Advanced sleep-wake phase disorder (ASP) is one of the circadian rhythm sleep-wake disorders that affect people's normal sleeping times. People with ASP have an "early bird" circadian clock, causing them to fall asleep at hours significantly earlier than usual, and wake up in the morning ahead of most people.
People with ASP typically find themselves increasingly tired in the late afternoon, leading to an early bedtime between 6 and 9 p.m. This usually results in rising again quite early too, usually between 2 and 5 a.m. However, the quality of sleep is unhindered by the timing.
All the biological changes associated with sleep happen earlier, such as a sooner release of certain hormones and a shifted body temperature curve. These have been utilized to identify this issue.
Some people with ASP can abide by a regular early schedule; however, they often run into difficulty managing late afternoon or evening engagements. This can cause them to become fatigued as the hours pass, resulting in someone appearing very drowsy or sleepy to others around them. An ongoing lack of late night rest can bring about chronic fatigue; yet, despite this deficit of sleep, those affected still tend to rise early.
People with ASP may misdiagnose their issue as something else. They could think that getting up too early is an indication of either insomnia or even depression. Being conscious while everyone else is asleep can be difficult, prompting them to fret about it.
People with ASP may adjust their lifestyles or occupations to suit their internal "early bird" clock. For example, they may be well-suited to a job with an early shift—such as a baker or surgeon. On the other hand, some individuals attempt to realign their natural sleep cycles, doing things like consuming too much coffee or taking stimulants to stay awake later in the evening. Similarly, they may drink alcohol or take sleeping pills in an effort to sleep through the morning hours—a decision that could potentially worsen their condition.
What are the signs of an advanced sleep-wake phase disorder?
A person with Attention Deficit Hyperactivity Disorder (ASP) may have difficulty paying attention, controlling impulses, and managing their activity level. They might find it hard to stay focused on one task or struggle to complete tasks on time. Additionally, they could be prone to outbursts of emotion or feel overwhelmed by their inability to focus or control their behavior.
If you find yourself nodding off in the late afternoon or early evening and then waking up too early while everyone else is still snoozing, you're not alone.
I tend to get drowsy in the late afternoon, but my energy levels peak early in the morning.
Many people find themselves rising and retiring earlier than they'd prefer. They may be conscious when they should be sleeping and snoozing when they ought to be awake.
It's essential to consider other potential factors that may be causing your sleep issues. These could include:
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What could put a person at risk for an advanced sleep-wake phase disorder?
Advanced sleep-wake phase disorder is a rare affliction, affecting roughly 1% of middle aged adults. It may be more common in the elderly and men and women are equally susceptible to it. Some studies indicate that it may have a genetic basis, or could be triggered by environmental factors such as social or work pressures.
Identifying advanced sleep-wake phase disorder requires analysis of the patient's sleeping pattern. Doctors must review the individual's rest periods, looking for signs of early onset and a persistent tendency to wake up too early. This disorder can be accurately diagnosed with a thorough evaluation of symptoms.
ASP can bring about changes to your sleeping schedule, either leading you to have no symptoms or pushing you to modify your lifestyle. However, it may be hard to adjust your job or social life around this “early bird” clock, potentially worsening the condition and causing sleepiness and even problems with interpersonal relationships. If this is the case, then consulting a health professional is recommended.
When consulting a doctor about your sleep, they'll seek information in a variety of ways. They may ask you to share details of your medical and family history, as well as giving you a questionnaire to rate how lack of sleep affects your daily life. Additionally, they may want you to fill out a sleep diary over the course of several weeks to gain insight into your sleep patterns. Don't forget to inform them of any past or present drug, alcohol, medication and other sleep disorder related experiences.
An office visit detailing your sleep diary can help detect ASP. Additional testing, such as a polysomnography (a sleep study), may be used if you're at risk for other sleep disorders. This type of study charts your brain waves, heartbeat, oxygen levels and breathing as you sleep. It also records how your arms and legs move to ascertain the presence of any connected disorders such as sleep apnea or periodic limb movement disorder. Since early sleeping is associated with this condition, it's advisable that the study be conducted during these hours to get a more accurate reading. If there are no further complications, the results should show a normal pattern of rest.
You may be asked to wear an actigraph on your wrist at home. This device will track your sleep activity over a one to two week period. Other tests can also be done; for instance, your body temperature could be monitored continuously. Melatonin levels may also be accessed by analysing your saliva, although this more commonly seen in research rather than clinical settings.
The treatment of advanced sleep-wake phase disorder requires an understanding of the illness. People with the condition should look into changing their lifestyle and habits. The key is to adjust bedtimes, wake times, and other behaviors to ease symptoms. This can involve delaying when a person goes to bed and wakes up or creating new behaviors for the day that align better with body’s normal schedule. Additionally, light therapy may help improve alertness during the day and reset sleep patterns.
One might not need to seek treatment for ASP. People with this condition can often adjust their lifestyles to mesh with an early schedule, and thus they won't have any issues while sleeping. However, if one attempts to conform to a later timing, difficulties could arise.
Sleep doctors aim to help patients adjust to their “early bird” clocks, often through educating and counseling them. With ASP, it is best to avoid scheduling activities late at night; night shift work and caffeine/stimulants should be avoided too as these can cause disruption in sleep. Alcohol or drugs should not be relied on as a means of keeping asleep during early hours.
Bright light therapy in the evening hours can assist you in “resetting” your clock. Regular sleep patterns will help to maintain the new time and with ASP being treatable, most people are able to arrange their activities accordingly enabling them to remain alert and participate in whatever activities they choose.