Advanced Sleep Phase Disorder: Stop Counting Sheep, Bore Yourself to Sleep

Sleep is something often sought after and rarely does it feel like it is found. Whether regular coffee was consumed too close to bedtime or perhaps there is too much to do. For some neither is the case and caffeine is not the issue at all, it is entirely due to their circadian rhythm. The circadian system is composed of clock neurons that track time via cell-autonomous molecular clocks. Those that suffer from an out of sync circadian rhythm (or sleep cycle) could possibly have Advanced Sleep Phase Disorder. The resultant is of course insufficient sleep, and even more serious than that, a higher risk for Alzheimer’s and Cardiovascular disease.            In the New York Times article Is Your Sleep Cycle Out of Sync? It May Be Genetic, author Jane E. Brody dives into the challenges those with ASPD face. She writes about a dairy farmer turned investment products specialist, in which the woman does not encounter daily fatigue but has short nights of sleep. Brody goes on to explain that this woman’s earlier years as a dairy farmer may indeed have influenced her sleeping patterns via programmed genes for a lifestyle she no longer lives. Sound crazy? Keep listening.            Jane Brody goes on to talk (write) about a large scale sleep study conducted by Dr. Louis J. Ptacek, a professor of neurology at the University of California, San Francisco. Dr. Ptacek, in collaboration with researchers in Salt Lake City and Madison, Wisconsin, found that within a sample of nearly 2400 patients who visited their sleep clinics, a small portion were categorized with unrecognized familial ASPD. It is described as “… [familial] permanent jet lag…”. Imagine the feeling of flying from Miami to Paris, but all the time (no thanks). Think you could just sleep off the jet lag? Nope, you have advanced sleep phase disorder so there no escaping that exhausting feeling (yikes).
Dr. Ptacek said that night-owl, short/long sleep, or lark (early rising) patterns can be familial and genetically influenced (those genes are still trying to be identified by Dr. Ptacek). Patients with “extreme morning phenotypes” were found to be 3 in 1000 with two thirds of those extremes having familial ASPD. This is where tendencies of those living with this disorder get interesting. Those with lark patterns (remember, early risers) have been shown to not consult sleep doctors due to their needs benefiting from their sleep rhythm; put differently, it fits their sleep-wake needs; maybe you’re a trauma surgeon or a postdoc. Advanced sleep phase patients need just as much sleep as the average person but do not have normal sleep cycles to do so. In the article, Dr. Ptacek goes on to explain that a single dominant gene mutation determines advanced sleep phase’s disastrous course.This is where social norms come into play. Lark tendencies are often overlooked due to them lacking social conflict. Rarely anyone is admonished for arriving early to work, especially in hustle culture. For example, an individual with lark tendencies working on Wall Street (or again, a postdoc). On the opposite end, night owls are more likely to seek help, because no one really prefers chronic sleep deprivation.            Yes, all of this may sound really unfortunate to live with. However, Dr. Ptacek recommends some behaviors that could work to provide those living with ASPD a solution via jet lag-like remedies. He recommends decreased blue light exposure in the evening and stimulating morning light to wake up in the morning. Melatonin may also help night owls and for those waking up in the middle of the night, he recommends regular exercise and not eating large meals close to bedtime. Finally Dr. Ptacek advises for those who cannot fall asleep, “’Get up and do something kind of boring for an hour or so then go back to bed’” in other words, if all else fails, bore yourself to sleep.

Reference: 

Brody, Jane E. “Is Your Sleep Cycle Out of Sync? It May Be Genetic.” The New York Times, The New York Times, 12 Aug. 2019, www.nytimes.com/2019/08/12/well/mind/is-your-sleep-cycle-out-of-sync-it-may-be-genetic.html.