There are several types of CRSDs. They include delayed sleep phase,
advanced sleep phase, jet lag, shift work disorder, free-running and irregular
sleep-wake type. All types stem from the fact that our tendency to be sleepy or
alert is to some degree regulated by a part of the brain that acts like a
clock. This “clock” is reset on a daily basis by exposure to bright light and
other regular activities such as meals or exercise. CRSDs occur when the
sleep-wake cycle of our internal “clock” is different from the sleep-wake
schedule we would like to follow.
CRSDs can make it harder for you to get high-quality, refreshing sleep.
Untreated CRSDs and increased sleepiness can increase your risk of accidents
such as car crashes. They may also raise your risk of having heart attacks and
diabetes. CRSDs may lead to poor work performance, social stresses and
depression.
You may have a CRSD if you find it hard to fall asleep during “normal”
sleep times and you are sleepy at times when you should be awake. If your
sleepiness is causing difficulties with work, school, or socially, you should
be evaluated by a sleep specialist. Before seeing the sleep specialist, keep a
detailed sleep history and a sleep log for 1 to 2 weeks. This will help the
specialist determine if your sleep problem is from a CRSD or due to another
sleep disorder or medical issue.
Treatment varies depending on the specific CRSD. The goal of treatment
is to fit your sleep pattern into a schedule that allows you to meet the
demands of the lifestyle you want.
Therapy usually includes several approaches:
■ Allowing enough time for sleep
■ Keeping regular bedtimes and wake up times (including days off)
■ Adjusting your wake-up time until you can fall asleep at the time you
want
■ Avoiding taking naps if you have difficulty falling asleep at your
desired bedtime
■ Sleeping in a dark, cool, quiet room
■ Avoiding caffeine and alcohol within six hours of bedtime
■ Taking melatonin (available over the counter) may be helpful in certain
situations as recommended by your healthcare provider
■ Using bright natural or artificial light soon after your desired wake-up time, and scheduling meals and activities at regular times to help reset the
sleep-wake cycle but avoiding bright light near bedtime.
Having good sleep habits will improve your
CRSD symptoms; to keep regular wake-up times and bedtimes.
It is especially important to get evaluated if your sleepiness is affecting your safety such as falling asleep while driving or you’re your ability at work.