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Every one of us has a natural circadian rhythm built into our system. Remarkably, the genes responsible for our biological timekeeping have stayed the same across multiple species and genera for more than a million years. As a result, the genes that dictate circadian rhythms in plants function in the same way as those that govern our personal internal clocks.

It is quite incredible to see how nature has conserved specific functions across multiple taxa. The expressions of these inheritable clock genes are highly diverse among the different organisms. In human beings and other higher animals, the clock genes determine the sleep-wake cycle and other factors of the circadian rhythm.  

How Common is Delayed Sleep Phase Syndrome in the US?

In the US, over 50 million people seek medical assistance for sleep disorders. Investigations estimate that there might be over 70 million people, who suffer from circadian rhythm disorders and other forms of sleep disorders. People see those with sleep disturbances and recurring bouts of chronic fatigue as lazy or weak. However, the case is rarely so.

People with sleeping disorders find it hard to experience restorative sleep or to fall asleep at socially acceptable hours. It causes accumulation of stress in their system and can lead to chronic sleepiness during the daytime. One such circadian sleep disorder is delayed sleep phase syndrome. People with DSPS find it difficult to fall asleep earlier than 12 am. Some of the people with chronic DSPS have sleep onset time at around 3 am or 4 am. As a result, their natural wake-up time is between 10 am, or 12 am.

Do you Have Delayed Sleep-Wake Phase?

Just because you have been feeling a little stressed these days, staying up late due to work and sleeping through your alarms up until 10 am, does not mean you have delayed sleep phase syndrome. For any circadian sleep-wake disorder, there must be a recurring history of at least three months. In most of the observed cases, the occurrence of DSPS began in the adolescent periods and continued into adulthood.

In many cases, researchers have seen the suppression of delayed sleep phases due to imposed social sleep-wake hours. As a result, children often miss out on 70 minutes to 90 minutes of sleep each night. The morning school hours keep them from completing their rest, and they suffer from daytime drowsiness, irritability, attention problems and other behavior problems.

What are the Common and Uncommon Circadian Rhythms that do not Qualify as a Delayed Sleep-Wake Disorder?

There are several types of circadian rhythms among human beings. While most people practice monophasic sleep, people from Spain, Portugal, and countries of South East Asia practice biphasic sleep. The melatonin levels peak at night, resulting in sleepiness.There is another sleepy phase in the mid-afternoon which contributes to siesta or afternoon naps in the countries mentioned above. People usually depend on several external cues to conform to their natural sleep-wake cycles like sunlight, alarm clocks, television routines and mobile wake-up calls.

A group of people with seemingly “normal” circadian rhythms can exhibit vastly different sleep-wake cycles. While some people are more active during the mornings, others are more active during the evening or nighttime. The morning larks usually exhibit lower levels of melatonin early in the morning, and they complete their restorative sleep by 6 am or 7 am each day. The night owls are often self-diagnosed insomniacs with late bedtimes that can range between 1 am, and 4 am.

There might be biological causes driving these characters since people with DSPS are unable to alter their bedtime routines. People with normal circadian rhythms find it easy to adjust to new bedtimes and wake-up times, but those with any form of a circadian rhythm sleep-wake disorder find it utterly impossible to achieve restorative sleep during hours different from their internal clocks.

Is Delayed Sleeping Phase a Fancy Term for Jet Lag?

DSPS might sound a lot like jet lag to you, especially if you have recently traveled across the world to a foreign country. However, it is very different indeed. The drastic change in the day-night hours due to the time zone change causes jet lag, but delayed sleep phase does not depend upon external cues. Jet lag usually resolves quickly, quite unlike DSPS.

People with this sleep disorder have sleep onset insomnia, due to which they find it impossible to fall asleep at regular hours. These people are more likely to wake up tired due to incomplete restorative sleep, go through the entire day exhausted, but liven up during the evening. When night comes, they are again wide awake and unable to sleep despite the severe lack of sleep. It is an indefinite cycle that causes chronic sleep deprivation among the sufferers. Without medical attention, these people might find it difficult to achieve good quality sleep at modified hours.

Why is Insomnia not the Same as DSPS?

You must realize that people with DSPS are not insomniacs either, although they tend to call themselves so. People with DSPS might find themselves awake at the wee hours of the night, but when they do fall asleep, they can experience restorative sleep as long as they stick to their internal biological clocks. Insomniacs find it difficult to fall asleep at any hour and do not suffer restorative sleep.

There are several stark differences between insomnia and DSPS since the treatments for them are entirely different from one another. Insomniacs can experience relief from their symptoms after treatment of underlying physical or mental disorders. The most common forms of therapy for insomniacs include behavioral therapy, psychotherapy and regulated administration of hypnotic medication. In case of DSPS, the diagnosis as well the treatment is more complicated. Investigators recently reported that over 10% of the self-diagnosed insomniacs in the US suffer from delayed sleep phase circadian disorder.  

What is the Relationship Between ADHD and Delayed Sleep Phase Disorder?

Over the years, experts have come to understand more about Attention Deficit Hyperactivity Disorder (ADHD) and its relationship with sleep. People with ADHD are often tired throughout the day. They are most likely to wake up feeling tired and stressed.

Although ADHD and sleep disorders have shared a long-standing relationship, researchers have only recently been able to explore the facets of the same due to the late onset of sleep disorders in ADHD individuals. Adults with ADHD, struggle with the following;

• Falling asleep

• Waking up

• Staying asleep

Several adults with ADHD report feeling a burst of energy as the sun goes down. Most of them endure drained off energy throughout the day, but they are re-energized as soon as they hit the hay. The incidence of sleep onset disorders usually begins among the ADHD individuals after the onset of puberty.

Currently, over 70% of the adults with ADHD report sleeping issues on a regular basis. Since over 80% of these cases indicate staying awake till about 4 am, it is understandable why they find it extremely difficult to wake up at socially acceptable times. They can sleep through alarms and angry mothers with ease. Several of these individuals report feeling groggy until noon.

In most of these cases, the night owls do not face a problem with their schedule. It is their friends, families, schools or employers, who become the source of their problems. ADHD and DSPS are ancient lovers and separating them is not any easier without behavior therapy, chronotherapy, medication, and psychotherapy.

So, What exactly Causes Delayed Sleep-wake Disorder?

Research shows intricate relationships between ADHD, depression, dementia and genetic abnormalities that tend to be inheritable. If you are currently suffering from DSPS, you must have already noticed that your internal clock is at least 2 hours behind the external clock. Experts often label this as “social jetlag” since the bodies and minds believe its midnight when its morning and the affected individuals appear to be tired and worn during morning meetings and morning classes.

Internal clocks are not always set for 9-5 work hours. People have their response system to external light and dark cues, which depend on the functions and products of their biological clock genes. Experts have observed that in most cases of DSPS, there is a complex correlation of causes including both internal and external stimulus.

Currently, the researchers believe that people with DSPS are unable to reset their sleep-wake periods as per external stimuli like light, darkness and noise. It can be because their biological clocks are not as sensitive to environmental cues. While it can be due to an aberrant increase or decrease in melatonin levels, it can also be due to continuous exposure to bright light right before bedtime.

How Do Experts Diagnose DSPS?

Delayed sleep phase is not insomnia or the lack of proper quality sleep. It is a lesser than a typical sleeping pattern that occurs among teens, young adults and adults alike. Office workers often report feeling wide awake at night and sleepy in the early office hours. It can be due to lifestyle effects or due to internal mechanisms which can trigger DSPS.

The diagnosis of a complex disorder takes time and keen testing. Over the years, technology has advanced, and it has allowed the doctors to diagnose DSPS decisively among individuals.

Sleep Log. In multiple cases, doctors recommend the maintenance of a sleep log. It can be a diary or a journal where the patients keep a record of their daily sleep onset time (approximate time), waking up time and incidences of sleep disturbances if any. This diary should also include daytime naps, incidences of drowsiness, exact times of caffeine consumption and a food log. Keeping a sleep diary helps the experts understand the tendencies of the internal system of an individual and their responses to environmental stimuli. Including the regular medication also helps experts understand the way DSPS might find its way into an individual’s life.

Actigraphy. Actigraphy helps significantly in the diagnostic process. It is a non-invasive method of observing the sleep-wake cycles in a human subject. The actimetry sensor helps in monitoring the cycle in individuals. With the advancement of technology, the actigraphy has become a wearable gadget that resembles a watch. This small but mighty gadget can keep an eye on the sleep patterns and circadian rhythms of an individual.

Polysomnography. Polysomnography is the gold standard of sleep assessment in individuals. Experts recommend polysomnographs since it is a multi-parametric test that can monitor brainwaves, eye movements, muscle movements and several other related body functions. This test can also measure the rates of respiration and monitor the sleep stages accurately.

Melatonin levels. Biochemistry now allows the scientists to study the levels of melatonin at specific intervals in the system of an individual. The study of the increase and decrease in the melatonin levels can help the sleep experts understand precisely what your body needs to stimulate sound sleep at socially acceptable hours. There are real-time melatonin level assays available, but there are several constraints including the cost that limits their availability to ordinary people.  

The diagnosis of DSPS is not as simple as many of us would like it to be. Although the overlapping results from some diagnostic procedures increase the accuracy, multiple doctors still rule out environmental factors as potential causes of DSPS. It makes it extremely necessary to log the exact hours of waking, eating, napping and sleeping, along with daytime drowsiness, unexpected feelings of overwhelming confusion and even frequency of exposure to bright light in your sleep log.

What are the Treatment Options for Delayed Sleep Phase Syndrome?

Sleep experts have been busy the last few years, trying to find a cure for delayed sleep onset in human beings. Several methods and medical compounds have failed to cure DSPS up until now, but the results have given experts further insight into the management of this circadian rhythm disorder.

Here are a few ways that have worked for several people in the past.

Sleeping habit modification. Since DSPS usually begins during adolescence; kids with such symptoms need to do everything in their control to get as much restorative sleep as possible. Parents need to be more understanding, yet at the same time, they must keep their children from consuming caffeinated products.

Maintaining a calm, quiet and non-blue light bedroom can be conducive to timely rest. Avoiding sleeping medication without professional advice, drinking alcohol and addiction to nicotine can disrupt quality sleep in all ages. Do not exercise for about 5-6 hours before bedtime. Finish heavy workouts before evening. Keep your bedroom for sleeping only. Leave your mobile phones and iPads outside or keep them switched off inside your bedroom.

If possible, take a long warm shower before bed, drink some chamomile tea and try to hit the hay at the same time every day. It will help you entrain your circadian rhythm into following a more desirable sleep-wake cycle. 

Chronotherapy. People undertaking chronotherapy often experience an advancement of their bedtimes and wake up times. Interestingly, it is quite impossible to shift people’s bedtimes earlier with chronotherapy, so the experts try to push their cycles further back till it entirely overlaps with the next day’s desired sleep-wake cycle. This method simple exploits the entrainable trait of our internal body clock. The process delays the bedtime of an individual by 3 hours at the maximum each day till they achieve desired sleep-wake cycle.

Chronotherapy allows youngsters and adults to adapt to socially acceptable resting schedules, without curtailing their sleep hours. The challenge comes with adhering to the new routine for an extended period as long as their social responsibility demands it. However, delaying the sleep onset time among DSPS patients can cause serious health issues. You should only try this under the care of a sleep expert or a doctor.

Bright light therapy. This involves a bright light box that can suppress melatonin secretion in the early hours of the morning. The increase in melatonin levels is responsible for sleep onset, and as we sleep, the levels of this neurohormone deplete in our system. Those who do not get to complete their sleep, have leftover melatonin from the previous night which makes them drowsy and muzzy next morning. This is what we see in people with DSPS most often.

Exposure to bright light in the mornings helps to lower the melatonin levels inside the body and reset the internal clock. The duration of exposure to the light needs to be between 30 minutes to 2.5 hours long, and the intensity should be around 10,000 lux. It is one way to tell the biological clocks that it is morning. You do not need to travel to a clinic every day for bright light therapy. You can now find several commercial and medically approved bright light boxes for regular use.

Dark therapy. This is the absolute opposite of bright light therapy. If the bright light in the mornings can stimulate awakeness, the avoidance of bright lights in the evenings can stimulate sleep. One can avoid bright lights in the evening by merely using blue light blocking goggles, checking their television time and cutting back their time on digital screens.

Children and adolescents of today are more likely to suffer from DSPS due to the frequent and constant use of digital screens that are the most prominent source of blue light in our day-to-day lives. You can experience an improvement in sleep onset time and sleep quality by avoiding the use of gadgets at least 3 to 4 hours before sleep. Several subjects have reported considerable improvement upon dark therapy.

When experts coupled dark therapy with light therapy, more than 75% of the times, the patients could conform to a 9 to 5 schedule for long periods of time without the recurrence of chronic delayed sleep phase.

Medications. Medications that can control DSPS are quite severe and can have significant side effects. Therefore, you should take somnolent only upon advice from an expert or a doctor. Melatonin and several other hypotonic compounds help in advancing the sleep onset time for people with DSPS. Medications usually work better with other forms of therapy like behavior or sleep habit improvement and chronotherapy.

Several methods can advance the sleep onset time for those with DSPS, but none of them can fully cure it unless the person has the motivation to stick to the new schedule. It is very common to find the individuals with DSPS to give up after a short while because it is too tiring or too demanding. You must remember that it is a property of your internal biological clocks, so you must keep at it to overcome the complications due to the DSPS you might be facing now.

What are the Most Common Comorbidities of Delayed Sleep-Wake Phase Disorder?

When a primary disease occurs with another or multiple others, then all the secondary diseases are comorbid disorders. For example, obesity often causes related heart problems and circulatory problems. Then the latter diseases are the comorbid disorders that occur along with or as a cause of obesity.

Contrary to what many people believe, comorbidity can occur as a result of the primary disease or independently with the primary disease. In several instances of adolescents and adults with delayed sleep phase syndrome, experts have noticed the concurrent symptoms of anxiety, depression and side effects of medication that delay sleep. It is still debatable whether ADHD causes DSPS or DSPS contributes to ADHD symptoms.

Researchers have often seen seasonal affective disorders (SAD) and delayed sleep phase disorder occur together. SAD occurs in people, who usually reside in places that experience prolonged periods of darkness during the winter months. The lack of natural light and increased exposure to artificial lighting often leads to abnormal levels of melatonin that disrupts their 24-hour circadian rhythms. Due to several constraints, researchers have not yet been able to explore the comorbidity of these disorders, but it is quite definite that they influence one another.

Obesity is another comorbid condition that occurs with DSPS. People with delayed sleep are more likely to resort to binge eating or indulge in midnight snacking. The untimely nature of increased carbohydrate intake sends a boost of energy to the system. Excess calories contribute to more adipocyte formation in human beings. It not only disrupts the natural sleep cycle, but it also affects the onset of sleep. It is a leading cause of health concern in the first world countries like the US, where over 30% of the adult population is obese.

What are the Defining Personality Traits of Individuals with DSPS?

The lack of proper sleep and delayed sleep onset can lead to some behaviour problems in adults and youngsters alike. The instances of DSPS induced personality disorders that are more common among the adolescents and young adults. It can be due to social changes, peer pressure or due to surmounting pressure in school.

• A new study showed that people with a significant delay in sleep period are often irritable due to lack of proper restorative sleep.

• Young adults with DSPS can become neurotic upon lack of treatment for an extended period.

• Children and adolescents exhibit slow response time, impaired cognitive processes and slow learning as a result of prolonged periods of sleep deprivation.

• Young adults with DSPD often score much less on extroversion as compared to individuals with regular sleeping patterns.

• Adolescents and adults with DSPS display lower ranges of conscientiousness than the control group.

• People with DSPS are more likely to have lower problem-solving abilities and weaker short-term memory as compared to those with regular sleep-wake cycles.

Several studies have also shown that DSPS affects children and adolescents more frequently than adults. Kids find it difficult to adjust with school routines as a result. They often face consternation for missing classes, being late or sleeping in since parents, teachers and even doctors deem them to be lazy. However, delayed sleep phase syndrome is a severe disorder that demands medical attention in all ages.

What Can you do to Lessen the Impact of DSPS in Your Life?

You must introduce several lifestyle changes to manage your delayed sleep-wake cycle.

• It is true that you might find it much easier to adjust to an early schedule with the help of melatonin supplements or sleeping pills, but those are not your long-term solution. Most sleeping medications have severe dependency issues, and they can also cause sleeping medication-induced depression. Melatonin can impact your liver and general health upon constant usage.

• Sometimes, breaking your monophasic sleep pattern into biphasic sleep can help you attain a better quality of sleep each time. You can opt for 6.5 hours of sleep at night and 1.5 hours of sleep in the afternoon, to make up for all the lost sleep. It will help you wake up early each morning without feeling worn out. However, this is only possible for those who work from home or have dedicated resting hours at the office. Some offices in Japan have nap time for their employees to ensure enhanced productivity from each employee.

• Biphasic sleep can also be of 4 hours in the afternoon and 4 hours at night. It helps you achieve a total of 8 hours sleep without worrying about missing the morning alarms or being late for office. Biphasic sleep is difficult to follow for the regular 9 to 5 office goers, which is why more number of people opts for sleeping aids.

• The external temperature can aid or delay sleep by modulating core temperature and melatonin release. Severely high external temperatures are not conducive to proper sleep. Unusually high temperatures and high levels of humidity impede adequate sleep quality and delay sleep onset. Your external room temperature needs to facilitate lowering of the core temperature of your body. Therefore, keep the room temperature low so your body can release heat quickly. It advances the sleep onset time and helps in attaining better sleep. The melatonin supplements successfully lower core body temperature in the patients and develops their sleep-wake cycle.

• You can try reducing your screen-time and introduce white noise in your natural environment. Invest in a good white noise machine or set up Alexa to play white noise for you about one hour before bedtime. Dim the lights down and surround yourself with pure white light (no blue light) LEDs. It might cost you a bit, but it will help you fall asleep much faster each day.

Modification of sleep patterns is quite severe, and you must only perform that upon the strict supervision of an expert or a specialist. During the time of change, you might experience daytime drowsiness, sudden periods of confusion and slow response to external stimuli. Sleep experts suggest their patients to avoid driving long distances and handling heavy machinery during this period.

Facts you Should Always Remember About Delayed Sleep Phase Syndrome

• You must always remember that you are not alone. There are over 15% adolescents across the 50 states of the US, who suffer from this sleeping disorder in 2018. It is not as uncommon as it used to be and modern technology is abetting the frequent incidence of DSPS among adults and adolescents alike.

• DSPS might be incurable in most of the cases, but it is entirely manageable. The symptoms start during the early teen years when the body experiences a shift in the internal clocks due to upheavals of hormonal levels. Changes in diet and exercise also assist this shift.

• Even children can have DSPS. It is easier to treat adults with melatonin supplements and sleeping medication. Children often need behavioural therapy and chronotherapy for rescheduling their body clock. Opting for pharmacological solutions for their sleeping problems is not ideal due to their heightened sensitivity to neurohormones.

If you are late for school or work every day because you struggle with your alarms every morning, it is time to do a double check. Do you always go to bed late? Do you often find yourself stargazing into the late hours of the night? Is your tendency to fall asleep late older than 3 months? If the answer to these questions is a “yes,” then you need to consult a sleep expert or a medical professional. These are telltale signs of delayed sleep phase disorder. Due to the high instances of comorbidity, DSPS demands instant attention from experts.

Ever get the feeling you’re from a different planet because you’re just getting started when everyone else is hitting the hay? Do you always feel like you’re stuck in a state of jet lag without even stepping foot on a plane? Maybe you don’t really hit your stride and begin to fully engage with the day’s activities until the afternoon rolls around, spending your mornings battling the urge to nod off and relying heavily on caffeine boosts. Well, you can be reassured that you’re very much meant to be on this Earth; it’s just that your internal clock marches to the beat of a different drum compared to those around you. So, what more is there to mention, except to say that it all boils down to your chronotype?

Chronotype sounds like a fancy term, but it is a portmanteau of two simple words. It defines the internal calibration of your biological clock. If your internal clock runs 4 hours behind the external cues, it is no wonder you always feel drowsy, tired and out of whack. While coffee, Redbull, and caffeine pills won’t do much to reduce this jetlag; you can still reduce your tedium by following the intrinsic rhythm of your biological clock. It is much easier for people with home offices and flexible work hours. Millions of people around the globe often feel the pangs of having a “misplaced” chronotype since they have to adhere to a 9 to 5 routine forcefully.

What Determines Your Chronotype?

Your chronotype is hardly the result of habit or external stimulus. So contrary to what the older generation believes and says your social jetlag is not a result of laziness or the lack of a “morning habit.” It is a function of the PER3 gene. The longer the gene is the more are your chances of becoming an early riser. A longer gene also generally means you need about 7 hours of sleep to feel fresh in the early hours of the day.

A shorter PER3 gene often corresponds to shorter hours of sleep among late risers. A night owl is hardly a result of practice or needs. A conflicting social schedule often arises from shorter versions of the PER3 gene, and it’s unique protein products that dictate more late-night activity among the carrier individuals.

As of now, researchers know for sure that the different chronotypes are results of the functions of the suprachiasmatic nuclei (SCN) which is a part of the hypothalamus. The PER3 and NR1D2 genes control the light response via signaling of the peripheral clocks.

Entraining the central clock with the help of external cues is possible. People often find it difficult to train their bodies to the external cues because they have multiple peripheral clocks that reside in the form of circadian signal receptors in almost all vital organs. Your pituitary gland, adrenaline glands, liver, skin, and even hair follicles contain several of these peripheral body clocks that control the responses to several environmental stimuli.

Therefore, the molecular oscillations at the peripheral clocks do not determine the direct measure of the central oscillator. They only act as a proxy, and they vary substantially between individuals. The areas of circadian clock-dependent behavior modifications and decision making are still not as clear as the genetic mechanisms of circadian rhythm.

How Does your Internal Clock Influence your Chronotype?

Your sleep-wake cycles and daily body rhythms are a result of the interactions between circadian rhythms and homeostatic drive. Each individual has an internal molecular pacemaker that dictates the states of sleep and arousal. Each person differs from the other considerably at a molecular level. The variation of these timings of the individual rhythms results in chronotypes.

Depending on the chronotype, a person’s response to a stimulus can vary significantly during different times of the day which is the reason why morning larks often perform cognitive tasks better early in the day and the night owls perform better at night. As per the homeostatic drive, the energy store of an individual gradually depletes over the duration of the day and the energy levels peak at varying hours of the day depending on the circadian drive. As a result, your awakeness and drowsiness is not just a result of your circadian rhythm. 

What are the Different Chronotypes that Exist Today?

In case you are looking for a reason for a chronotype rather than the cause of it, you are in luck. Recent research by the American Sleep Association shows that your circadian rhythm might be a result of years of evolutionary process. It is Mother Nature’s way of showing when your body needs rest.

In nature, there are several groups of people with a variety of wake-sleep cycles. It must have helped the survival of cohorts and communities in the early Stone Ages. While one group rested, the others could keep a watch, gather and prep food and take care of the children. Naturally, there are several groups predominant among the urban communities right now. It is a simple matter of heredity and adaptation.

• Lions.These are the individuals, who are most active during the daytime. They are not as active during the night. They hit the hay quite early at night.

• Wolves. These are the complete night owls. They wake up late, sleep late and work through the evening and night. They are most active during the evening when the morning birds are going to sleep.

• Bears. They have a natural energy cycle that is very much in tune with the external light cues. The energy levels of these individuals rise and fall with the sun.

• Dolphins. While the real cetaceans often sleep with one brain hemisphere on, the people belonging to this group usually sleep with one eye open. They are the lightest sleepers, and they always seem to wake up even when you tiptoe around them.

Although there are huge variations between the sleep-wake cycles of this chronotype, there is little diversity when it comes to working hours. If you have always felt that the 9 to 5 schedule was never suitable for you, you are right. Your internal circadian clock dictates the hours you are most likely to be awake, active and most alert.

Work Schedules Make it Difficult for Evening People to get Enough Rest

Listening to your internal clock can give you better rest. Almost 70 million Americans suffer from some kind of sleeping disorder, and millions more have not had a good night’s rest in the last few months. Good sleep does not just depend on the hours of falling asleep and waking up. It also depends on the quality of sleep. Sleeping soundly throughout the night and not waking up every couple of hours to the slightest sound or experiencing nightmares defines good sleep.

Research shows that one of the simplest ways to achieve good quality sleep is by following your chronotype. Your circadian rhythm can tell you exactly when you should be asleep and when your brain should be able to offer you a better sleep quality. Sometimes, that means not sticking to the conventional 24-hour cycles as the rest of the world does. However, there is no replacement for a good night’s rest, and that is exactly what modern-day studies on human biological clocks show.

In several industrialized societies people take up shift jobs. The current job scene is gradually obliterating the traditional working hours. Media companies, international relations companies, IT solution providers and online marketing agencies are providing round the clock services to their clients. People working in similar sectors often have rotating shifts and erratic working hours. It often leads to sleep-wake disturbances among them.

The rotation of work hours has been causing sleep disorders, irritable bowel syndrome and increasing susceptibility to several “lifestyle” diseases. Occurrences of diabetes, high levels of cholesterol, high blood pressure and obesity are increasing due to the lack of importance towards chronotype and circadian rhythms.

 

Are you Getting Enough Rest as per your Biological Sleep-Wake Cycle?

 

About 50% of the world’s population consists of Bears, and about only 15% are Lions. So why do almost all workplaces stick to work hours that are fit for Lions? Is there a way you can find out your actual internal circadian clock and improve your sleep quality? You will find several quizzes and studies that aim at helping people find their rhythm.

Here is a brief look at the sleep cycle you should be idealizing as per your chronotype.

• The average sleep cycle lasts for about 90 minutes for all types of sleepers.

• Lions and Bears get about 5 cycles each which translate to 5 cycles of 90 minutes each.

• Lions are the early risers and bears are often somewhere in the middle of the road.

• Lions are up, and active by 6 am, whereas the Bears are awake and working by 7 am.

• Since each of them needs about 470 minutes or about 8 hours of sleep, lions need to be in bed by 10:00 pm and bears need to be in bed by 11 pm.

• Dolphins and Wolves usually experience 4 cycles of 90 minutes each.

• Therefore, they need about 400 minutes to sleep (including 40 minutes to fall asleep).

• Dolphins and Wolves need to be in bed by 12:00 am, and 11:50 am for waking up at 7 am and 6:30 am respectively.

Investigations into sleep quality and pattern among the different types of sleepers show that Dolphins are more likely to stay up late. Most Dolphins are either insomniacs or self-diagnosed insomniacs. They can spend an hour or longer in bed worrying about past incidents, their upcoming day, plans and random things.

In case you identify with these tendencies, you can spend 30 minutes each evening writing in your “worry journal.” Rather than pushing the thoughts and anxieties at the back of your mind, you should haul them up front and be done with them once and for all.

Recent researches show that people who are more likely to work on their next day’s to-do list or a worry list right before bed are more likely to fall asleep earlier and experience better sleep than the ones who struggle every day to not think about similar matters. The release of information is all it takes to clear your mind and fall into a “dreamless” sleep that can refresh you next day.

Can Internal Circadian Clocks Dictate Sleep Disorders in Children and Adults?

While some people are morning larks and some are night owls, places of employment and education rarely give them the opportunity to accommodate a full 8-hours sleep.

A recent study claims that high school students lose about 70 minutes of sleep each night at an average due to school timings and extracurricular activities. The Lions and the Wolves are at the opposite ends of the pole. It is difficult for either one to conform to the biological rhythm of the other. As a result, several people fall under the spectrum of sleep disorders.

If you find it difficult to wake up every morning and your sleep schedule interferes with your daily routines, you might have a sleep disorder too. Circadian rhythm disorders are not as rare as we would like them to be. There are several common disorders that people often ignore as stress from work or laziness. Two of the most commonly occurring sleep disorders include;

• Advanced sleep phase syndrome (ASPS). This is where a person feels sleepy earlier than the socially accepted bedtime. A person can feel drowsy, lethargic and experienced cognitive impairment by as early as 7 pm every evening. To classify as a disorder, your early sleeping tendencies should recur for 3 months or more. These people are also extreme early risers. They are usually awake, and alert by 3 am to 4 am. They experience complete 8 hours of sound sleep as long as they go to bed as per the demands of their biological clock.

• Delayed sleep phase syndrome (DSPS). People with DSPS often self-diagnose themselves as insomniacs. Delayed sleep disorder causes people to lay awake at night until 12 am to 2 am. However, when they fall asleep, they are likely to experience good quality restorative sleep for 8 hours. It is only possible for most people to sleep on weekends. The natural wake-up time for people suffering from DSPS varies between 8 am to 10 am. People with more chronic cases of DSPD often find it difficult to fall asleep before 4 am and wake up before noon.  

Troubled sleep or bad quality sleep is not the problem for either DSPS or ASPS. The problem is the “improper” timing of sleep. People with ASPS often report feeling isolated or socially aloof due to their early bedtimes. Their impaired cognition in the early evenings also takes a significant toll on their social lives.

People suffering from DSPS are often irritable by the end of the day due to the lack of enough sleep in the mornings. Their school routines or workplace requirements usually cut their morning sleeping hours short by more than one hour on a regular basis. People suffering from either of these conditions often find themselves suffering from chronic sleep deprivation and chronic fatigue.  

When Does the Shift of Chronotype Usually Occur in Human Beings?

The body clock starts to shift noticeably during the adolescent years. It is a result of hormonal changes, social demands, and peer pressure. Increasing need for rest, variation in eating habits and levels of physical activities determine a considerable part of the sleep-wake schedule of the teens and the young adults. However, it is all about the individual’s genetic makeup.

In case, your teenage child likes to sleep in till late or does not fall asleep before 12 am, you can entirely blame it on their genes. They are not lazy, especially since their early school time clashes with their natural need for rest. Most adolescents are likely to be late risers due to the changes their bodies are going through. Forcing them into an irregular schedule can lead to behavior problems, learning problems and discipline issues.

You could say, a lot of adolescents “grow out” of this phase. After all, 50% of the people in the world have an 11 pm to 7 am sleep-wake cycle. Nonetheless, several offices, managers, and even schools are finally giving importance to the “sleep problems” that are ravaging productivity among their employees and students. It is a result of the wide-ranging investigations and studies on adolescents, young adults, and adults, who report feeling out of sync with their school hours and work hours.

Several organizations are helping people work with their internal wiring and not against it. One of the leading reasons is the increasing levels of productivity that comes with the re-adjustment of work schedules.

Can your Circadian Rhythm Determine your Physiological Health?

Finding your chronotype is critical for your health. Not recognizing the demands of your body can wreck your health. There is a strong correlation between sleep disorders and chronotypes in all ages. A recent study shows a healthy relationship between eveningness and attention deficit hyperactivity disorder (ADHD) in children belonging to several ethnic groups. Several investigations have highlighted the relationship between chronotypes and obesity. Apart from physical health, the lack of proper sleep due to unusual sleep-wake cycles can potentially affect mental health as well.

The natural cycle of your body determines the rise and fall of several hormone levels in your system. One of the most important hormones is melatonin that controls your sleep onset and wakefulness throughout the day. Higher melatonin levels at night help you fall asleep, and lower levels during the morning-day keep you alert. As a result, your sleep pattern can impact your general mood, increase or decrease instances of depression, increase your binge eating habits and impact your blood glucose levels. Chronotype mismatch increases your chances of getting Type 2 diabetes. It is an important factor in non-alcoholic fatty liver disease (NAFLD) and obesity.

A recent study involving over 400 normal weight participants belonging to several chronotype classes shows that the morning birds consumed most of their calories in the mornings with breakfast and some with lunch. The eveningness group usually consumes higher calories during dinner. In overweight individuals, the eating habits are more erratic. Overweight early birds typically consume more calories at night and overweight night owls usually consume more calories in the mornings.

The most exciting find was – food preferences varied according to the internal circadian clock. Morning people typically show higher intake of fruit and night owls preferred their proteins. Most overweight people are overweight because they deviate from their natural physiological rhythms. It might point towards the necessity of specific diets for people belonging to different chronotype since their daily energy needs usually vary significantly according to their intrinsic rhythms.

How can People with Eveningness Adjust to a Morning Schedule Efficiently?

Evening people show higher incidences of emotional eating and binge eating. Therefore, they are twice as likely to suffer from insulin resistance, joint inflammation problems, and liver problems. Their systems often withstand more oxidative damage and stress hormones. They are also more likely to become caffeine dependent and alcohol dependent. Therefore, it is no surprise that they often find it more difficult than usual to fall asleep at regular hours.

Problems of the circadian rhythm mismatches are one of the toughest to reckon with, but you can make it better for yourself, your family, friends, and colleagues, by trying a few things.

• Exercise. Exercise is the best way to stimulate your joints and improve your restorative mechanisms of the body. Exercising also helps you to enhance insulin sensitivity naturally and control hunger.

• Proper diet. Manage your calorie intake. A fascinating and somewhat viral study shows that as long as you watch how many calories you are eating per day, the rest of the factors can take care of themselves.

• The right fat. This might confuse you a little bit since dieticians often tell people to avoid fat. However, there is a right kind of fat that you need to consume. Focus on increasing your omega-3-fatty acid intake and reduce your omega-6-fatty acid consumption.

• Gut health. Pay attention to what you are eating, but also pay attention to what’s coming out. Your gut health will determine a lot, and it will dictate your hunger-fullness signals as well. Paying attention to your gut health will help you eat better, sleep better and stay healthier.

If you know by now that you are an evening person, you merely need to cut down the complex carbohydrates and reduce your intake of inflammatory food. Do not drink caffeine at least 3 hours before bedtime. Alcohol often impedes sleep and interferes with sleep quality, so try to refrain from drinking before heading to bed.

Several studies also elicit a complicated relationship between nicotine consumption and sleep quality. Smokers have higher chances of suffering from sleep apnea, interrupted sleep and poor sleep quality. People already suffering from sleep deprivation should try to cut down on alcohol consumption and smoking before starting any therapy or treatment for the improvement of sleep.

Can Therapy Help you Tackle odd Sleep-wake Hours and Sleep Disorders?

Chronotherapy often works wonders for most people suffering from weird daily routines. It includes drug-free rescheduling for insomnia, delayed sleep phase syndrome (DSPS) and advanced sleep phase syndrome (ASPS). It uses slow but steady advancement or delays in bedtimes, changes in daily routines and dietary modifications to help people achieve better quality sleep at socially acceptable hours.

Several cases report long-term relief from sleep disorders and insomnia from patients. Sometimes, chronotherapy includes bright light therapy. It is now a popular fact that intense blue light can reduce the levels of melatonin in an individual’s system. Therefore, exposure to extreme blue light can lead to alertness and sleep deprivation.

Modern studies show that exposure to LEDs, CFLs, and digital screens leads to chronic sleep deprivation in people. Scientists have utilized this fact to induce alertness in people suffering from delayed sleep phase syndrome or the night owls by exposing them to intense blue light box therapy in the mornings.  

Melatonin treatment has also proven useful in case of some individuals, who do not respond that well to drugless rescheduling therapy. Drug-based sleep cycle rescheduling is especially necessary for people who have been experiencing chronic sleep disorders for a long time. People with over 4 years of delayed sleep phase syndrome, insomnia, and sleep apnea can shift their bedtime from 4:50 am to 12:20 am upon drug-assisted chronotherapy. 

For many patients, melatonin therapy results in long-term relief from sleep disorders which a lesser common chronotype can bring. Doctors usually couple melatonin therapy with sleep medications that do not react with psychoactive agents. However, if you are on other medicines for depression or anxiety disorders, you must always disclose it to your physician before starting your melatonin treatment.  

Bright light therapy, sleep rescheduling, and melatonin therapy can work together. In fact, severe sleep disorders often need the help of all therapies and sleep treatments possible for long-term redressal. For undertaking melatonin treatment, it is crucial that you first consult a doctor or a sleep expert.

Self-administration or adjustment of melatonin dosage is highly risky since hormone therapies can have grievous side effects. Doctors usually refrain from giving melatonin supplements and caffeine supplements to growing children, but there have been several instances of teenagers benefiting from the same. Adults have lower risks of similar side effects from prolonged treatment.

Who Can Make the Best of their Sleep-Wake Cycles?

An uncommon chronotype is not a problem when you do not have to work with others. Lone wolves find it easier to adjust to their biological clocks.

Writers, painters, musicians, designers and online talents are commonly night owls or dolphins. Freelancing talents find it much easier to adhere to their intrinsic circadian rhythms. Working with a large team, harmonizing with multiple associates from all across the country and coordinated decision making become more challenging for those, who are suffering from sleep disorders. It is unfortunate that millions have to face the brunt of not being able to coordinate their peak energy times with their work hours even today.

The Lions usually do not face any problem due to their early rising habits, unless they have to live with a Wolf chronotype. Since a majority of the world’s population belongs to the Bear chronotype, they find it the easiest to adjust to work schedules, school routines, and social obligations without compromising their sleep duration or quality. Nonetheless, with improving technology, non-invasive therapy, and supplemental treatment, even the Wolves might find it comparatively easier to adjust to external cues.

What Does your Chronotype Say About You?

Chronotype is your sleep-wake cycle. It is true that the best way to get sound sleep is by listening to your internal clock, but that is rarely possible due to our daily routines. Even a biphasic sleep schedule can help you mitigate the impacts of sleep deprivation.

Several parents, teenagers and young adults believe that they can make up for the daily lack of sleep by oversleeping on the weekends. Sadly, that is ineffective as far as the restorative mechanisms are concerned. It is imperative that you stop being hard on yourself for having a less common or awkward chronotype. In fact, you must remember that you are not alone.

There are possibly millions of other people out there, who share your sleep-wake cycle. You might not know anyone with your bedtime and wake-up time in your vicinity right now, but that is not reason enough to beat yourself up about it. Your body clock says nothing about your productivity levels or your personality. It signifies your body’s natural central clock. If you have the opportunity to adjust your daily routine as per your circadian rhythm, you should, by all means, do so. Adhering to your chronotype is the only way to improve your health and say goodbye to chronic fatigue.  

Circadian rhythm disorders are notably common across individuals of all ages, professions, and health backgrounds in the United States. Presently, upwards of 70 million adults in the U.S. suffer from a form of circadian rhythm disorder, ranging from mild to severe. These disorders can interfere with almost all biological processes by disrupting the body’s natural sleep and wake cycles.

People with any circadian rhythm disorder suffer from lack of sleep, too much sleep or simply not enough sleep at the right time. Circadian rhythm disorders often cause bodies to only respond to their internal biological clocks. Unlike insomnia, the affected individuals experience a normal quality of sleep when they listen to their inner clocks.

What is a Circadian Rhythm Disorder?

Research shows that several sleeping disorders trouble people all across the globe. The kind of circadian rhythm disorder that might affect you does not depend on your age or your geographic location. It depends mainly on your clock genes, several hormones, and other intrinsic factors. Investigations on sleep disorders for over the last decade or more show that a complex network of neurobiological factors is responsible for the genesis of circadian rhythms in people and their subsequent disorders.

One could say that the circadian rhythms are the natural behavior pattern changes, mental and physical changes that a person goes through every day. The primary stimulus for this change is external light. The most common of all circadian rhythms is staying awake in the mornings and sleeping at night. If you think that only human beings experience this rhythm, you are wrong.

Every animal, plants and other tiny microbes experience circadian rhythms that depend on external light cues. The highly conserved structure of biological clocks among the animal and plant life are responsible for the regulation of these biological clocks. Although biological clocks and circadian rhythms are not synonymous, they are closely related to one another.

What are the Simplest Classifications of Circadian Rhythm in Animals?

You must have already seen the simplest breakdown of the 24-hour cycles depending on the maximum activity peak and sleep onset time of different species.

• Diurnal. Human beings tend to be grossly diurnal. We are active during the daytime, irrespective of the delays or the advances in our circadian clocks.

• Nocturnal. These are the animals that are active during the night. Nocturnal animals include hyena, fox, and possums.

• Crepuscular. Cats and some big cats (this explains why your cat always wants you to wake up and play with them at 4 am!) are crepuscular in nature. They are active during dawn and dusk when their target preys are more likely to forage or return home from foraging.

The peak activity hours and resting hours of any species depend on their habits as functions of evolution and adaptation. While circadian rhythms depend on endogenous regulations and exogenous signals, the biological clocks may as well depend upon multi-trophic (multiple feeding) systems.

Gene oscillations, lunar rhythms, tidal rhythms, and ultradian rhythms are also responsible for the control and modulation of the circadian clock. The inclusion of so many control factors opens up the possibility of a few things that may go wrong with the circadian rhythm of a complex organism, like a human being.

How to Distinguish Circadian Rhythm from Regular Repetitive Traits?

You might wonder how it is possible for a body to know when it is time to wake up, eat and sleep. It is possible due to the presence of a master clock in the brain of the animal. The case is different for plants since they do not have a defined neuron system or a central nervous system (CNS). In case of animals, the autonomous circadian activity at the cellular level can affect core temperature, hormone production, cell repair and brain wave activity.

The circadian rhythm is a result of several clock genes that remain unchanged throughout several species and genus. However, you must also understand that not all recurring behavior or changes are products of the circadian rhythm. To be a part of the circadian rhythm, your biological rhythm must fulfill the following requirements;

I. The biological rhythm has to be internal, self-dependent and close to 24 hours in duration.

The rhythm should withstand constant conditions with the approximate period of 24 hours. This period of free-running is tau, and it should persist in the absence of external cues. Generally, the Taus are longer than 24-hour periods for diurnal creatures and nocturnal animals, and the free-running period is usually shorter than 24 hours.  

II. The circadian rhythms should be entrainable.

Although the circadian rhythms are endogenous, they are not entirely recalcitrant to training. They should be entrainable by external cues. The simplest of all exemplification of this trait is when subject travels through several time zones. The person usually suffers from jetlag, and then they can train their internal circadian clocks to respond to local time

III. These rhythms should follow specific physiological temperature changes.

The biochemical reactions at the cellular level are highly sensitive to external temperatures. The temperature will affect the levels of kinetic energy at the molecular levels. Now, irrespective of these changes, the molecular clocks of most mammals can maintain a 24-hour periodicity. The increase or decrease in the rate of a reaction in the biological system in response to a variation of 10-degree centigrade is Q10 temperature coefficient. It is a measure of the compensating effect of the circadian rhythms.

What Are The Two Categories of Circadian Rhythm Sleep Disorders?

The Circadian Rhythm Sleep has two main categories, namely;

Extrinsic Type Circadian Rhythm Disorder

While a deviation of the natural system from these circadian rhythms almost always leads to devastating physiological and mental changes, not all the causes of this deviation are intrinsic. Sometimes, some external cues cause circadian rhythms to deviate from the norm.

Shift Work Sleep Disorder

This is a typical example of an extrinsic type of circadian rhythm disorder. It is highly circumstantial. It mostly affects people working in night shifts or changing shifts. Doctors, nurses, call center workers, customer service agents, police officers, firefighters, and emergency responders often show signs of heightened fatigue due to different shift work sleep disorder.

The Intrinsic Type Circadian Sleep-wake Rhythm Disorder

A majority of the sleeping disorders have an internal or built-in cause.

Advanced sleeping phase disorders (ASPS). This is when people easily fall asleep during the early evenings and have wake-up times in the early hours of night or dawn. People with ASPS often fall asleep by 9 pm and wake up by 2 am or 3 am.

Delayed sleeping phase syndrome (DSPS). DSPS causes people to stay up till late. Adolescents and young adults often exhibit early symptoms of DSPS. They show later than usual sleep onset time and wake up much later too. They often experience peak alertness in the middle of the night.

Non-24-hour sleep-wake disorder. People, suffering from hypernychthemeral syndrome or a non-24-hour sleep-wake disorder can cause them to fall asleep much later each day. The sleep onset and offset times usually shift by an hour or more each day.

Irregular sleep-wake rhythm. While the total sleep time for a person tends to be regular or typical for the person’s age, people with irregular sleep-wake rhythms usually fall asleep more than once per day.

There are several types of circadian rhythms among people even though the hours can be very diverse. There are morning people, who like to wake up early and go to bed early. Then there are the evening people, who prefer to stay up until late and wake up late. Nonetheless, people with regular circadian rhythms find it easier to wake up at a fixed time each morning. They also find adjusting to new routines or a new time zone much easier than people with circadian rhythm disorders. We will learn more about the different types of CRDs in the next section.

What are the Different Circadian Rhythm Abnormalities?

Since there are various types of natural biological clocks, there are several types of circadian rhythm phase disorders that can affect a group of people.

People often find it difficult to understand what kind of a disorder they might be suffering from without the help of an expert. If you feel you are a victim of one such disorder, seek the help of a professional.

Delayed Sleep Phase Disorder 

Patients with delayed sleep phase disorder or syndrome (DSPD or DSPS), experience a standard quality of sleep when they are allowed to follow their biological clocks. Usually, they experience a delay of about 3 to 6 hours in sleep onset time. Understandably, their wake-up times also experience a delay to compensate for delayed sleep onset time. People with DSPS are not lazy or unmotivated. Their day starts at least 3 hours later than it does for the regular people.

They conform to a 24-hour schedule, but they are unable to fall asleep or wake up at socially acceptable hours. 10% of the people with chronic insomnia suffer from DSPS. Their sleep-wake cycle delays are independent of their age, sex, geographic location and profession. They find it impossible to sleep even when they are physically tired at the end of a day.

People with DSPS are likely to fall asleep and wake up at pre-set “usual” time as per their internal body clocks. They find it impossible to retrain their sleep-wake cycles. They often get lesser than necessary sleep per day, since they tend to wake up at fixed times irrespective of the amount or duration of sleep and as a result often complaint about day-time sleepiness.

Over 15% of the teens in the US currently suffer from delayed sleep phase syndrome. A lack of morning light exposure can also lead to DSPS in individuals, so it is a common occurrence in the Scandinavian countries that experience six months of light and six months of darkness. It is also common among those suffering from depression and anxiety disorders.

Advanced Sleep Phase Disorder 

Advanced sleep phase disorder (ASPD) is a classic circadian phase disorder. The patients experience an advancement of their sleep-wake cycle. Their sleep onset time can advance between 9 pm and 7 pm and their offset time can advance between 5 am, and 3 am.

Some people wake up as early as 2 am after completion of their five REM and five non-REM sleep cycles. Just like in case of DSPD, people with ASPD have no troubles with the quality of sleep. They fail to stay up after a point in time, and this often causes social isolation, family problems and other issues due to evening sleepiness.

A study shows that when researchers deprived a group of patients from getting early sleep, they still woke up at their regular hour in spite of not completing their sleep. Environmental cues do not impact individuals with ASPD as much as their genetic makeup. There is a strong genetic link with early sleep onset that these people can pass on to their next generation 50% of the times.

While some erroneously believe that people suffering from ASPD are merely early larks, you can get your polysomnography test from a reputed sleep clinic to find out if you have a circadian sleep disorder. This test notes the limb movements, breathing patterns, heart rate and brain activity of the patient to confirm whether the subject has ASPD or any other sleeping disorder. It is a standard test that can also unravel tendencies of sleep apnea and insomnia in the subjects.

Psychologists, psychiatrists, and ordinary people often correlate waking up unusually early with the precedence of depression. However, investigations characterize ASPS or ASPD as a genetic condition that might lead to depression due to increasing social alienation and lack of social interactions.

Non-24-hour Sleep-Wake Disorder 

The non-24-hour sleep-wake disorder or non-24 is a chronic non-24-hour biological rhythm pattern that qualifies as a circadian rhythm disorder. It affects the regular synchronization of the internal biological clock with the external stimuli. One of the most common types of the non- 24-hour sleep-wake disorder is the free running type or hypernychthemeral syndrome.

People with non-24 usually have body clocks that have a slightly longer than the usual 24-hour night-day cycle. It has steady graduation. For example – people with a 25-hour body clock will sleep one hour later the first day, 2 hours later on the second day and this will continue up until they complete their 24-hour cycle on the 24th day. It is a chronic and steady delay of their sleep onset time due to a slightly longer circadian clock.

People with this affliction often find it difficult to fall asleep at the correct time. About once or twice a month the person can experience a period of great sleep since their sleep-wake cycle realigns with the external 24-hour photoperiod. Nonetheless, this is a temporary relief since their cycles soon start shifting by an hour once they achieve a perfectly aligned sleep cycle. Since they have no way to entrain their circadian clocks with the help of external cues, their natural circadian rhythms are often off by a couple of minutes or even hours.

Sleep experts recommend biochemical circadian rhythm signal tests to ascertain the presence of non-24 hour among people. The levels of melatonin in the body over a period can help the experts understand whether the person has non- 24-hour sleep-wake disorder or some other circadian rhythm disorder.  

Irregular Sleep-Wake Rhythms 

Although rare, an irregular sleep-wake rhythm is a form of circadian rhythm disorder in human beings. Many still confuse this with polyphasic sleep patterns. The main difference between irregular sleep-wake rhythm and polyphasic sleep patterns is the lack of special hours of sleep during a 24-hour day.

There is no particular sleep-wake cycle or prolonged sleep phase at night. There is a sheer absence of regularity of sleep patterns. You can easily find yourself wondering if you suffer from irregular sleep-wake rhythm after a long flight to another part of the country or world. When broken sleep or disruptions in sleep follows a long trip, it is usually jet lag and not irregular sleep-wake rhythm.

In fact, the latter is quite rare and severe. Experts often refer to it as the invisible disability. ISWD has several causes that further weaken a weak circadian clock. It is essential for someone with ISWD to consult with a doctor and a sleep expert since they usually suffer from other neurobiological diseases or neurodegenerative diseases like Alzheimer’s, dementia, mental retardations and brain damage.

The risk of ISWD increases with advancing age, mainly due to the sharp increase of co-morbid health conditions. The confirmed diagnosis usually needs polysomnography and actigraphy. The lack of proper quality sleep is one of the defining characters of this disorder, which makes it unique among other circadian sleep disorders. Restorative sleep with irregular sleep-wake rhythm is almost impossible without medication and prolonged treatment.

Shift Work Sleep Disorder 

Shift work sleep disorder (SWSD) used to be a defining trait of people working on continuous rotating shifts. It is a classic circadian rhythm disorder that consists of insomnia and work-time sleepiness. In a majority of the cases, the rotating work hours often coincide with the typical sleep period of the individual. Since the working shifts and their rotations are highly unpredictable, the defining characters of SWSD (barring a few) are highly variable.

There is a certain degree of sleep deprivation that always occurs with shift work sleep disorders. In many cases, nightshift workers are unable to get good quality sleep in the morning-noon due to familial and social responsibilities. In other cases, the internal biological clocks prevent these workers from getting restorative sleep. According to an International Agency for Research on Cancer study in 2007, shift-work increases the risks of cancer in people of almost all ages. The chances increase with increasing age.

Over the years, doctors, sleep researchers, and scientists have associated several medical co-morbidities with SWSD. Increasing sleepiness during work hours, slow response to external stimuli, non-natural hunger-satiation response, lack of restorative sleep and several other circadian misalignment symptoms often characterize the occurrence of shift-work disorders in people.  

What are the Leading Causes of Circadian Sleep rhythm Disorders?

Several times people mistake the cause of circadian rhythm disorders to be external. There are several doctors across the globe, who believes that disruption of the circadian rhythm in an individual is a result of the lifestyle problems or behavior problems only.

Sadly, the causes are not so simple and just taking away the external stimuli does not restore the intrinsic biological rhythm in people. There are myriads of causes to the simplest of the simple circadian rhythm disorders.

1. Sensitivity to zeitgebers. Zeitgebers directly translates to time givers in English. These include external time cues like light, temperature, and darkness. Disruption of sensitivity towards these time givers is one way to explain the most common circadian rhythm disorders in human beings. Several studies on blind subjects and their intrinsic circadian rhythms show why it might be challenging to entrain the internal biological clock to light cues in the absence of a complete visual system.

2. Environmental factors. This is the next most common cause of some sleep-wake disorders in human beings. High room temperature bright light and more noise are not conducive towards better sleep. These are important factors that affect the quality of sleep in night workers and shift workers.

3. Imperfect pacemaker function. Biological pacemakers maintain the balance of the clock gene products depending on the time. They are necessary for the internal coupling mechanisms of the body. Your sleep-wake cycle is inherently dependent on the temperature cycle and light cycle. The lack of a pacemaker function can potentially compromise the balance. 

4. Frequent travelling. Short distance trips, from one region of the state to another might not be as disruptive for an individual. However, moving from one country to another, crossing several time zones can be challenging to your internal body clock that is already set for a 24-hour period. When the night becomes day, your body often feels confused as the biological clock says its night, yet the external light cues state it’s day. It is our old friend, jetlag. The intensity of the effect depends on how far you are moving away from your time zone.

5. Neurobiological factors. We cannot overlook the possibility of a solely neurological or a neurobiological factor for the disruption of one’s circadian rhythms. Alzheimer’s is one of the few diseases that can always contribute to sleep-wake disorders. Researchers have often cited several neurobiological causes for sleep disorders like Parkinson’s, Huntington’s and sclerosis.

Lifestyle and social causes are of course the contributing factors, but they cannot act without the help of internal mechanisms to disrupt the sleep-wake cycle in people. Blue-light devices, high-intensity CFLs and LEDs, traffic noise and improper eating habits significantly disrupt circadian rhythms in adults, adolescents and children alike. More and more children are staying up late and going to school tired.

Mobile phones and tablets are the most significant reason for this. Children are spending more time with these blue light emitting devices. They are suppressing the secretion of melatonin and thus delaying sleep onset on a regular basis. As we have said before, it is possible to entrain your internal biological clock. Therefore, with prolonged exposure to bright blue light up until a certain period can entrain individuals to stay up till late and wake up late, by disrupting their natural biological clock.

Is there any Treatment for the Myriads of Circadian Sleep-Wake Rhythm Disorders?

There are several methods and combinations of techniques that doctors and therapists use to help people to overcome their sleeping disorders. Here are a few of those that might help you too –

• Behavior therapy. This is a broad term, experts often use to describe several steps of clinical psychotherapy to modulate circadian rhythms in people. Behavior analysts first assess the environmental stimuli, the behavior issues and the internal factors that can influence a person’s sleep-wake pattern. Then it is the responsibility of the behaviorists or the psychotherapists to apply their analyses in clinical therapy which often helps in entraining the internal biological clocks of individual subjects. Assessment of phobias, desensitization technique for anxiety and anger, psychotherapy for depression and other psychological disorders are often parts of the behavior therapy. In case of sleep disorder related behavior therapy, therapists often ask the subject to avoid naps and stimulants throughout the day.

• Bright light therapy. The lack of bright light in the mornings can prevent the reduction in the levels of melatonin which in turn can cause increased sleepiness throughout the day. On the other hand, exposure to bright lights in the evening or night can prevent proper sleep-wake cycles in the subject. Investigations highlight the importance of blue-light stimulus to increase the synthesis of melatonin in people. Scientists have carefully outlined several processes that can use the blue light and bright light therapy to manipulate the levels of melatonin in the human system. People with delayed sleep phase disorders benefit from exposure to bright light in the mornings and dark treatment in the evenings. Those suffering from ASPD often find it useful to opt for bright light treatment in the evenings to prevent early sleep onset.

• Dark therapy. This is complementary to bright light therapy. Under dark treatment, people have to use blue-light blocking goggles and surround themselves with non-blue LEDs. It blocks blue and green wavelengths from reaching the eyes and prevents untimely suppression/secretion of melatonin. Blocking blue-light wavelengths in the evening avert melatonin suppression and aids early sleep hours. It is especially helpful for people suffering from DSPD.

• Chronotherapy. Chronotherapy involves gradual but steady training of the internal biological clock to obey external cues. It means a continuous delay of bedtime by about 10 minutes to 30 minutes in an attempt to correct the sleep-wake cycle. People with DSPS should always try chronotherapy before moving onto hormone therapies and sleep medication. One of the most popular forms of sleep chronotherapy is the controlled sleep deprivation with phase advance or SDPA. According to this rather stringent therapy, people stay up for 24 hours and then go to bed 90 minutes in advance. This process continues till the person achieves the desired bedtime.

• Medicines. Melatonin, modafinil, and melatonin agonist compounds are particularly beneficial in the treatment of sleep disorders. Increasing levels of melatonin (a natural hormone) correspond with sleep onset. Medications are necessary for adults and sometimes, adolescents, who suffer from chronic circadian rhythm disorders. Taking short-term sleep aids in the combination of wake-promoting agents can help people achieve the necessary sleep-wake times.  

The effectiveness of any therapy depends on the person’s ability to entrain their biological clock, the persistence of comorbid conditions and the efficiency of their therapists. Just like any treatment for other medical conditions, different people may report different levels of benefits from the same therapy or medication. In short, not everyone will benefit equally from these treatments.  

Circadian rhythms are a product of evolution and adaptation for millions of years. The science of sleep includes the study of anatomy, comparative anatomy, molecular biology, genetics, and behavior. Epigenetics, evolution, and environment also play an essential role in chronobiology or the biology of time. The first instance of circadian rhythm as a function of inheritable factors is present in the works of Linnaeus in 1751. He designed flower clocks using flowering plants of selected species. In 2018, researchers and medical professionals are finally able to control the sleep-wake cycles on their human patients by utilizing genetic therapy, light therapy, and chronotherapy in coordination with each other.   

Circadian rhythm is a product of chronobiology in almost all higher creatures. Plants, invertebrates, vertebrates, and even some microbes’ exhibit functions of their internal biological clock. While human beings depend on their circadian clock for their sleep and wake times, plants depend on them for the opening of their stomata, oxygen synthesis, CO2 release, and glucose synthesis. Interestingly, the genes responsible for the organism’s circadian rhythm remain conserved throughout the different stages of evolution.

 

Ever pondered buying a mattress online? Feels like everyone’s doing it, right? You could be next in line! Honestly, it’s a breeze and comes with loads of options to mull over. If you’re diving in for the first time, fret not. You’ve got all you need right here to nail that choice.

Just like buying other merchandise online, buying a mattress is as simple as reading the description and after confirming that everything is as you want it to be, you click the “Buy It” button. In most cases, the vendor allows you to confirm that your delivery is okay with an allowance for money back if something is not right.

There are some reasons why you need to purchase your mattress online. Some of these reasons include:

• The “buy mattress online” option helps you to make a collaborative decision

Let’s say you have just moved into your new home with your partner and want to start a new life. When it comes to furnishing your house, including buying a mattress, you would want to buy one that both of you would be comfortable lying on.

In the case where one of you is too busy at work to have time to visit the store, purchasing a mattress online would be the perfect solution. He or she can actively take part in the process of obtaining one after a day’s work or when you share product links and social tools.

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What is better than purchasing a product from the comfort of your home and having it delivered right to your doorstep? In the case where you have a tight schedule and you cannot afford to flex it to squeeze time to replace your old mattress, online shopping would be an excellent option for you.

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Talking about old stuff, just because you want to purchase a mattress and use bed sheets on it doesn’t mean that the bed removal should be aged. Alright, you don’t sleep on it directly, but still, you want your mattress to look good. Online sellers do not have cushions with old bed removal because they rarely deal with such items.

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• You Can Get a Good Discount

Many online retailers offer discounts on the products that they deal with, so if you want to score a significant discount on your mattress, you should consider purchasing it online. This is a great deal for you because you would be able to save some few dimes.

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Who doesn’t want to do business with a retailer who cares about his or her customers and whose priority is to offer the best of the best to them? Now, since you are also not left out, you should consider going for a service with excellent customer support. Apart from getting quick responses to your enquiries, you would be well attended to in case of a problem with your purchase. How convenient, right?

• Online Buyers are Well-Researched

Many are times we need assistance when it comes to purchasing a product from any store or shopping mall. As compared to other buyers, online buyers build an excellent measure of expertise when it comes to doing research. Because they tend to rely on themselves, they do their homework, conduct their thorough research and check out a mattress buying guide to get the best brands of products or services.

• There is no Pressure in Buying

So you go to this online store which the retailer hasn’t met his selling target for the day. What next? Pressure! You do not want to purchase a mattress because the retailer told you that it was the only one left or because he said you wouldn’t find any other comfortable mattress other than that particular one.  With this kind of pressure, you can get tones of surprises when you take the new item home.

• You Might Get a Different Satisfaction from a Store

Have you ever tried on a cloth, say stretchy jeans, that you lent a friend who has a body figure bigger than yours? How was the experience? Well, you know better. I bet the jeans didn’t fit perfectly like they used to before your friend wore them.

The case is the same with a mattress – you visit a shopping mattress store, and you love the feeling of one when you sit on it. Understand that it’s a showroom, meaning, many people have sat on it to get that feeling too. When you get one straight from the warehouse, chances are you would get a different feeling.

• The Satisfaction from Online and Offline Purchases Doesn’t Vary that Much

Research shows that purchasing a mattress online or getting one directly from a store has almost the same level of satisfaction, so even if you get one online, there are very minimal chances of dissatisfaction.

• You Have Better Chances to Compare Many Mattresses

With an online purchase, you would be able to compare different mattresses in terms of their pricing, design, sizes, make and other crucial mattress features. This would enable you to avoid any mishaps or surprises that come with purchasing a wrong item or an item that does not meet your targeted level of satisfaction.

You can’t even think of making rounds in the city from store to store to look for that particular mattress that you want. Aside from other expenses and drawbacks, the time that you would spend alone won’t even allow you talk about it.

Mattress Buying Guide: How to Buy the Right Mattress for You

So, you have gone through the reasons why you need to purchase your mattress online and have finally decided to get a fabulous one for yourself.  How would you go about it? Well, no hassle. You have to get familiar with a mattress buying guide that would help you to replace your old, lumpy mattress with another one that is more comfortable.

The experience of getting a mattress can be exciting, especially the thought of a fair price and you getting comfortable on your sofa and having your bed delivered to you right to your doorstep. Understand that you will be spending a great part of your life lying on it (well, depending on how long you sleep).

Many sites deal in mattresses in the online business world; there are a few tips that can come in handy when you decide to take the plunge to get one. Some of these tips are explained below:

Do Your Homework and Check out a Mattress Buying Guide as Well

Conducting your research is the first thing that you need to do before clicking your button to order a mattress. As you read earlier, there are some mattress websites in the industry today, so it is essential to identify one that is the best fit for your needs.

Good for you if you know the kind of mattress that you want, but in case you do not, you should consider visiting the store to get a clear sense of the type of bed that you want before purchasing it online. I guess you’ll have to get up from that comfortable couch!

Identify the Type of Mattress That you Need

There are many types of beds in the industry, so you have to identify one that best suits your needs and your budget. Select a mattress based on your needs and preferences – do you need a soft or a firm bed? What is your preferred sleeping position? How much support do you need? Answering such questions would enable you to identify the most suitable choice.

Just to get a glimpse of it, below are some of the mattress options from which you can choose in a mattress store:

• Open spring mattresses. These mattresses have a long piece of metal wire that is coiled to form several springs. These types of beds have machine-stitched ends, and their feature of being light makes it easy to turn them. Such options are suitable for instances where replacement has to be done as time goes by, such as children’s beds. They can be easily replaced as your kids continue to grow; so you won’t feel much of a pinch because it would be a necessity at that time.

• Latex mattresses. These types of beds have organic latex foam that is made from rubber trees. In case you are looking for a bed that has a bouncy effect and offers a rounded contour to your body, this is an excellent option for you. Their unique features also tend to make them one of the most expensive options in the industry.

• Airbeds. These kinds of mattresses have air chambers that feature foam comfort layers to provide support. With an airbed mattress, you can adjust the level of your firmness using an electric air pump to get yourself comfortable. Such mattresses last for a long time, but you will also have to part with a few more dimes.

• Innerspring mattresses. As the name suggests, these mattresses have a spring-like feeling when you lie to them because they use a support core that is steel-like. They are also the most popular type and are commonly used traditionally. As an added plus, they have a bouncy effect, which makes them ideal for conjugal activities. As much as these types of mattresses are good, they tend to sag when used for long and they do not contour the body as other beds do.

• Memory foam mattresses. Aside from the fact that these mattress options trap a lot of heat, they tend to last longer than the innerspring mattress and conform significantly to your body, giving you a ‘hugging’ effect.

• Hybrid mattresses. These mattresses have the same body contouring effect to that of memory foam mattresses, but they do not trap any heat.

Consider Checking out Mattress Review Sites

When purchasing any product, be it online or in the store, you do not want to be the first one to test and try it out. To be on the safe side, always consider checking out mattress review sites to see what other customers have to say about different mattresses before embarking on your purchase process.

In the case where you have already narrowed a particular mattress to your interest, see what other customers have to say about it. Ensure that you look at everything concerning the item, from the comfort, customer support services, and the level of satisfaction with the delivery process.

Consider your Budget

Your budget would always guide you when you want to purchase an item either online or in the store, or when you want particular services to be rendered to you. When finding a mattress that meets your needs, you should consider your budget.

Before making your purchase, come up with a suitable budget and stick to it. From there, you can begin looking to find several mattress models that are in your price range.

Avoid Middle Connections

It’s a good idea to buy a mattress from a company that manufactures them directly, other than buying one from an intermediary. As such, you will be able to identify an excellent value for your mattress. To get your mattress at a fair and affordable price, approach a company that makes beds themselves and transports them to their customers directly.

Check out if the Shopping Mattress Return Policy Works on Your Terms

Does the return policy of your purchase work on your terms? Do not wait to know the answer to this question after making your purchase. As a buyer, you should check the return policy of your mattress before making any investment. This would ensure that you get to return your mattress after purchasing in case of any problems.

Always Consider the Maintainability of Your Mattress

A good mattress should be one that can be easily maintained after purchase in terms of hygiene. Does the mattress have a removable cover that can be washed? Finding a mattress that has a zipper on one end of its cover would be more suitable.

You do not want to spoil your mattress by having to tear one end of your cover to wash it. As expensive as a mattress with a zipped cover may seem, it is a great option, especially if you often retire to bed with unwashed feet.

The Density of the Mattress

You do not want to lie on a mattress for a while and begin to feel the steel or board on the base of your bed. You can’t even sleep, can you? You will be tossing in your bed and turning all night long and wake up with a sore and paining body. You do not want that. For this reason, ensure that you check the density of the particular mattress that you would like to purchase for longevity purposes.

Find out How Well the Mattress Brand is Known and Trusted

Before purchasing a mattress online, ensure that the brand that you are seeking to go for is well known and trusted. That would guarantee you peace of mind and the comfort of knowing that you will be able to use your mattress for a long time without having to replace it soon. A trusted mattress company on a website that is well known would always guarantee the prospective customers a memorable and outstanding experience in purchasing their items.

To get the most out of your research in your quest to look for a suitable mattress, there are some aspects that you would need to watch out for to ensure that you get the most out of your research. Now, understand that a mattress is a big purchase, and very much so depending on the type of mattress that you go for and its quality. Not all online mattress websites are reputable. Thus, it is essential that you shop wisely with utmost care. As you do that, ensure that you pay attention to the following detail:

Certification Information of the Item

Certification proves that all products, including mattresses, have passed through several tests or are manufactured in a certain way to ensure the safety of the prospective consumers who will use it.  Certification companies put such measures in place to indicate that the products being delivered are of high quality and nothing less than that.

In a nutshell, ensure that before you purchase a mattress, you get the certification information from the online retailer to boost your confidence in shopping with the particular website.

Customer Education Information

Does the particular online company that you choose have any customer education information, including snapshots and videos that explain the features of their products? Approaching a company that uses digital technology to describe the characteristics of its mattresses would enable you to have a good understanding of what the beds feature before making an informed decision on which one to buy.

Depending on the information that you want to access, the company should provide precise details of it. As a customer, you are not left out regarding playing your role. You alone know what you need, so based on those concerns, you can watch videos of the educational info that would be most helpful in your case.

For instance, if you are not sure of how a bed with an adjustable spring works and you long to get one, you will need to visualize that by checking out a video of the same. In the case where you need to check out customer reviews and certification info, an article would do fine.

A Medium of Contact

So you have done your shopping mattress research and identified the type of mattress that you want to purchase. Better yet, that is still not enough. Ensure that the website offers a telephone number through which you can speak to someone.

Shopping online does not guarantee that you will get everything right and go ahead and make your purchase without a problem. Most likely, you will have a few questions that need to be answered.  Contacting someone would increase your chances of making a legit purchase.

A Showroom and Staff for Product Testing

A well-established company should have a well-managed office and team – in this case, a well-equipped showroom and management staff. Let us say you have identified a mattress online that is suitable for you and discovered that the company that deals with it is situated near your locality. Wouldn’t you want to test the mattress before making a final purchasing decision?  

Ensure that the company that you choose to buy from has a permanent showroom to enable you to take a look at and test the mattress that you want to purchase.

A Mattress Warranty Guide and Well Spelt out Terms and Conditions

You do not want any surprises, be it before or after purchasing your mattress. Before shopping online, ensure that the online company has well spelt out terms and conditions regarding trials and a mattress warranty guide with information on warranties or any discount rates. If you manage to get the terms and conditions jolted down in detail, it will be even better.

Since both parties have a role to play, both your responsibilities and those of the company, looking out for this aspect would eliminate any chances of being charged with hidden fees.

A Secured Mode of Payment

With the everyday advancing digital technology, cases of identity thefts have substantially gone up. You do not want to be a victim of the same. Hence, you should ensure that the online company processes payment using a secure encrypted method and that the particular company also accepts gateways such as PayPal and other visa cards for payment.

With these in place, the company would get access to your credit card details; hence, this gives you the comfort of using a legitimate and secure payment procedure.

A Platform for Viewing Products and Their Pricing

Can you buy any item from an online website which does not allow you to see the particular things or their pricing? Certainly not. That also goes for a mattress. When talking about viewing a product, it’s not only a matter of looking at one photo and making your final buying decision. You have to see the features of the mattress clearly and visualize them from all possible angles.

As much as the particular online mattress stores may offer their items at relatively lower prices, you might smile in the beginning and regret making your purchase when you open your door to find what you did not expect lying on your doorstep.

The Aspect of Product Descriptions, Deatures and Specifications

Checking out photos and videos of the mattress that has appealed to you is not enough.  Since convenience is the primary reason for your decision to opt for an online purchase, you should ensure that you examine the descriptions of different types of mattresses and compare them.

Following the fact that description is a summary of what the particular mattress features, it would help you save considerable time in getting a clear understanding of the item. An excellent product description should be able to give you a feel and picture of what the product entails.

Buying a mattress online has several advantages and drawbacks, just like shopping for any other item online. The limitations aside first, check out some of the reasons why you need to give online mattress shopping a try:

Pros of Purchasing A Mattress Online

• It is easy.

Buying a mattress online does not require much of a hassle. The whole procedure of doing so is simple and straightforward. You escape the sale pressure in stores by making your purchase from the comfort of your home.

• You will access full-service delivery at any time.

Many shopping stores do not offer delivery services when you purchase a mattress from their store. As such, you have to equip yourself with the necessary mode of transportation and at the same time ensure that your item gets home safe and sound. With online shopping, you can get your item delivered right to your doorstep.

• It is affordable.

Many online retailers offer high discount rates for their customers. Okay, you can still bargain and negotiate accordingly in a store, but the discount that you’ll get won’t be that much to smile about. Purchasing online can help you save about 15% cash.

• You get an item of high quality.

Purchasing a mattress online means that, you do not have to sit on it, which means that other customers have not sat or laid on it for testing and trial. This is a huge plus for you because the mattress that you will get will have great specifications and provide long-term comfort. It will also be durable.

• You experience low return fees.

As compared to store retailers, online retailers have low return fees. In a case where you have purchased a mattress and it doesn’t tend to meet your needs and concerns, you would still be able to return it at a lower cost. As for buying it at a store, you will part with more cash than you except or worse still, you might have to learn to get comfortable with your purchase when you buy from a store with a no-return policy.

• Good customer support.

On average, online retailers tend to have well-established and better customer services than mattress stores. This guarantees you of purchasing your item after getting helpful information that will guide your purchasing decision.

• You escape pushy salespeople.

Many salespeople in stores seek to achieve the target of their daily sales to up their commissions. For them to reach their targets, they become somewhat aggressive in trying to convince customers to get them to purchase their items.  

Certain levels of aggressiveness can be too much at times, whereby the salesperson may use statements such as, “This is the only one left.” Or “You won’t find it stocked anywhere else.” This kind of pressure is not good for you and for your buying decision as you might end up purchasing a mattress that does not suit your needs.

• It’s a better option if you feel uncomfortable testing your mattress.

When it comes to testing and trying the suitability and comfort of a bed, not everyone would be comfortable enough to do that in a mattress store.  Such stores are usually packed, especially in times when particular items are on offer, so if you are not the kind of person who likes every eye to be fixed on you, you won’t lie on that mattress for a test.

Cons of Purchasing Your Mattress Online

Just like any products available in the market, mattresses have their fair share of cons too. Check them out below!

• You can’t test or try your mattress before buying.

Unless you know the type of mattress that you want and the model, buying one online can be a terrible experience for you. This is because you cannot feel it, try it and see how it has been made.

• Lack of an immediate personal assistance.

With online shopping, you can post your inquiries but you might not get immediate responses. Many are times you would have to wait for at least 24 hours to get your questions answered.

• You may experience shipping costs and delays.

This would be a massive blow for you, especially if you need your mattress delivered to you with immediate effect. In the case where you pay for a bed that is not in stock at the moment, a refund would then be processed, which would take longer than usual.

For many years, this question has circulated among diverse communities – including established pairs, new parents, people opting to stay single, young workers buried in their job tasks, and dedicated single careerists – “Do I really need a box spring for my bed?” If you’re tossing and turning, struggling to fall asleep, it’s unlikely that this question is the cause of your insomnia.

However, it is very likely that you need a box spring to be more comfortable in bed. Box springs add more comfort to your bed and give you a better night’s sleep. However, before you make the purchase, there are things you need to know.

What Is A Box Spring?

Modern mattresses come with complete support, and they do not necessarily need the help of a box spring to offer complete comfort. A box spring or a foundation is the base component that can provide optimum support to the mattress. This protects them from wear and tear for long periods of time. People sometimes manage to use the same mattress for more than a decade.

A survey shows that families who manage to preserve the integrity of their mattresses for extended periods of time usually opt for the right box spring while installing the mattress. Any good box spring provides a buffer zone between the bed frame and the mattress. Direct contact between the soft outer cover of a mattress and the wood or metal of the bed frame can increase the wear and tear over the next few years. The presence of a box spring structure can help spread out the impact and absorb the pressure evenly across the entire area.

How Does A Box Spring or Foundation Look and Function?

Any traditional box spring design usually includes a wooden frame and steel support rings. However, modern box springs rarely make use of the springs inside wooden frame designs for the same purpose. Several box springs use heavy gauge wire coils and added steel reinforcements within the wooden grid to improve the support. The top cover of the mattress is usually skid-resistant fabric that can act as a dust-proofing for the mattress and the foundation below. Au contraire, a semi-solid grid box spring consists of a wooden frame and a stiff metal grid that acts as the mattress support.

Many modern manufacturers no longer use real springs in the designs. Many modern designs hold a candle to the old engineering concepts that worked together with the mattress design to provide complete support. They consist of pre-bent birch or beech slats that join the opposite ends of the wooden frame with flexible rubber sockets or shoes. The number of slats dictates the support for the mattress. The closer they are, the more support they provide. These foundations are perfect for memory foam mattresses and latex mattresses. Experts usually refer to the modern box spring designs as foundations as they are more aptly the base of a mattress rather than the shock absorption grid system they used to be.

Why Do People Use Box Springs with Their Mattresses?

Most manufacturers can consider a warranty void if the buyer does not use their new mattress with a box spring. In many cases, the warranty papers and instructions for mattress maintenance does not come with explicit directives to use it with a box spring but coupling it with one always ensures that you get the best warranty services. It provides better support to a sleeping body, and at the same time, the presence of added springs can make a stiffer mattress seem softer.

Another huge advantage of using a box spring is the added height that the mattress receives with the box spring to boost it from below. This makes removing, cleaning and placing the mattress on the bed a much easier task. The biggest advantage of using a dedicated traditional box spring design is the extension of the mattress’ longevity. Buying a costly, ergonomic mattress becomes an investment rather than a recurring expense with the purchase of a traditional, shock absorbent box spring.

Which Mattresses Require Different Types of Bed Bases?

Many users believe that modern mattress designs do not need box springs to function. You should consider a box spring if you use a both-sided innerspring mattress. When the coils of the box spring move with the springs inside the mattress, it can effectively spread out the pressure on the mattress while a person sleeps.

As per expert opinion, a single-sided innerspring or no-flip coil mattress does not last as long as box springs on the bed. At the same time, they also state that if you were to use latex mattresses, you could directly use them on a box spring irrespective of your bed height and type. Nonetheless, latex mattresses are not popular for the preservation of their integrity, and your mattress could sag prematurely if you were to put them directly on box springs.

Both the mattress types we have mentioned here perform much better with a little help from foundations or platform beds. Platform beds do not require a box spring to support latex, memory foam gel or no-flip mattresses.

What Are The Ideal Dimensions of A Box Spring Bed-frame?

Currently, almost all mattress and box spring manufacturers address the personal need of their customers. They design box springs and foundations as per the individual necessities instead of mass producing them like in the past.

• High profile box springs: these are usually 23 cm in height and provide more flex.

• Medium profile box springs: they are between 15 cm to 21.5 cm in height.

• Low profile box springs: these are between 13 cm and 14 cm in height. They are stiffer.

As a result, they are always available in pairs for the best fit. Manufacturers always construct them as per mattress specifications. They usually have the same size as the mattress for optimal support. In case, you want to order or pre-order your box spring set, you should refer to your mattress manufacturer’s size chart.

Here is a general idea about the average size chart of box springs or foundations for your mattresses –

 

Size	Width (inches)	Length (inches)
King	76	80
California king	72	84
Queen	60	80
Full	54	75
Twin	38	75
Twin XL	38	80

A lot of customers are interested in split box springs for split mattresses for the king, California king or queen beds. Experts state that the general bedspring designs for King, California king, and queen beds are ideal for split-style mattresses as well as regular mattresses.

Why Should You Not Use Your Old Bed Base For Your New Mattress?

Those who are thinking about using their old box springs for new mattresses need to read the next part. Consumer services state that old box springs can contribute to substantial amounts of wear and tear to your new mattress. This usually happens due to uneven pressure on the old springs over the last few years. If you are ready to invest in a new mattress that will give you comfort and support, then you should also be ready to invest in a box spring fresh from the mint to protect your mattress. Nonetheless, it can help you save a lot of money on mattress maintenance and reconstruction.

The price of a bedspring will depend on the size of the mattress, the hardness of the mattress (the support it needs) and the manufacturer or brand value. While shopping for a box spring, it is, of course, wiser to find one from a reputable retailer. Experts and reliable consumer reports will tell you to choose a box spring from the mattress dealer you have been shopping from for years. The right box spring may set you back by a good couple of hundreds, but you will not have to worry about your mattress or your back for the coming decade!

Advantages of Using A Box Spring with Your Mattress

Box springs have been around since time immemorial. In the US, the UK, and other European countries, the design has been consistent with the eponymous wooden grid structure and steel springs since the mid-19th century.

Gradually, the use of coil spring mattresses coupled with bedsprings has spread to other countries in the east like China, Japan, India, and Singapore. Box springs offer significant benefits that have led to their widespread acceptance and popularity.  

• Extended lifespan. The even diffusion of pressure all across the inner layers of the mattress with the help of the box springs helps the maintenance of the inner structure of the mattress. Modern mattresses can cost a bomb in case you are looking for special ergonomic designs. The presence of an external support system for your mattress will extend its lifespan beyond the usual 3 to 4 year.

• Reduces sagging. Box springs are ideal for double-sided inner-spring mattresses, and the foundations are ideal for softer mattress varieties including latex, memory foam and single-sided innerspring mattresses. Closely placed wooden slats of a foundation provide optimal support for the softer mattress variants, and the box spring adds to the pressure distribution mechanism of double-sided innerspring mattresses to distribute weight evenly. This prevents sagging.

• Cost-effective. Box springs and foundations are cheaper than other base alternatives for modern mattresses. Even getting a box spring or foundation customized for your exclusive needs can be cheaper than most of the standard alternatives. They also maintain the mattress in proper health for longer, thereby reducing the costs of maintenance or replacement.

• Easier to maintain. It makes taking the mattress off for dusting and maintenance much easier. This is primarily due to the extra height it adds to the mattress

• Complete support. Research shows that spring mattresses on box springs are ideal for people suffering from backaches. If you find it difficult to get out of bed every morning due to muscle soreness or stiffness of the back, you might benefit from the use of a box spring for your double-sided innerspring mattress.

However, modern homeowners often prefer platform beds to box springs since the former comes with storage space. This is ideal for apartment living that understandably creates a dire need for storage. You can easily store containers or add drawers under your platform bed without any added adjustments. Additionally, they are also more aesthetically pleasing.

Most modern homes use memory foam mattresses since the provide complete body support and platform beds are quite ideal for these mattresses. Although they are difficult to move around, platform beds are quite suitable for beds with cheaper and softer mattress types.

Disadvantages of Using A Box Spring

Every rose has its thorn, and every box spring has its con. There might be several advantages of using box springs for your mattresses, but there are a few drawbacks you must consider before you go ahead and invest in one.

A good marketer will always tell you about the disadvantages of a traditional box spring as well as that of a platform or foundation before you can take your credit card out.

• Like everything good and long-lived, box springs need a little maintenance. They can lose their support and integrity over time. This can cause the mattress to sag in places.

• The springs of the grid can weaken over constant use for years. This can lead to the creation of weak spots under the mattress. This will mildly shift the support, but that mild shift can make a lot of difference to the health of the user.

• Box springs leave nearly no space under the bed for storage. If you have some containers and drawers full of backup bed sheets and pillows, you will have to find a new place to stow them away.

• Years of use can wear the frame and the springs down. Several homeowners come in complaining of a backache and leave with new frames or rails each year. Unless you are ready to maintain the box spring properly and turn them from time to time, you should reconsider your plan of investing your hard-earned money on a box spring for your double-sided inner-spring mattress.

However, platform beds have their share of cons too. They do not provide as much support to the vertebra and getting up from sleep each morning can be challenging for people with back problems and arthritis. In fact, the amount of support and comfort you get from your platform bed depends on the quality of the mattress you pick and not the platform at all! This is in sharp contrast to the box springs that provide the infrastructure of support to the entire bed.

Cost of Box Springs and Foundations Today

While buying a mattress, wonders about the necessity of the box spring at least once. Do people need to spend the extra cash? How much should the best box spring for your bed cost? Will that help you save more money in the long run?

In reality, most mattress companies consider their warranty void if you do not use a box spring along with it. In fact, you should think about investing in the box spring that comes with the mattress for the ideal protection of the warranty. If your mattress delivers less than optimum performance while within the warranty period, you can confidently walk up to the seller and challenge their USPs.

A new box spring can cost you between $150 and $200.  However, the lack of a box spring can revoke your right to ask for post-sales services or replacement in many cases. It is common belief that box springs protect the structure of a mattress and sellers uphold this belief.

Alternatives To Box Springs

Due to the lack of storage and aesthetics, a lot of homeowners and interior designers forego box springs altogether. They often settle for replacements and alternatives that can somewhat serve the same purpose as box springs.

Here are a few alternatives people have been using in place of box springs for years now.

• Platform beds. As we have already mentioned, these are more aesthetically pleasing, and they offer greater storage area. However, many platform bed designs take up a lot of space in the room. They come in lots of shapes, sizes and makes. You can choose from upholstered designs, metal and wood combinations, rustic pine finishes and simple navy button details. Platform beds eliminate the need for a box spring, and they have been a favorite of interior designers for a long time now.

• Foundations. They are the solid base for supporting most soft mattresses need to provide complete spinal care. They offer better durability as compared to box springs and adjustable frames. If you are annoyed with your mattress showing dents from continuous sleeping in, you need a foundation to take care of your mattress. Although they are a little more expensive than the platform bed designs, they come in a wide range of materials (including wood and metal). Therefore, you can pick one within your budget.

• Adjustable bed frames. These are the most expensive of all box spring alternatives. Adjustable bed frames are ideal for those suffering from chronic spondylosis, arthritis or lumbago. They are the favorites of all orthopedic specialists since they are capable of providing complete comfort and support to the occupant. They promote healthier postures, improve general blood circulation and reduce inflammation of joints in users. They do not hold impressions of the sleeper, and the adjustable bed frames are ideal for light sleepers, who shift sides to accommodate their weight frequently. These beds allow you to move the foot and the head of the mattress up or down independently. They heed all the pressure points and helps care for joint health.

• Metal bed frames. They are a superior alternative to box springs, although they are not a cost-effective alternative. The metal bed frames are compact and strong. The modern grid design with the ergonomic distribution of the support makes the metal bed frames a great choice for people in need of enhanced mattress support. They are usually sleeker than the common wooden platform beds. They can make rooms appear a lot bigger than they are and they provide added storage space too.

• Bunkie boards. This is one great box spring substitute that can change the way you sleep at night. A Bunkie board usually substitutes a low-profile box spring, where even the lower profile makes the bed too high. Just as the name suggests, they are ideal for use in bunk beds and lofts. In smaller apartments with lower roofs, you can forego box springs for Bunkie board designs that are much sleeker. They usually come in two variants, wood, and steel. Therefore, you can pick a 5-inch model in steel or a 1-inch thick model in wood. If you want to pick a Bunkie board that is slimmer than 1 inch, you should always ensure that it is on additional slats.

These alternatives and substitutes have been around for quite a few decades. They do not always serve the exact purpose as the box spring for your mattress, but they can fulfill the support necessities of your mattress to a certain degree. In case you want to go for any of the alternatives instead of a traditional box spring design, you should consult your mattress company about warranty requirements.  

How Do Box Springs Aid Warranty Considerations?

A mattress warranty usually covers all kinds of physical defects that include sagging. However, this does not mean you can take your mattress back to the seller after two whole years. It simply means that if your mattress sags while no one is on it immediately after buying it or unpacking it, that is a serious warranty issue. Several manufacturers offer a 0.75-inch margin for non-use sags, but the general threshold for mattress sagging is around 1.5 inches for most manufacturers. You will find the fine prints on the warranty papers that you must always double check before leaving the store.

You can measure the level of sagging in your mattress by using a string or a straight line across the surface. Measure the exact level of sag by measuring from the string to the bottom of the sag. You can use a standard ruler for this. Be careful to stick to either the metric system or the imperial system during measurement. This will help you make the correct comparison.

Many customers are not aware of this, but a mattress warranty also covers coils breaking, coils popping from the sides and bunching up of foam at the top. In fact, breaking the seams and other manufacturing defects are also inclusive of the mattress warranty. First, you need to contact your mattress merchant and convey your problem. In case, that does not work out; you need to go to the manufacturer.

How Do Customers Accidentally Void Warranties on Mattresses and Box Springs?

A warranty does not cover comfort issues you might be having with your mattress. That means in case your mattress “feels” lumpy or provides uneven support to your body; you might be out of luck. The level of warranty coverage can vary from one manufacturer to another. However, there are several other incidents can void a warranty.

• Staining your mattress. Eating or drinking in bed is a common practice among millennial homeowners. We love to munch on snacks and slurp our smoothies while watching an episode of our favorite TV series in bed. So, finding the odd stain here and there on the mattress is not very uncommon. However, stains on the mattress can void the warranty, even though it is certain that the stain did not cause the sag! This is primarily because stained mattresses are gross and unsanitary. No company usually wants to deal with a return product that has stains on it. One way to get out of this soup is investing in a waterproof cover for the mattress when you buy one. With kids in the house, there is no telling when something is going to spill on the bed. Waterproof covers do not sound or feel like plastic. They do not reduce the feeling of comfort, and they prevent all kinds of stains, including the sweat stains that collect on the mattress after years of use.

• Bad support. This obviously includes the lack of a box spring. You need proper support for the mattress you want to use for at least the next few years. So, whether you choose the costliest adjustable bed frame, the somewhat inexpensive box spring or the pocket-friendly platform bed, you should be able to comfortably ascertain that your new mattress has all the support it needs for the best performance. Mattress manufacturers usually do not offer warranty services if you do not use a box spring with certain mattress types. In case you do not want to go with a box spring for one reason or another, talk to your manufacturer and find out what their standing is on foundations and slats.

• Not keeping the law tag. This might sound silly, but you cannot remove the law tag at the back of the mattress. It usually says, “Do not remove, under penalty of law.” Removing that tag even by accident instantly voids the warranty. In reality, the law part pertains to the manufacturer or the seller, but when the end-user removes it, the selling party is no longer compelled to provide them after-sales services as the warranty promises. This is essential because that law tag is the only proof that shows that it is the same mattress as you ordered or purchased from the manufacturer. Without this tag, the manufacturer cannot give you the perks of a warranty, even if they wish to.

When you are shopping for a new mattress, you are looking forward to spending quite a pretty sum. You should always consider the warranty and the conditions of the same before you complete your purchase. Warranties can cover more than faulty manufacturing, defective parts and structural flaws for mattresses. For enjoying the full perks of the after-sale services from the manufacturers, always read the fine print of warranty conditions very carefully before paying.

Conclusion: So, Do you Need a Box Spring for Your New Mattress?

Your mattress needs support either in the form of a box spring or an alternative. Either way, you need to research into the advantages and disadvantages of all the prospective support designs you choose before you make the purchase. As we have seen by now, you need a suitable base for your mattress to keep the mattress warranty valid. A perfect box spring can serve you and your bed for decades to come, that’s precisely why you should not think of buying one as an added expense.

Picking the right kind of support for your mattress might seem daunting irrespective of your experience in housekeeping. It is a big expense and a formidable responsibility since it can determine your health and the health of your loved ones too. Now, to find out if your current model of the mattress or your new mattress needs a box spring, you need to ask yourself a few questions.

1. How old is your existing box spring? Is it as old as your old mattress?
2. Does the current mattress feel very saggy? Are there lumps inside? Does your current box spring provide optimum support to your current/old mattress?
3. Why are you changing your old mattress? Is your old mattress support somehow responsible for the damage?
4. What do the warranty conditions on your new mattress state? Is it mandatory for users to opt for box springs?
5. What is your budget? Can you afford a new box spring or a platform bed or a foundation?
6. What is the space available in your bedroom? Do you need extra storage space?

Answering these simple questions with “yes” and “no” can help you understand if your new mattress at all needs a new box spring or a foundation or a new platform bed.

Is it possible that early risers possess health insights unbeknownst to them? Could it be that these morning people are silently dealing with a chronic sleep condition? Or, are we exaggerating completely common sleeping behaviors by reading too much into them? Interestingly enough, studies have found a connection between our genetic makeup and our preference for going to bed early.

When the bedtime advances several hours to sometime between 6 pm and 9 pm, the person is bound to wake up by 4 am or 5 am. People suffering from this kind of a disorder often wake up rejuvenated in the early hours of the morning. Therefore, scientists have rightly monikered this as the advanced sleep phase syndrome.

Why Is Learning About Advanced Sleep Phase Syndrome Necessary for Everyone?

We have seen our grandmothers; great grand uncles and several other elderly members of the family doze off on their armchairs during evening family time or doze at the dinner table. They have been the subject of several harmless family pranks and jokes.

Surprisingly, they were also the most active around the house by the time the first rooster cawed, and that has always intrigued the other younger members of the family. People have always wanted to know how the elderly members of the family suddenly became early risers with age. Some attributed this shift in sleep time to age-related insomnia, and some have blamed their diet on the sudden change.

What Are The Leading Causes of Advanced Sleep Cycle Syndrome In Adults?

Recent research shows a telltale link between the circadian genes in human subjects and their sleep patterns. The circadian genes control the 24-hour body clock in every mammal. This is what controls our responses to daylight and nighttime. Any alteration in the circadian genes or the body clock genes can cause changes inside the body by altering chemical signals. These signals are usually hormones that the body releases in response to daylight or the absence of it. Changes to the circadian clock cause changes in the circadian rhythm and this can lead to several sleep abnormalities like the advanced sleep phase syndrome.

Several studies involving multiple families exhibiting advanced sleep onset showed that this trait passes down from one generation to another in a dominant fashion. Your sleep-wake cycle depends on clock genes. Current research has zeroed in on two such genes that are responsible for controlling the sleep cycles and phases in people. Interestingly, two independent research groups have isolated two similar genes with completely different properties that affect circadian rhythm in human beings. This further underlines the heterogeneous nature of this disorder and explains why it took scientists and doctors so long to recognize advanced sleep phase disorder-like syndromes as clinical disorders.

A study from the Archive of Neurology involving 32 members of a single family with advanced sleep phase syndrome helped in the accurate measurement of the sleep duration in each subject, their melatonin levels, and the sleep onset-offset times. The study used the Horne-Ostberg questionnaire to characterize the extent of the syndrome in each member cum subject. As per observation and interviews, the members reported the average onset time as 9 pm and the average offset time as 5 am. The unaffected family members usually started feeling sleepy at around 12 am and woke up at around 8:30 am. Further studies revealed that the affected members experienced melatonin onset about 3.5 hours earlier than the unaffected members.

Do You Suffer From Advanced Sleep Onset As Well?

However, just because you have been hitting the hay early for a couple of days does not mean you suffer from advanced sleep phase syndrome. Sometimes, increase in fatigue level causes people to fall asleep earlier than usual for a few days. Those who suffer from ASPS do not experience bad quality sleep. The sleep is normal, but the sleep cycles simply occur at early stages. As a result, the body temperature curve also advances in these subjects. Sleep regulates normal human body temperature.

The rise and fall of hormone levels during nighttime sleep can decrease the core temperature of a human being. Since human beings can regulate their body temperatures without external help, the hypothalamus ensures that the body reaches the lowest temperature at around 5 am. A drop in the core (area containing the vital organs like the stomach, lungs, heart, and brain) temperature starts to drop and facilitates sleep.

Research shows that a higher core temperature induces more alertness in human beings. The core temperature usually fluctuates between 96.8o Fahrenheit and 100.4o Fahrenheit in a 24-hour circadian cycle. Further digging into the matter has revealed that early birds experience an early drop in core temperature. They might experience the lowest temperature dip at around 12 am to 2 am, instead of the more common 5 am or 6 am. They are most alerts at around 5 am or 6 am, when their core temperature reaches its peak.

What Is The Worst Effect of Advanced Sleep Phase Disorder?

People suffering from advanced sleep syndrome often report feeling aloof and forlorn. While a lot of doctors used to think there were disjointed cases of depression, modern research shows that the lack of time to socialize in the evenings, the lack of family dinners and hobnobs with friends, may be responsible for these feelings.

Advanced sleep-wake phase is not a conventional effect of depression in human adults. However, the lack of time to socialize due to early sleep onset is a major dampener of adult social life. As a result, people with advanced sleep phase syndrome often report the lack of socialization, participation in family activities, the avoidance of community activities and a serious dearth of social relationships. The lack of a proper evening’s time is one of the major drawbacks of having ASPS.

For the lucky ones, getting a good night’s sleep is regular, and they do not need their lucky stars to align to fall asleep “on time” each night after they get home. Some people close their eyes and fall asleep within 10 minutes of getting into bed. The unlucky ones often have to pray to stay awake beyond 7 pm or stay in bed after 4 am. The problem is much lesser for adults, who live alone. Married couples, especially couples with kids often find it difficult to adjust to aberrant sleep schedules like the ones ASPS causes.

ASPS can not only disrupt social life, but it can also cause a lot of problems within a family. Sleep and sleep schedules often so erratic in families where one or multiple members suffer from ASPS that leaving home, making dinner plans or involving all members in family activities becomes an ordeal. The problem becomes worse due to the lack of awareness about advanced sleep phase syndromes and other related sleep disorders that do not involve the lack of sleep, but the unpredictable hours of sleep.

Is there any hope for those falling asleep incredibly early regularly?

Modern science and medicine have opened new doors that facilitate the treatment of different kinds of sleep disorders. For years, people did not deem advanced sleeping phase syndrome as a sleeping disorder, but right now researchers categorize it as one since it disrupts the normal flow of life for many. They have been exploiting the factors that control circadian rhythm to control and correct aberrant sleep patterns in human subjects potentially.

The circadian pacemaker is present in the Suprachiasmatic Nucleus (SCN) of the human brain. This center responds to both bright light and melatonin levels in the system. Therefore, these two factors provide the best pathways of treatment for advanced sleep phase syndrome in adults.

Train Your Brain To Tell The Time: Delay The Onset of Your Advanced Sleep Cycle

A rather popular technique that can potentially treat sleep disorders including ASPS is chronotherapy. You could say that chronotherapy is a way to reschedule sleep. This process worked in case of advanced sleep phase disorders and delayed sleep phase disorders. Unlike insomnia or sleep apnea, cases of sleep phase disorders do not involve the lack of sleep or the lack of good quality sleep.

The people suffering from these disorders only experience the onset of sleep at socially unacceptable hours. Therefore, any method that can reset their circadian rhythm can potentially be beneficial for their treatment and cure. In fact, several cases of ASPS report an improvement of their sleep onset and offset timing after accepting chronotherapy. This can be because, contrary to popular belief, children also suffer from ASPS. In most cases, these children inherit the disorder from one or both of their parents who suffer from it.

Doctors often shy away from subjecting children to melatonin therapy or sleeping medication, but results have proved practices of chronotherapy that do not involve the use of hormones or somnolent to be quite effective and devoid of side effects.

You can train your system to adopt a good sleep schedule. A proper schedule for sleep is the only way you can prevent insomnia and keep ASPS at bay. Time training your circadian clock is a proven way of keeping all kinds of existing advanced sleep phase syndrome away for a long time. People who have undergone sleep scheduling chronotherapy have reported long-term improvement in their sleep disorders without any dependency on sleeping medication.

Here is a very simple method even you can try to re-train your biological clock to perform on schedule.

1. Find a Sleep Pattern

Most people would find it bizarre to pick a sleep pattern that does not involve at least 6 hours of continuous sleep. This is the conventional sleep pattern for most people in the US. This monophasic sleep pattern involves falling asleep by 11 pm and waking up by 7 am for most.

If you find it difficult to stay asleep for continuous hours, you can pick a biphasic pattern. This is common among a lot of people, who have been suffering from advanced or delayed sleep syndromes for long periods of time. A biphasic sleep pattern involves a night sleep of 5 to 7 hours and a siesta of 30 minutes to one hour in the afternoon. Older people or stay-at-home adults will find it easier to practice a biphasic sleep pattern.

Polyphasic sleep patterns also exist among the mammalian kingdom, but the human circadian clock is not ideal for adapting one of the polyphasic sleep patterns. Especially since you are possible here looking for a solution to advanced sleep phase syndrome, adopting a polyphasic sleep pattern may prove to be counterintuitive to your cause.

2. Choose Your Sleep and Wake Times

This is easier said than done! You need to find a time that works for your body and everyone else in the house. You cannot fall asleep at 9 pm because it is easier for you if you are sure that you will have leftover office work every day till 10 pm! You need to find a schedule that accommodates your sleep pattern comfortably. It often helps to do a reverse set up.

First, find out what time you need to be awake each morning. If you need to wake up by 7 am, your bedtime should be 11 pm. No matter what your peers try to tell you, it is normal for an adult body to seek a complete 8 hours rest at night. The lack of proper rest each night can result in compromised cognitive abilities, slower response to stimulus and worsened decision-making abilities. To be alert and productive throughout the day, you need to plan your sleep and wake times carefully.

3. Move to the New Schedule

This is going to be by far the most challenging thing you have done to date. Abandoning a sleep schedule, you have followed for months or even years, and shifting to a new one may seem impossible. Honestly, it will be impossible, if you do not plan it out well enough.

Always remember that the trick is to shift your body clock by 1 hour each day. If you are falling asleep by 7 pm or 8 pm each day, you need to (without the help of caffeine) stay awake one added hour each day. It helps to stay in bed for an added hour each morning either. It sends a message to your body that it is the time to rest and relax, and that the day has not begun yet.

If you have the habit of taking a shower before going to bed or brushing your teeth right before, you should push these activities an hour back to tell your body and mind that it is not yet sleepy-time. It is very normal to feel zombie-ish every day for at least 3 to 4 weeks till you feel settled in the new schedule. You will feel the urge to fall asleep early once a week or so, just for old time’s sake, but you need to overcome this urge. Giving in one day will bring you back to square one, and you will have to reset your sleep schedule all over again.

Calibrating your body clock will help your body make sense of the new timings. You cannot go through life forcing sleep times and wake times on your body. Sleep disorders are a result of myriads of different factors working on the circadian genes and receptors. This means that there is a chance that your body is “misinterpreting” the signs that command the sleep-wake cycle in the human system. Feeling the urge to ask for professional help is completely understandable in a case of sleep training or rescheduling.

Modern sciences have provided several recovery techniques for people suffering from a plethora of sleep disorders. The two most popular ways to adjust sleep schedules or aid chronotherapy are natural light therapy and melatonin therapy.

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Think Bright: External Light Sources Can Modulate Advance Sleep Phase Syndrome

Several cases of ASPS have shown that light therapy often works better in combination with strategic avoidance of light, scheduled physical exercises, sleep preventing medication at the right time and sleep-promoting medication before bed.

A thorough study by Auger et al. in the Journal of Clinical Sleep Medicine in 2015 showed that light stimulation in the evening and the final core body temperature delays lead to phase advances. The increase in light intensity directly corresponds to an increase in these phase shifts.

Scientists have known for a few years that an increase in light intensity can lead to the suppression of melatonin levels in the body. Chronotherapy in combination with phototherapy yields the best results for all patients.

How Can External Light Make Changes Inside The Body?

The human body clock depends greatly on the external light stimulus. Our brains do not exactly have a 24-hour body clock set since our birth. Just like a lot of other factors, the brain “teaches” itself to process the light and darkness cues. That is the reason why almost everyone experiences jetlag while traveling from one-time zone to another or people shifting to areas of the midnight sun often experience problem sleeping.

The body clock resets itself according to the light from the sun (or any other bright source of light as research shows). Thus, when you expose your body to the sun or any bright source of light at an hour before expectation, it resets an hour early. If you delay the exposure to light by an hour, this delays the sleep response by almost an hour. However, the human body and its circadian rhythm are not as simple. It involves quite some factors including at least two gene products to complete the response.

As a result, scientists now often use light to control the melatonin responses in the human body. Melatonin secretion is responsible for the onset of sleep time, and the stimulation of the SCN with bright light can suppress the production of melatonin for long hours.

The doctors studying the patients suffering from sleep disorders (ASPS) for over three months found it more useful to treat them to a lack of bright light in the early hours of the day. The pretreatment phase coupled with bright light therapy in the evening often yielded better results in patients. Further research shows that the strategic avoidance of light can help delay the onset of sleep with the help of bright light therapy. However, studies fail to recognize an optimal dose of melatonin that the patients should receive in coordination with their bright light therapy for improvement of their ASPS.

How Do Doctors Administer Phototherapy for ASPS?

Seasonal depression has always been a reality and research showed that people who opted for bright white light therapy experienced relief from their symptoms, including the lack of sleep. This began in 1982 when science was taking baby-steps into the domain of biological clocks in plants and mammals. The basics of wavelength selection for light therapy has changed over the years, and scientists have fine-tuned their therapy procedures over the last few years, but the name “bright list therapy” has stuck.

Modern research shows that light from the visible region of the green spectrum is the most effective in stimulating the circadian systems in human beings. A lot of incredulous sources highlight the effectiveness of blue light for the treatment of ASPS, but research teams from Harvard have recently elucidated the harmful effects of high energy blue light on the retina.

A Stanford Health Care study shows that a light source of 10,000 lux can easily stimulate melatonin suppression in subjects after exposure of about 30 minutes to 90 minutes. Bright light therapy in the evenings (between 7 pm and 9 pm) can delay the circadian rhythm, induce better sleep at night and maintain proper sleep quality. In fact, for people suffering from insomnia like symptoms due to chronic disruption of their sleep-wake cycle can also benefit from the regular exposure to bright light therapy.

It is very necessary for the patients to seek the help of a specialist to push their sleep cycle back to stay awake longer. Some people prefer to continue their phototherapy sessions for life, while others gradually wean themselves off the therapy over a year or so. People have found exposing themselves to phases of bright light for about 15 minutes or so to be helpful in overcoming advanced sleep phase syndrome.

A Little Help From Your Friends: Melatonin Administration Therapy Can Boost Recovery From Advanced Sleep Phase Syndrome

All kinds of phototherapy and chronotherapy work best when melatonin treatment accompanies them. As we already know, melatonin boosts the sleep onset time in individuals. The concentration of melatonin in the system varies daily between sleep hours and the daytime. During wakefulness, people experience the lowest levels of melatonin. This keeps us awake, aware and responsive to stimuli.  

The careful administration of melatonin can advance people’s sleep onset, but this hormone has found its way into the treatment of advanced sleep phase syndrome. As per the study by Emens and Eastman in 2015, melatonin stimulation can result in higher levels of the biological compound in the system for hours. This can both stimulate the advancement and the delay of melatonin in the system. Introducing phase delay through the administration of melatonin has been a part of sleep cycle resetting for quite a few years.

How Can A Sleep-inducing Agent Delay The Onset of ASPS?

This can be a bit confusing for a lot of people. It is after all the same molecule that is introducing both delays and advancement in the phase cycles. How is that possible? It is possible because melatonin cannot act alone. It needs external stimulus in the form of light to act.

Further research into the matter reveals that controlled introduction of melatonin along with exposure to bright light in the evening (4 to 6 hours) before ideal bedtime results in a significant delay of sleep onset. While starting melatonin treatment, you should be very careful to consult a sleep specialist and your general physician.

Melatonin is a natural component of the body, and aberrant dosages can result in some physiological and psychological challenges. Any patient about to undergo melatonin and bright light therapy should take the process and doses very seriously.

Does Melatonin Treatment for Advanced Sleep Onset Have Side Effects?

Melatonin administration can have side effects like feeling hung-over or drowsy the next morning, sudden onset of sleepiness during the afternoon and feeling of confusion or the lack of orientation the following day. Some people often react in strange ways to melatonin, and they experience vivid dreams and nightmares during the melatonin administration. These are all serious side effects, so the patient has to be very careful while remaining in therapy.

In case you believe your dose to be insufficient for some reason; you should never increase the quantity of intake. You should immediately contact your doctor for an immediate check of the melatonin level in your body. The same goes for people who are experiencing increasing side effects of melatonin therapy. Several countries do not support melatonin therapy. The doctors usually recommend the use of standardized melatonin agonists that look and behave like melatonin for the treatment procedure.  

Why Is The Treatment for Advanced Sleep Phase Disorder So Diverse?

Any advanced sleep-wake phase disorder treatment aims to align the biological clock with the external clock. Advanced sleep-wake phase is usually common among older men and women. This disorder shows no gender bias, and it can occur equally in both men and women. Modern day research shows that adolescents and children may also exhibit cases of advanced sleep onset, but in most cases, physicians or parents dismiss them as results of increasing fatigue.

Several genes are responsible for controlling the sleep-wake cycle in mammals, and research shows that mutation of these genes or the inheritance of mutations in these genes from parents can lead to sleeping disorders in the next generation. Since ASPS occurs mostly in the older population, it is much easier to treat them to phototherapy, monitored scheduling and melatonin treatments.

The causes of ASPS can vary from person to person. There is no fixed age for the onset of this syndrome. As a result, it is difficult for doctors to diagnose the problem within a short span of time decisively. More often than not, adults do not seek medical help as their sleep onset time advances through the evening. The simply rely on coffee, tea, and other caffeinated products to stay alert till it is time for bed.

In most cases, old people in the modern society either live alone or in homes for the aged. As a result, it is very common for a majority of the residents to fall asleep early. It does not strike as odd or a disorder to the other inhabitants, caregivers or resident nurses. We have a hard-set belief that children and the elderly should always go to bed early. So, when grandma dozes off on the couch or grandpa falls asleep at the dinner table, it is no more than a funny incident. Years of not looking at something so common as a syndrome has led to a delay in research and treatment of advanced sleep cycle syndrome in adults.

Finally, with the help of light therapy, melatonin therapy, physical exercises, sleep rescheduling and resetting of sleep routines people with advanced sleep cycle disorders are finding relief from their premature sleep onset. There is again the hope of having a social life for thousands of people out there, who could not manage to stay awake beyond 7 pm at a time. The correct therapy from an experienced medical expert can finally help you become the amiable host, life of the party and the entertaining companion you once were.

Tea has held a central place in various cultures worldwide for more than a hundred years, cementing its position as a globally favored drink. It first emerged in the traditions of East and South East Asia, but the broadening of trade routes brought tea to the attention of Western cultures. The earliest records of tea, dating back to Chinese medical documents from 2737 BC, describe it as a health elixir prized by the emperors. Soon after, it became a cherished beverage among emperors and feudal lords in Eastern regions, enjoyed for its leisurely qualities.

It was the 16th century when this magical brew made its first mark in Europe after traveling the seven seas with Portuguese merchants and priests. After that, it did not take long for tea to become a part of every European household and reach the new colonies on merchant ships. The mildly strong, rejuvenating taste soon won over the entire world with its unique refreshing and healing properties.

Right now, tea is the most popular hot brew in the US and Europe. You can find different kinds of tea all across supermarkets, specialist stores, grocery stores, bodegas and convenience stores. It is ruling the market through one-dip tea bags, loose leaves in limited edition cans, conveniently packaged cardboard boxes, ready-mix bottles and designer mixes in handmade diffusers.

Thanks to the huge variation in the flavor, strength, and effects, different regions of the world have different favorites. Black, green and white teas are the most common variants. However, you will often come across several herbal concoctions that add recognizable regional flavors to the teas along with distinct pro-health properties.

Several countries across the world have associated drinking special brews containing tea leaves and a varied mix of different herbs, roots, leaves, and flowers with therapeutic outcomes. Since times immemorial, people have been drinking green tea to stimulate proper digestion, induce weight loss and release toxins from the system. In ancient Egypt, people used chamomile tea to experience relief from cold.

Many experts state that the first mention of tea and sleep appears together in the ancient Egyptian texts, while others often state that the first juxtaposition of tea and sleep first occur in the ancient Roman texts. Irrespective of which civilization found the relationship between tea and sleep, the truth in the belief still stands strong.  

An Insight into the Chemical Components and Mechanisms of the Best Tea for Sleep

The most famous recent studies involving tea shed light on the relationship between tea and relaxation. Sipping warm tea before bedtime is not a new practice, and that provides us much evidence to substantiate the relationship.

Over the years, a few types of brews have become more famous than the other for their extraordinary ability to improve sleep quality. So, without further ado, here are some of the best sleepy-time tea recipes, secrets and facts that we have collected from around the world, just for you.

Chamomile tea: The best Nighttime Tea Every Doctor and Researcher Swear By

There is no adult or child in the country, who has not heard about chamomile tea and its bedtime marvels. This might partially be because drinking this best tea for sleep has been a practice for the last 4000 years or partially because of its recurring mention in popular culture. We have seen the mention of it in popular movies, TV shows, and talk shows.

While some swear by its tranquilizing abilities, others are loyal to chamomile tea for its anti-anxiety and antidepressant abilities. Recent research on the effects of the ingredients of chamomile tea on the human physiology has confirmed its relaxing effects on the human mind and body. It has several ingredients that can relax muscles and relieve the stress accumulated by an entire day’s work.

A 2011 study, by a research team under the leadership of Susanna M. Zick involved two groups. One group was the control, and the other received chamomile extract two times a day for over a month. The group that received placebo doses showed no effect on sleep quality, sleep duration and onset times. However, the one that received the actual extract showed lower levels of stress and better day-time functionality.

A similar study on nursing home residents suffering from insomnia showed that the group that received chamomile extract enjoyed lower levels of anxiety, stress and better sleep initiation. The second study involved a group of 60 patients cum subjects, 30 among them took 400mg of chamomile extract on a regular basis. This study showed that chamomile improved sleep quality in those who take the extract on a regular basis.

Latest research exhibits its safety on post-partum women. Pregnancy can often cause strange sleep disturbances due to hormonal upheavals and general physiological discomfort. The post-partum period is not much different. Another study on post-partum women shows that those who drank tea with chamomile extract experienced more relaxing sleep with up to 15 minutes improvement in initiation time. Most importantly, they woke up less frequently during the night as compared to the ones who did not receive the extract.

Over the years, pharmaceutical companies have been making millions by designing and selling drugs that can manipulate human circadian rhythm or allegedly improve sleep quality. Even today, there is no known research can completely highlight the way in which an anti-depressant works to relieve depression and anxiety. However, human beings have been successfully treating these long-standing problems with natural extracts like chamomile in their nighttime tea.

Natural ingredients in food and beverages often have a lesser impact on health as compared to the chemical ingredients pharmaceutical companies design to induce sleep or hormone (and neurotransmitter) production. People have hailed chamomile through the rise and fall of several civilizations; this gives us more than enough reason to give this magical elixir a try.

Chamomile Tea Recipe

There are several ways to make chamomile tea. While some people like to use the dried flowers directly in the brew, others prefer using essential oils only. Which process is more effective? Do you need to add something more to make it more potent? Today, we will answer all the questions with the best recipe for chamomile herbal tea.

1. Take 8 ounces of water for each cup.
2. You can use both fresh chamomile flowers and dried chamomile flowers for the tea. Take two tablespoons of dried chamomile or 4 tablespoons of fresh chamomile flowers for 8 ounces of water.
3. Once the water starts boiling, remove the kettle from the water.
4. Pour the chamomile flowers in the teapot and pour the water in. Stir the flowers.
5. Steep it for 5 minutes.
6. Use a sieve to pour the tea (extract) into a cup.

You should adjust the level of chamomile in your tea as per your taste or the strength. Several people like to add some wild honey to their tea. Pure, organic honey does not compromise the action of chamomile, so you can go ahead and indulge in some pre-bedtime sweetness if you want.

Valerian Root: The Best Sleep Tea To Help You Sleep Like A Baby

Long before valerian root became a part of western alternative medicine, people have been using Valerian for its somnolent properties. Several cultures have been using this root for treating nervousness, headaches, and insomnia for centuries. In fact, records from the Second World War mention the use of valerian roots to treat war fatigue, anxiety and stress in soldiers.

This was especially seen in England. Right now, several studies highlight the use of valerian as a sleeping aid across Europe and the USA. In English, people often call it setwall. Its distinctive odor is quite unpleasant, and that is the primary reason it has become a part of the bedtime tea drinking ritual in multiple countries. In fact, Greek medicine experts and philosophers often used the extracts of the valerian plant to treat gastrointestinal spasms and digestive distress.

There have been no new revelations about the mechanism of action of the components of valerian on sleep or anxiety, but the consumption of the root extract along with tea does improve sleep onset time and quality. One of the more prevalent theories states that valerian root extracts can boost the creation of gamma-aminobutyric acid or GABA in the synapses. This is a neurotransmitter that promotes the feelings of satiation, happiness, and relaxation. In ways, it acts like the popular anti-depressant Xanax that hundreds of thousands use on a regular basis to combat depression.

In sharp contrast to most of the sleeping pills and anti-depressants that are ever so popular in the market today, valerian roots do not have the adverse side effects. Most of the sleeping medications as well as the anti-depressants and anti-anxiety meds in the market tend to make the patients drowsy the next day or to induce a haze in thoughts. Living with anti-depressants or anxiety medication can be very tough even for the strongest of the individuals, but valerian makes this process a lot easier. Transiting from disturbed sleep and nightmares, to sound dreamless sleep with little to no anxiety problems becomes a reality without the price of next-day drowsiness or delirium.

A study involving 27 people showed that almost 89% of the participants experienced better sleep after consuming valerian extract for four weeks continuously. Another larger-scale double-blind study on 128 people shows that the participants who receive 400mg of the extract took lesser time to fall asleep as compared to the ones who did not. In another double-blind study, researchers treated over 75 participants with 600mg of commercial production of valerian extract or 10mg of Oxazepam. This study continued for 28 days, and the results depended on a 4-step rating scale at the end of the process. Each participant receiving the extract showed improvements in sleep, but the ones who received valerian reported fewer side effects.

Sadly, none of these studies show any documentation of data involving heart rate or brainwave activities during sleep. Nonetheless, drinking tea with valerian root helps in , improvement of sleep by increasing GABA activity without adverse side effects.

Valerian Root/Extract Tea Recipe

Valerian root is another one of nature’s powerful somnolent ingredients. You can use the root to brew your tea, or you can buy ready-to-steep valerian and green tea mixes for a quick cup before bedtime.

1. For the best results opt for tap water. It has a natural taste that always makes the valerian root        extract taste better.
2. Boil about 8 ounces of water in a kettle.
3. Get your tea infuser ready with the root or the ready to use a mix. Usually filling your infuser up with valerian root will give you a good strong brew. You can adjust the quantity as per your taste.
4. Once the water starts to boil, pour it into the teacup or mug.
5. Let it steep for at least 10 minutes. In case of roots, water takes some time to penetrate and              bring all the Phyto-compounds out.

Word of caution: valerian root is bitter. Some people find it an intriguing taste, while others find it difficult to drink. So, start with a smaller quantity of valerian root in your infuser and do not forget to add a dash of honey.

Lavender: The Aroma of The Best Sleep Tea Has Remained Unchanged Through The Centuries

Valerian and chamomile reign supreme among all sleepy-tea concoctions, but lavender has its charm. First, well, lavender simply smells amazing. There can be no one who can hate this flower and the aroma.

Over the years, people have used lavender in incense sticks, room fresheners, aromatherapy and in cosmetics to induce a soothing effect on the body and mind. The small purple flowers hold a lot of healing and relaxing power.

Lavender has been a favorite of the Romans and the Greeks for its calming properties. They would often infuse their bathwater and bathing oils with extracts from the purple inflorescences.

Right now, getting your hands on lavender extract is very easy. Any health conscious and home DIY lover always has some lavender essential oil within an arm’s reach. What was once endemic to only Mediterranean regions now grows worldwide irrespective of weather and climate. People have taken the effort to cultivate lavender like any other precious food crop due to its widespread positive health effects.

A study from the last decade shows that Taiwanese post-natal women, who took time to appreciate the aroma of lavender from time to time and even drank its tea, showed fewer symptoms of fatigue. This study duration was two weeks and the participants who drank it twice a day showed significantly less stress levels as compared to women who did not. Unlike the studies with valerian root, the one involving 67 women taking lavender extract with tea showed a distinct reduction in heart rate fluctuations.

Scientific research over the last few decades have gone on to prove how lavender has helped in the improvement of sleep quality, induced REM sleep and decreased the incidence sleep-related sleep disorders in participants who consumed the tea on a regular basis.

Lavender Tea Recipe

Making lavender tea is quite straightforward, especially since the flowers are quite delectable and require very little preparation.

1. You will need 8 ounces of water in a kettle or a saucepan.
2. While the water heats up, prepare a tea ball or a strainer cum infuser with the chamomile                  fowers.
3. Let it brew for 5 minutes.
4. Remove boiling water from the stove and pour it in a mug with the infuser in it.

Add some wildflower honey or regular sweetener to the tea for added taste.

Many people prefer to use chamomile and lavender together in the brew in a 50-50 mixture. If you are steeping the two together, always steep for about 10 minutes to get the proper extract.

Passionflower: A Bedtime Tea That Reinvigorates and Rejuvenates You

Traditionally, people have used passionflower tea to reduce anxiety levels. Anything that reduces your stress and anxiety automatically contributes to better sleep quality.

Passionflower tea has been around for several centuries due to its calming effects on the body and mind. Native Americans have relied on this natural component for its medicinal effects. It can treat boils, wounds and even cure liver problems.

However, the disease the plagues the modern society most is insomnia. Children, young adults, adults and the elderly suffer from the deleterious effects of chronic lack of sleep due to one reason or another. The increasing stress levels and rampant use of technology with blue light emission often exacerbate the effects of insomnia in today’s society. There has never been a greater need for health-boosting and calming tea as today.

There are over 500 recognized species of passion flower. They belong to the Passiflora family, and almost all the species have several medicinal benefits. The name comes from the resemblance of the passionflower with the crucifix that Spanish merchants and colonists thought were significant among the species Peruvians used for treating several illnesses. Right now, passionflower is a very common flavor in aloe juices, fruit blasts, fruit juices and mocktails all across Europe and the US.

The National Center for Complementary and Integrative Health (NCCIH) has led several studies that have led to the discovery of the scientific bases of passionflower’s calming effects. This is a soothing concoction that increases the levels of GABA just like valerian. An increase in GABA helps to calm the drinker down and induce a state of tranquility. This is the reason several cultures and historic civilizations including the Native Americans, used extracts from the passionflower in their herbal teas to treat the distressed. In fact, several studies of the ancient culture show the use of this extract in the treatment of stomach problems including ulcers.

A recent study from the Phytotherapy Research shows that people who can drink passionflower herbal tea on a regular basis, can improve their REM sleep and experience lower stress levels. In adults, this flower extract can regulate sleep cycles and regularize sleep hours. Endless night shifts and stress from late night work are the main causes of skyrocketing stress levels among the majority of American and urban European youth. Studies show that people, who choose natural remedies like passionflower herbal tea over chemically synthesized sleep-inducing compounds or tranquilizers, often receive better results with fewer side effects. Passionflower tea often contains other ingredients like chamomile, lavender and rose to create a delectable blend of delicate notes that soothe the olfactory senses and induces a deep harmony with the surroundings before bedtime.

Passionflower Tea Recipe

Passionflower flavor is one the most popular ice cream, iced tea and slurpee flavors in several countries now. You could easily mistake it for a fad, but the recipes for passionflower tea and iced tea have existed for centuries. Today, we will give you the simplest recipe that can help you sleep better at night with little to no side effects.

1. You can use the flowers and the leaves of passionflower to brew this tea.
2. You should use one teaspoon of the dried-up ingredients and one tablespoon of the fresh                ingredients per cup.
3. You can use tap water for this brew. Boil the water in a kettle.
4. Once it starts boiling pour it into the herbal mix.
5. Steep for about 10 minutes for the extract to diffuse into the water.

You can always customize your tea according to your palate. You can add honey, lemon balm or mint to your passionflower tea to make the aroma enthralling and soothing at the same time.

Lemon Balm Sleep Tea: The Best Old Zesty Flavor for The New-age Epidemic of Insomnia

Lemon balm does not belong to the lemon or lime family. It does not have a zesty flavor, but it does have a delicate lemony aroma and the eponymous freshness of mint. It belongs to the mint family, and it goes perfectly with all kinds of tea. People have been using lemon balm tea for centuries since it has myriads of medicinal and therapeutic effects.

You will be able to find the mention of lemon balm in herbal tea recipes and medical journals from over 100 years ago. No one knows for sure who discovered the use of it in medicine, but historians have found its first mention in Roman and Greek ancient medicines. If you dig deeper, you will also be able to find the mention of the use of lemon balm spirits in west European folklore that is over a millennium old.

Along with several kinds of research that show the effect of lemon balm tea on stress-induced anxiety disorders, several studies show the use of lemon balm in the treatment and prevention of Alzheimer’s disease. It is a degenerative disorder that is genetic. According to the Georgetown University Medical Center, lemon balm can reduce the anxiety levels in people suffering from different progressions of Alzheimer’s disease.

In people with susceptibility towards Alzheimer’s, it can help keep the brain healthy and the neuronal connections strong by stimulating the right kind of neurotransmitters. Another recent study from the University of Maryland Medical Center shows that it can improve cognitive function among those suffering from the neurodegenerative disease.

Drinking lemon balm tea has a soothing effect on the digestive system, heart, brain, and the muscular system. It relaxes every system in the body. Therefore, it is quite easy to imagine why tea with lemon balm extract in it is ideal for the improvement of sleep. University of Michigan Health System cites a study on the comparative effects of lemon balm extract and Halcion. The herbal concoction was as effective as the triazolam or Halcion in enhancing the sleep quality in participants.

In most of the cases, you will find the researchers have used lemon balm in combination with other compounds like lavender, hops, chamomile, and valerian to achieve the best possible results. Nonetheless, in almost all research from noteworthy institutes and universities, groups have managed to show the benefits of drinking lemon balm herbal tea in human beings.

Lemon Balm Herbal Tea Recipe

Just like every other herbal tea blend, you can choose to brew your tea from the dried leaves of lemon balm, or you can use the fresh leaves for the same. Dried leaves have the compounds in a much-concentrated form, so you should always try to take a lesser amount of dried ingredients and more fresh ingredients.

1. Boil a cup of water for the tea.
2. Take two heaping teaspoons of the dried leaf or 2 tablespoons of the fresh leaves.
3. Use a tea ball or a strainer to make the tea by pouring the boiling water into the cup.

Several people also believe that the best way to enjoy the benefits of a good lemon balm tea on a sunny day is by making Sun Tea.

For making Sun Tea – keep the herbs in the jar and pour cool (not cold) water on it. Place it in the sun for a few hours. Keep the lid of the jar closed; you do not want the delicate aromas to escape.

Now, add honey or some lemon to enjoy!

Magnolia Bark: The Easiest Tea for Driving Away Sleepless Nights

The magnolia tree has been around for over a hundred million years. It has evolved to adapt to the whimsies of nature, and over the last few million years, it has acquired several compounds that contribute to unique health benefits.

Chinese medicine has been using the magnolia tree for the last few millennia to treat a plethora of common and not-so-common afflictions among people.

Ancient texts on the medicinal properties of magnolia show the presence of Honokiol. It is an organic compound that occurs abundantly in the stems and dried flower buds.

Honokiol modifies the GABA receptors in a likely competitive reaction and increases the concentration of neurotransmitters in the brain. This boosts the release of stress relief hormones that can relieve muscle fatigue and induce sleep. In the last few decades, there has been substantial work on the effects of magnolia bark tea on insomnia, sleep apnea, and other sleep disorders. There have been several studies on mammalian species that show the direct correlation between an increase in dosage of magnolia bark extract in tea along with a decrease in the time it took to fall asleep.  

Preliminary research involving magnolia tree bark tea shows an improvement in both sleep quality and duration in the human subjects. There has been no observation of adverse side effects upon daily consumption of tea made with magnolia bark extracts, provided the process is correct, and it uses the right amount of ingredients.

Magnolia Bark Extract Recipe

You can always find magnolia bark extracts and buds for sale online. You should take no more than 500mg daily in the form of an herbal tea mix. Magnolia bark extract is easily soluble in water.

1. Use warm water for the instant brew.
2. Add about 250 grams to 500 grams of extract per cup of hot water.
3. Mix well.

You can always add other ingredients to the tea to make it less bitter. Try adding lemon balm, lemon, and honey. You can also make delicious smoothies and add the extract to them for an extra health boost.

Conclusion

In modern-day USA, Europe, and East Asian countries, you will find the widespread practice of drinking tea before bedtime. While many believe that a warm beverage with low (to no) caffeine content can stimulate muscle relaxation and induce better quality sleep, others often add several other ingredients like chamomile, ginseng, and valerian to common tea brews to improve the quality of sleep.

There are several popular types and brews that even children of these regions enjoy. In fact, starting this practice early in life often gifts these children with better immunity, better physical strength, and mental acumen. Sleep decides a huge part of our day, and proper sleep can contribute to a stronger immune system. Therefore, people, who encourage the practice of consuming herbal tea before sleep often, show better resistance to viral diseases, lesser susceptibility to degenerative diseases and autoimmune disorders.

Many long-standing studies have often highlighted the strong relationship between regular consumption of certain types of tea with immunity towards tumor progression and different types of cancer. You can be a dedicated tea drinker or a beginner, but you should definitely give these herbal teas a go to see a positive change in your life.

It is a known fact that Americans are desperate for sleep. Millions of Americans are sleep-deprived on a regular basis, and it has a vital impact on various aspects of their lives. For example, the lack of sleep can have an adverse influence on their relationships. The reason for this is simple – being sleep-deprived destroys sex drive, which in turn affects the relationship. Job performance can also suffer a lot because of the lack of rest.

During the night, people recharge their batteries, rest their minds, and get ready for new challenges that await them. When they don’t get a good night’s rest, they are not able to concentrate and be as productive as they should, and this behavior affects job performance. Mental and physical health also suffer a lot because of the sleep deprivation. It can cause a wide variety of health problems, including high blood pressure, obesity, diabetes, memory loss, strokes, and more. 

If they want to reduce the negative impact of sleep deprivation, Americans need to focus more on getting enough rest. The United States is one of the countries with the highest rate of sleep deprivation. It is not surprising that more than one-third of people in the U.S. feel they are in need of quality rest and recommended hours of sleep. 

According to research, almost 50% of Americans who don’t get enough rest during the night blame it on worry and stress. Many people in the United States have stressful jobs, and they deal with high levels of stress on a regular basis. Something like this keeps them awake at night because they are not able to relax and fall asleep. They simply have too much on their minds. Some of the leading causes of stress include the economy, loss of employment, worries about paying bills, and bad bosses. 

Places to Fall Asleep 

As a result of being too tired during the day, Americans can fall asleep at random places. For example, many doze off at work because they are not able to get through the day without a short nap. Another favorite place to take a nap, besides the bedroom, is public transportation. You can often see people sleeping in buses and subways.

However, things become dangerous when sleep-deprived individuals doze off behind the wheel. It is very dangerous as someone can get injured, or worse. Lucky people make it home without napping in random places but are too tired to enjoy their free evening. As a result, almost 5% of Americans have fallen asleep at the cinema. 

Lack of Sleep and Sex Drive 

Many people in the United States have admitted that sleep deprivation is killing their sex drive. It is not a surprise as sleep boosts testosterone levels. Testosterone is what keeps people horny and vitalized. When they don’t get enough sleep, their T-levels are affected. It also impacts their ability to focus and perform different activities, and their bodies also need more time to recover. Not being able to recover properly prevents them from giving their best performance in bed. 

It is crucial to be aware that, besides the desire for sex, the lack of rest also has an impact on fertility. According to research, sleep deprivation leads to lower sperm count in men. It happens because, if our sleep cycle is interrupted, and we don’t get enough rest, our bodies release less reproductive hormones than normally, which affects fertility. Finally, another consequence of sleepless nights is erectile dysfunction.  

Americans need to start focusing on getting enough good night’s rest because their relationships may be in danger. If the lack of sex drive continues for a prolonged period, it can have a detrimental impact on the relationship. Their job performance is also jeopardized, and that’s why they should make getting enough sleep their top priority. 

According to research, many Americans are not getting enough sleep during the night. Consequences of sleep deprivation are numerous, including feeling very tired at work and being at risk of falling asleep behind the wheel. People also often lose interest in sex because of being too sleepy. Sleep deprivation should be taken very seriously. It is important for people to be aware that insufficient sleep can significantly impact their daily activities. 

Quality should be as important to us as quantity. Many Americans claim that they wake up tired even when they get a recommended number of hours of sleep. It happens because their rest was of poor or fair quality, and as a result, they don’t wake up feeling refreshed. 

Unfortunately, more than 30% of Americans are sleep deprived on a regular basis, and they are not doing much to change that. Most of these adults fall within the age group of 35 to 54 years. Women are more likely to report the symptoms of sleep disorders, such as insomnia, while men are more prone to snoring. They are also less ignorant to the effects of the lack of rest compared to men, and they focus more on the comfort of their bedroom by using comfortable bedding and mattress.  

How do Americans Deal with Sleep Deprivation? 

Instead of trying their best to get a recommended number of hours of rest at night, most of them turn to other options. For example, 30% of Americans can’t function without having a cup of coffee in the morning. They also try to make up for the lack of sleep by consuming caffeinated beverages during the day.

The use of healthy methods like going for a walk or taking a nap is less common, whereas the popularity of prescription sleep aids is increasing rapidly. 

Problems Related to the Lack of Sleep 

Many Americans are at risk of developing various health issues connected to sleep deprivation. For example, sleeping only a few hours a night increases the risk of high blood pressure. The lack of rest also contributes to heart disease, strokes, diabetes, memory loss, and obesity.

Mood changes, troubles concentrating, and weakened immune system are also consequences of not getting enough rest. Unfortunately, most people are not aware of the impact that sleep deprivation can have on their lives. The proper rest is crucial to our overall health.  

The Behavior of Sleep-Deprived Individuals 

It is reported that sleep deprivation can have the same impact on our bodies as driving a vehicle under the influence of alcohol. People also tend to be less social when they are tired. The reason for this is simple – their brains have difficulty reading facial expressions, and that’s why they are less likely to engage in social interactions. They can also be short-tempered, quick to judge, volatile, cranky, and they tend to react negatively.

Depression and low perception of self can also occur when a person is sleep-deprived. Problem-solving and decision-making skills can also be affected, and as a result, people tend to engage in risky behaviors.

Sleep Disorder Statistics

Many people sometimes struggle to get enough rest. A variety of elements, such as stress or a hectic work agenda, can interfere with sleep. Now and then, factors like sickness, travel, or a temporary change to one’s usual schedule might lead to sleep difficulties. When sleep problems begin to consistently interfere with your daily life, it could indicate the presence of a sleep disorder.

Sleep disorders should be taken very seriously because they can cause much more than daytime sleepiness. If not addressed in a timely and proper manner, they will take a toll on your mental and physical health. Poor sleep can lead to memory problems, weight gain, irritability, and much more. Lack of sleep will also severely impact your energy and mood.[1]

If you have a sleep problem, there is no need to simply accept your fate and live with it. Learn what you can do to get a better night’s sleep and improve your overall health and wellbeing.

What is a Sleep Disorder or a Sleep Problem?

Having a sleep disorder means you are suffering from a condition that regularly impacts your ability to get enough shuteye. It is normal to occasionally have a hard time to fall asleep. However, it is not normal if you have regular sleep problems and you wake up every day sleepy and exhausted.

Being sleep deprived can severely affect every aspect of your life. When you sleep badly at night, you will wake up dead tired in the morning, and the little energy that you have left will be quickly drained by your daily activities and obligations. Then, even though you are exhausted, you still can’t fall asleep at night. Before you even notice, you are trapped in a vicious cycle that slowly consumes you and takes a toll on your mood, energy, efficiency, and ability to handle stress.

Sleep problems mustn’t be ignored because they can lead to severe physical and mental health damage. Lack of sleep will lead to weight gain, impaired job performance, memory issues, and so on.[2] Due to sleep deprivation, you won’t be able to focus and stay alert which increases your risk to cause an accident.[3] Your social life may also suffer by putting a strain on your relationships. In order to stay healthy, you need quality sleep. Always keep in mind that quality sleep is not a luxury but a necessity.

Even though you have struggled with sleep problems for a very long time, it is never late to do something about it. In order to sleep better, it is important to track your symptoms and sleep patterns. Implementing healthy changes to your daytime habits, bedtime routine[4] and sleep-wake schedule should also help. If self-help doesn’t work, it is time to turn to medical practitioners who specialize in sleep medicine. A sleep specialist will be able to help you identify the cause of your sleeping problem, as well as way to improve your sleep and quality of life.

Signs and Symptoms of a Sleep Disorder

Since everyone experience a sleeping problem occasionally, it may be hard to determine if your sleep troubles are just a minor annoyance or a sign of a more serious condition. In some cases, sleeping difficulties can also be a sign of an underlying medical condition.

If you experience the following symptoms, you should look into your sleep problem more closely.

• You are sleepy during the day
• You feel irritable during the day
• You have difficulties staying awake during the day, especially when sitting still (for example when watching television or reading)
• You feel very tired while driving
• You have problems concentrating
• You are often told by others that you look tired
• Your reactions are slow
• You have a hard time controlling your emotions
• You cannot handle stress well
• You feel like you need a nap every day
• You require caffeinated beverages to keep yourself going through the day

If you experience any of the above symptoms every day, we have bad news – you may be dealing with a sleep disorder. The more you answered affirmatively, the more likely it is that you have a serious problem.

Types of Common Sleep Disorders

There are over 96 different diagnosable sleep disorders. However, the most common are insomnia, sleep apnea, restless leg syndrome, and narcolepsy.

A disrupted circadian rhythm causes most sleep disorders.[5] Circadian rhythm is our body’s internal clock that is responsible for regulating our 24-hour sleep and wake cycle. Natural light significantly influences our circadian rhythm. When there is less light, a hormone that makes us sleepy, melatonin, releases. In the morning, the release of melatonin is decreased which signalizes our brain that it is time to wake up.[6]

If your circadian rhythm is disrupted, you will feel sleepy at inconvenient times, disoriented and irritable. Circadian rhythm disruption can be caused due to many reasons and even other diseases such as depression, bipolar disorder, and seasonal affective disorder also known as winter blues.

The ICSD has classifies sleep disorders into six major categories – insomnia, sleep-related breathing disorders,  central disorders of hypersomnolence, circadian rhythm sleep-wake disorders, parasomnias, and sleep-related movement disorders.

Insomnia

Insomnia is the inability to fall or stay asleep at night. This sleep problem can be caused by stress, jet leg or another health condition. Medications that you take also affect your sleep. Consuming too much coffee and other caffeinated beverages will also cause insomnia. Mood disorders such as depression and anxiety can also cause insomnia.

People who suffer from insomnia have the following symptoms:

• Difficulties falling asleep
• Difficulties staying asleep
• Waking up in the middle of the night
• Waking up too early in the morning
• Feeling tired and exhausted in the morning

Types of Insomnia

Insomnia can be primary and secondary. Primary insomnia is not directly associated another health condition or disease. Secondary insomnia means that your sleep problems are caused by another medical condition such as asthma, depression, arthritis, heartburn, pain and so on.

Insomnia can also be acute and chronic. Acute insomnia is short-term and usually lasts from one night to two weeks, while chronic insomnia is long-term and can least from three nights to a month or longer.

Causes of Insomnia

Acute insomnia can be caused by many reasons, commonly due to severe life stress. It can also be caused by physical or emotional discomfort, as well as an illness. Environmental factors such as noise, bright light, or extreme temperatures can also disrupt your sleep. Chronic insomnia, among other, can be caused by depression, chronic stress, and pain.[7]

Diagnosing Insomnia

In order to diagnose insomnia, it is essential to talk to your doctor. Diagnosing this condition requires a physical exam, and checking your medical and sleep history. Keeping a sleep diary and tracking your sleep patterns, as well as how you feel during the day is often required to diagnose insomnia. If you are sleeping with your partner, your doctor may have to interview him or her to find out more about your sleep quality. It is not rare that you will have to visit a sleep center and undergo special tests.

Treatment for Insomnia

In most cases, acute insomnia doesn’t require treatment. Individuals suffering from mild insomnia can often alleviate the symptoms by practicing good sleep habits.[8] If sleep habits don’t work, your doctor may prescribe you some sleeping pills. Using over-the-counter sleeping pills is not wise because they have many unpleasant side-effects the following day. Keep in mind that taking sleep drugs is not a long-term solution to your problem. As you build tolerance, all sleep meds lose their effectiveness over time.[9]

To treat chronic insomnia, your doctor must determine the underlying cause that is causing it. If insomnia is persistent, your physician may recommend behavioral therapy. Behavioral therapy focuses on helping you to change behaviors that can worsen insomnia as well as learning new behaviors that promote better sleep.[10]

Sleep Apnea

Sleep apnea is a very common and treatable sleep disorder. Individuals suffering from this condition wake up frequently during night because their breathing temporarily stops. People with sleep apnea often don’t remember waking up, but they will certainly feel dead tired in the morning and notice a decrease in their productivity. Sleep apnea is a health condition that must be taken seriously, especially because it’s potentially life-threatening. Sleep apnea can be obstructive and central.

Obstructive Sleep Apnea

Obstructive sleep apnea happens because something is partly or completely blocking your upper airway during sleep. This causes your diaphragm and chest muscles to work harder to open the obstructed airway and pull in air. In these cases, breathing resumes with a snort, loud gasp or sometimes a body jerk.[11] Although you don’t sleep well, you probably won’t be aware of any of this. If obstructive sleep apnea is not treated, it will continue reducing the flow of oxygen to vital organs which may lead to irregular heart rhythms.

Symptoms of Obstructive Sleep Apnea

Signs of obstructive sleep apnea include the following:

• Sleepiness or fatigue during the day
• Dry mouth and sore throat in the morning
• Morning headaches
• Night sweats
• Restlessness during sleep
• Snoring
• Waking up suddenly due to a feeling of gasping or choking

Symptoms in children are different than in adults. They include the following:

• Bedwetting
• Choking or drooling
• Night Sweats
• Ribcage moves inward when exhaling
• Sleepiness (often misinterpreted as laziness)
• Snoring
• Teeth grinding
• Restlessness in bed
• Unusual sleeping positions (sleeping on the hands and knees, or with the neck extended)

Individuals who share their bed with someone are lucky because their partner will probably notice these symptoms. Parents who suspect their children may have sleep apnea should check them overnight.

Sleep Apnea Self-Tests

Right now, the most reliable sleep apnea self-tests are the Epworth Sleepiness Scale[12], the Berlin Sleep Questionnaire[13], and the STOP-BANG test.

The STOP-BANG survey[14] is a self-test that can assess the chances of having sleep apnea. However, to get a proper diagnosis, you must see a doctor. Your doctor will decide if you need further evaluation. If you have obstructive sleep apnea, additional testing will be necessary.

Who Has High Risk of Sleep Apnea?

 Look out for the following five criteria that increase your risk of sleep apnea:

High BMI: Being overweight or obese doesn’t necessarily mean you will get sleep apnea. However, extra weight significantly increases your risk because it puts added pressure on your respiratory system, and makes it harder to breathe at night.

A Large Neck Circumference: If a man has a neck that is 17 inches or greater in circumference, his risk of sleep apnea is increased. A woman whose neck measures 16 inches or greater are also at risk. Risks are increased due to weight of the neck that pushes on the airway during sleep.
Snoring: Loud snoring should be worrying because it is a first indicator that you are not breathing freely.

Smoking and Alcohol: Since alcohol relaxes throat muscles, they may obstruct your airways easier. Smokers are also at risk because the tobacco irritates and inflames the upper airway.
A Small Airway: If your upper airways are naturally smaller, you may have troubles breathing at night.

As you can notice, you are more likely to get sleep apnea if you are overweight and have a thick and large neck. Also, this condition is more common among men that are more than 50 years old.

It is obvious that you cannot change the size of your neck and airways. However, you can make certain lifestyle changes, such as losing some weight and reducing cigarettes and alcohol to decrease your risk for sleep apnea.

Apart from smaller airways in their throat, nose, and mouth, people with enlarged tonsils, uvula and soft palate are also at hogher risk of OSA.[15] A tongue that is larger than average can sometimes also block the airway. Lastly, a deviated septum can cause obstructive sleep apnea. Apart from the mentioned, other risk factors include smoking, diabetes, hypertension and heart disease.[16]

Sleep Apnea Diagnosis

Diagnosing this sleep disorder requires a physical exam, and checking your medical and sleep history. Your bed partner will most likely be asked for more information about your sleep habits. In many cases, a sleep study will have to be done at your home or in a sleep center. A sleep study requires wearing devices that will monitor your air flow, breathing patterns, heart rate, muscle activity, brain activity and similar. The study is necessary in order to determine how many times your breathing was impaired during sleep.[17]

Sleep Apnea Treatment

In 90% of the cases, losing some weight will make a difference. People who suffer from sleep apnea should avoid alcohol and sleeping drugs because these tend to cause your airway to collapse during sleep. It is not recommended to sleep on your side. If you have problems with nasal congestion, using nasal sprays is recommended to facilitate breathing.

Standard treatments include positive airway pressure therapy, oral pressure therapy, oral appliances, surgery and behavioral therapy.

CPAP machine is a device that consists of a mask and an air blower. Since the air blower continuously forces air through the nose or mouth, it will prevent your upper airway tissues from falling down during sleep. A similar device to CPAP is BPAP that has two levels of air flow.[18]

People who suffer from mild sleep apnea can use oral devices such as dental or mandibular appliances that will prevent their tongue from blocking the throat. These devices help the airway stay open during sleep.

Surgery is recommended to people who have a deviated septum, a small lower jaw, adenoids that need to be removed, enlarged tonsils, or extra or misshapen tissue that blocks proper airflow through the nose and mouth.

Treating Sleep Apnea with Oral Appliance Therapy

An oral appliance looks similar to a sports mouth guard or orthodontic retainer. This oral appliance can help you reduce snoring and ensure your airways are open during the entire night.

Obstructive sleep apnea is typically treated with continuous airway pressure therapy or CPAP. This type of therapy requires wearing a mask that blows air into the airways to keep them open. The mask is worn only during sleep. However, most people find wearing this mask uncomfortable. If you can’t tolerate CPAP, maybe an oral appliance is more suitable for you.

Oral devices can be prescribed to patients who suffer from mild sleep apnea. These oral devices are custom-made by dentists. Your dentist will show you how to wear and properly clean it. Although oral appliances are not effective as continuous airway pressure therapy, many people prefer using a dental device because it’s much more comfortable and has minimal side effects.

The Latest Treatments for Obstructive Sleep Apnea

Obstructive sleep apnea affects more than 18 millions of American adults. Since this sleep disorder continuously grows and affect more and more people every day, sleep scientists are doing their best to come up with new treatments that will help patients sleep better and live a better and more productive life. The latest treatments for OSA are hypoglossus nerve stimulation and expiratory positive airway pressure therapy.

Hypoglossus Nerve Stimulation

This type of treatment for sleep apnea was approved by the FDA in 2014. It includes implanting a small device in the chest that can be turned on and off by the patient. During sleep, the device monitors the patient’s breathing and stimulate the hypoglossus nerve to keep the upper airway open. Since this type of therapy is invasive, it is recommended only when patients are not helped by standard OSA treatments.

Expiratory Positive Airway Pressure

The EPAP therapy consists of placing disposable adhesive valves over the nose when you sleep. The device ensures the patient’s airways are open during inhaling and exhaling.

Central Sleep Apnea

Central sleep apnea is rarer than obstructive sleep apnea. Individuals with this disorder suffer from disrupted breathing during sleep. Unlike obstructive sleep apnea, in central sleep apnea, the breathing stops because of the way the brain functions. The brain fails to tell your muscles to breathe for a short amount of time. This type of sleep apnea is often associated with severe health problems and diseases in which the lower brainstem is affected.

Conditions that may be associated with central sleep apnea are congestive heart failure, hypothyroid disease, and kidney failure. Some neurological diseases such as Parkinson’s and Alzheimer’s disease can also cause central sleep apnea. Damage to the lower brainstem caused by an injury or a stroke may also lead to central sleep apnea. Symptoms, diagnosis, and treatment are the same as for obstructive sleep apnea.

Central Disorders of Hypersomnolence

The most familiar central disorder of hypersomnolence is narcolepsy. These sleep disorders are also known as excessive sleepiness disorders because they are characterized by daytime sleepiness that is not caused by disturbed night sleep or misaligned inner body clock.

Excessive Sleepiness

Poor sleep habits typically cause excessive sleepiness. In order to handle this problem efficiently, it is recommended to review your routines, schedules, and the environment you’re sleeping in. This way, you may identify a potential problem and make some adjustments to improve your sleep.

Causes of Excessive Sleepiness

The primary cause of excessive sleepiness is insufficient sleep. Sleeping less than the recommended 8 hours per night will lead to irritability, drowsiness, and stress. Sleep deprivation will also cause you to feel moody and underproductive, especially as your slept debt accumulates over time.

If you practice healthy sleep habits such as avoiding caffeine and blue light in the evening and sticking to a regular bedtime schedule, the problem may be in your sleep quality. Poor sleep quality means your sleep is interrupted or not deep enough to have a restorative effect.

If you have a problem with frequent waking up during the night, you should practice relaxation, avoid electronic devices before bed and make sure your bedroom is dark, comfortable and reasonably cool.

If you believe your sleep is interrupted during the night but you still wake up tired in the morning, you may have sleep apnea, which significantly reduces sleep quality.

Excessive sleepiness can also be caused by a change in schedule that is caused by tight work schedules or school responsibilities. Shift workers are the ones that are at highest risk for excessive sleepiness. Since their sleep time is not in hours when it should be, they experience difficulties falling asleep. Our body needs time to adjust to a new sleeping schedule. Unfortunately, sometimes, when their body adjusts, their work schedules change again, and they are back at the beginning. That is why shift workers have so many problems with sleep.

Treatment for Excessive Sleepiness

If you’ve tried to improve your sleep habits and still experience excessive daytime sleepiness, you should talk to your doctor or ask for a referral to a sleep specialist.

Certain medications can be used to address daytime sleepiness. Drugs for excessive sleepiness are meant to increase your level of wakefulness and alertness. However, it’s still vital to hold off on driving and doing anything that could be potentially dangerous until you see how the meds work for you.

Narcolepsy

Narcolepsy is a sleep disorder that is characterized by uncontrollable daytime sleepiness. This sleepiness is caused by a dysfunction of the brain mechanism that controls sleeping and waking. An individual suffering from narcolepsy feels like he is experiencing sleep attacks in the middle of working, talking and driving. The sleep attacks can occur during any time of the day and during any activity.

Normal sleep cycle consists of five stages of sleep. During those stages, a person traverses from light sleep to deep sleep and REM stage. Rapid eye movements or REM sleep typically occurs 90 minutes of deeper sleep stages.[23] However, if you suffer from narcolepsy, your REM sleep will occur almost immediately after you fall asleep, as well periodically during the waking hours. In REM sleep we experience dreams and muscle paralysis, which may explain some of the symptoms of narcolepsy.

This sleep disorder usually begins when a person is between 15 and 25 years old. However, it can become apparent at any age. Narcolepsy often goes undiagnosed and due to that untreated.

Causes of Narcolepsy

The causes of narcolepsy are unknown. Sleep experts have discovered that narcolepsy with cataplexy is caused by the loss of a chemical in the brain called hypocretin. Hypocretin is a chemical compound that is responsible for keeping us awake and alert. It also helps to regulate our inner body clock. Without hypocretin, it is hard or almost impossible to stay awake. The person suffering from narcolepsy also experiences disruptions in the normal sleep-wake cycles. Most likely, narcolepsy is caused by multiple factors that disrupt normal neurological functioning and REM sleep disruption.[24] 

Symptoms of Narcolepsy

Symptoms of narcolepsy include uncontrollable daytime sleepiness, cataplexy, hallucinations and sleep paralysis.

Excessive daytime sleepiness occurs on a daily basis, no matter if a person with narcolepsy had sufficient sleep the previous night. People suffering from narcolepsy also report a lack of energy and concentration, memory lapses, a depressed mood and extreme exhaustion.

Cataplexy is a sudden loss of muscle tone that manifests as a feeling of weakness and loss of muscle control. Depending on the muscles involved, it can cause a number of issues, from slurred speech to total body collapse. This symptom is often triggered by intense emotions such as laughter or anger.

Hallucinations are mostly visual, but sometimes other senses may be involved. Lastly, sleep paralysis affects temporary inability to move or speak while falling asleep or waking up. It occurs in episodes and lasts a few seconds or several minutes.[25]

Narcolepsy Diagnosis

In order to diagnose narcolepsy properly, the patient must undergo a physical exam. Medical and sleep history also must be checked.  Two specialized tests for narcolepsy are polysomnogram test and multiple sleep latency test. The polysomnogram will help establish abnormalities in the sleep cycle and find out when if REM sleep occurs at abnormal times. The multiple sleep latency test is performed during the day, and it is used to measure an individual’s tendency to fall asleep.

Narcolepsy Treatment

Currently, there is no cure for narcolepsy, but there are medications and behavioral treatments that can relieve the symptoms so affected individuals can lead a normal and productive life. Sleepiness is treated with stimulants based on amphetamine. Abnormal REM sleep symptoms are treated with antidepressant drugs. Pharmacologists have recently developed a drug called Xyrem that helps people who suffer from narcolepsy with cataplexy have a better night’s sleep and feel less sleepy during the day.[26]

Idiopathic Hypersomnia

Every person has unique sleeping needs. While some need eight to nine hours of sleep to feel refreshed in the morning, other feel great with just six hours of sleep per night. If you sleep more than ten hours every night and have a couple of long naps during the day, and you still feel sleepy and tired, you are probably suffering from idiopathic hypersomnia, otherwise known as extreme sleepiness.

People with idiopathic hypersomnia suffer constant or frequent episodes of extreme sleepiness. Extreme sleepiness is usually caused by another sleep disorder or medical condition such as narcolepsy, obstructive sleep apnea, REM sleep disorder, and so on.

If getting extra sleep doesn’t alleviate your sleepiness, you should consult with a doctor or a sleep specialist about the duration and intensity of your symptoms. You most likely suffer from idiopathic hypersomnia if your symptoms last at least six months, your polysomnography results are normal and if your condition is not caused by another medical or mental disease or a head injury.

The most common treatments for this sleep disorder are stimulant medications. However, these medications are not a substitute for sleep. People with idiopathic hypersomnia often sleep longer than other people, even when they are using such drugs.

Circadian Rhythm Sleep Disorders

Circadian rhythm sleep disorders affect the timing of sleep. People with these disorders are unable to go to sleep and awaken at times commonly required for work and school or other social needs. Among the most common circadian rhythm sleep disorders are non-24h sleep-wake disorder, shift work disorder, delayed sleep phase disorder.

Non-24-Hour Sleep-Wake Disorder

This sleep disorder affects the normal 24-hour regulation and synchronization of our circadian rhythm or inner body clock. Since light mostly regulates sleep and wake cycle, non-24 sleep-wake disorder is a common sleep issue in blind people. Due to the lack of light information received from the eyes, their internal body clock cannot regulate the 24-hour day-night cycle properly.

As a result, their internal body clock returns to a non-24 hour period, characterized by fluctuating periods of good sleep, poor sleep and excessive daytime sleepiness. Although this sleep disorder mostly affects blind people, it can also occur in healthy people, but it is typically temporary and caused by stress, hectic schedules and similar.

Shift Work Sleep Disorder

Shift work sleep disorder occurs when your work schedule and your inner clock are out of sync. People suffering from this disorder have to work night shifts or rotating shifts. The primary problem is that you are forced to be awake when you should sleep and vice versa. A problem develops when you have trouble sleeping or you have trouble staying alert when you are supposed to be awake.

If you are sleep deprived, you may have a hard time struggling with sleepiness on the job. This may also affect your productivity and increase the risk of injury.[27]

Reduce the Impact of Shift Work on Your Sleep

The best way to reduce the impact of shift work on your shuteye is to take regular breaks. If possible, try to minimize the frequency of shift changes. When you have to change shifts, request one that is later rather than earlier because our body adjusts easier if we go forward in time. Try to regulate your circadian rhythm by increasing light exposure at work and limiting it when it’s time to sleep.

Manage Your Shift Work Schedule

If you have control over your work schedule, you can do some things to make the adjustment easier. For example, if you often work night shifts, try to keep the same sleep and wake schedule each day, even when you have a day off. This will help you improve your sleep quality and regulate your circadian rhythm. Proper sleep is vital for staying alert at work during your shift.

If you often rotate shifts, rotate them clockwise for easier adjustment. For example, go from a day shift to an evening shift and then to a night shift. Rotating shift the other way or without a pattern will disrupt your sleep. It is also important to adjust your sleep and wake time gradually.

Delayed Sleep Phase Disorder

Delayed sleep phase disorder is a health condition characterized by a delayed inner clock. As a result, people suffering from this disorder go to sleep and wake up much later than other people. It is important to have in mind that this is not a preference. It is a disorder that disables you to keep normal hours. People with delayed sleep phase disorder can’t make it to their morning classes and can’t keep a 9-to-5 job. No matter how hard they try, these individuals can’t fall asleep earlier than 2 a.m. to 6 a.m.

A very interesting fact is that when they are allowed to keep their own hours (such as during a vacation or a school break), their circadian rhythm is restored. This sleep disorder is mostly experienced by teenagers, and most of them overgrow it with age.[28]

If a person continues to struggle with a delayed inner clock, light therapy and chronotherapy are recommended and mostly helps.[29]

Jet Lag

Jet lag is a temporary sleep disruption that occurs when you travel across time zones. Symptoms include daytime sleepiness, fatigue, headaches, stomach problems, and insomnia.[30] Symptoms are more pronounced when the flight is long. Flying east also tends to cause worse symptoms than flying west. Typically, a person requires only one day per time zone to adjust to the new time zone. So, if you have flown from Los Angeles to New York and passed three time zones, you should be fine after three days.

How to Reduce Jetlag

It is possible to reset your circadian rhythm when you travel through time zones. If you are travelling through several time zones, you should adjust your sleep time gradually. Depending on the time zone you need to adjust, you should go to bed half an hour earlier (or later) than usual and also get up half an hour earlier. The next day, go to bed and get up one hour earlier. The day before you travel you should go to bed and get up 90 minutes earlier. On the day of your trip, you should adjust to the new time zone much easier and faster.

Exposing yourself to sunlight should also help tune your inner clock to the new time.[31] If you feel sleepy, avoid caffeine because it will only make your problem worse.

Parasomnias

Parasomnias are sleep disorders characterized by an unwanted physical movement, behaviour or action during sleep. The most common parasomnias, also known as abnormal sleep behavior disorders are REM sleep behavior disorder, sleep talking, sleepwalking and nightmares.

REM Sleep Behavior Disorder

The main problem individuals who suffer from REM sleep behavior disorder have is acting out their dreams, which in most cases, leads to self-injuring or injuring another person. What acting out a dream means? For most of us, dreaming is an activity that remains mental, meaning it doesn’t involve any physical movement or talking. Dreams occur in our mind and no matter how vivid and exciting they may be, our body always stays at rest. However, people with RBD physically move their arms and legs or start hitting and punching in bed. While some individuals with RBD often get out of bed and perform different activities that we normally do when we are awake, others talk in their sleep or even shout and scream.

REM sleep behavior disorder is usually noticed when it jeopardizes the safety of the sleeper or his bed partner. Acting out a dream often leads to self-injury. However, in most cases, the bed partner is the one that gets physically hurt, especially if the RBD sufferer kicks and hits in bed.

Causes of RBD

In order to comprehend RBD, we must be aware that during sleep, we transition between three states – wakefulness, REM sleep, and non REM sleep. Each state and stage of sleep has its own unique characteristics.

REM sleep stage is the most important for understanding this disorder. In REM sleep behavior disorders, the neurological barriers between three main states of sleep break down or misfunction. Due to neurological dysfunction, characteristics of one state invades the other and vice versa. Sleep researchers do not know what affects these neurological barriers and cause them to break down. The neurological barriers between three main stages of sleep are also altered in narcolepsy and parasomnias. Rapid eye movement is characterized by temporary muscle paralysis and associated with dreaming

Since individuals suffering from RBD lack muscle paralysis that normally occurs during REM sleep, they are enabled to act out their dreams. RBD sufferers don’t act out their dreams immediately. Sleep talking or jerking during dreaming can last for years before the symptoms of this disorder fully develop.

Treatment of RBD

Good news for all RBD sufferers is that when the proper diagnosis is set, the condition can be successfully treated. In 90% of the cases, a drug from the group of benzodiazepines, called clonazepam, successfully eliminates REM sleep behavior disorder. The advantage of using this medication is that it doesn’t develop tolerance, even during extended use that lasts for years. If clonazepam doesn’t work, a sleep specialist may recommend antidepressants or melatonin to reduce the violent behavior.

Creating a safe sleep environment is vital to prevent injuries. All sharp or breakable objects from the area near the bed should be removed. The doors and windows in your home should be locked during the night.

Sleep Talking (Somniloquy)

Sleep talking is a sleep disorder that is characterized by talking during sleep without being aware of it. Sleep talking can include mumbling, complete nonsense or complicated dialogues or monologues. This sleep disorder is very rare, and in most cases, only a temporary issue. Although anyone can experience sleep talking, it is more common in children and males.

Sleep-talkers are not aware of their speech, so it is not unusual if their voices or type of language sound completely different from wakeful talking. Sometimes, sleep talking can be triggered by conversing with the sleeper. It can also be spontaneous.

When it comes to the content of sleep talking, it may be complete nonsense, or it can relate to past events, and experiences. Sleep experts claim sleep talking is not a product of a conscious or rational mind. Although it’s not physically harmful or dangerous, this sleep disorder can cause embarrassment or annoy a bed partner or a roommate.

Causes of Sleep Talking

Sleep talking is a temporary condition. It may be caused by different external and internal factors, such as stress, sleep deprivation, anxiety, alcohol, fever and so on. External factors typically stimulate the behavior. This disorder can also occur together with nightmares, sleep apnea, and REM sleep behavior disorder. In rarer cases, sleep talking is associated with a mental or medical disease.

Symptoms of Sleep Talking

Signs of sleep talking can be of different severity and duration and can occur during any stage of sleep. In light sleep, speech is more comprehensible, and in the deeper stages of sleep, the speech is more incomprehensible. The number of sleep talking episodes per night, as well as its duration, determines the severity of the disorder.

Based on severity, sleep talking can be mild, moderate or severe, and based on duration; it can be acute, subacute and chronic.

 Apart from talking during sleep, other symptoms may appear, such as sleepwalking, nightmares, sleep apnea, nocturnal seizures, REM sleep behavior disorder, and confusional arousals.

Sleep Talking Treatment

Typically, no treatment is necessary for sleep talking. If you experience this problem for a more extended period, it is best to consult with your doctor and look for an underlying medical explanation. In most cases, sleep talking is triggered by stress or by another undiagnosed sleep disorder.

Practicing good sleep habits such as sleeping eight hours per night and sticking to a regular sleep schedule can reduce the frequency and severity of sleep talking. To reduce sleep talking, also stay away from alcohol, heavy meals and stress.

Sleepwalking (Somnambulism)

This sleep behavior disorder is characterized by walking or performing other behaviors while asleep. Somnambulism is much common if a person is sleep deprived. Since sleepwalking occurs during stages of deep sleep, the sleepwalker may have difficulties to be awakened. Individuals affected by this sleep disorder do not remember their sleepwalking incidents.

Symptoms of Sleepwalking

Symptoms of sleepwalking include sitting up in bed and looking around, walking around the house or outside, and even driving.

It is a common misconception we mustn’t wake up a sleepwalker. A sleepwalker should be awakened. Otherwise, we put his safety in danger.

Other symptoms may include sleep talking, inappropriate behavior such as urinating in closets, screaming, violent attacks on the person trying to awake the sleeper and so on. Inappropriate behavior is more common in children while screaming only occurs when in conjunction with nightmares and sleep terrors.

Causes and Triggers of Sleepwalking

Causes are mostly unknown. However, sleepwalking can be triggered by sleep deprivation, certain medications with a sedative effect, alcohol, and febrile illnesses. Sleepwalking is mainly experienced by children between the ages of three and seven. Bedwetting and sleep terrors also commonly occur with sleepwalking.

Sleepwalking Treatment

There is no specific treatment for this sleep issue. In many cases, practicing healthy sleep habits eliminates the problem. If the problem persists, your doctor may recommend medical therapy such as sedative-hypnotics or antidepressants. Many adults have successfully treated sleepwalking with hypnosis.

Creating a safe sleep environment is vital to prevent injury during sleepwalking episodes. If your child is sleepwalking, it should not sleep in a bunk bed. All sharp or breakable objects from the area near the bed should be removed. The doors and windows in your home should be locked during the night. Install gates on stairways will also help prevent injury.

Nightmares and Sleep Terrors

Nightmares are dreams with vivid and disturbing content that often causes the sleeper to wake up immediately and recall of the dream. Nightmares are more common in children but can also occur in adults. Sleep terrors are considered extreme nightmares, and they are also typically common in children. However, unlike nightmares that occur during REM sleep, sleep terrors occur during non-REM sleep.

Sleep terrors are accompanied by arousal, agitation, and sweating. The sleeper also has large pupils and increased blood pressure. Usually, the child screams in terror and remains terrified for a few minutes. After they relax, they fall asleep again. The child typically doesn’t remember the dream or has an unclear memory of it.

Sleep-Related Movement Disorders

These sleep disorders are characterized by simple, and repeating movements during sleep or wake. These rhythmic movements often disturb the sleep of the patient and his bed partner. Most common sleep-related movement disorders are restless legs syndrome, periodic limb movement in sleep and teeth grinding or bruxism.

Restless Legs Syndrome (Willis-Ekbom Disease)

Restless legs syndrome is a sleep disorder characterized by involuntary rhythmic movements of legs while at rest. The desire to move the legs is often followed by unpleasant sensations that are alleviated by movement or pressure.

Since symptoms of are most severe in the evening and during night, they can severely disrupt a patient’s sleep and daily life. Movements can occur periodically or cluster in episodes that can last a few minutes or even a few hours. Restless legs syndrome is not similar to normal muscle spasms that we tend to experience during sleep or while trying to fall asleep.[19]

Causes of RLS

The causes of this sleep disorder are still unknown. The issue can be caused by other medical conditions such as Parkinson’s disease and narcolepsy. Restless legs syndrome can also be caused by antidepressants.

Symptoms or Restless Legs Syndrome

Symptoms include involuntary leg movements. Sometimes, a partial flexing of the ankle, knee, or hip can occur. The movements can cause a partial or full brief awakening. However, patients are often unaware of the movements.

People have difficulties describing the sensations that make them rhythmically move their legs. Sometimes, the sensations are described as “ants crawling through legs” or “soda running through veins”.

Do I have Restless Legs Syndrome?

If you are worried you may have RLS, answer the following questions. If most of your answers are “yes”, you should further discuss your symptoms with your health care professional.

• Do you have strong desire to move your legs when you sit or lie down?
• Is your urge to move your legs impossible to resist?
• Do you experience unpleasant sensations that are alleviated when you move your legs?
• Can these sensations be described as creeping, itching, pulling or similar?
• Does your urge to move the legs appear when you are resting?
• Does moving your legs make you feel better?
• Do symptoms aggravate at night?
• Have your symptoms disrupted the sleep of your bed partner?
• Do you ever have involuntary leg movements while awake?
• Do any of your family members have similar symptoms?

Restless Legs Syndrome Diagnosis

If you are sharing a bed with a partner, he or she will notice your problems sooner or later. In fact, restless leg syndrome affects the partner more than the person suffering. Proper diagnosing requires having a polysomnogram test that will record all bodily functions during sleep. Blood work may also be necessary to test your iron status, folic acid, vitamin B12, magnesium levels and so forth.[20]

Restless Legs Syndrome Treatment

Restless legs syndrome is a treatable condition. Lifestyle changes are the first step towards alleviating and controlling some of the symptoms.

Medical Treatment for RLS

There is no cure for restless leg syndrome. However, anticonvulsant medications mostly treat restless leg syndrome. Benzodiazepines and narcotics also work well.[21] Doctors and sleep specialists recommend using anti-Parkinson’s type of medicines as the first line of defense because they work the best.[22] Using these drugs significantly reduce or eliminate the symptoms of the disorder.

RLS drugs approved by the FDA are Horizant, Mirapex and Requip. all three drugs are used to treat moderate or severe primary RLS. However, since Requip is used to treat Parkinson disease, it must be given at lower doses.

In addition, there are several medications that are not primarily used to treat RLS, but have been shown to alleviate RLS symptoms. Dopaminergic agonists and agents relieve the symptoms, while benzodiazepines and opiates induce relaxation, relieve unpleasant sensations and ensure less disturbed sleep.

Foot Wrap Treatment for RLS

This non-pharmacological treatment includes using a specially designed foot wrap at night in order to relieve the symptoms of RLS. The foot wrap applies continuous pressure to targeted foot muscles and signalizes the brain to relax the muscles of the leg, alleviating symptoms of this sleep disorder.

Vein Treatment for RLS

Studies suggest that RLS symptom relief can be achieved by treating varicose veins in the legs with a non-surgical procedure called sclerotherapy. Sclerotherapy is pain free, and takes about an hour to complete. The patient can immediately walk after the procedure and resume his daily activities. However, this should be done only if your doctor determines that your issue is caused by an underlying vein problem.

Home Treatment of RLS

In addition to lifestyle changes, a number of self-directed activities can help you manage the symptoms of restless legs disorder. Such activities include walking, stretching, legs massage, hot or cold packs, and similar. Practicing relaxation techniques such as meditation or yoga can also help you alleviate the symptoms.

Periodic Limb Movement Disorder

Periodic limb movement disorder is characterized by involuntary movement of arms and legs. The rhythmic movements typically seem like brief muscle twitches or jerking and occur every 20-40 seconds. The symptoms often cluster into episodes that can last from a few minutes to a couple of hours.

Cause of PLMS

The cause of this sleep disorder is unknown. Doctors and sleep specialists believe an underlying cause exists in the patient’s nervous system. This disorder is not considered very serious. However, since it disturbs sleep, it can lead to daily fatigue or insomnia. In rarer cases, PLMS can be caused by severe medical conditions such as kidney disease or diabetes.

Symptoms of PLMS

Patients usually experience an irresistible desire to move their arms or legs. Individuals mostly have the urge to move their legs. The urge is often followed by unpleasant sensations in the calves or thighs. These sensations may keep you awake at night or even wake you up from your sleep.

People suffering from PLMS sometimes don’t experience symptoms or aren’t aware of them. The patient’s bed partner is usually the first one who notices these movements.

Treatment of PLMS

Physicians recommend treating PLMS only when it’s accompanied by RLS, insomnia, and fatigue. If you think you suffer from periodic leg movement disorder, it is best to consult with your family doctor.

Teeth Grinding (Bruxism)

Nocturnal tooth grinding, also known as sleep bruxism is a common condition that affects around 8% of adults. Teeth grinding is more common in children, and it is estimated that approximately 1/3 of parents have a child that experienced symptoms of this condition.

Causes of Bruxism

Cause of teeth grinding is mostly unknown. Temporary nocturnal teeth grinding is usually caused by stress. Some studies link bruxism with alcohol consumption, smoking, caffeine, snoring, and fatigue. Some medications such as amphetamines can cause nocturnal teeth grinding. Internal factors do not contribute to bruxism. In most cases, the issue is caused by idiopathic reasons or external factors.

Symptoms of Teeth Grinding

Occasional teeth grinding is not harmful. However, if it occurs regularly, it may lead to permanent dental damage, facial pain, and interrupted sleep. Common symptoms of this condition are worn down teeth, headaches, earaches, sore gums, teeth, and jaw. If the symptoms are severe, the patient can experience interrupted sleep.

If you have bruxism, it is essential to take action before permanent dental damage occurs. You can consult with a sleep expert or your dentist. A sleep specialist will teach you how to reduce stress and relax before bed, while a dentist will make an oral appliance that will protect your teeth from damage.

Treatment of Bruxism

Since stress and anxiety often cause this condition, it is recommended to minimize it. Symptoms in children usually disappear on their own. For persistent and severe cases, a dentist may suggest wearing an oral appliance that will protect your teeth. Jaw-aligning exercises may also help alleviate the symptoms.

Overcoming a Sleep Disorder

The first toward overcoming a sleep disorder is to identify and track your symptoms carefully. It is also important to track your sleep pattern. To keep track efficiently, downloading a sleep app or keeping a sleep diary should be sufficient.

Your focus should be to pinpoint day and nighttime habits that may be contributing to your sleep problems. Keeping track of your sleep pattern will also be helpful if you decide to visit a doctor. Make sure your sleep diary is as detailed as possible because it can reveal how certain behaviors and activities can prevent you from getting a good night’s rest.

Self-Help for Sleep Disorders

Most sleep disorders such as narcolepsy and sleep apnea require professional help. However, there are also ways you improve your sleeping problems and help yourself.

The first step is to improve your sleep hygiene. Proper sleep hygiene consists of keeping a consistent sleep schedule, healthy stress management[32], healthy eating[33], regular exercising and limiting your intake of drinks and foods that can disrupt your sleep. Limiting alcohol and nicotine is also helpful.

Developing a soothing bedtime routine that helps our mind unwind and prepare to sleep is also important. You should also make sure your bedroom is quiet, dark, and cool[34], and that your bed is comfortable.

When to Call a Doctor

If improving your sleep habits didn’t work, it is recommended to visit a sleep specialist or ask your family doctor for help. Schedule an appointment if the following applies to you:

• Your main sleep problem is daytime sleepiness
• Self-help hasn’t improved your symptoms
• You or your bed partner chokes or stops breathing during sleep
• You sometimes fall asleep at inappropriate times (such as while talking, walking, or eating)

When visiting a doctor, make sure you provide him information from your sleep diary. In order to determine whether or not you have a serious sleep problem that requires medical treatment, a specialist will have to do a polysomnogram test, as well a series of other analyses, such as blood work. After diagnosis, a sleep expert will design a unique treatment program that will alleviate or completely eliminate the symptoms of your sleep disorder.

Resources and references:

[1] http://healthysleep.med.harvard.edu/healthy/matters/consequences

[2] https://www.ncbi.nlm.nih.gov/books/NBK19961/

[3] https://www.cdc.gov/features/dsdrowsydriving/index.html

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2675894/

[5] https://medlineplus.gov/sleepdisorders.html

[6] https://nccih.nih.gov/health/melatonin

[7] https://www.ncbi.nlm.nih.gov/pubmed/14661186

[8] http://healthysleep.med.harvard.edu/healthy/getting/overcoming/tips

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3656905/

[10] http://www.sleepeducation.org/treatment-therapy/cognitive-behavioral-therapy

[11] https://www.nhlbi.nih.gov/health-topics/sleep-apnea

[12] http://epworthsleepinessscale.com/

[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3433717/

[14] http://www.stopbang.ca/osa/screening.php

[15] https://www.sleepapnea.com/diagnosis/sleep-apnea-risks

[16] https://www.health.harvard.edu/blog/snored-to-death-the-symptoms-and-dangers-of-untreated-sleep-apnea-2017021311159

[17] https://emedicine.medscape.com/article/1188764-overview

[18]https://www.health.harvard.edu/blog/weight-loss-breathing-devices-still-best-for-treating-obstructive-sleep-apnea-201310026713

[19]https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Restless-Legs-Syndrome-Fact-Sheet

[20] https://emedicine.medscape.com/article/1188327-workup

[21] https://www.drugs.com/condition/restless-legs-syndrome.html

[22] https://emedicine.medscape.com/article/1188327-medication

[23] http://healthysleep.med.harvard.edu/healthy/science/what/sleep-patterns-rem-nrem

[24] https://www.nhs.uk/conditions/narcolepsy/

[25]https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Narcolepsy-Fact-Sheet#3201_3

[26] https://www.xyremhcp.com/xyrem-clinical-trials

[27] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4050212/

[28] http://www.sleep.theclinics.com/article/S1556-407X(14)00018-6/abstract

[29] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3020104/

[30] https://www.medicinenet.com/jet_lag/article.htm

[31]https://med.stanford.edu/news/all-news/2016/02/study-finds-possible-new-jet-lag-treatment.html

[32] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538178/

[33] http://advances.nutrition.org/content/7/5/938.abstract

[34] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3427038/