All articles in Circadian Rhythm Sleep Disorders

Beating Jet Lag: 8 Ways You’re Doing It Wrong And How To Do It Right

Now that humankind has been flying across time zones for generations, it’s easy to forget that our bodies were not designed to travel long distances at high speeds. Dr. Alon Avidan of UCLA’s Sleep Disorders Center calls the result “circadian rhythm disorder.” The rest of us call it jet lag.

“I fly a lot, and I observe the people sitting around me and how devastating a time zone change can be,” Avidan says. “I can also see how doing things incorrectly can be very harmful.”

Here, then, are eight common mistakes travelers make, with suggestions of how to do it right from experts at some of America’s leading sleep clinics.

1 – “I always try to sleep on the plane.”

“It is important to decide whether sleeping on the plane is in the best interest of the passenger,” says Dr. Lisa Medalie, behavioral sleep medicine specialist at University of Chicago Medicine.

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How to Use Melatonin Correctly

Using melatonin correctly can help sleep and mood problems, but melatonin can be tricky, and if misused can cause insomnia and even depression. Here are some of the common mistakes people make, and guidelines to use melatonin the right way.

Mistake #1: Melatonin is a sleep hormone

Most people think melatonin is a natural sleeping pill. This couldn’t be more wrong; melatonin on its own won’t induce sleep, and is usually only effective in short-term applications. It’s more correct to think of melatonin as a ‘darkness’ signaler, that is, it tells the brain that it needs to prepare for a night time or winter cycle. If taken in the evening or when it’s dark, melatonin can speed up sleep preparation, and it can tell the body clock to shift its sleep cycle to an earlier time.

Mistake #2: I can take melatonin at any time.

If melatonin is used during daytime brightness, it can cause adverse effects.

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The Importance of Melatonin

Melatonin is a hormone that plays a critical role in your health and well being. In a healthy circadian cycle, melatonin is released by the pineal gland in the brain when it starts to get dark. Melatonin prepares your body for sleep, but it also performs a host of tasks critical for your continued health and longevity. The problem though, is that an imbalance of melatonin can have disastrous effects from depression to shortened life span and even cancer.

How does melatonin work?

Melatonin helps to break down the active, energetic hormones in your system to allow your body to sleep and recuperate. It shuts down brain activity, and makes it harder to think clearly or to concentrate. Melatonin also pulls oxygen and needed hormones away from your muscle tissue and other cells, making it difficult to be physically active. As a result, you feel tired, withdraw, and want to sleep.

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Sleep Restriction Therapy: When Nothing Else Works

So you’ve tried all the ‘better sleep tips;’ seen a doctor, dieted, exercised, excluded caffeine and bad foods etc, and nothing seems to really help? If so, don’t lose hope. Researchers are learning new and effective ways to help us regain those few precious hours and even minutes of sleep. One of these most effective treatments is called Sleep Restriction Therapy.

Dr. Spielman at Columbia Presbyterian in New York may have pioneered a new, effective treatment called sleep restriction therapy. Within a month, his insomniacs were sleeping a good seven hours, and they reported that the quality of their sleep was much improved.

Retraining Your Body

Sleep deprivation therapy is based on the idea that your body has learned how to get along without sleep. Whether this was caused by circadian rhythms, trauma or bad habits when you were young, good evidence shows that you can retrain your body to sleep again. 

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Circadian Rhythm Sleep Disorders

One fourth of all chronic sleep disorders are the result of a mismatch between the body’s internal clock and the external 24-hour schedule. These sleep-timing problems are called circadian rhythm sleep disorders because ‘circadian’ describes the body’s daily sleep/wake hormone regulation (Circadian is Latin for ‘about a day’). In addition, most other sleep disorders can damage circadian rhythms and further compound sleep problems. The National Institute of Health estimates that over 35 million Americans suffer from circadian rhythm disorders.

What is the body clock and how does it work?

Our daily activity and sleep rhythms are regulated by a control center in the hypothalamus region of the brain called the Suprachaismatic Nucleus (SCN) or in layman’s terms, the body clock. The body clock needs to receive signals to tell it when to shut down and prepare for sleep and when to produce the active waking hormones. The most powerful signaler or ‘zeitgeber’ is bright light such as sunshine.

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Treatment of Circadian Rhythm Sleep Disorders

Chronotherapy

Chronotherapy means rescheduling or shifting sleep/wake patterns in the hope that out-of-sync rhythms could be gradually pushed back to their normal pattern. This therapy was first used when researchers discovered circadian rhythm disorders, but didn’t recognize that circadian rhythms weren’t self regulating; they depended on external signals or ‘zeitgebers’ to reset each day. Without knowing what these zeitgebers were, researchers were unable to effectively manage circadian rhythm problems.

Melatonin

In the early 80′s, Dr’s Lewy and Sack at the National Institutes of Health discovered that melatonin was closely related to circadian rhythms, and that measuring melatonin levels was an accurate indication of what was happening to these rhythms. If that was the case, why not take melatonin tablets at certain times to push rhythms back to normal? This seemed to help, but it was apparent that melatonin alone couldn’t sustain a normal rhythm and that a more powerful signaler was needed.

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What Causes Circadian Rhythm Sleep Disorders

If we all had body clocks that ran true to a 24 hour day, we probably wouldn’t suffer from circadian rhythm disorders. But day lengths don’t stay the same; they change seasonally (and we compound the problem with Daylight Saving-time changes). As a result, our body clocks have evolved in order to constantly adjust. ‘Normal’ body clocks tend to run a bit slow, about 24 ½ hours instead of 24.

This adjustment was perfect for the eons of time when we didn’t depend on artificial lighting. When the nights were longer, our body clocks would naturally run a bit slow, so we would sleep in a little more each morning. As morning light increased with spring, the new light signal would speed up our body clocks and help us have increased energy during the longer spring and summer days.

Seasonless Society

You could say that circadian rhythm disorders are a by-product of the industrial age.

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Circadian Rhythm Sleep Tips

Whether you’re suffering from a circadian rhythm sleep disorder or your sleep problems are affecting your circadian rhythm, here are some effective sleep tips you can use to strengthen your sleep and circadian rhythm:

Sleep Tips

  1. Regular Routine. Getting up and going to bed around the same time, even on weekends, is the most important thing you can do to establish good sleep habits. Waking and sleeping at set times reinforces a consistent sleep rhythm and reminds the brain when to release sleep and wake hormones, and more importantly, when not to.
  2. Prepare for bed. It’s important to understand that your body can’t immediately switch from ‘Drive’ to ‘Park.’ You need time to slowly shift into sleep. Your bedtime preparation should include activities such as dimming the lights an hour or more before going to bed, taking a warm bath, listening to calming music, relaxation exercises, and lowering the bedroom temperature (60° – 68° is optimal).
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How Circadian Rhythms Regulate Sleep and Activity

Knowing how circadian rhythms regulate sleep and activity helps us better understand why we sometimes have sleep problems, and what we can do to prevent circadian rhythm problems from happening.

It doesn’t take a sleep expert to know that the most powerful influences over sleep are light and darkness. Through eons of time, people have awakened to morning light and fallen asleep in evening darkness. This cycle seems natural; we feel energetic in sunlight and yawn and become lethargic at night. Those of us on different schedules have to fight to stay awake and struggle to sleep.

Although they seem axiomatic, these reactions to light and darkness are precisely controlled by a ‘master clock’ in our brain called the suprachiasmatic nucleus, or body clock. The body clock uses signals like light and darkness to know when to release certain hormones and neurotransmitters that tell us when to wake up or go to sleep.

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The Circadian Pathway

Understanding how circadian rhythms work is essential in controlling and preventing problems. Scientists have been able to show that when bright light enters the eye, it stimulates photoreceptors in the periphery of the retina. These photo-cells are connected to the body’s master clock or suprachiasmatic nucleus via a nerve pathway called the retinohypothalamic tract. At the right time of day, light triggers the body clock into resetting its daily rhythms.

The circadian pathway breaks down when the photoreceptors in the eye can’t perceive these light zeitgebers. Scientists have learned that very bright light can restore the circadian pathway, but they only recently discovered which photoreceptors are responsible. We now know what causes circadian related rhythm problems, and it’s not what we thought.

Breakthrough Discovery

For over a hundred years, scientists believed that the rod and cone cells of the eye were responsible for our body’s reaction to light. We now realize that a newly discovered photoreceptor, calledmelanopsin is responsible for activating the circadian pathway, and it does not respond to the same light as rod and cone cells.

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