How does circadian rhythm affect your body. What factors influence your internal clock. Can you reset your circadian rhythm. What are the best practices for improving sleep schedules. How does circadian rhythm impact overall health and well-being.

Understanding Circadian Rhythm: The Body’s Internal Clock

Circadian rhythm is more than just a buzzword in sleep science; it’s a fundamental aspect of human biology that governs numerous physiological processes. This 24-hour internal clock doesn’t just control our sleep-wake cycle; it orchestrates a symphony of bodily functions, from hormone production to immune system activity and digestion.

Dr. Alicia Roth, a behavioral sleep medicine psychologist, emphasizes the far-reaching impact of circadian rhythms: “It’s not just for sleep. It’s for everything that goes on in our body. We have internal clocks for our hormones, our immune system, our digestion. Our organs all run on some sort of timing system.”

The Individuality of Circadian Rhythms

One crucial aspect of circadian rhythms is their variability among individuals. Some people are natural early risers, others are night owls, and many fall somewhere in between. This individual variation is not merely a matter of preference but is rooted in our biology.

Understanding your personal circadian rhythm is key to optimizing your daily routine. As Dr. Roth points out, “It’s also ideal to be aware of your circadian rhythm because it also dictates when you’re going to be most alert during the day and when you’re going to be the most productive.”

The Science Behind Circadian Rhythms: Zeitgebers and External Cues

Our circadian rhythms are not isolated systems; they are constantly influenced by external factors known as zeitgebers. These environmental cues help synchronize our internal clocks with the outside world. Some of the most influential zeitgebers include:

• Light exposure (especially sunlight)
• Temperature fluctuations
• Meal timing
• Work and school schedules
• Exercise routines

By manipulating these external cues, we can potentially influence and reset our circadian rhythms. This understanding opens up possibilities for improving sleep quality and overall well-being.

Signs Your Circadian Rhythm Might Be Off

Recognizing when your circadian rhythm is out of sync is crucial for taking corrective action. Here are some common signs that your internal clock might need resetting:

• Difficulty falling asleep at your desired bedtime
• Waking up feeling unrefreshed, even after a full night’s sleep
• Experiencing daytime fatigue or excessive sleepiness
• Irregular hunger patterns or changes in appetite
• Mood swings or irritability
• Decreased cognitive function or difficulty concentrating

If you’re experiencing these symptoms, especially after significant changes in your routine (like shift work or international travel), it might be time to consider resetting your circadian rhythm.

Strategies for Resetting Your Circadian Rhythm

Resetting your circadian rhythm is not an overnight process, but with consistency and patience, it’s entirely achievable. Dr. Roth explains, “Resetting your circadian rhythm really means resetting the timing of when you sleep and when you wake up. It has to do more with the schedule of your sleep, rather than how well you fall asleep.”

Establish a Consistent Sleep Schedule

The cornerstone of resetting your circadian rhythm is maintaining a consistent sleep schedule. This means going to bed and waking up at the same time every day, even on weekends. While it might be tempting to sleep in on days off, this can disrupt your body’s internal clock and make it harder to maintain a regular sleep pattern.

Gradual Bedtime Adjustments

If you need to shift your sleep schedule, do it gradually. Dr. Roth recommends moving your bedtime in half-hour increments. For instance, if you currently sleep from 1 a.m. to 9 a.m. but want to shift earlier, start by going to bed at 12:30 a.m. and waking up at 8:30 a.m. for a week. Then, shift another 30 minutes the following week, and so on until you reach your desired schedule.

Optimize Light Exposure

Light is one of the most powerful zeitgebers. To reset your circadian rhythm:

• Expose yourself to bright light (preferably sunlight) soon after waking up
• Reduce blue light exposure from screens in the evening
• Use blackout curtains or a sleep mask to create a dark sleeping environment

Exercise Strategically

Regular exercise can help regulate your circadian rhythm, but timing matters. While some people find morning exercise invigorating, others might feel more energized by evening workouts. Experiment to find what works best for you, but avoid intense exercise close to bedtime as it can interfere with sleep onset.

The Role of Diet in Circadian Rhythm Regulation

What and when you eat can significantly impact your circadian rhythm. Here are some dietary considerations for maintaining a healthy internal clock:

Meal Timing

Try to eat meals at consistent times each day. This helps reinforce your body’s natural rhythms. Avoid large meals close to bedtime, as digestion can interfere with sleep quality.

Caffeine and Alcohol Consumption

Both caffeine and alcohol can disrupt your circadian rhythm. Limit caffeine intake, especially in the afternoon and evening. While alcohol might make you feel drowsy initially, it can lead to fragmented sleep and circadian disruption in the long run.

Hydration

Proper hydration is essential for overall health and can indirectly support your circadian rhythm. However, be mindful of fluid intake close to bedtime to avoid nighttime awakenings for bathroom trips.

The Impact of Technology on Circadian Rhythms

In our digital age, technology plays a significant role in shaping our daily routines and, consequently, our circadian rhythms. While technological advancements have brought many benefits, they’ve also introduced challenges to maintaining a healthy sleep-wake cycle.

The Blue Light Conundrum

One of the most significant technological impacts on circadian rhythms comes from the blue light emitted by electronic devices. This light can suppress melatonin production, the hormone crucial for sleep onset. To mitigate this effect:

• Use blue light filtering apps or settings on your devices
• Avoid screen time at least 30 minutes before bed
• Consider using amber-tinted glasses in the evening to block blue light

Smart Home Technology for Better Sleep

On the flip side, technology can also be leveraged to support healthy circadian rhythms. Smart home devices can be programmed to adjust lighting throughout the day, mimicking natural light patterns. Smart thermostats can optimize bedroom temperature for sleep, as body temperature fluctuations play a role in circadian rhythm regulation.

Circadian Rhythms and Mental Health

The relationship between circadian rhythms and mental health is bidirectional and complex. Disruptions in circadian rhythms have been linked to various mental health issues, including depression, anxiety, and bipolar disorder. Conversely, these mental health conditions can also lead to circadian rhythm disturbances.

Seasonal Affective Disorder (SAD)

SAD is a prime example of how circadian rhythm disruptions can impact mental health. This condition, characterized by depressive symptoms during certain seasons (typically winter), is thought to be related to changes in light exposure that disrupt circadian rhythms.

Circadian Rhythm Sleep-Wake Disorders

These disorders are characterized by a misalignment between a person’s internal clock and the external environment. Examples include:

• Delayed Sleep Phase Disorder: A persistent pattern of late sleep onset and late awakening
• Advanced Sleep Phase Disorder: Early sleep onset and early morning awakening
• Non-24-Hour Sleep-Wake Rhythm Disorder: A circadian rhythm that’s not synchronized with the 24-hour day

Treatment for these disorders often involves a combination of light therapy, melatonin supplementation, and behavioral interventions to realign the circadian rhythm.

Circadian Rhythms Across the Lifespan

Our circadian rhythms are not static; they evolve throughout our lives. Understanding these changes can help us adapt our routines and expectations at different life stages.

Infants and Children

Newborns don’t have a fully developed circadian rhythm, which explains their erratic sleep patterns. As they grow, their internal clocks gradually synchronize with external cues. Establishing consistent routines can help reinforce healthy circadian rhythms in children.

Adolescents

During puberty, there’s often a shift towards later sleep and wake times. This biological change can conflict with early school start times, potentially leading to chronic sleep deprivation in teenagers.

Adults

While individual preferences for sleep timing persist into adulthood, most adults settle into a relatively stable circadian rhythm. However, factors like shift work, travel, and lifestyle choices can disrupt this stability.

Older Adults

As we age, circadian rhythms tend to shift earlier, leading to earlier bedtimes and wake times. Older adults may also experience more fragmented sleep and spend less time in deep sleep stages.

Understanding these age-related changes can help individuals and caregivers make informed decisions about sleep schedules and routines.

The Future of Circadian Rhythm Research

As our understanding of circadian rhythms deepens, new avenues for research and potential therapies are emerging. Some exciting areas of development include:

Chronotherapy

This approach involves timing medical treatments to align with an individual’s circadian rhythm. For example, certain cancer treatments may be more effective and have fewer side effects when administered at specific times of day.

Personalized Circadian Medicine

Advances in genetic testing and wearable technology may soon allow for highly personalized recommendations for optimizing individual circadian rhythms.

Circadian Lighting

Researchers are exploring how dynamic lighting systems that mimic natural light patterns throughout the day can support healthy circadian rhythms in indoor environments.

As we continue to unravel the complexities of circadian rhythms, the potential for improving sleep, health, and overall quality of life is immense. By understanding and respecting our internal clocks, we can work towards a more balanced and harmonious relationship with our natural biological rhythms.

Do You Need to Reset Your Circadian Rhythm? – Cleveland Clinic

If you work third shift, pull all-nighters (whether it’s studying or bingeing a TV show) or experience jetlag, your internal clock might be off.

Circadian rhythm, the name given to your body’s 24-hour internal clock, controls your body’s sleep-wake cycle.

“It’s not just for sleep,” says behavioral sleep medicine psychologist Alicia Roth, PhD. “It’s for everything that goes on in our body. We have internal clocks for our hormones, our immune system, our digestion. Our organs all run on some sort of timing system.”

And everyone’s internal clock varies — you might be an early riser, a night owl or somewhere in between.

If you’ve been feeling tired and think your internal clock is off, can you reset your circadian rhythm? Dr. Roth gives us advice on how to improve our sleep schedule.

Can you reset your circadian rhythm?

Yes, you can reset your circadian rhythm. But first, it’s important to understand your own individual circadian rhythm.

“I tell a lot of patients that they’re trying to fit a square peg into a round hole,” says Dr. Roth. “For example, they might be natural night owls and their body wants to go to bed at midnight, but they’re pushing their body to go to bed at nine.”

In this example, because your body is not set up to go to bed that early, you might have trouble falling asleep and trouble waking up at the time you’d like.

“It’s also ideal to be aware of your circadian rhythm because it also dictates when you’re going to be most alert during the day and when you’re going to be the most productive,” says Dr. Roth. “People who are night owls tend to be most productive in the later evening. And people who are morning people tend to be most productive in the morning.”

Factors like light, temperature and when you eat affect your circadian rhythm as well. These are known as zeitgebers, external cues that impact your internal clock.

“So the sun is a zeitgeber,” says Dr. Roth. “Our school schedule, our work schedule, when we exercise, those are all zeitgebers. We can do things to change our circadian rhythm by what we expose ourselves to.”

How to reset your circadian rhythm

“Resetting your circadian rhythm really means resetting the timing of when you sleep and when you wake up,” says Dr. Roth. “It has to do more with the schedule of your sleep, rather than how well you fall asleep.”

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The following tips can help reset your circadian rhythm.

Have a routine

If you’ve been going to bed at all different hours of the night, try setting up a schedule and sticking with it. Once you’ve established a routine, you’ll be able to fall asleep and wake up easier.

It’s also important to stick close to that schedule on weekends or days off.

Exercise

Overall, exercise helps with melatonin production, which can help you sleep. And working out can help your body’s other systems sync with your circadian rhythm.

But when you work out and how you feel from it is different for everyone.

“Some people exercise in the morning because it makes them feel more energetic,” says Dr. Roth. “For others, it makes them tired, so they save it for after work.”

Avoid alcohol and caffeine in the evening

Pay attention to when you have that last cup of coffee. Drinking caffeine, which is a stimulant, can keep you awake late into the evening, when you’d ideally like to be winding down.

If you’re a fan of a nightcap, reconsider drinking alcohol in the evening, too. While you may find you’re sleepy or drowsy after drinking alcohol, it can affect your circadian rhythm in the long run.

Limit screen time

If you have a habit of scrolling through social media right before bedtime, stop.

The blue light from your cellphone and tablets restricts the production of melatonin and leads to a disruption in your circadian rhythm.

Try to avoid screens 30 minutes before bedtime.

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Avoid naps

While you may love taking an afternoon nap, that hourlong (or more) snooze can harm your circadian rhythm by making it harder to fall asleep at night.

If you do need to take a nap, limit it to 30 minutes or less and aim to nap before 3 p.m.

Gradually move your bedtime

Don’t expect to fix or reset your circadian rhythm overnight. Dr. Roth recommends gradually moving your bedtime. This can be done in half-hour shifts.

For example, if you currently go to sleep at 1 a.m. and wake up at 9 a.m., focus on going to bed at 12:30 p.m. and waking up at 8:30 a.m. for a week, and then shift those times back another half-hour the following week.

Why your circadian rhythm matters

Your circadian rhythm affects all aspects of your life, says Dr. Roth.

“For example, if your sleep times are off, your hunger could be off or your eating times,” says Dr. Roth. “We often see people who are sleep deprived that their hunger changes, either goes up or down and the timing of when they get hungry can change.”

How to tell it’s time for a reset

You might need to reset your circadian rhythm if you:

• Have trouble falling asleep.
• Have trouble staying awake in the evening.
• Have trouble waking in the morning.
• Have trouble focusing on daily tasks and responsibilities.

If you’re having trouble resetting your circadian rhythm on your own, a sleep medicine specialist or a behavioral sleep medicine psychologist can help determine if you have a circadian rhythm disorder.

“A circadian rhythm disorder is when your preferred sleep schedule isn’t aligned with what you want it to be,” says Dr. Roth. “Your doctor can recognize these disorders, do an assessment of these disorders and figure out how to help treat them.”

Dr. Roth says that treatments can include changing schedules, habits and behaviors, using light therapy and adding melatonin supplements.

“Our circadian rhythms evolve over time,” says Dr. Roth. “As we age, our circadian timing gets earlier. People in their 50s, 60s and 70s may start to want go to bed earlier and wake up earlier. If you were a night owl as a teenager, you could be a morning person when you’re an older adult. ”

Do you have a broken body clock? Here’s how to fix it — Groov

Your circadian rhythm is a 24-hour internal clock that controls how sleepy or awake you feel. 

You may try listening to the falling rain to get to sleep, but there’s a better rhythm to take notice of.

That’s your circadian rhythm ‒ a 24-hour internal clock that controls how sleepy or awake you feel. It moves at regular intervals between the two states and is also known as your sleep/wake cycle.

There’s a special part of your brain, magnificently called the suprachiasmatic nucleus (SCN), that controls your circadian rhythm. The SCN responds to light and dark. Light is a cue to the SCN to prepare the body to be up and awake.  Darkness signals the SCN to get the body ready for sleep.

Your circadian rhythm roughly lines up with day and night – meaning you’ll feel awake during the day and sleepy at night. 

That’s because when it’s dark, your body releases a hormone called melatonin, which makes you feel sleepy.

This explains why it can be hard to sleep during the day and stay awake at night, which is especially relevant for shift workers. Your circadian rhythm can also be disrupted if you travel overseas to a different time zone – hello, jetlag.

Age can affect your circadian rhythm. For example, teenagers’ circadian rhythms mean they stay up later and find it hard to get up early.

10 tips to balance your circadian rhythm, sleep, and feel good

1. Expose yourself to bright light first thing in the morning

Fling open the curtains and expose yourself to bright light first thing in the morning. This lets your brain know it’s time to wake up. And make sure you’re exposed to bright light during the day – either sunlight or artificial light does the trick.

2. Reduce your exposure to blue light

At night, reduce your exposure to blue light, which is emitted from computer screens and devices such as smartphones. Blue light interferes with your production of melatonin.

3. Make sure your bedroom is comfortable

At night, make sure your bedroom is dark, cool and quiet. This lets your body know it’s time to sleep. Good quality curtains or black-out ones help keep the light out, as do eye masks. If you find noise a problem, try using ear plugs.

4. Wake and fall asleep at the same time each day

Go to bed at the same time each night and get up at the same time each morning, even in the weekends. This helps you sleep better at night and makes you feel better during the day.

5. Snack on melatonin before bedtime

Have a handful of melatonin-rich snacks, such as almonds or walnuts, before bed. You could also try having a glass of warm milk or a relaxing caffeine-free herbal tea.

Read on: 10 bedtime snacks that can help you sleep

6. Avoid caffeine before bed

Avoid caffeine 4 to 6 hours before bed. This will help you sleep better and be less wired.

7. Create a bedtime ritual

Create a bedtime ritual to signal to your brain that it’s time for bed. You could read or listen to relaxing music. Having a bath before bed can really enhance your quality of sleep.

8. Practise deep breathing

Practise deep breathing for sleep or progressive muscle relaxation techniques.

9. Set aside ‘worry time’ earlier in the day

To rid yourself of the thoughts keeping you awake, it can be helpful to list them earlier in the day and write a plan of action for each individual worry. That way, if worries arise in the night you can reassure yourself that you are dealing with them.

10. Don’t force sleep

If you’re having trouble sleeping after 20 minutes in bed, get up and do something quiet and relaxing then go back to bed again.

More tips and advice on sleep:

• How much sleep do you really need?

• 5 ways to relax your mind at bedtime for better sleep

• Boost your energy with a power nap

Download Mentemia from your favourite app store.

what it is and how to get enough sleep

We are controlled by circadian rhythms. This biological clock affects how we sleep, expend energy, and digest food. Let’s figure out how to make friends with them.

Our sleep schedule and activity schedule, and well-being in general, are subject to daily cycles. Therefore, sometimes, no matter what we do, it can be difficult to get ready for work in the afternoon or force ourselves to go to the gym in the morning.

In this article, we will figure out how to make friends with your biological clock in order to use it to your advantage.

Contents

• 1. What are circadian rhythms
• 2. How Our Internal Clock Works
• 3. How circadian rhythms affect our health
• 4. Why it is dangerous to disrupt circadian rhythms
• 5. How to reset your internal clock
• 6. Note

What are circadian rhythms

Circadian rhythms are the human biological clock. They set the rhythm for all vital processes in the body. The body clock is determined by genes that start and stop metabolic processes, such as storing energy or releasing hormones.

24 hours

how long does one biological clock cycle last on average

About 20% of all our genes are “turned on” and “off” during one complete cycle.

The main mechanism of the biological clock is the suprachiasmatic nucleus (SCN) of the hypothalamus. This part of the brain is responsible for the response to stress, sexual behavior, coordination of actions and other important functions.

This nucleus receives information from light-sensitive cells of the retina and other receptors and based on it synchronizes the work of biorhythms .

Approximately so biological processes follow each other during the day

Also, the suprachiasmatic nucleus informs the pineal gland and endocrine gland when it is time to produce the sleep hormone melatonin.

Melatonin concentration increases in the evening, peaks at night and decreases during the day.

A with another important hormone, cortisol , the reverse story.

Photo by Jamie Street / Unsplash

Its concentration rises in the morning, when we need to be alert, and decreases in the evening, when we start to feel sleepy.

How our internal clock works

The genes responsible for the operation of the internal clock are called period and timeless . Their activity fluctuates throughout the day and is regulated by a feedback loop mechanism. As soon as the level of proteins encoded by these genes reaches a certain level, the synthesis of these proteins stops. The level drops – synthesis resumes.

Sleep and wakefulness are affected by light

Light and its absence are the main, though not the only, regulators of circadian rhythms.

Cold blue light from office lamps, computer screens, TVs and smartphones disrupts these rhythms. As a result, the body “thinks” that daylight hours are in full swing. Red and green light also negatively affect the course of the internal clock.

Circadian rhythms are “turned on” and “turned off” by light. Bright artificial light triggers cascades of chemical reactions and disrupts the correct daily routine.

Human circadian rhythms are not a separate organ, they cannot be seen or felt. But they are necessary for health and normal life – and persist even in many blind people.

Photo by Max van den Oetelaar / Unsplash

If you watch TV shows at night, eat late and heavy dinners, work the night shift and go to bed at dawn, the coordinated work of genes and circadian rhythms is disrupted. Some metabolic processes start later than usual, while others stop altogether.

How Circadian Rhythms Affect Our Health

Night shifts can increase your risk of cancer – disrupted circadian rhythms make it harder for the body to prevent tumor formation.

The International Agency for Research on Cancer has even classified shift work as a carcinogen.

Working with a constant night schedule rather than a hopping schedule may be less dangerous in this regard.

Photo by Kartabya Aryal / Unsplash

Scientists have linked circadian rhythm disturbances to serious but preventable diseases: type 2 diabetes, cardiovascular disease, obesity, stroke and cancer.

To understand how these diseases develop, we need to look at what happens when we break our sleep hygiene.

• How circadian rhythms affect digestion

The gastrointestinal tract produces the most enzymes, gastric juice and related substances in the first half of the day.

Therefore, it is advisable to have a hearty breakfast, but have a light supper.

Also in the morning the peristalsis works most actively. If you eat heavily at night and wake up late, the risk of constipation, colic, bloating and indigestion increases, because the digestion process slows down.

Taking care of your digestive health is easier with the Atlas Microbiota Test. You will learn how diverse the composition of the bacteria in your intestines, whether there are enough beneficial bacteria, and how the microflora protects you from diseases. How circadian rhythms affect the brain

Photo by Konstantine Trundayev / Unsplash

This fluid removes metabolic products, including toxic compounds that impair memory function. Also, during sleep, myelin sheaths are actively restored – they are needed to transmit signals between neurons.

Sleep phase disruption interrupts these important processes.

As a result, we wake up tired, lethargic and not ready for serious intellectual work.

If you constantly ignore your biological rhythms, this can lead to neuropsychiatric disorders.

• How circadian rhythms affect disease risk

Insomnia, lack of sleep and poor sleep quality lead to hypertension and insulin resistance, which increases blood glucose levels. These symptoms signal metabolic disorders and diseases of the cardiovascular system.

Studies show that people who work night shifts are more likely to suffer from obesity, type 2 diabetes and hypertension.

The risk of developing these diseases is also increased in people with disturbed circadian rhythms.

Why disrupting circadian rhythms is dangerous

Poor sleep quality brings other, less obvious problems. A sleepy person easily gains weight and hardly loses it.

He crave sweets and junk food more often than healthy food, because the body tries to compensate for the lack of energy with cravings for simple carbohydrates.

Also, if jet lag becomes more difficult to fall asleep and wake up, addiction to caffeine develops.

Photo by Nathan Dumlao / Unsplash

I want to sleep as long as possible, but sleep stops replenishing my strength.

The risk of depression increases, there are mood swings during the day and bursts of negative emotions. And the body becomes more vulnerable to diseases and infections.

How to reset your internal clock

The good news is that a broken body clock can be repaired.

Together with the correct daily routine, you will return to productivity and healthy sleep. Restoring your circadian rhythms and daily routine doesn’t mean going to bed right after sunset, especially if you’re a night owl.

The main thing is to avoid artificial light and fall asleep during the time period when melatonin is produced, that is, from 12 am to 4 am.

Avoiding gadgets an hour or two before bed will help you fall asleep easier. Also in the evening it is worth turning on lamps with warm dimmed light instead of bright fluorescent lamps. To restore the sleep pattern, you need to go to bed every day at about the same time, even if it is a day off.

If you often feel tired and distracted during the day and do not sleep well, you may have thrown off your biological clock. Here’s what will help bring everything back to normal:

• If you really need to check social networks before going to bed or watch a movie on your tablet, turn on the night mode – with it, the backlight becomes yellowish and less bright.
• Switch from visual content to audio before bed: listen to podcasts and audio books.
• Avoid alcohol in the late evening – it impairs the quality of sleep.
• Go to bed slightly hungry.
• Buy heavy, light-blocking curtains and open them as soon as you wake up.
• In the afternoon, choose decaffeinated drinks.
• Use ear plugs and a sleep mask if outside noises or street lights interrupt your sleep.

Genetics can also influence sleep patterns: for example, insomnia can be inherited. To identify the genetic predisposition to insomnia and the characteristics of caffeine metabolism, you can use the Atlas Genetic Test.

More interesting articles about sleep on the Atlas blog:

• Sleep, diet, and giving up your smartphone: habits that will make you happier
• Night work: dangers and health benefits
• Sleep and microbiota: how appetite and digestion are related to sleep quality

• Sachin Panda, The Circadian Code
• Koch C. E. et al., Interaction between Circadian Rhythm and Stress 2017
• S. Panda et al., Coordinated Transcription of Key Pathways in the Mouse by the Circadian Clock
• Blue light has a dark side
• Circadian rhythms fact sheet
• Thomas C. Erren et al., Shift Work and Cancer 2010
• Bennett J.E. et al. (2018). NCD Countdown 2030: worldwide trends in non-communicable disease mortality and progress towards Sustainable Development Goal target 3.4
• NHS Prevalence, Achievements and Exceptions workbooks 2016
• The role of sleep and wakefulness in myelin plasticity
• Night shift work, short sleep and obesity

Circadian rhythm disorders. What is Circadian Rhythm Disorders?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Circadian rhythm disorders are a type of insomnia in which there is a mismatch between the internal sleep-wake cycle and the external day-night cycle. The condition develops when changing time zones (jet lag), shift and shift work schedule, neurological diseases. Disorders of circadian rhythms cause psycho-emotional disorders, reduce performance, increase the risk of endocrine and cardiological problems. Diagnosis includes a detailed history taking, polysomnography, and neuroimaging. Drugs (melatonin, sleeping pills), non-drug correction of the rest regimen are used for treatment.

ICD-10

G47.2 Disorders of sleep and wake cycles

• Causes
• Pathogenesis
• Symptoms
  • Jet lag
  • Insomnia during shift work
  • Sleep phasing disorder
• Complications
• Diagnostics
• Treatment of circadian rhythm disorders
• Prognosis and prevention
• Prices for treatment

General information

Disruptions in physiological circadian rhythms are one of the most common problems in modern neurology, with various manifestations of which every person periodically encounters. The condition is of great relevance due to the lack of effective medical methods of correction, a pronounced negative impact on the well-being and somatic health of patients. Despite improvements in treatment, many people continue to suffer from circadian sleep disorders.

Circadian Rhythm Disorders

Causes

Changes in sleep cycles may have physiological prerequisites: in adolescence, falling asleep is usually delayed, which does not match the prescribed norms, while in old age, on the contrary, people go to bed too early and then wake up in the middle of the night and can no longer fall asleep. The pathological causes of circadian biorhythm disorders include the following:

• Features of the work schedule. People who work in shifts (day/night), on a daily basis or on a rotational basis are more likely to encounter problems with somnological disorders. Pathology is caused by the inability of the body to adapt to different times of falling asleep and waking up, frequent episodes of rest in the daytime in bright light.
• Frequent travel. The change of time zones negatively affects the coordination of endogenous and external biorhythms. As a result, insomnia develops in the first few days. The situation is exacerbated by regular business trips with a time shift of more than 2 hours.
• Neurodegenerative diseases. Since circadian rhythms are regulated by the central nervous system, persistent changes in sleep-wake cycles are often formed in its pathology. Typical causes: Alzheimer’s disease, Parkinson’s disease, Huntington’s chorea.
• Blindness. People who are blind from birth are most likely to suffer from sleep disorders because they are unable to detect external circadian rhythms. In such patients, their own internal biorhythms are not consistent with the generally accepted 24-hour system.

Pathogenesis

The regulation of human internal circadian rhythms is subject to a complex molecular mechanism that includes 9 main “clock” regulator genes. They contribute to the production of transcription factors, the activation of casein kinases, cryptochrome proteins responsible for capturing the level of illumination. An important role is played by genes that stimulate the production of melatonin and contribute to the realization of the effects of the hormone.

Normally, all substances work together, maintaining the circadian cycle, which is regulated by feedback. But with a sharp change in external daily rhythms (time zones), constant exposure to lighting at night (shift work, non-compliance with sleep hygiene), natural circadian rhythms are desynchronized. In the brain, the production of melatonin decreases, functional pathologies of the central nervous system occur.

Symptoms

Circadian rhythm disorders have similar clinical features: insomnia at night, pathological daytime sleepiness, impaired performance and concentration associated with sleep deprivation. As a rule, there are headaches, causeless mood swings, many patients are worried about unexplained anxiety, nervousness. Sometimes there are digestive disorders, interruptions in the work of the heart.

Jet lag

The symptom complex is most clearly manifested in jetlag (a sharp change in time zones). Disorders of circadian rhythms disturb a person from 2-3 days to several weeks. The greater the difference in time between the starting point and the place of the current stay, the more pronounced the signs. Trips to the east with the transfer of falling asleep to an earlier time are more difficult to endure, while the body adapts to traveling to the west rather quickly.

Shift work insomnia

In this case, the intensity of the symptoms of jet lag depends on the number of work shifts per month, their duration, and the rotation schedule. The most severe manifestations are noted in non-fixed work with a chaotic alternation of shifts and counterclockwise rotation. In addition, often patients deliberately sleep less in order to spend time with their families and participate in social life.

Sleep phasing disorder

This type of disturbance is characterized by a normal quality of night rest combined with a discrepancy between the physiological schedule and the desired daily routine. Young people mostly have a delayed onset of the sleep phase, which is why they go to bed late at night, and then hardly wake up in the morning to study or work. The elderly, on the contrary, suffer from an advanced phase, waking up too early.

Usually, there is no difficulty in falling asleep at “one’s own rhythm”, which distinguishes the condition from typical insomnia. The main problem of sleep phase disorders is the need to adapt to the generally accepted routine, as a result of which patients experience a constant lack of rest, during working hours they suffer from problems with thinking, memory, and concentration.

Complications

With prolonged disruption of circadian rhythms, the content of leptin (the hormone of satiety) decreases by 7-10%, and the rate of ghrelin (the hormone of hunger) increases. This is fraught with overeating, obesity, to which women are more susceptible due to metabolic characteristics. Chronic lack of sleep reduces the immune defense of the body, increases the risk of developing diabetes, cardiovascular disease.

Another danger of circadian disorders is that people with this problem often do not seek medical help, trying to cope with the situation on their own. Patients resort to alcohol, sleeping pills, and sedatives to help them fall asleep, and take psychostimulants during the day to improve their performance. As a result, the pathology is exacerbated by dependence on psychoactive substances.

Diagnosis

The main step in the diagnosis of biorhythm desynchronization is a detailed questioning of the insomniac: collecting complaints, information about professional activities, and the frequency of travel. Several doctors are often involved in the examination – neurologists, psychiatrists, somnologists, specialized specialists in somatic diseases. The diagnostic plan includes:

• Polysomnography. The study is used for a comprehensive study of various sleep parameters, identifying the root cause of insomnia, excluding dangerous diseases (obstructive sleep apnea, sleep paralysis, narcolepsy).
• MRI of the brain. Neuroimaging is prescribed for suspected organic lesions of the cerebral cortex or subcortical nuclei. MRI is an important diagnostic tool for Alzheimer’s and Parkinson’s disease.
• Psychiatric consultation. Disorders of circadian rhythms can occur against the background of neurosis, depression, psychopathy, so the patient definitely needs a profile examination, passing special tests and questionnaires.

Treatment of circadian rhythm disorders

Therapy of circadian rhythm disorders is a complex task. The best option to deal with the problem is to eliminate the precipitating factor, if possible (move to a position with a standard working day, limit long-haul flights). However, in most cases, radical measures are not suitable for patients, or the trigger cannot be completely eliminated. In such a situation, several directions of treatment are used:

• Compliance with the rules of healthy sleep. This item is especially important for people who work in shifts and are forced to sleep during the day. It is necessary to ensure the maximum darkening of the room, protect yourself from harsh sounds, explain to family members in advance, ask them to treat the situation with understanding.
• Advance preparation for the flight. To minimize the manifestations of jet lag, it is recommended to start shifting the time to fall asleep in advance in order to adapt the mode to the intended travel destination. For convenience, there are special sites that help to shift the sleep-wake schedule correctly, without harm to health.
• Taking melatonin. The hormonal drug has a physiological effect on endogenous rhythms, helps to fall asleep faster, improves the quality of sleep. Taking into account the type of insomnia, an individual schedule for taking the medication is selected at least 1-1.5 hours before the desired moment of falling asleep.

According to indications, other medications (hypnotics, psychostimulants, adaptogens) can be prescribed. In each case, a personalized regimen of drug use is selected in order to eliminate negative symptoms and at the same time not aggravate circadian disorders. Dosages and medication schedules are carefully monitored by a neurologist.

Prognosis and prevention

Circadian disorders are quite difficult to treat, however, with an integrated approach, a combination of drugs and non-drug methods, it is possible to synchronize biorhythms. A less favorable prognosis for patients with neurodegenerative pathologies that are not subject to correction. Prevention includes the observance of hygiene of rest, the correct organization of the labor process, regular medical examinations of people employed in shift/shift work.

You can share your medical history, what helped you in the treatment of circadian rhythm disorders.
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• Diagnosis and treatment of insomnia / O.V. Kurushina, E.A. Kurakova, S.V. Ryazantsev // Medicinal Bulletin. – 2014. – No. 2.
• Insomnia: diagnosis and correction options / M.G. Poluektov // Attending physician. – 2010. – No. 10.
• This article was prepared based on the materials of the site: https://www.krasotaimedicina.ru/

IMPORTANT
Information from this section cannot be used for self-diagnosis and self-treatment In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.