Doctors Answers (5)
This is a difficult disorder to treat without a well kept diary over a few weeks. One can only assume that your employment is such that it will allow for working when you please. There are states of "free running" circadian rhythms which are often present in some blind persons. Forcing arousal each day is easier than just trying to sleep when the brain clock doesn't tell you that you are sleepy. You may need a sleep aide plus some effort on your part to force wakefulness, avoiding light at certain times and making certain you are exposed to light at other times. I assume there is no history of a brain injury, infection or stroke. You need to start the diary and then see a sleep specialist.
Shifting bed times and rise times can be related to shifts made purposely or indirectly to the bodies circadian rhythm. This is regualted by the light dark cycle and how much light enters the retina to activate the system (body's biological clock) in a roughly 24 hour period. Excercise, caffeine intake and certain medications can affect (or shift) this rhythm. To help maintain the constancy of the body 's rhythms watch caffeine intake and avoid exercise and excess light exposure later in the day. Try and keep a uniform bed time and rise time and only use the bed for sleeping only. No daytime related activities i.e. reading or TV should be happening there. If you have trouble falling asleep don't linger in bed more that 30 minutes if you can't fall asleep. Go to a low lit room and read something non-stimulating until you feel tired enough to re-engague sleep. With regard to the leg cramps or straining, this may be Restless Leg Syndrome if it occurrs at about the same time every day. If the time is variable, another systemic disorder should also be investigated by your primary doctor if this has been going on consistently for more than a few months.
Your sleep cycle sounds like it's free running, i.e. not entrained to a 24 hour circadian rhythm. Early morning sunlight exposure may help improve your sleep as may low dose melatonin 1-2 mg 2-4 hours prior to your desired bedtime. A sleep consult would be highly recommended.
The symptoms you describe may be indicative of a sleep disorder. Circadian rhythm disorders are "sleep timing" disorders, and can influence the times at which you are most likely to fall asleep and wake up. The type of disorder that you are describing suggests that your bedtime is progressively delayed, and it sounds like the delay is about 30 minutes in duration. The straining of your leg muscles you experience may be reflective of another condition, such as restless legs syndrome or periodic limb movement disorder. You may be correct that this experience is not related to the delay of your sleep phase, as these two problems are not commonly linked. However, having one type of problem does not necessarily make you immune to the other... you may have both a circadian rhythm disorder and a restless legs/limb movement disorder! Fortunately, both of the problems I've described can be diagnosed, and there are treatments for both. Circadian rhythm disorders may improve with behavioral treatments that involve sleep scheduling, timing of light exposure, meal timing, and the use of therapeutic agents (such as melatonin). Restless legs syndrome and/or periodic limb movement disorder can improve with certain behavioral or medication treatments. The key is to speak with your doctor about your options for diagnosis and treatment.
The normal time clock period in humans, better known as circadian period, is approximately 24.2 hours. Because the period is slightly longer than 24 hours, this means there is a slight phase delay for human sleeping. To combat this, we have to try to phase advance our sleeping time clock. To do this, one should try to go to bed the same time every night and wake up the same time every morning. First try to start with seven hours of sleep, that is the sleep time starts seven hours before the same wake time for one week. Then one goes to bed seven and one half hours before the same wake time during the second week. This keeps on going on till one gets to at least eight hours or ones normal required sleep time. In addition, there should not be any napping. I hope this will help and answer your sleep problem/ question.
