Circadian Rhythm Disorders in Children

All humans have a sleep-wake cycle which nearly remains same with minor variations and repeats roughly every 24 hours. This natural, internal process is called as circadian rhythm. This is controlled by the suprachiasmatic nucleus located in our brains. The sleep-wake cycle is further modulated with the external world factors like light, melatonin, physical activity, body temperature, and meals.

A circadian rhythm sleep disorder describes when a child or teenager's internal body clock causes them to sleep at a time that is not normal for the rest of the family. The onset of these disorders are most common in adolescence, with the peak age in the 20s.

What are the common Circadian Rhythm Disorders in Children?

The common circadian rhythm disorders are delayed sleep phase type (sleeps late and wakes late), advanced sleep phase type (sleeps early and wakes early), free-running type, shift work type and jet lag type.

What is a delayed sleep phase disorder?

In delayed sleep phase disorder the child finds difficulty falling asleep and waking up at socially acceptable times (at least a two-hour delay). The child would have quite late bedtimes (2 am or later) and difficulty awakening on normal times. However, once the child sleeps there are no frequent nighttime awakenings. The child usually has no problems with daytime functioning; but occasionally, the child is sleepy in the day, unable to wake for school and experience poor school performance. The diagnosis of delayed sleep wake disorder requires a documentation of sleep and wake times on a sleep diary. Aligning the circadian rhythm with desired sleep-wake times requires a good sleep hygiene, reducing electronics use and using melatonin.