Advanced sleep phase disorder
Overview
Advanced sleep phase disorder (ASPD) is a chronotype characterized by a sleep pattern that is shifted significantly earlier than conventional or socially acceptable times. This condition causes individuals to fall asleep and wake up earlier than most people. ASPD is a type of circadian rhythm sleep disorder, which refers to a group of sleep disorders affecting the timing of sleep.
Symptoms
The primary symptom of advanced sleep phase disorder is an uncontrollable need to fall asleep early in the evening, typically between 6 p.m. and 8 p.m., and to wake up early in the morning, usually between 1 a.m. and 3 a.m. Other symptoms may include difficulty staying awake in the evening, excessive sleepiness in the early evening, and waking up too early and being unable to fall back asleep.
Causes
The exact cause of ASPD is not fully understood. It is believed to be influenced by a combination of genetic and environmental factors. Genetic mutations in certain genes, such as PER2 and CRY1, have been associated with the disorder. These genes are involved in the regulation of the body's internal clock, or circadian rhythm.
Diagnosis
Diagnosis of advanced sleep phase disorder typically involves a clinical evaluation, detailed patient history, and a sleep diary or actigraphy to track sleep patterns. In some cases, a polysomnogram, a type of sleep study, may be conducted. Genetic testing may also be performed, particularly if other family members have the disorder.
Treatment
Treatment for ASPD aims to shift the individual's sleep-wake cycle to a more socially acceptable or convenient schedule. This can be achieved through various methods such as chronotherapy, light therapy, and medication. In chronotherapy, the individual's bedtime is gradually delayed by 1-2 hours each day until the desired bedtime is reached. Light therapy involves exposure to bright light upon waking in order to reset the body's internal clock.
Epidemiology
ASPD is relatively rare, with an estimated prevalence of less than 1% in the general population. It can occur at any age but is more common in older adults. The disorder appears to be more prevalent in females than males.
Prognosis
The prognosis for individuals with ASPD is generally good. With appropriate treatment, most individuals can successfully adjust their sleep-wake cycle. However, without treatment, the early sleep-wake schedule can interfere with social and occupational activities.
See Also
References
- American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd ed, American Academy of Sleep Medicine, 2014.
- Jones CR, Huang AL, Ptáček LJ, Fu YH. Genetic basis of human circadian rhythm disorders. Exp Neurol. 2013;243:28-33. doi:10.1016/j.expneurol.2012.07.022
- Reid KJ, Chang AM, Dubocovich ML, Turek FW, Takahashi JS, Zee PC. Familial advanced sleep phase syndrome. Arch Neurol. 2001;58(7):1089-94. doi:10.1001/archneur.58.7.1089