Chronotherapy (sleep phase)

Classification

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Chronotherapy is a behavioral treatment approach that aims to adjust an individual's sleep patterns by gradually shifting bedtime and rising time later each day until a person is sleeping on a normal schedule. This therapy can be particularly useful for individuals with delayed sleep phase disorder (DSPD), a type of circadian rhythm sleep disorder characterized by a mismatch between a person's internal biological clock and societal norms. Chronotherapy uses the human phase response to light or melatonin to adjust sleep patterns, and the American Academy of Sleep Medicine has recommended it for the treatment of circadian rhythm and sleep disorders.

Indications

Chronotherapy is primarily indicated for the treatment of circadian rhythm sleep disorders, such as:

Delayed sleep phase disorder (DSPD) Advanced sleep phase disorder (ASPD) Non-24-hour sleep-wake disorder (N24) Jet lag Shift work disorder

Treatment process

In chronotherapy, the individual's bedtime and rising time are progressively moved later each day, typically by 1-2 hours, until the desired sleep schedule is achieved. This process should be done gradually and consistently, with exposure to natural light or bright artificial light during the waking hours and a dark environment during sleep time. Additionally, melatonin supplementation can be used in conjunction with light exposure to facilitate the adjustment of the circadian rhythm.

Risks and challenges

While chronotherapy can be effective in adjusting sleep patterns, it may also temporarily disrupt the individual's daily routine, leading to increased daytime sleepiness, reduced cognitive performance, or difficulty adhering to work or social commitments. Additionally, individuals undergoing chronotherapy should be cautious about maintaining consistent sleep schedules to prevent relapse into previous sleep patterns.

Efficacy

Chronotherapy has been found to be effective in treating circadian rhythm sleep disorders, particularly delayed sleep phase disorder, by helping individuals adjust their sleep patterns to better align with societal norms. However, long-term success may depend on the individual's ability to maintain consistent sleep habits and schedules.

See also

• Circadian rhythm
• Sleep disorder
• Light therapy
• Melatonin