Circadian Rhythm Sleep-Wake Disorder, Advanced Sleep Phase Type

Primer

Circadian Rhythm Sleep-Wake Disorders, Advanced Sleep Phase Type is a circadian rhythm sleep-wake disorder characterized by sleep-wake times that are several hours earlier than desired or conventional times.

Epidemiology
  • The prevalence of advanced sleep phase type is around 1%.[1]
Prognosis
Comorbidity
Risk Factors

Diagnostic Criteria

Criterion A

A persistent or recurrent pattern of sleep disruption that is primarily due to an alteration of the circadian system or to a misalignment between the endogenous circadian rhythm and the sleep-wake schedule required by an individual’s physical environment or social or professional schedule.

Criterion B

The sleep disruption leads to excessive sleepiness or insomnia, or both.

Criterion C

The sleep disturbance causes clinically significant distress or impairment in social, occupational, and other important areas of functioning.

Specifier Criteria

Advanced sleep phase type specifier

Specify whether:

  • Advanced sleep phase type: A pattern of advanced sleep onset and awakening times, with an inability to remain awake or asleep until the desired or conventionally acceptable later sleep or wake times.
    • Specify if:
      • Familial: A family history of advanced sleep phase is present.

Length Specifier

Length Specifier

Specify if:

  • Episodic: Symptoms last at least 1 month but less than 3 months.
  • Persistent: Symptoms last 3 months or longer.
  • Recurrent: 2 or more episodes occur within the space of 1 year.

Signs and Symptoms

Screening and Rating Scales

Pathophysiology

Differential Diagnosis

Investigations

Physical Exam

Treatment

Light therapy

  • Late evening exposure to 10000 lux for 30 minutes.

Guidelines

Resources

For Patients
For Providers
Articles
Research

References

1) American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.