people's ability to get sleepy and their ability to wake up refreshed. Someone with DSPS will typically not feel sleepy until 2-7 a.m. and will similarly not feel ready to wake up until late morning or the afternoon.
Certainly most people can alter their sleep schedules somewhat, sometimes by many hours, but by the same token, most people can go back to a normal schedule without needing more than a few days to adjust. People with circadian disorders typically spend most of their lives trying to adjust to a normal schedule without success.
Actually, scientific studies have shown that most day people do not adapt well to being awake during the night and sleeping during the day. Their physical and mental well-being suffers, as does their job performance. There are some things that enlightened shift schedulers can do to help them cope, such as providing bright lights during night shifts, but the adaptation is never perfect and the aids, such as bright lights, must be maintained as long as the day person is required to maintain a night schedule because a day person's body will immediately try to revert to a day schedule without such aids. In exactly the same way, night people never do make a permanent adjustment to day schedules. There are aids that sometimes help them cope, but a normal day schedule is not their bodies' natural rhythm and is not ideal for eliciting their best job performance.
It's true that the average American (and the people in many other industrialized countries) is living with a sleep deficit in modern times. One notable difference, though, is that when people with circadian disorders try to stick to a normal schedule, they get even less sleep than do normal people who are burning the candle at both ends.
Even when they do, they will be frustratingly alert at the normal bedtime, no matter how sleepy they were during the day. That's one of the important signs that someone may have a circadian disorder. When normal people are exhausted and they go to bed at night, they sleep. When people with DSPS are exhausted and they go to bed at night, they typically end up lying awake in bed for several hours.
Yes, yes, and yes. What doctors call "good sleep hygiene," such as cutting out all caffeine, is the first thing they prescribe. Antidepressants are usually the second. While chronic sleep deprivation can be a depressing thing, depression does not cause circadian disorders. Tranquilizers, such as valium, will often have an effect, but they are potentially addictive and the body can build up a tolerance to them. They are unsuitable for permanent sleep problems such as circadian disorders.
Yes, yes, and yes. The majority of people with circadian disorders go undiagnosed by themselves and even by their doctors for many years. During that time, they typically run through every folk remedy and fad in the book in an attempt to normalize themselves.
