Advanced Sleep Phase Disorder (ASPD) is a circadian rhythm sleep disorder characterized by early sleep onset and early awakening times, without any disturbance in the sleep structure itself. Individuals with ASPD often find themselves getting sleepy early in the evening and waking up early in the morning, well before most people's typical wake-up times. This condition affects a small percentage of the population but can have a significant impact on an individual's life, particularly in terms of aligning with standard social and work schedules.
What is Advanced Sleep Phase Disorder?
ASPD is defined by a chronotype that is significantly earlier than the societal norm, leading to symptoms such as difficulty staying awake in the evening and difficulty sleeping in until more conventional morning hours. The disorder has been linked to changes in the body's internal clock, which dictates natural sleep and wake cycles. Research has identified mutations in various clock genes among those with familial advanced sleep phase disorder, suggesting a strong genetic component in some cases [1][2].
Mitigating Advanced Sleep Phase Disorder
Mitigation strategies for ASPD focus on adjusting the patient's internal clock to more closely align with their desired sleep schedule. Treatment options include:
Light Therapy: Exposure to bright light in the evening can help delay the body's sleep clock, making it easier for individuals with ASPD to stay awake later into the evening [3][4].
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Chronotherapy: This involves gradually delaying the individual's bedtime and wake time to shift their sleep phase to a more socially compatible schedule [5].
Melatonin Supplementation: Taking melatonin in the evening can also help shift sleep timings later. The timing and dosage of melatonin supplementation should be carefully managed under medical supervision [6][7].
Lifestyle Adjustments: Incorporating regular exercise, maintaining a consistent sleep schedule, and limiting exposure to light sources before bedtime can also help manage ASPD symptoms [8].
Counseling and Behavioral Therapy: Psychological support can be beneficial, especially for individuals who experience anxiety or stress related to their sleep disorder.
Conclusion
Advanced Sleep Phase Disorder poses unique challenges to those affected by it, but with a combination of therapeutic interventions and lifestyle adjustments, individuals can mitigate the impact of ASPD on their daily lives. The key is a personalized treatment plan that takes into account the severity of the disorder and the individual's lifestyle, with a focus on gradually adjusting the sleep-wake cycle to align more closely with societal norms.
References
Ondzé, B., Espa, F., Ming, L., Chakkar, B., Besset, A., & Billiard, M. (2001). Advanced sleep phase syndrome. Revue neurologique, 157(11 Pt 2), S130-4.
Auger, R. (2009). Advance-Related Sleep Complaints and Advanced Sleep Phase Disorder. Sleep Medicine Clinics, 4, 219-227.
Mundey, K., Benloucif, S., Harsanyi, K., Dubocovich, M., & Zee, P. (2005). Phase-dependent treatment of delayed sleep phase syndrome with melatonin. Sleep, 28(10), 1271-8.
Terman, M., Lewy, A., Dijk, D., Boulos, Z., Eastman, C., & Campbell, S. (1995). Light Treatment for Sleep Disorders: Consensus Report. Journal of Biological Rhythms, 10, 135-147.
Palmer, C., Kripke, D., Savage, H. C., Jr., Cindrich, L., Loving, R., & Elliott, J. (2003). Efficacy of Enhanced Evening Light for Advanced Sleep Phase Syndrome. Behavioral Sleep Medicine, 1, 213-226.
Hirano, A., Shi, G., Jones, C. R., Lipzen, A., Pennacchio, L., Xu, Y., Hallows, W., McMahon, T., Yamazaki, M., Ptáček, L., & Fu, Y.-H. (2016). A Cryptochrome 2 mutation yields advanced sleep phase in humans. eLife, 5.
Sack, D., Nurnberger, J. I., Rosenthal, N. E., Ashburn, E., & Wehr, T. A. (1985). Potentiation of antidepressant medications by phase advance of the sleep-wake cycle. The American journal of psychiatry, 142(5), 606-8.
Saxvig, I., Wilhelmsen-Langeland, A., Pallesen, S., Vedaa, Ø., Nordhus, I., & Bjorvatn, B. (2014). A randomized controlled trial with bright light and melatonin for delayed sleep phase disorder: Effects on subjective and objective sleep. Chronobiology International, 31, 72-86.
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