Journal of Sleep Disorders & Therapy
Open Access

Advanced Sleep Phase Disorder: A Chronically Early Bedtime

Jane Aaron^{* *}Correspondence: Jane Aaron, Department of Psychiatry, American University, Atlantic Union College, Massachusetts, USA, Email:

Author info »

Description

Sleep disorders often disrupt our daily lives in various ways, and one such condition, Advanced Sleep Phase Disorder (ASPD), involves an unusual and chronic shift in the sleep-wake cycle. This circadian rhythm disorder causes individuals to experience an extreme early bedtime and an early morning wake-up time, often making it difficult to maintain a normal social or professional schedule. Unlike other sleep disorders, ASPD is not about sleeplessness, but rather about an unnatural sleep schedule that deviates from typical societal norms. While it may seem like an unproblematic condition at first glance, ASPD can have a significant impact on an individual’s daily functioning, relationships, and overall quality of life.

What is advanced sleep phase disorder?

Advanced Sleep Phase Disorder (ASPD) is a type of circadian rhythm sleep disorder where the body’s internal clock is shifted earlier than desired. Individuals with ASPD feel the need to go to sleep in the late afternoon or early evening and wake up in the very early hours of the morning, often as early as 2 or 3 a.m. While this might sound like a healthy sleep schedule to some, it causes significant issues for those affected by it, as it conflicts with the typical societal schedule. Most people with ASPD experience difficulty staying awake during the evening hours, and they may struggle to participate in social activities, attend evening work meetings, or even engage in normal family routines.

ASPD is more than just a preference for an early bedtime-it’s a condition that forces individuals to fight against their biological clock. People with this disorder feel naturally sleepy much earlier than what is considered normal, and they may experience difficulty staying awake or alert after a certain hour, even when required to do so for work or social obligations.

Causes of advanced sleep phase disorder

While the exact cause of ASPD is not entirely understood, researchers have identified several contributing factors that may influence its development:

Genetic factors: There is evidence to suggest that ASPD can run in families, implying a genetic Component to the disorder. Some individuals may inherit a tendency for an early sleep-wake cycle, which is set earlier than typical societal norms.

Aging: ASPD is often more common among older adults. As people age, their circadian rhythms tend to shift, causing them to feel sleepy earlier in the evening. This shift is partly due to changes in hormone levels and the natural aging process of the body’s internal clock.

Environmental and lifestyle factors: Although ASPD is largely driven by biological factors, environmental influences can also contribute. For example, living in an environment where there is limited exposure to natural light in the evening can impact circadian rhythms. Additionally, engaging in stimulating evening activities or using blue light-emitting devices (such as smartphones or computers) at night may further disrupt the body’s natural sleep cycle.

Psychological factors: Stress, anxiety, or depression may also exacerbate ASPD symptoms. While ASPD itself is not a direct result of mental health issues, the condition can be increased by emotional or psychological factors that affect sleep.

Symptoms of advanced sleep phase disorder

The symbol of ASPD is a persistent early sleep-wake cycle, but the symptoms can extend beyond just the timing of sleep. These include:

Early sleep onset: Individuals with ASPD naturally feel the urge to fall asleep between 6 p.m. and 9 p.m., which is much earlier than the typical bedtime. They may feel drowsy in the early evening and find it hard to stay awake, even during evening activities.

Early morning awakening: People with ASPD often wake up at an unusually early hour, such as 3 a.m. or 4 a.m., regardless of when they went to sleep. This early rising can lead to frustration and sleep deprivation, as they may not be able to get the recommended amount of sleep.

Difficulty staying awake late: Individuals with ASPD find it difficult to remain awake during late-night events or activities. They may miss social gatherings, late dinners, or evening entertainment due to their early sleep onset.

Daytime sleepiness: Despite going to bed early, people with ASPD often feel sleepy and groggy throughout the day, especially in the afternoon and evening. This sleepiness may interfere with their ability to focus, work, or interact with others.

Mood disturbances: The chronic misalignment between sleep patterns and societal demands can lead to irritability, anxiety, or even depression. Social isolation and an inability to participate in normal evening activities can exacerbate these mood changes.

Diagnosis and treatment of advanced sleep phase disorder

Diagnosing ASPD typically involves a thorough review of the individual’s sleep patterns and behaviors, along with their medical history. A sleep study, or polysomnography, may be used to monitor sleep stages and determine the timing of sleep-wake cycles. Additionally, actigraphy (a wrist-worn device that tracks sleep patterns) can be helpful in assessing sleep-wake timing and consistency over an extended period. Once diagnosed, treatment for ASPD aims to realign the individual’s circadian rhythm to better match societal norms. Some of the most common treatment options include:

Light therapy: Light therapy is one of the most effective treatments for ASPD. Exposure to bright light in the evening hours helps delay the onset of sleep, essentially resetting the body’s internal clock to a later time. Light therapy can be done using a special lightbox or by spending time outside in the natural evening light.

Chronotherapy: Chronotherapy involves gradually shifting the sleep-wake cycle by adjusting bedtime and wake-up time in small increments (typically 15-30 minutes) every few days. This method can help reset the circadian rhythm and move the sleep-wake cycle to a more conventional time.

Melatonin supplements: Melatonin, a hormone that helps regulate sleep, is often used in the treatment of circadian rhythm disorders. Taking melatonin in the evening, at a time when the body would naturally start to feel sleepy, can help delay sleep onset and encourage a later bedtime.

Cognitive Behavioral Therapy for Insomnia (CBT-I): Cognitive Behavioral Therapy for Insomnia (CBT-I) is another option for individuals with ASPD. This therapeutic approach focuses on changing behaviors and thoughts around sleep, helping individuals develop healthier sleep habits and manage the stress associated with sleep disruptions.

Sleep hygiene improvements: Adopting good sleep hygiene practices is important for managing ASPD. This includes maintaining a consistent sleep schedule, avoiding caffeine and heavy meals before bed, and creating a sleep-friendly environment that is dark, quiet, and cool.

Conclusion

Advanced Sleep Phase Disorder (ASPD) is a challenging circadian rhythm disorder that affects a person’s sleep-wake cycle, causing them to feel the urge to sleep early in the evening and wake up at an unusually early hour. Although the disorder can be frustrating, especially when it interferes with work, social, and family life, there are effective treatments available to help realign the body’s internal clock. With appropriate interventions such as light therapy, chronotherapy, and behavioral strategies, individuals with ASPD can improve their sleep patterns and enjoy a more balanced lifestyle. Recognizing the symptoms and seeking professional guidance is key to managing this condition and improving one’s overall health and well-being.