Journal of Sleep Disorders & Therapy
Open Access

Advanced Sleep Phase Disorder: Understanding Causes, Symptoms, and Treatments

David Wade^{* *}Correspondence: David Wade, Department of Neurology, Adam Mickiewicz University, Wieniawskiego, Poland, Email:

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Description

Advanced Sleep Phase Disorder (ASPD) is a circadian rhythm sleep disorder in which an individual’s sleep-wake cycle is shifted earlier than what is considered typical. People with this disorder tend to feel sleepy much earlier in the evening and wake up several hours earlier in the morning than most others. For instance, someone with ASPD may feel the urge to go to bed around 6 or 7 PM and wake up naturally at 3 or 4 AM. While this early shift in sleep timing may not seem problematic, it can cause significant issues in modern society, where schedules typically revolve around later bedtimes and waking hours. ASPD is a relatively rare disorder, but understanding its causes, symptoms, and available treatments can help those affected manage the condition and improve their overall quality of life.

ASPD is a type of circadian rhythm disorder, which means that the body’s internal clock-responsible for regulating sleep-wake cycles-is out of sync with societal norms. Circadian rhythms follow a roughly 24-hour cycle, and they are influenced by external cues such as light and darkness. In ASPD, however, the internal clock runs ahead of schedule, leading to early sleep onset and early waking. The disorder is most common in older adults but can also affect younger individuals. People with ASPD often experience little difficulty in falling asleep or staying asleep once they go to bed. However, the timing of their sleep is advanced, meaning they fall asleep and wake up earlier than the conventional sleep-wake cycle.

Sleep phase disorder symptoms

The primary symptom of ASPD is a significant shift in the timing of sleep. Key characteristics of the disorder include:

Early sleep onset: Individuals with ASPD consistently feel the urge to go to bed much earlier than others, often between 6 and 9 PM. Once they go to bed, they typically fall asleep quickly.

Normal sleep quality: Despite the unusual timing of their sleep, individuals with ASPD typically experience normal sleep duration and quality. They usually sleep for the same number of hours as others, just earlier.

Daytime functioning issues: The early sleep schedule can interfere with an individual’s social and professional life, especially if they are expected to stay awake late into the evening or work during standard business hours. This misalignment with societal schedules can lead to feelings of isolation and frustration.

Familial history: ASPD tends to run in families, and individuals with a family history of circadian rhythm disorders are at higher risk of developing it themselves.

Sleep phase disorder causes

The exact cause of ASPD is not fully understood, but several factors may contribute to its development:

Genetic pre-disposition: Research has shown that ASPD often runs in families, and specific genetic mutations have been linked to the condition. These mutations affect the body’s internal clock, altering the timing of sleep-wake cycles.

Age: ASPD is more common in older adults, possibly due to agerelated changes in circadian rhythms. As people age, their sleepwake cycles may naturally shift earlier, though not everyone experiences this shift as a disorder.

Environmental factors: Light exposure plays a critical role in regulating circadian rhythms. Reduced evening light exposure, particularly in older adults, can advance the body’s internal clock and contribute to ASPD.

Melatonin regulation: Melatonin, a hormone that helps regulate sleep, is produced in response to darkness. In individuals with ASPD, melatonin production may start earlier in the evening, leading to early sleep onset.

Sleep phase disorder treatment

There are several treatment options available to help manage ASPD and realign the body’s sleep-wake cycle with societal norms. These treatments include:

Light therapy: Bright light therapy is one of the most effective treatments for ASPD. It involves exposure to bright light in the evening to delay the body’s internal clock. By exposing the individual to bright light later in the day, the body’s sleep-wake cycle can gradually shift later.

Improving sleep hygiene: Establishing good sleep habits, such as maintaining a consistent bedtime routine, limiting caffeine intake in the afternoon and evening, and creating a relaxing sleep environment, can also help manage the symptoms of ASPD.

Behavioral therapy: Cognitive-Behavioral Therapy (CBT) can help individuals with ASPD address any psychological or behavioral issues that may be contributing to their early sleepwake cycle. CBT may include techniques for managing stress and anxiety, which can exacerbate sleep issues.

Conclusion

Advanced sleep phase disorder is a challenging circadian rhythm disorder that can disrupt daily life for those affected. While individuals with ASPD may experience normal sleep quality, the early timing of their sleep can lead to difficulties in social, professional, and personal functioning. With proper diagnosis and treatment, including light therapy, chronotherapy, and behavioral interventions, individuals with ASPD can adjust their sleep patterns and improve their quality of life. Recognizing and managing the disorder early on can help mitigate its impact and restore a more balanced sleep-wake cycle.