The following steps may help prevent shift work disorder: Take a short nap before your night shift to help prevent sleepiness at work. Adopt a sleep schedule on your days off that overlaps with your sleep time on work days. Avoid multiple schedule switches between day and night shifts, if possible.
The following steps may help prevent jet lag disorder: A few days before traveling across several time zones, begin adjusting your sleep-wake cycle to match the time at your destination.
You may gradually change your sleep schedule and use bright light to help advance or delay your waking time. If you can, arrive at your destination a few days before an important event, to help you gradually adjust to the local time. Your body adjusts to the time at your destination at a rate of 1 to 1.
Spend plenty of time outside at your destination. Outdoor light may shorten symptoms of jet lag. Diagnosis will discuss tests and procedures that your doctor may use to diagnose types of circadian rhythm disorders. Living With will discuss what your doctor may recommend to prevent your circadian rhythm disorders from recurring, getting worse, or causing complications. Research for Your Health will discuss how we are using current research and advancing research to prevent circadian rhythm disorders.
Participate in NHLBI Clinical Trials will discuss our open and enrolling clinical studies that are investigating prevention strategies for circadian rhythm disorders.
Signs and symptoms. Common symptoms of circadian rhythm disorders include: Consistent difficulty falling asleep, staying asleep, or both Excessive daytime sleepiness or sleepiness during shift work Fatigue and exhaustion Lethargy Decreased alertness and difficulty concentrating Impaired judgment and trouble controlling mood and emotions Aches and pains, including headaches Stomach problems, in people who have jet lag disorder How do circadian rhythm disorders affect judgment?
Circadian rhythm disorders may increase your risk for the following health conditions: A weakened immune system , which can lead to infections and poor recovery from illnesses Cardiovascular diseases, such as atherosclerosis or stroke Cognitive and behavioral disorders , such as decreases in attention, vigilance, concentration, motor skills, and memory.
These can lead to reduced productivity, workplace mistakes, or road accidents. In teens and young adults, circadian rhythm disorders can cause risky behavior and problems with concentrating at school, controlling emotions, and coping with stress. Digestive disorders, such as stomach ulcers, gastroesophageal reflux disease GERD , and irritable bowel syndrome. Circadian rhythm disorders may influence the signaling from the brain to the gastrointestinal tract.
They may also increase inflammation in the bowel, which can lead to digestive symptoms. Fertility problems. Circadian rhythm disorders may disrupt the hormone cycle that controls fertility and reproduction. Metabolism disorders, which can lead to diabetes , metabolic syndrome , and overweight and obesity Mood disorders, including irritability, anxiety, and depression Worsening of other sleep disorders, such as sleep apnea Do you want to learn more about how circadian rhythm disorders cause problems with metabolism in shift workers?
Diagnosis will discuss tests and procedures used to detect signs of circadian rhythm disorders and help rule out other conditions that may mimic circadian rhythm disorders. Treatment will discuss treatment-related complications or side effects. Diagnosis - Circadian Rhythm Disorders. Medical history and physical exam. To do this, your doctor may do the following: Ask when, how long, and how well you sleep. Ask when your symptoms began. Symptoms that have lasted for three months or more may indicate a circadian rhythm disorder.
Ask about your personal and family history of health conditions. Perform a physical examination. Diagnostic tests. Your doctor may have you undergo or use some of the following tests and measurements: A sleep diary to help you keep track of when and how long you sleep Actigraphy, in which you wear a small motion sensor for three to 14 days to measure your sleep-wake cycles Sleep studies to measure how well you sleep and how your body responds to sleep problems.
Other studies to look at your natural patterns of sleep and wakefulness. Your doctor may repeatedly measure your body temperature and the levels of melatonin and cortisol in your blood or saliva.
The way these factors rise and fall over time can help determine the type of circadian rhythm disorder you may have. Ruling out other medical conditions. To rule out other causes of your symptoms, your doctor may do the following: Ask about your use of caffeine, nicotine, alcohol, or illegal drugs, as well as your exposure to artificial light at night. These lifestyle habits may cause insomnia or tiredness.
Ask you to keep a sleep diary or have a specific type of sleep study to rule out other problems with sleep, such as insomnia, sleep apnea, and narcolepsy Ask you whether you have chronic pain that may be preventing good-quality sleep Examine you for heart or lung conditions that may prevent good-quality sleep Examine you for large tonsils or small airways to help rule out sleep apnea For women, ask whether you are pregnant or undergoing menopause.
Return to Risk Factors to review family history, lifestyle, or other environmental factors that increase your risk of developing circadian rhythm disorders.
Return to Signs, Symptoms, and Complications to review common signs and symptoms of circadian rhythm disorders. Treatment - Circadian Rhythm Disorders.
Healthy lifestyle changes. Your daily routine may include: Adopting a regular meal schedule, especially if you are a shift worker or sleep at irregular times of the day or night.
Adopting a regular bedtime routine. Sleep in a cool, quiet place and follow a relaxing bedtime routine that limits stress.
These practices, along with regular sleep and waking times, can help you fall asleep faster and stay asleep longer. Avoiding daytime naps, especially in the afternoon. However, shift workers may benefit from a short nap before the start of their shift. Exercising regularly. Your doctor may recommend getting regular physical activity during the daytime and avoiding exercising close to bedtime, which may make it hard to fall asleep.
Limiting your intake of caffeine, alcohol, nicotine, and some medicines, especially close to bed time Managing your exposure to light.
Light is the strongest signal in the environment to help reset your sleep-wake cycle. You may need more sunlight during the day and less artificial light at night from TV screens and electronic devices.
Artificial light can lower your melatonin levels, making it harder to fall asleep. Light-blocking glasses, screen filters, or smartphone apps can help dim the light from your electronic devices. Dim lighting for a period before bed may also help reduce the symptoms of a circadian rhythm disorder.
For shift workers, wearing light-blocking glasses when you are outside during the day may help. Light therapy. To move your sleep and wake times earlier, use the light box when you wake up in the morning. This may also help reduce daytime sleepiness. This method may be used to help treat delayed sleep-wake phase disorder, irregular sleep-wake rhythm disorder, and jet lag disorder when you travel east. To move your sleep and wake times later, use the light box late in the afternoon or early in the evening.
This method may be used to help treat advanced sleep-wake phase disorder, shift work disorder, and jet lag disorder when you travel west. Melatonin medicines or supplements.
Options may include the following: Melatonin receptor agonists are medicines to treat non—hour sleep-wake rhythm disorder. Side effects can include dizziness and fatigue. Melatonin supplements are lab-made versions of the sleep hormone that your doctor may recommend to treat delayed sleep-wake phase disorder, irregular sleep-wake rhythm disorder, and non—hour sleep-wake rhythm disorder.
These supplements are not regulated by the U. Food and Drug Administration. Thus, the dose and purity of these supplements can vary. Talk with your doctor about how to find safe, effective melatonin supplements, as well as any possible side effects or medicine interactions.
Side effects of melatonin may include excess sleepiness, headaches, high blood pressure, low blood pressure, stomach upsets, and worsening symptoms of depression. Other medicines which may be used to treat the symptoms of circadian rhythm disorders include: Beta blockers to reduce the levels of melatonin in your body during the day Caffeine to help prevent daytime sleepiness. Your doctor may recommend that you avoid caffeine within eight hours of your desired bedtime.
Sleep-promoting medicines, such as benzodiazepines and zolpidem, to help you fall asleep faster and stay asleep longer. These medicines may cause side effects and complications that may be more severe in older adults and people who have dementia. These complications can include confusion, headaches, poor medicine interactions, long-term dependence, muscle weakness, falls, and nausea.
Wake-promoting medicines, such as modafinil and armodafinil, to help you stay alert and improve performance during shift work. The effects of these medicines may last only for a short time, and you may still experience some sleepiness.
Research for Your Health will discuss how we are using current research and advancing research to treat people who have circadian rhythm disorders. Participate in NHLBI Clinical Trials will discuss our open and enrolling clinical studies that are investigating treatments for circadian rhythm disorders.
Living With will discuss what your doctor may recommend including lifelong lifestyle changes and medical care to prevent your condition from recurring, getting worse, or causing complications. Sleep is a complex and dynamic process that affects how you function in ways scientists are now beginning to understand.
This booklet describes how your need for sleep is regulated and what happens in the brain during sleep. The hypothalamus , a peanut-sized structure deep inside the brain, contains groups of nerve cells that act as control centers affecting sleep and arousal. Within the hypothalamus is the suprachiasmatic nucleus SCN — clusters of thousands of cells that receive information about light exposure directly from the eyes and control your behavioral rhythm.
Some people with damage to the SCN sleep erratically throughout the day because they are not able to match their circadian rhythms with the light-dark cycle. The brain stem , at the base of the brain, communicates with the hypothalamus to control the transitions between wake and sleep.
The brain stem includes structures called the pons, medulla, and midbrain. Sleep-promoting cells within the hypothalamus and the brain stem produce a brain chemical called GABA , which acts to reduce the activity of arousal centers in the hypothalamus and the brain stem. The thalamus acts as a relay for information from the senses to the cerebral cortex the covering of the brain that interprets and processes information from short- to long-term memory.
During most stages of sleep, the thalamus becomes quiet, letting you tune out the external world. But during REM sleep, the thalamus is active, sending the cortex images, sounds, and other sensations that fill our dreams. People who have lost their sight and cannot coordinate their natural wake-sleep cycle using natural light can stabilize their sleep patterns by taking small amounts of melatonin at the same time each day.
The basal forebrain , near the front and bottom of the brain, also promotes sleep and wakefulness, while part of the midbrain acts as an arousal system. Release of adenosine a chemical by-product of cellular energy consumption from cells in the basal forebrain and probably other regions supports your sleep drive.
Caffeine counteracts sleepiness by blocking the actions of adenosine. The amygdala , an almond-shaped structure involved in processing emotions, becomes increasingly active during REM sleep. Each is linked to specific brain waves and neuronal activity. Stage 1 non-REM sleep is the changeover from wakefulness to sleep. During this short period lasting several minutes of relatively light sleep, your heartbeat, breathing, and eye movements slow, and your muscles relax with occasional twitches.
Your brain waves begin to slow from their daytime wakefulness patterns. Stage 2 non-REM sleep is a period of light sleep before you enter deeper sleep.
Your heartbeat and breathing slow, and muscles relax even further. Your body temperature drops and eye movements stop. Brain wave activity slows but is marked by brief bursts of electrical activity. You spend more of your repeated sleep cycles in stage 2 sleep than in other sleep stages. As adenosine levels increase, scientists think that the chemical begins to inhibit the brain cells that promote alertness.
This gives rise to the sleepiness we experience when we have been awake for many hours. Because these nerve cells cannot sense adenosine in the presence of caffeine, they maintain their activity and we stay alert. Lawrence Epstein describes how caffeine works to promote alertness, but can also inhibit restful sleep. For instance, caffeine generally decreases the quantity of slow-wave sleep and REM sleep and tends to increase the number of awakenings.
Alcohol is commonly used as a sleep aid. However, although alcohol can help a person fall asleep more quickly, the quality of that individual's sleep under the influence of alcohol will be compromised. Ingesting more than one or two drinks shortly before bedtime has been shown to cause increased awakenings—and in some cases insomnia—due to the arousal effect the alcohol has as it is metabolized later in the night.
Alcohol also tends to worsen the symptoms of sleep apnea , which will further disrupt sleep in people with this breathing disorder. Dozens of prescription drugs that are used to help control common disease symptoms may have varying effects on sleep.
Beta blockers, which are used to treat high blood pressure, congestive heart failure, glaucoma, and migraines, often cause decreases in the amount of REM and slow-wave sleep, and are also associated with increased daytime sleepiness. Alpha blockers, which are also used to treat high blood pressure and prostate conditions, are linked to decreased REM and increased daytime sleepiness. Finally, antidepressants, which can decrease the duration of periods of REM sleep, have unknown long-term effects on sleep as a whole.
Some antidepressants, from the class of drugs known as SSRIs, have been found to promote insomnia in some individuals. The bedroom environment can have a significant influence on sleep quality and quantity. Several variables combine to make up the sleep environment, including light, noise, and temperature. By being attuned to factors in your sleep environment that put you at ease, and eliminating those that may cause stress or distraction, you can set yourself up for the best possible sleep.
To minimize this effect, nightlights in hallways and bathrooms can be used. As for noise, although background sounds may relax some people, the volume level must be low.
Otherwise, increased frequency of awakenings may prevent transitions to the deeper stages of sleep. Doctors recommend that you:. The safety and effectiveness of melatonin have not been thoroughly tested. Taking large doses of it may disrupt your sleep and make you very tired during the day.
If you have epilepsy or are taking warfarin such as Coumadin , talk to your doctor before you use melatonin. The sleeping pills eszopiclone Lunesta and zolpidem Ambien have been studied for jet lag. They may help you sleep despite jet lag if you take them before bedtime after you arrive at your destination.
Side effects include headaches, dizziness, confusion, and feeling sick to your stomach. If you work the night shift or rotate shifts, you can help yourself get good sleep by keeping your bedroom dark and quiet and by taking good care of yourself overall.
In some cases, prescription medicine or over-the-counter supplements may help. Here are some tips on sleeping well when you do this type of shift work:. For more information, see the topic Shift Work Sleep Disorder.
Some people, no matter what they do, have trouble falling asleep at night and being up early during the day. This may or may not cause problems for them. It depends on their lifestyle and work or school schedule. If you are one of those night owls, there are things you can try so that you fall asleep earlier and sleep through the night.
People who fall asleep very early and wake up before dawn may try the following to try to stay up later at night and sleep later in the morning. After you get treatment for the illness or health problem that is causing your sleep problem, you will need to practice good sleep habits. This includes getting regular exercise, going to bed at the same time each day, and using the bed only for sleep and sex.
Current as of: September 23, Author: Healthwise Staff. This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.
Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Updated visitor guidelines. Top of the page. Topic Overview What is the body clock?
The hour body clock controls functions such as: Sleeping and waking.
0コメント