Today's #Sleeptember FACT --- The Sun and Moon may not be our circadian systems' only dynamic duo

#SLEEPTEMBER

We've long understood that the rhythms we live by (sleep, wake, hunger, even our digestive system rhythms) are finely tuned to the circadian cycles of the planet which revolve around the daily light-dark cycle and, in the longer view, the seasons.

Now scientists have found a couple of neurological companions in the brain which may also be responsible for turning these cycles off and on via biochemical activity noticed in membranes referred to as ion channels.

Image courtesy www.columbia.edu

As reported in MD, sodium and potassium channels worked in opposition to shift the circadian cycles in both fruit flies and mice. This potentially suggests that circadian rhythms are not only influenced by external forces like light and darkness, but internal processes built into our systems which are entrained to those external forces.

Up to 16 percent of the population struggles with some form of circadian rhythm disorder, according to statistics published by the American Academy of Sleep Medicine. 

That's a lot of people who might have faulty biochemistry when it comes to switching from sleep to wakefulness or mitigating other processes that are information by circadian rhythms.

Ultimately, "[a] better understanding of this mechanism could lead to new drug targets to address disturbances of the sleep-wake cycle, such as jet lag, shift work, and circadian disorders," writes Melissa Glim for MD. "It may become possible to reset a person’s internal clock to match his or her situation." Read more here

Today's #Sleeptember FACT --- Non-24-Hour Sleep-Wake Disorder

Non-24-Hour Sleep-Wake Disorder (or simply, Non-24) is a circadian rhythm disorder in which the body and brain fall out of alignment (or "entrainment") with the timing of the body's biological clock.

#SLEEPTEMBER

When this happens, people with Non-24 do not have neurological control over their sleeping and waking periods and may struggle to stay awake during the day or struggle to fall asleep at night.

Because the circadian rhythms are not stable, the biological clock is always "off," leading to ever-shifting cycles of sleepiness and wakefulness that may or may not coincide with the activities of daily living such as working, school, caregiving and other time-relevant activities. Special calculators have been developed to help these people adjust their days and nights to their sleep-wake schedules to maximize their functional time and to allow for quality sleep time.

No, this is not a fun fact. But it is a real fact for tens of thousands of people in the United States alone. 

Many blind people have non-24 (perhaps as many as 95,000, according to statistics published by the National Sleep Foundation).

The incidence of non-24 is less prevalent in sighted populations, but that does not mean that few sighted people suffer from it. Because the sighted population is considerably larger than that of the blind population, there are still untold numbers of sighted people who potentially suffer from this circadian rhythm disorder. Identifying, diagnosing and treating them has proven difficult, which makes non-24 a critical candidate for further research and awareness.

Learn more about Non-24 here:

• Circadian Sleep Disorders Network (CSDN) -- Non-24 Q&A 
• Follow the CSDN on Facebook
• Follow the CSDN on Twitter @CSD_N
• Follow the CSDN on Linked In

Today's #Sleeptember FACT --- Non-24-Hour Sleep-Wake Disorder

Sleep Hygiene Tip of the Week || SHED SOME LIGHT: Teens can benefit from "happy lights"

One of the biggest circadian rhythm problems relates to Delayed Sleep Phase Disorder (DSPS), in which teenagers, due to the developmental nature of their changing brains, tend to fall asleep later and require sleeping later in the morning.

It's a challenge because teens have been shown to be at risk for sleep deprivation because of late bedtimes mixed with school start times which are too early. Also, those kids who are active in sports or jobs which have challenging hours may also struggle to get more than 5 hours a sleep a night because they have practices or shifts that cut into their homework and sleep schedules.

Society, on the one hand, demands that we keep our kids busy, but the price they often pay to stay out of trouble is sleep deprivation, which can contribute to other kinds of trouble: poor grades, motor vehicle accidents, mood disorders.

So how are we to get adolescents out of bed in the morning with so much stacked against them? Using phototherapy can help.

In one randomized parallel clinical trial, the use of bright light (compared to dim light) as part of a sleep phase adjustment protocol was shown to improve morning sleepiness in the subjects. Bright light was defined as measuring at 2700 lux, while dim light was measured as 0.1 lux. Phototherapy in this study was delivered via a special mask.

The sleep phase adjustment protocol in this experiment was designed for nine weeks: one week to establish a baseline sleep schedule for each subject, then four weeks of chronotherapy treatment which included one-hour shifts in bedtimes per week with no naps or bright light after 5pm, followed by four weeks of followup.

Not only did bright light help improve morning sleepiness, but the overall treatment protocol for DSPS in this study ultimately suggested that complete adjustment therapies using chronotherapy without bright light treatments were not as effective.

If you have a teenager who struggles to get out of bed in the morning, and there are no other options for them (such as delayed school start time), it might be a good idea to visit the doctor to discuss the possibility of a sleep phase adjustment using both phototherapy and chronotherapy. A doctor will, at this time, want to rule out other causes for daytime sleepiness, such as narcolepsy or sleep apnea. If the doctor determines that your teen has DSPS, they will wish to work with you and them on a behavior therapy that the teen must follow to reset their rhythms; it requires strict adherence to a bedtime protocol, careful use of lighting, and a sleep diary, among other things. It has been shown to be helpful and doesn't usually require medication.

This Verilux product, the Rise & Shine Serenity series,
gives timed light that mimics natural sunrise and sunset times.
It may be useful in resetting circadian rhythms in teens
suffering from DSPS. Image courtesy Verilux.

In addition, the investment of a so-called "happy light" can be very useful. Full-spectrum lighting systems which adjust light brightness in the teen's bedroom on a gentle timed schedule can gradually help them to adjust to nature's circadian rhythms and light cues.

Some of these come equipped with alarms, as well. Verilux offers two different systems which may work well for you. Avoid bright lighting with ultraviolet rays; most full-spectrum systems do not include it for safety reasons.

Sleep Disorders 101 || Is Your Body Clock Broken? There's Help For You

• Do you have problems sleeping on a "normal" schedule? 
• Do you sleep a few hours on, rise for a few hours, then repeat this cycle over and over again? 
• Are you an extreme night owl or morning lark? Does this have a negative impact on your life?
• Do you constantly experience jet lag? 
• Do you find your work on the night shift is messing with your sleep rhythms?

If you answered yes to any of these question, you might have a circadian rhythm disorder (CRSD or CSD). A circadian rhythm disorder is described as a neurological condition in which you have trouble synchronizing the sleep-wake cycle with the day-night cycle. CRSDs can wreak havoc on work and family life, but fortunately, they are treatable.

How do you find out if this is what's plaguing you? First, see your doctor and get tested and diagnosed. You can't do much until you know exactly why your sleeping habits are the way they are, and it will be important for you to rule out other hidden health conditions or even personal sleep habits which might be leading to these kinds of symptoms.

Treatments for CRSDs vary widely and depend upon your specific condition. For more information about CRSDs in general, and their treatments, you are encouraged to visit the Circadian Sleep Disorders Network.