Lifestyle Choices

Do you find it difficult to fall asleep until well after midnight, yet are able to sleep a normal length of time if you don’t have to get up for work? Or, do you fall asleep too early in the evening and wake up too early in the morning? If so, your biological clock may be out of sync with your preferred sleep-wake schedule.

Someone with delayed sleep phase syndrome has sleep-onset and wake times that are later than desired, but little or no difficulty maintaining sleep once it has begun. Many adolescents, because of their neurophysiology as well as school and social schedules, suffer from this syndrome.

Teenagers often do not want to sacrifice their social lives or their after-school jobs for the sake of a full night’s sleep. They do not get to bed until late at night and then have to wake up for early-morning classes. The result is that they are “walking zombies” for the first few hours of the day.

Workers on rotating shifts, college students who stay up late to study and eastbound jet-lagged travellers can also experience delayed sleep phase syndrome. Effects can be minimized by avoiding alcohol, sedatives or stimulants, and by practising good sleep hygiene, including maintaining consistent sleep-wake schedules.

Advanced sleep phase syndrome is the opposite of delayed sleep phase syndrome. Sufferers of advanced sleep phase syndrome fall asleep too early in the evening and wake up too early

In the morning, often before dawn. Like delayed sleep phase syndrome, advanced sleep phase syndrome becomes a problem when it conflicts with work and social schedules.

The sleep phase syndromes are most effectively treated with bright light (2,000 to 10,000 lux) therapy. (Lux is a measure of illumination. The intensity of office lighting is about 200 to 500 lux. A bright overcast sky provides about 10,000 lux.) Those with delayed sleep phase syndrome are treated with exposure to daylight first thing in the morning, and are asked to avoid bright light in the evening. People with advanced sleep phase syndrome are exposed to daylight full-spectrum light during early evening hours. They must keep their bedroom dark during early morning hours.

To establish the proper treatment schedule and to avoid damage to the eyes, consult a sleep specialist before you attempt any bright light therapy.

PARASOMNIAS

The parasomnias are a group of disorders that are not associated with the processes of sleep per se, but rather are physical abnormalities that occur for the most part during sleep. They include REM sleep behaviour disorder, sleep terrors, sleepwalking, bruxism and enuresis and sudden infant death syndrome.

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