Circadian Disorders in Children

What are Circadian Disorders?

A circadian rhythm is a hormonal cycle that regulates the sleeping pattern of the human body, often referred to as an ‘internal body clock’. The most common circadian disorder is Jet Lag or Rapid Time Zone Change Syndrome.

Circadian Disorders include:

  • Shift Work Sleep Disorder, which affects night workers and workers with rotating shifts
  • Advanced Sleep Phase Syndrome, which triggers evening sleepiness, resulting in sleeping earlier (between 6pm and 9pm)  and waking earlier than desired (between 1am and 5am)
  • Delayed Sleep Phase Syndrome, which causes late night wakefulness, making it difficult for individuals to wake up in the morning
  • Non 24-Hour Sleep Wake Disorder, which specifically affects people are blind from birth, affecting the quality and duration of sleep

Anatomy of Childhood Circadian Disorders

Circadian disorders most often affect people with irregular sleep patterns. Teenagers have a natural delay in sleep phase and tend to fall asleep later. Other teenage behaviours such as excessive screen time, social media usage and late night studying mean that teens are at particular risk of developing delayed sleep phase disorder. Having depression or other mental health issues are also risk factors.   

What Causes Childhood Circadian Disorders?

Circadian Disorders are caused by a variety of factors. Potential causes include:

  • Poor sleep hygiene e.g. excessive screen times
  • Late night studying
  • Time zone changes
  • Shift work
  • Mental health issues
  • Medications ( including caffeine)

What are the Symptoms of Circadian Disorders in Kids?

Circadian disorders can produce the following symptoms:

  • Lethargy
    • Extreme drowsiness during waking hours
    • Irritability
    • Concentration difficulties
    • Headaches
    • Lightheadedness
  • Disturbance in sleep timings

    • Waking significantly earlier than usual and going to bed earlier

    • Waking significantly later than usual and going to bed later

How Are Circadian Disorders Diagnosed?

Methods of diagnosis include:

  • Sleeping Logs - a record of a patient’s sleeping schedule to determine patterns
  • Actigraphy - the measurement of sleep-wake cycles via a wrist motion sensor, which is worn on the dominant hand
  • Sleep Studies - involve monitoring the patient while they sleep with specialised equipment, either at home or in a sleeping lab
  • Epworth Sleepiness Scale - a questionnaire designed to measure sleepiness

Why Treat Your Child's Circadian Disorders?

Circadian disorders impact everyday life and can have a significant effect on a person’s capability to meet the demands of their professional and personal lives, diminishing the quality of their life.

What are the Treatments for Circadian Disorders?

Treatment varies according to the disorder diagnosed. Common treatments include changes to lifestyle:

  • Avoiding stimulants and alcohol
  • Ensuring the bedroom is dark and comfortable
  • Avoiding naps
  • Avoiding computer and phone screens around bedtimes
  • Relaxation techniques

External stimulus therapies are also used to treat circadian disorders. These therapies alter the circadian rhythm:

  • Bright Light Therapy resets the Circadian rhythm by controlled exposure to light.
  • Chronotherapy incrementally adjusts sleeping periods.

Medication may be prescribed:

  • Melatonin, a hormone produced by the pineal gland that regulates the sleeping cycle.
  • Sleeping Tablets - usually not needed.

Individuals with jet lag should avoid naps, spend more time outdoors and factor in time zones when scheduling sleep (i.e. when travelling, they should adhere to local time, and still sleep in the evening).