Circadian rhythm sleep-wake disorders (CRSWDs) are conditions where the natural sleep-wake cycle, driven by the body’s circadian rhythm, becomes disrupted. These disorders lead to sleep disturbances, including excessive sleepiness, insomnia, or both, and impact on daily functioning and mental health. Let’s understand what these disorders are, their diagnostic criteria, types, and effects on mental well-being.
What Are Circadian Rhythm Sleep-Wake Disorders?
CRSWDs occur when the internal circadian rhythm does not align with external environmental factors or personal schedules. This misalignment can result in irregular sleep patterns, and lead to challenges in maintaining healthy sleep-wake cycles. The disruption often stems from alterations in the body’s biological clock, which regulates sleep timing, alertness, and various physiological functions.
The Diagnostic Criteria
Sleep Disruption: This refers to a recurring pattern where sleep is consistently disrupted, either because the internal circadian rhythm (your body’s natural sleep clock) is out of sync or due to a misalignment between this rhythm and external factors such as work schedules or social demands.
Symptoms: Individuals with CRSWDs experience insomnia (difficulty falling or staying asleep), excessive sleepiness (struggling to stay awake during the day), or a combination of both. These symptoms are persistent and interfere with regular functioning.
Impact on Functioning: The sleep disturbances caused by CRSWDs significantly impair important areas of life, such as social relationships, job performance, and daily responsibilities. This distress can lead to frustration and decreased quality of life.
Types of Circadian Rhythm Sleep-Wake Disorders (DSM-V-TR)
Delayed Sleep Phase Type
People with delayed sleep phase type have a significantly delayed sleep-wake cycle, often by more than two hours, compared to societal norms. They experience difficulty falling asleep at earlier desired times, leads to excessive sleepiness in the morning time. However, when allowed to follow their conditional schedule, they achieve normal sleep quality and duration.
Advanced Sleep Phase Type
This type is characterized by an earlier-than-desired sleep-wake pattern. Individuals often wake up very early in the morning and struggle to stay awake during the evenings. Despite these challenges, their sleep quality and duration remain normal when they adhere to their conditional pattern.
Irregular Sleep-Wake Type
Individuals with irregular sleep-wake type experience fragmented and disorganized sleep patterns. They lack a consolidated sleep period, often suffer from insomnia at night and excessive daytime sleepiness. The individual experience their sleep is distributed across several short periods throughout the 24-hour day.
Non-24-Hour Sleep-Wake Type
This disorder occurs when the internal circadian rhythm is not synchronized with the 24-hour day, and leads to a daily drift of sleep and wake times. Symptoms alternate between insomnia and excessive sleepiness, and individuals find it increasingly difficult to maintain a stable schedule.
Shift Work Type
Shift work type is associated with irregular work hours, such as night shifts. It results in insomnia during the intended sleep periods and excessive sleepiness during work hours. These symptoms often resolve when individuals revert to a conventional daytime schedule.
Unspecified Type
This category represents for individuals that do not align with the specific criteria of other CRSWDs but still present significant disruptions in sleep-wake patterns.
Circadian Rhythm Sleep-Wake Disorders
- Episodic: Symptoms last for 1-3 months and are often triggered by temporary changes in schedule or environmental factors, such as traveling across time zones or seasonal shifts.
- Persistent: Symptoms persist for more than 3 months and often require long-term strategies for management. Persistent cases are usually tied to chronic misalignment of the circadian rhythm.
- Recurrent: Two or more episodes occur within a year. These episodes are often linked to seasonal or situational factors, such as job changes or recurring stressors that disrupt the sleep-wake cycle.
Impact on Mental Health
CRSWDs significantly affect mental health, and lead to:
- Increased risk of depression and anxiety.
- Cognitive impairments like reduced focus and memory.
- Irritability and mood swings.
- Social isolation due to mismatched schedules.
- Decreased productivity at work or school.
- Feelings of helplessness and frustration.
- Higher vulnerability to stress.
- Overall reduction in quality of life.
Support from Live Again India
At Live Again India, we understand the challenges of CRSWDs. Our mental wellness programs offer tailored support, and ensure you are not alone in your journey to better sleep and mental health.
If you are experiencing any mental health issue, or know someone, who is suffering. Seek Professional Help and talk to your mental health expert. Your mental health care is our priority. Your life is precious; take care of yourself and family. You are not alone. We are standing by you. Life is beautiful. Live it fully. Say yes to life. Welcome to life.
